Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2021
Risk factors for mechanical failure of intertrochanteric fractures after fixation with proximal femoral nail antirotation (PFNA II): a study in a Southeast Asian population.
Intertrochanteric hip fractures pose a significant health problem. The proximal femur nail anti-rotation (PFNA IIDePuySynthes) is the most commonly used implant for intramedullary nailing of unstable intertrochanteric fractures at our institution. We aim to identify the risk factors predisposing to mechanical failure of intertrochanteric hip fractures fixation with PFNAII in our Southeast Asian population. ⋯ To avoid mechanical failure, one should aim to achieve a good quality of reduction and centre blade position on lateral hip X-ray. Tip apex distance did not predict mechanical failure in our study.
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Arch Orthop Trauma Surg · Apr 2021
Mid- to long-term outcome in patients treated with a mini-open sinus-tarsi approach for calcaneal fractures.
While the extended lateral approach was the gold standard for treatment of calcaneal fractures for decades, the mini-open approach through the sinus tarsi gained popularity in recent years. Although widely used, there are only a few reports available in the literature reporting on mid- to long-term results. Therefore, the purpose of the study was to report on mid- to long-term radiographic and clinical outcomes of calcaneal fractures treated surgically using a mini-open sinus tarsi approach. ⋯ Level IV, Retrospective Case Series.
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Arch Orthop Trauma Surg · Apr 2021
Risk adapted diagnostics and hospitalization following mild traumatic brain injury.
Traumatic brain injury (TBI) remains a leading cause of hospital admission and mortality, intracranial hemorrhage (ICH) presents a severe complication. Low complication tolerance in developed countries and risk uncertainty, often cause excessive observation, diagnostics and hospitalization, considered unnecessary and expensive. Risk factors predicting ICH, progression and death in patients hospitalized with mild TBI have not been identified yet. ⋯ Age, skull fracture and chronic alcohol abuse require vigilant observation. Repeated CT in initially ICH negative cases should only be considered in newly identified high-risk patients. Non-ICH cases aged < 65 years do not gain safety from observation or hospitalization. Recommendations from our data might, without impact on patient safety, reduce costs by unnecessary hospitalization and diagnostics.
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Arch Orthop Trauma Surg · Apr 2021
A single K-wire to prevent poor outcomes in closed soft-tissue mallet finger management due to patient non-compliance.
Soft-tissue mallet finger occurs due to loss of terminal extensor tendon secondary to rupture of distal phalanx. Although using noninvasive splints for 6-8 weeks is the gold standard for conservative treatment of closed soft-tissue mallet injuries, patient compliance is an important factor impacting on patient outcomes. In this study, we used a single Kirschner Wire (K-W) to fix the distal interphalangeal (DIP) joint in extension in those patients failed to comply with routine splinting. ⋯ Internal fixation via K-W may be a suitable treatment option compared to splint therapy for management of closed soft-tissue mallet finger in noncompliant patients. Using this treatment approach, the success rate for patients could satisfactorily be improved.
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Arch Orthop Trauma Surg · Apr 2021
Fracture reduction and screw position after 3D-navigated and conventional fluoroscopy-assisted percutaneous management of acetabular fractures: a retrospective comparative study.
Navigational techniques in orthopaedic trauma surgery have developed over the last years leaving the question of really improving quality of treatment. Especially in marginal surgical indications, their benefit has to be evident. The aim of this study was to compare reduction and screw position following 3D-navigated and conventional percutaneous screw fixation of acetabular fractures. The study hypothesis postulated that better fracture reduction and better screw position are obtained with 3D navigation. ⋯ Comparison of 3D-navigated and conventional percutaneous surgery of acetabular fractures on the basis of pre- and postoperative CTs revealed no significant differences in terms of fracture reduction and screw position.