Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
Surgical outcomes of dual-plate fixation for periprosthetic femur fractures around a stable hip arthroplasty stem.
The incidence of periprosthetic femur fractures is increasing. Multiple treatment methods exist to treat fractures surrounding stable hip arthroplasty implants including locking plate fixation, cable fixation, allograft augmentation, and revision arthroplasty. No consensus regarding optimal treatment has been reached, and significant complications remain. Recently, biomechanical studies have demonstrated the benefits of orthogonal dual-plate fixation, but little clinical data exist. The purpose of the current study was to investigate the clinical and radiographic outcomes of dual-plated periprosthetic femur fractures around stable hip stems. ⋯ Dual-plating achieved high union rates with an acceptable complication profile for the treatment of periprosthetic femur fractures surrounding a stable hip arthroplasty stem. Our preferred fixation construct involves a lateral plate spanning the entire femur secured with non-locking bicortical screws supplemented with an anteriorly based reconstruction plate. Additional prospective research is required to confirm the results of this study.
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Arch Orthop Trauma Surg · Dec 2022
Comparison between single anterior and single posterior approaches of debridement interbody fusion and fixation for the treatment of mono-segment lumbar spine tuberculosis.
To compare the efficacy of single anterior and single posterior approach of debridement, interbody fusion, and fixation for the treatment of mono-segment lumbar spine tuberculosis (TB) patients. ⋯ Both single anterior and single posterior approaches of debridement, interbody fusion and fixation are effective for mono-segment lumbar TB patients, although the single posterior approach is of a shorter duration and results in less blood loss.
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Arch Orthop Trauma Surg · Dec 2022
Comparative study of Vancouver type B2 periprosthetic fractures treated by internal fixation versus stem revision.
Currently, accepted treatment for periprosthetic femoral fractures with loose femoral stem indicates its revision; however, recent studies have proposed treating Vancouver type B2 fractures via internal fixation without stem revision, particularly in the elderly or multi-morbid patients. Despite indications for stem revision, some surgeons tend to perform internal fixation. The main goal of this study was therefore to identify the parameters that were significantly different comparing internal fixation to stem revision for Vancouver type B2 fractures. ⋯ Revision did not exhibit better radiological results; moreover, internal fixation resulted in significantly less perioperative blood loss and a shorter operating time, concluding that ORIF is a viable alternative to revision arthroplasty, particularly in older patients.
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Arch Orthop Trauma Surg · Dec 2022
Radiologic restoration inaccuracy increases postoperative dislocation in primary total hip arthroplasty: a retrospective study with propensity score matching.
Dislocation is a complicated process and associated with multivariate etiology and risk factors. The purpose of this study was to verify if radiologic restoration inaccuracy increases postoperative dislocation in primary total hip arthroplasty (THA) individually or synergistically. ⋯ Hip offset (HO) restoration inaccuracy increased the risk of dislocation following primary THA. Multivariate radiologic restoration accuracy is critical for the prevention of dislocation and needs to be valued by surgeons.
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Arch Orthop Trauma Surg · Dec 2022
Arthroscopic modified Broström operation versus open reconstruction with local periosteal flap in chronic ankle instability.
The modified Broström operation (MBO) has found widespread use in the therapy of lateral chronic ankle instability (CAI). However, alternative surgical techniques like the open reconstruction using a periosteal flap (RPF) are still an important part of the surgical treatment of lateral CAI. Both procedures differ in terms of the reconstruction material used and the surgical procedure. Comparative studies on the surgical therapy of CAI are limited and generally refer to similar surgical procedures. Aim of this study was to compare the arthroscopic MBO and the RPF. ⋯ Both surgical procedures give very good results one year postoperatively in terms of pain, instability, function and complication rate. With significantly better results regarding pain and instability three months postoperatively, the MBO allows a faster recovery in patients operated with this technique.