Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Nov 2022
Atraumatic femoral head necrosis: a biomechanical, histological and radiological examination compared to primary hip osteoarthritis.
Atraumatic necrosis of the femoral head (AFHN) is a common disease with an incidence of 5000-7000 middle-aged adults in Germany. There is no uniform consensus in the literature regarding the configuration of the bone in AFHN. The clinical picture of our patients varies from very hard bone, especially in idiopathic findings, and rather soft bone in cortisone-induced necrosis. A better understanding of the underlying process could be decisive for establishing a morphology-dependent approach. The aim of this study is the closer examination of the condition of the bone in the AFHN compared to the primary hip osteo arthritis (PHOA). ⋯ The present study (NCT, evidence level II) shows that AFHN has a very well detectable higher bone density compared to PHOA. However, neither biomechanical stress tests nor histomorphological evaluation did show any significant difference between the groups. The results allow the conclusion that there is no "soft" necrosis at all in the AFHN group.
-
Arch Orthop Trauma Surg · Nov 2022
Correlation of quantitative computed tomography derived bone density values with Hounsfield units of a contrast medium computed tomography in 98 thoraco-lumbar vertebral bodies.
Vertebral fractures in patients with bone density reduction are often a major challenge for the surgeon, as reduced bone density can lead to screw loosening. Several options are available to determine bone density preoperatively. In our study, we investigated the correlation of Hounsfield units (HU) of a contrast medium computed tomography (CT) to the bone density values of a quantitative computed tomography (QCT) and computed a formula to estimate bone density values using HU. ⋯ Bone density values correlate well to HU measured in contrast medium CT. Using simple formula, the bone density of a contrast medium CT of vertebral bodies can be estimated based on HU without additional examinations and unnecessary costs.
-
Arch Orthop Trauma Surg · Nov 2022
Elimination of irreducible intercalary fragment and fixation using locking plate for Mayo type IIB olecranon fracture-outcomes compared with type IIA.
We hypothesized that the outcomes of articular reduction with elimination of irreducible articular intercalary fragments for Mayo type IIB fractures fixed using olecranon locking plates would be as satisfactory as those of noncomminuted fractures. ⋯ Level IV, Retrospective therapeutic study.
-
Arch Orthop Trauma Surg · Nov 2022
Early versus delayed surgery for hip fragility fractures in patients treated with direct oral anticoagulants.
Delaying surgical treatment for hip fragility fractures increases mortality, but early intervention in patients treated with direct oral anticoagulant (DOAC) may increase the risk of perioperative blood loss due to residual drug activity. This study aimed to evaluate the effect of the timing of hip fragility fractures surgeries in patients treated with DOAC. ⋯ Early surgery did not increase perioperative blood loss. Delayed surgery ≥ 48 h of patients receiving DOAC who underwent surgery for hip fragility fractures showed a trend towards increased 30 day and 90 day mortality.
-
Arch Orthop Trauma Surg · Nov 2022
The effect of native knee rotation on the tibial-tubercle-trochlear-groove distance in patients with patellar instability: an analysis of MRI and CT measurements.
This study aimed to quantify the effect of lower limb rotational parameters on the difference in the tibial-tubercle-trochlear-groove (TTTG) distance when assessed with magnetic resonance imaging (MRI) and computed tomography (CT) in patients with patellar instability. It was hypothesized that an increased native knee rotation angle significantly contributes to an underestimation of TTTG by MRI. ⋯ Level III.