Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2020
Is continuation of anti-platelet treatment safe for elective total hip arthroplasty patients?
Acetylsalicylic acid (aspirin) is a commonly prescribed medication, especially in the age group of individuals who undergo elective total hip arthroplasty (THA). Preoperative discontinuation of aspirin is believed to reduce intraoperative bleeding and other complications, but it may increase the risk of perioperative cardiovascular events. In this study we have sought to evaluate the safety of continuous aspirin treatment in patients undergoing elective THA. ⋯ Peri-operative continuation of aspirin treatment in patients undergoing elective primary THA did not increase perioperative complications or mortality compared to the non-aspirin-treated patients. The protective effects of aspirin from postoperative thrombotic and cardiovascular events are well documented. The current findings dispute the need to preoperatively withhold aspirin treatment in patients undergoing elective primary THA.
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Arch Orthop Trauma Surg · Dec 2020
Case ReportsPatellofemoral ankylosis: case report and technical note.
It is our understanding that there is no consensual solution for the treatment of post-traumatic patellar ankylosis; therefore, the purpose of this work is to present two cases of patellofemoral retinacular interposition arthroplasty, and its corresponding technical note. CASE 1: Female, 24, patellar ankylosis secondary to supratranscondylar fracture, associated with comminuted diaphyseal tibia fracture. CASE 2: Female, 48, patellar ankylosis secondary to femoral diaphysis and lateral femoral condyle fracture. ⋯ Using our surgical technique, we were not able to restore normal function to our patients, but their improvement was certainly impressive relative to their initial clinical situation.
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Arch Orthop Trauma Surg · Dec 2020
ReviewPosterolateral corner of the knee: a systematic literature review of current concepts of arthroscopic reconstruction.
Injuries of the posterolateral corner (PLC) of the knee lead to chronic lateral and external rotational instability and are often associated with PCL injuries. Numerous surgical techniques for repair and reconstruction of the PLC are established. Recently, several arthroscopic techniques have been published in order to address different degrees of PLC injuries through reconstruction of one or more functional structures. The purpose of this systematic review is to give an overview about arthroscopic techniques of posterolateral corner reconstructions and to evaluate their safeness. ⋯ Different approaches to arthroscopic PLC reconstruction are presented, yet clinical results are scarce. Up to now good and excellent clinical results are reported. No major complications are reported in the literature so far.
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Arch Orthop Trauma Surg · Dec 2020
Comparative StudyComparing iatrogenic radial nerve lesions in humeral shaft fractures treated with helical or straight PHILOS plates: a 10-year retrospective cohort study of 62 cases.
Humerus shaft fractures are common and often treated surgically with a proximal humerus internal locking system like the long PHILOS® plate. Due to its close anatomical proximity to the humerus, the radial nerve is particularly susceptible to traumatic and iatrogenic damage. The iatrogenic radial nerve damage associated with internal locking systems is described in about 7% of the cases. In order to avoid this lesion, helical plates have been suggested since 1999. This technique continues to not being used as standard as there is still a clear lack of evidence. This study aimed to understand if twisting a long PHILOS plate can reduce the rate of iatrogenic radial nerve damage in humerus shaft fractures. ⋯ Level 3, retrospective cohort study.
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Proximal femoral nail antirotation (PFNA) cut-in is a unique phenomenon seen in pertrochanteric hip fractures treated with the PFNA. Cut-in refers to the superomedial migration of the proximal femoral blade into the femoral head and hip joint. We recognize that cut-in is a completely separate entity from the well-described cut-out failure. This study assesses relevant radiological and patient risks factors for cut-in. ⋯ We propose a standardized nomenclature of "cut-in" for the phenomenon of superomedial migration of the proximal femoral blade. An anatomical neck-shaft reduction, accurate blade placement and increased surveillance for patients with severe osteoporosis are required to reduce the incidence and morbidity of cut-in.