Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2019
Review Meta AnalysisShoulder arthroplasty volume standards: the more the better?
The wide use of hip and knee arthroplasty has led to implementation of volume standards for hospitals and surgeons. For shoulder arthroplasty, the effect of volume on outcome has been researched, but no volume standard exists. This review assessed literature reporting on shoulder arthroplasty volumes and its relation to patient-reported and functional outcomes to define an annual volume threshold. ⋯ There is insufficient evidence to support the concept that only the number of shoulder arthroplasties annually performed (either per hospital or per surgeon) results in better patient-reported and functional outcomes. Currently, published volume thresholds are only based on short-term parameters such as length and cost of hospital stay.
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Arch Orthop Trauma Surg · Jan 2019
The hamstring/quadriceps ratio is an indicator of function in ACL-deficient, but not in ACL-reconstructed knees.
The purpose of this study was to investigate the isokinetic, eccentric and isometric hamstring/quadriceps (HQ) ratios in patients before and after ACL reconstruction (ACLR) using bone-patellar tendon grafts and to establish the relationships between HQ ratio and knee function. ⋯ Level IV, case series.
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Arch Orthop Trauma Surg · Jan 2019
Management of elderly hip fractures by an orthopaedic trauma surgeon reduces surgical delays but does not improve outcomes compared to non-trauma surgeons.
Recent literature on hip fractures has focussed on the optimal environment for best outcomes. One factor that has not been studied is the managing surgeon's training background. Our study aims to examine if hip fracture patients managed by fellowship-trained orthopaedic trauma surgeons have better outcomes compared to non-trauma trained general orthopaedic surgeons. ⋯ This study did not find any difference in the functional outcomes of hip fracture patients managed by trauma surgeons or non-trauma surgeons. However, trauma surgeons had faster times to surgery and shorter surgical times when fixing intertrochanteric fractures.
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Arch Orthop Trauma Surg · Jan 2019
Dorsal transosseous reduction and locking plate fixation for articular depressed middle phalangeal base fracture.
An articular depressed fragment at the base of the middle phalanx can be an obstacle to congruent reduction and stable fixation. This study assessed the outcomes of a transosseous reduction technique combined with locking plate fixation for the treatment of articular depressed middle phalangeal base fracture. ⋯ Therapeutic, level IV.
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Arch Orthop Trauma Surg · Jan 2019
Limited reliability of grading scapular notching according to Nerot-Sirveaux on anteroposterior radiographs.
Incidences of scapular notching (SN) in reverse shoulder arthroplasty (RSA) range between 0% and 96%, and controversy remain as to its relevance for patient outcome. We assessed the reliability of scapular notching (SN) grading based on the Sirveaux classification system using anteroposterior radiographs. ⋯ Agreement between individual surgeons was low when grading SN in RSA according to Sirveaux using anteroposterior radiographs. Consensus among several assessors may increase reliability in research settings.