Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2022
Potential pitfalls of lateral radiographic assessment of the nail position in the distal femur.
Antegrade nailing of proximal femur fractures is a widely accepted treatment that relies on lateral radiographs to assess distal nail positioning. However, the distal femur is trapezoidal in cross section, consequently standard lateral radiographs may be insufficient. This study aimed to utilise 3D modelling to virtually assess the accuracy of lateral radiographs in defining the position of a femoral nail in the distal femur, specifically considering distal cortical encroachment. ⋯ Femoral nails are often anteriorly located in the distal femur and reviewed using lateral radiographs. However, this research demonstrates that owing to the geometry of the distal femur, a lateral radiograph may be inadequate for determining the true position of a femoral nail within the distal femur. Accurately assessing the position of femoral nails may help to address and prevent thigh pain, and iatrogenic fracture or perforation which have been associated with anterior positioning.
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Arch Orthop Trauma Surg · Jul 2022
The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate.
To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. ⋯ A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.
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Arch Orthop Trauma Surg · Jul 2022
Using a patella reduced technique while balancing a TKA results in restored physiological strain in the collateral ligaments: an ex vivo kinematic analysis.
Poor soft tissue balance in total knee arthroplasty (TKA) often results in patient dissatisfaction and reduced joint longevity. Patella-in-place balancing (PIPB) is a novel technique which aims to restore native collateral ligament behavior without collateral ligament release, while restoring post-operative patellar position. This study aimed to assess the effectiveness of this novel technique through a detailed ex vivo biomechanical analysis by comparing post-TKA tibiofemoral kinematics and collateral ligament behavior to the native condition. ⋯ Balancing a TKA with the PIPB technique resulted in reduced joint laxity, while restoring collateral ligament strains. The technique also seemed to restore kinematics and strains, especially in passive flexion.
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Arch Orthop Trauma Surg · Jul 2022
Assessment of acetabular chondral damage and labral pathologies via direct MR arthrography: specialization matters.
To compare the diagnostic accuracy of investigators from different specialities (radiologists and orthopaedic surgeons) with varying levels of experience of 1.5 T direct magnetic resonance arthrography (dMRA) against intraoperative findings in patients with femoroacetabular impingement syndrome (FAIS). ⋯ Retrospective cohort study; III.
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Arch Orthop Trauma Surg · Jul 2022
High initial graft tension increases external tibial rotation on the axial plane after anatomical anterior cruciate ligament reconstruction.
The purpose of this study was to clarify the effects of applying different amounts of initial graft tension on the femorotibial positional relationship on the axial plane after anatomical ACL reconstruction. ⋯ Applying high initial graft tension (maximum manual force) resulted in the external rotation of the tibia against the femur just after anatomical ACL reconstruction. In contrast, applying low initial graft tension (80 N at full knee extension) did not change the femorotibial rotational relationship.