Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2022
Does intraoperative periprosthetic occult fracture of the acetabulum affect clinical outcomes after primary total hip arthroplasty?
The frequency of intraoperative periprosthetic occult fracture of the acetabulum (IPOA) in primary total hip arthroplasty (THA) is relatively high. However, the effect of this fracture on clinical outcome and survival of primary THA remains unknown. This study aimed to determine the impact of IPOA on the outcomes of primary THA during a minimum follow-up of 5 years. ⋯ Primary THA with IPOA provides favorable mid- to long-term outcomes. On IPOA diagnosis, although radiographic follow-up is necessary, additional treatments or rehabilitation programs are not required. Furthermore, postoperative computed tomography images for the detection of IPOA may be unnecessary.
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Arch Orthop Trauma Surg · Nov 2022
Long-term follow-up results of medial opening wedge high tibia osteotomy with a pre-countered non-locking steel plate.
This retrospective study investigated the long-term follow-up results of medial opening wedge high tibial osteotomy (MOWHTO) with a pre-countered non-locking steel plate implant (Puddu plate = PP) used for medial knee osteoarthrosis (OA) treatment. ⋯ The PP has feasible MOWHTO results with a cumulative survival of 67% at 10 years with no need for conversion to TKA. Many adverse events occurred and revision rate due to any reason was high. Age or gender did not have statistically significant differences in terms of survival.
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Arch Orthop Trauma Surg · Nov 2022
Sequential low molecular weight heparin and rivaroxaban for venous thromboprophylaxis in pelvic and acetabular trauma.
Patients with pelvic trauma are at high risk of thromboembolic complications, but effective methods of prophylaxis are still to be accepted widely. The incidence of venous thromboembolism (VTE) has been reported to be as high as 61%, which represents the commonest cause of morbidity and mortality in this cohort. New oral anticoagulants are now available and may be used instead of LMWH injections for extended prophylaxis. Rivaroxaban has not been comprehensively considered in the previous pelvic and acetabular trauma literature, but its known benefits include increased patient compliance, especially in the minority of patients who are unable to self-administer injections, and that it does not require monitoring. ⋯ Our data show that this VTE regimen protocol is safe and effective in this group of injured patients and is at least non-inferior to the standard prophylaxis of LMWH alone.
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Arch Orthop Trauma Surg · Nov 2022
Case ReportsFlexor tenodesis procedure in the treatment of lesser toe deformities.
In this technical report study, we describe the use of a flexor tenodesis procedure in the treatment of lesser toe deformities (LTD). Using a specific implant, both the flexor digitorum longus and brevis tendons are attached to the plantar aspect of the proximal phalanx, allowing dynamic correction of flexible deformities of metatarsophalangeal and interphalangeal joints. Good clinical results and absence of complications were observed in a series of 3 patients, with considerable correction of the LTD, and absence of substantial residual floating toe or metatarsophalangeal joint stiffness. LEVEL OF EVIDENCE: V - Technical Report/Case Report/Expert Opinion.
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Arch Orthop Trauma Surg · Nov 2022
The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn anterior cruciate ligament.
Restoration of proprioceptive function after anterior cruciate ligament (ACL) reconstruction is as important as mechanical stability. For this purpose, remnant of the torn ACL is the only source of nerve endings. Our aim in this study is to investigate the quantity of mechanoreceptors in the remnants ACL stumps in injured knees and to correlate that with the quantity in intact ACL in control cases. ⋯ The time from injury to surgery is an important factor affecting the mechanoreceptors at stump of torn ACL. The surgeon and patient should be aware of the fact that delay in surgery could lead to the loss of mechanoreceptors.