Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2022
Meta AnalysisCombined application of adductor canal block and local infiltration anesthesia in primary total knee arthroplasty: an updated meta-analysis of randomized controlled trials.
Perioperative pain after total knee arthroplasty (TKA) may seriously affect the rapid recovery of patients. The purpose of this study was to assess whether the combined use of adductor canal block (ACB) and local infiltration anesthesia (LIA) can further reduce postoperative pain and improve early functional recovery. ⋯ The current meta-analysis showed that ACB + LIA significantly reduced postoperative walking pain and morphine consumption and promoted rapid recovery in the early postoperative period. There is no statistical difference in the length of stay and ROM after 72 h in the two groups.
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Arch Orthop Trauma Surg · Jun 2022
ReviewUnion rates and functional outcome of double plating of the femur: systematic review of the literature.
The optimal treatment strategy for the surgical management of femur fractures and non-unions remains unknown. The aim of this study is to assess union rates, complications and outcome after femoral double plating. Treatment of shaft, distal, periprosthetic fractures and pathological proximal femur fractures as well as femoral non-unions with double plating were evaluated. ⋯ IV.
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Arch Orthop Trauma Surg · Jun 2022
Meta AnalysisSame-day discharge arthroplasty has a higher overall complications rate than fast-track arthroplasty: a systematic review and meta-analysis.
Published studies have reported many inconsistent results regarding the comparison of same-day discharge total joint arthroplasty (TJA) and inpatient TJA. More notably, many recent studies comparing same-day discharge TJA with fast-track TJA presented higher rates of complications for same-day discharge TJA, which raises concerns about the safety of same-day discharge TJA. ⋯ The overall safety of same-day discharge TJA is satisfactory; however, more complications were detected in same-day discharge TJA than that in fast-track TJA. Complications in same-day discharge TJA might be underestimated in some previous studies taking long-staying inpatient TJA as control. Being more cautious about complications is necessary in the care of same-day discharge TJA, and extensive prospective studies are needed to explore the optimized option that weighs both cost and complications.
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Arch Orthop Trauma Surg · Jun 2022
Cementless femoral stems with lower canal fill ratio have similar mid-term to long-term outcomes to those with adequate fill ratio in Dorr type C femurs.
Lower canal fill ratio was reported to correlate with aseptic loosening in many studies. However, the most widely used standard of fill ratio seemed inapplicable to Dorr type C femurs. We aimed to adapt the method of measuring the fill ratio in Dorr type C femurs and compare the outcomes among patients with different fill ratios. ⋯ Patients with lower fill ratios at 2 cm below the lesser trochanter did not have poorer functional scores or more subsidence, but had a lower intraoperative fracture rate. The revision rates of the two groups presented no significant difference, but this result need to be confirmed in larger cohort in the future. In Dorr type C femurs, risk of fracture and the special morphology of the femur should be noted, and high fill ratio is not the most decisive factor for stem size selecting.
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Arch Orthop Trauma Surg · Jun 2022
Randomized Controlled TrialComparison of extension block pinning technique versus pin orthosis-extension block pinning technique for acute mallet fractures: a prospective randomized clinical trial.
The extension block pinning technique (EBPT) is a popular surgical treatment for mallet fractures; however, it has several drawbacks. The purpose of this randomized clinical trial was to compare EBPT to the pin orthosis-extension block pinning method (PO-EBPT) in the treatment of mallet fractures involving more than one-third of the joint surface but without primary joint dislocation. ⋯ In comparison to the EBPT technique, the group of patients operated with PO-EBPT had superior clinical outcomes and less loss of extension at the DIP joint according to the Crawford's criteria.