Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2022
Impact of fatty degeneration on the functional outcomes of 38 patients undergoing surgical repair of gluteal tendon tears.
Gluteal tendon tears (GTT) can cause pain and weakness of the hip. We analyze the impact of gluteal muscle fatty degeneration, atrophy and tear morphology on clinical outcomes of surgical repair. ⋯ While fatty degeneration can negatively impact functional outcomes, pain relief is reliably achieved. Tear morphology and muscle atrophy did not correlate with outcomes in this patient cohort. Patients should be counseled to expect a residual limp after surgery if they have GFC ≥ 2° on MRI.
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Arch Orthop Trauma Surg · Sep 2022
Patient-reported outcomes at 1 and 2 years after total hip and knee arthroplasty: what is the minimum required follow-up?
The purpose of this study was to test for differences between patient-reported outcome measures (PROMs) at 1 and 2 years following total hip (THA) or knee (TKA) arthroplasty. ⋯ These data support a minimum follow-up of 1 year for studies with PROMs as the primary outcome variable following THA and TKA.
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Arch Orthop Trauma Surg · Sep 2022
Scattering and clustering the proximal screw construct in unilateral locking plate osteosynthesis of distal femoral fractures.
The importance of fixation construct in locking compression plate (LCP) is not well enlightened until recently. The aim of this study was to investigate radiological and clinical outcomes of scattering and clustering of the proximal screw fixation construct in unilateral LCP treatment of the distal femoral fractures. ⋯ Despite a delay in initial callus and bridging callus formation, scattering the proximal screws was better in achieving earlier and more balanced radiographic union than the clustered fixation. We recommend to avoid bridging more than five holes in the whole plate fixation construct to lessen the asymmetric callus formation and to prevent eventual plate breakage.
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Arch Orthop Trauma Surg · Sep 2022
Multidisciplinary care model for geriatric patients with hip fracture in Japan: 5-year experience.
Japan is a super-aging society, the geriatric care system establishment for hip fractures is at an urgent task. This report described our concept of multidisciplinary care model for geriatric hip fractures and 5-year outcomes at the Toyama City Hospital, Japan. ⋯ We have organized a multidisciplinary team approach for geriatric hip fracture. This approach resulted in a shorter time to surgery and hospital stay than the national average. The incidence of severe complications and mortality was low. The multidisciplinary treatment has maintained a high rate of osteoporosis treatment after discharge and at follow-up. Furthermore, the total medical cost per person was less than the national average. Thus, the multidisciplinary treatment approach for geriatric hip fractures was effective and feasible to conduct in Japan.
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Arch Orthop Trauma Surg · Sep 2022
Nonunion of the femoral shaft associated with limb shortening treated with a combined technique of external fixation over an intramedullary nail versus the Ilizarov method.
Post-traumatic nonunion of the femur remains a challenging problem even for experienced orthopedic surgeons. The main question is the choice of the optimal surgical tool. ⋯ Hybrid technique provides bone union with compensation of limb shortening and reduces the treatment period as compared with the Ilizarov method used alone. However, deep infection may happen.