Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2021
After hours surgery for elderly hip fracture patients: How safe is it?
The recent focus on early surgery for hip fractures to reduce complications and improve morbidity, has led some resource-constrained institutions to perform after hours surgery in a bid to meet these timelines. However, there are concerns about the potential increase in complications and poorer outcomes in after hours surgery. This study aims to evaluate the safety of after hours hip fracture surgery and its related complications. ⋯ In conclusion, our study did not show that after hours surgery increases complication rates in hip fracture surgery and had equivalent functional outcomes.
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Arch Orthop Trauma Surg · Jul 2021
Does trapeziectomy with ligament reconstruction and tendon interposition arthroplasty correct the metacarpophalangeal joint hyperextension associated with trapeziometacarpal osteoarthritis?
Trapeziometacarpal osteoarthritis sometimes results in hyperextension of the thumb metacarpophalangeal (MCP) joint, which could negatively impact outcomes following trapeziectomy with ligament reconstruction and tendon interposition (LRTI) arthroplasty. Although algorithms on performing trapeziectomy with LRTI for the management of this deformity are available, they lack clear evidence. Here, we investigate the function of the thumb MCP joint after trapeziectomy with LTRI and whether this procedure alone corrects preoperative MCP hyperextension, and also analyze clinical factors correlated with MCP hyperextension post-surgery. ⋯ Trapeziectomy with LRTI alone could prevent postoperative thumb MCP hyperextension deformity for patients with thumb MCP extension < 30° and improve preoperative thumb MCP hyperextension. However, for patients with loss of radial abduction and MCP flexion due to the contracture, indirect correction of the MCP hyperextension was improbable.
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Arch Orthop Trauma Surg · Jul 2021
Femoral fractures are an indicator of increased severity of injury for road traffic collision victims: an autopsy-based case-control study on 4895 fatalities.
The course of road traffic collision (RTC) victims with femoral fractures (FFx) from injury to death was reviewed. We sought to correlate the presence of femoral fractures with the overall severity of injury from RTCs using objective indices and to identify statistically significant associations with injuries in other organs. ⋯ This study has documented that femoral fractures are associated with increased severity of injury, shorter survival times and higher incidence of associated thoracic, abdominal and skeletal extremity injuries, compared to controls. These findings should be considered for an evidence-based upgrading of trauma care.
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Arch Orthop Trauma Surg · Jul 2021
A histoanatomical study of the fiber bundle forming the 'Comma Sign,' a critical marker of the torn edge of the subscapularis tendon.
The "Comma sign" is a well-known indicator of the subscapularis torn edge of the shoulder. We undertook a histoanatomical study of the fiber bundle forming Comma sign (FBCS) to determine why FBCS is maintained even in cuff tear cases. ⋯ As FBCS extends from the capsule beneath SSP and to the bursal surface of SSC, the FBCS connection to SSP and SSC is hardly lost, even though SSP or SSC detaches from the greater or lesser tubercle, respectively. Additionally, as degeneration make the elasticity difference gradual, the stress concentration at the borders may be diminished, leading to less breakage of FBCS.