Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2020
Clinical and radiological mid- to long-term results after direct fixation of posterior malleolar fractures through a posterolateral approach.
Direct fixation of posterior malleolar fractures has been shown to lead to higher accuracy of fracture reduction compared to an indirect anterior to posterior fixation but lacks long-term clinical results. This study shows the mid- to long-term clinical and radiological outcome after direct fixation of the posterior malleolus through a posterolateral approach. ⋯ Therapeutic Level IV. See Instructions for authors for a complete description of levels of evidence.
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Arch Orthop Trauma Surg · Nov 2020
Partial resection of the infrapatellar fat pad during anterior cruciate ligament reconstruction has no effect on clinical outcomes including anterior knee pain.
Anterior knee pain (AKP) is a major complication that occurs after anterior cruciate ligament reconstruction (ACLR), even when hamstring tendon (HT) grafts are used. Damage to the infrapatellar fat pad (IPFP) during arthroscopy can cause AKP. The purpose of this study was to evaluate the influence of IPFP preservation on clinical outcomes, including AKP, in patients who underwent ACLR with HT autografts using the inside-out technique. ⋯ Level II.
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Arch Orthop Trauma Surg · Nov 2020
Multiple drilling and multiple matchstick-like bone allografts for large osteonecrotic lesions in the femoral head: an average 3-year follow-up study.
We aimed to present the clinical outcomes of multiple drilling and multiple matchstick-like bone allograft for large osteonecrotic lesions of the femoral head as a joint-preserving surgery. ⋯ Multiple drilling and multiple matchstick-like bone allograft may be a useful treatment option for alleviating the symptoms in ONFH patients with large lesions who want to preserve their hips.
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Arch Orthop Trauma Surg · Nov 2020
Reoperation rate, mortality and ambulatory ability after internal fixation versus hemiarthroplasty for unstable intertrochanteric fractures in elderly patients: a study on Korean Hip Fracture Registry.
The treatment of unstable intertrochanteric fracture in elderly patients is challenging and how to treat these patients remains controversial. The purposes of this study were to compare (1) reoperation rate, (2) mortality and (3) the postoperative change of walking ability between patients undergoing internal fixation (IF) and those undergoing bipolar hemiarthroplasty (HA) due to this type of fracture based on the data from the Korean Hip Fracture Registry. ⋯ This study showed HA was associated with lower rate of reoperation and lower decrement rate of walking ability compared to IF in elderly patients with unstable intertrochanteric fractures.
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Arch Orthop Trauma Surg · Nov 2020
The effect of coronal splits on the structural stability of bi-condylar tibial plateau fractures: a biomechanical investigation.
Surgical treatment of bi-condylar tibial plateau fractures is still challenging due to the complexity of the fracture and the difficult surgical approach. Coronal fracture lines are associated with a high risk of fixation failure. However, previous biomechanical studies and fracture classifications have disregarded coronal fracture lines. ⋯ Coronal articular fracture lines substantially affect the mechanical response of tibia implant structures specifically on the medial side. With this in mind, utilizing a clinically relevant fracture model for biomechanical evaluations regarding bi-condylar tibial plateau fractures is strongly recommended.