Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2023
Changes in the femoral varus and rotational profiles are correlated in women with varus osteoarthritic lower limbs.
Previous studies have reported the relationship between coronal alignment of the lower limbs and the rotational profile of the femur and tibia. However, the relationship between coronal alignment of the femur and tibia and their rotational profiles in patients with varus osteoarthritic knees is unclear. ⋯ Femoral anteversion and the rotational profile of the distal femur were negatively correlated with the degree of femoral varus in Asian women with varus osteoarthritic knees. This study enhanced the understanding of the relationship between changes in coronal alignment of the femur and tibia and their rotational profiles in patients with varus osteoarthritic lower limbs, although this study was limited by the small sample sizes and methodological quality.
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Arch Orthop Trauma Surg · Feb 2023
Incidence and local risk factors of infection after anterior sub-axial cervical spine surgery: retrospective database analysis of 4897 consecutive procedures.
The anterior cervical spine approach is safe and effective in many cervical spine pathologies. It is considered one of the most common approaches in spine surgery. Postoperative infections after anterior cervical surgery are rare but serious. ⋯ Postoperative infection after anterior cervical surgery is low (0.49%). In addition to the general risk factor for infection, the local risk factors are trauma, myelopathy, spinal cord injury, and revision surgeries. In the case of postoperative infection, an oesophageal injury should be excluded.
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Arch Orthop Trauma Surg · Feb 2023
A windows technique for sustentaculum tali screw fixation using the sinus tarsi approach for calcaneal fractures: a cadaveric study.
The minimally invasive approach for displaced intra-articular calcaneal fractures is significantly reducing postoperative wound complications. One minimally invasive method, the sinus tarsi approach (STA) has been increasingly widely used. STA is, however, challenging due to its technical demands and the risk of injury to the sural nerve (SN). The purpose of this study was to identify the SN and its branches including their anatomical relationship to the STA as well as to describe an anatomical windows technique for STA including determination of the safe angle for screw insertion into the sustentaculum tali fragment. ⋯ The distal window is the safest for surgical approach and for calcaneal surgery screw fixation in terms of avoiding sural nerve injury. In addition, that window provides a wide working angle for screw fixation.
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Arch Orthop Trauma Surg · Feb 2023
Intra-articular fragment mapping in associated both-column acetabular fractures.
Associated both-column acetabular fractures (ABC-AF) are complex. A detailed description of the morphology of the articular surface of the acetabulum is not reported. This study was designed to describe the morphology of the intra-articular fragments using a fracture mapping technique to provide reference in more appropriate approach selection in surgical treatment of the fractures. ⋯ The articular fragments of ABC-AFs were composed of CFs, WFs and IFs. The junction of the fossa to the anterior lunate surface and the posterior region of the rim were mostly involved. The location of the articular fragments and their connections to the periphery of the innominate may be considered in selection of approaches.
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Arch Orthop Trauma Surg · Feb 2023
A retrospective analysis of controlled active motion (CAM) versus modified Kleinert/Duran (modKD) rehabilitation protocol in flexor tendon repair (zones I and II) in a single center.
The aim of this study was to analyze primary flexor tendon repair results in zones I and II, comparing the rupture rate and clinical outcomes of the controlled active motion (CAM) protocol with the modified Kleinert/Duran (mKD) protocol. ⋯ The gut feeling that lead to change in our rehabilitation protocol could be explained by the heterogenous bias. A precise outcome analysis of group 1 could underline that in patients with complex hand trauma, nerve reconstruction, oedema or early extension deficit, an even more intensive and individual rehabilitation has to be performed to achieve better TAM at 6 or 12 weeks. Our study explicitly demonstrated a significant better outcome in the modK/D group compared to CAM group. This monocenter study is limited by its retrospective nature and the low number of patients.