Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
STRYDE versus PRECICE magnetic internal lengthening nail for femur lengthening.
Magnetic internal lengthening nails (MILNs) have been used for femoral lengthening to avoid complications associated with external fixation. The titanium version of the MILN (PRECICE®) has been in use since 2011 but had limitations (50-75 lb) in post-operative weight bearing. A new stainless-steel version of the MILN (STRYDE®) allows 150-250 lb of post-operative weight bearing. The aim is to compare the outcomes of using these two different MILNs for both unilateral and bilateral femoral lengthening. ⋯ Level III, Therapeutic study.
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Arch Orthop Trauma Surg · Dec 2022
Peri-implant fracture: a rare complication after intramedullary fixation of trochanteric femoral fracture.
Trochanteric femoral fractures are among the most common operatively treated fractures. Intramedullary fixation has become the treatment of choice in many centers around the world. Nevertheless, the knowledge of rare complications of these fractures is limited. In this study, the incidence and treatment strategies for peri-implant fractures (PIF) were assessed. ⋯ A PIF is a rare complication of intramedullary fixation of trochanteric fractures. It can be treated with either locking plates or exchange nailing with sufficient results. There are no grounds for favoring long nails to avoid PIFs.
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Arch Orthop Trauma Surg · Dec 2022
ReviewPost-operative peri-prosthetic fracture rates following the use of cemented polished taper-slip stems for primary total hip arthroplasty: a systematic review.
Peri-prosthetic fractures (PPFs) are a serious complication of total hip arthroplasty (THA) associated with significant morbidity, mortality and re-operation similar to the rates seen following femoral neck fractures. When exploring the PPF rates around cemented stems, many studies combine the results of composite beam and taper-slip stems despite their different philosophies. This review looks specifically at PPFs with the use of cemented stems of the taper-slip philosophy to evaluate the demographics, PPF rate and fracture patterns in this patient cohort. ⋯ This review suggests an association with being older and female, and a greater risk of PPFs secondary to low energy falls in cemented polished taper-slip stems.
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Arch Orthop Trauma Surg · Dec 2022
ReviewAre we staying up too late? Timing of surgery of displaced supracondylar fractures in children. Clinical audit in a paediatric tertiary UK trauma centre and literature review.
The British Orthopaedic Association (BOA) guidelines in managing supracondylar humerus fractures in children, outline indications for urgent fixation of these fractures. We present our data from a regional paediatric trauma centre before and after implementing a change in practice as per these guidelines. ⋯ When there is no indication for same night operating out of hours, delaying treatment until the next day seems to be a safe way of treating these difficult fractures. Our data show that there is no increase in complications when these fractures are managed the next day.
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Arch Orthop Trauma Surg · Dec 2022
Stem-bone contact patterns of a long straight tapered uncemented stem for primary THA.
Despite excellent long-term survival, total hip arthroplasty (THA) can fail due to aseptic loosening, dislocations, sepsis and periprosthetic fractures, all of which remain considerably burdensome. Aseptic loosening is one of the main causes of THA failure, often due to osteolysis, stress shielding and/or lack of primary stability. This study aimed to investigate stem-bone contact patterns of a long straight-tapered uncemented stem following primary THA, and to determine whether these contact patterns are related to preoperative femoral morphology and whether they influence postoperative outcomes. ⋯ The stem-bone contact patterns of a long straight-tapered uncemented stem are related to preoperative femoral morphology, but do not influence short-term postoperative outcomes. Contact patterns were related to preoperative femoral offset, NSA, and sagittal CFI, but not coronal CFI. Surgeons should, therefore, consider sagittal morphology for surgical planning and templating, in addition to the conventional parameters of coronal morphology.