Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2021
Need for early exploration of radial nerve in humeral shaft fractures with radial nerve palsy.
Radial nerve palsy (RNP) associated with humeral shaft fracture (HSF) is the most common nerve complication in long bone fractures. There is still controversy over the need for immediate exploration of the radial nerve (RN) in HSF with RNP. The purpose of the current study was to determine which situations of HSF with RNP require early exploration of the RN. ⋯ Early exploration of the radial nerve should be considered in patients with radial nerve palsy associated with proximal third humeral shaft fracture, regardless of the fracture patterns caused by the high-energy trauma.
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Arch Orthop Trauma Surg · Jul 2021
Heterotopic ossification in primary total hip arthroplasty using the posterolateral compared to the direct lateral approach.
Total hip arthroplasty (THA) is a successful procedure. However, in time, heterotopic ossification (HO) can form due to, amongst others, soft tissue damage. This can lead to pain and impairment. This study compares the formations of HO between patients who underwent either THA with the posterolateral approach (PA) or with the direct lateral approach (DLA). Our hypothesis is that patients who underwent THA with a PA form less HO compared to THA patients who underwent DLA. ⋯ THA with the PA causes less HO formation than the DLA.
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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
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.