Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2023
Trans-fracture approach for ORIF of coronal shear fractures of the distal humerus.
Open reduction and internal fixation (ORIF) of comminuted coronal shear fractures of the distal humerus is challenging. When a concomitant lateral condyle fracture is present, it may be used for a trans-fracture approach to facilitate exposure and fracture reduction. This study aimed to investigate the frequency of lateral condyle fractures in coronal shear fractures of the distal humerus and analyze fracture reduction, fracture union and clinical results following ORIF through a trans-fracture approach. ⋯ Lateral condyle fractures are present in about one third of coronal shear fractures of the distal humerus. This injury can be used for a trans-fracture approach to facilitate exposure and to reliably achieve anatomic fracture reduction.
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Arch Orthop Trauma Surg · May 2023
A propensity score-matched comparison between Mako robotic arm-assisted system and conventional technique in total hip arthroplasty for patients with osteoarthritis secondary to developmental dysplasia of the hip.
The clinical effectiveness of robotic arm-assisted systems remains unclear for total hip arthroplasty (THA) in patients suffering from osteoarthritis secondary to developmental dysplasia of the hip (DDH). ⋯ The robotic arm-assisted system may provide more accurate cup placement in THA for DDH.
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Arch Orthop Trauma Surg · May 2023
Correction of the pelvic incidence using a bilateral extending pelvic osteotomy: a proof of concept study.
The aim of this proof of concept human cadaver study was to quantify the effect of a bilateral extending pelvic osteotomy (BEPO) on pelvic incidence (PI) as a potential alternative for a pedicle subtraction osteotomy (PSO) in patients with severe spinal sagittal malalignment. ⋯ There was a feasible and effective correction of PI using the BEPO technique on the os ilium. This was a preliminary cadaveric study. No conclusions could be made on global sagittal alignment. We postulate that an extending osteotomy of the ilium could be a potential alternative for a PSO reducing the complexity of spine surgery in patients with severe spinal sagittal malalignment.
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Achieving normal rotational alignment of both components in total knee arthroplasty (TKA) is essential for improved knee survivorship and function. However, malrotation is a known complication resulting in higher revision rates. Understanding malrotation of the components and its concomitant clinical and functional outcomes are important for early diagnosis and management. The purpose of this study was to evaluate the effect of malrotation on clinical outcomes and failure modes in both single and combined rotational malalignment. ⋯ III.
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Arch Orthop Trauma Surg · May 2023
Combined distal femoral osteotomy and tibial tuberosity distalization is effective in patients presenting with patellar instability and patellofemoral pain due to patella alta and femoral malalignment.
Patellar malalignment has been considered one of the major pathomechanical causes of patellofemoral instability and pain. The results have been reported after femoral varization/torsional osteotomy and tibial tuberosity distalization osteotomy (TTD-O). However, the combination of a femoral deformity (genu valgum/increased femur antetorsion) and patella alta remains underreported. Therefore, the aim of this study was to investigate the clinical outcomes of patients simultaneously treated by distal femoral osteotomy and TTD-O. The hypothesis was that restoration of patellofemoral (PF) alignment via the abovementioned osteotomies would achieve good patient-reported outcome measures. ⋯ The findings of this study indicate that the combination of a distal femoral osteotomy and a tibial tuberosity distalization osteotomy is effective in patients presenting with patellar instability and patellofemoral pain due to patella alta and femoral malalignment.