Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2023
ReviewMechanical complications of hip spacers: a systematic review of the literature.
Temporary spacers used in the staged revision of a hip prosthetic joint infection (PJI) have been associated with several mechanical complications with very variable reported general complications rates up to 73%. The aim of this systematic review was to assess the mechanical complications associated with hip antibiotic-loaded spacers when treating periprosthetic hip PJI. ⋯ Spacer placement in chronic PJI of the hip with bone and soft-tissue defects is challenging and bears a high risk of mechanical failures and progressive bone loss during the interim period. A careful patient selection for spacer implantation is mandatory.
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Arch Orthop Trauma Surg · May 2023
The effect of long calcar screws on the primary stability of 3-part, varus impacted proximal humeral fractures compared to short calcar screws: a real fracture simulation study.
Complex proximal humeral fracture ranks among the most common fracture types, especially in elderly patients. In locked plate fixation of proximal humerus fractures, the calcar is deciding for screws providing further medial column support. To date, the biomechanical effect of the length of these calcar screws is not well known. The purpose of this study was to analyze the effect of long calcar screws on fresh frozen prefractured cadaveric specimens. ⋯ Basic science study.
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Arch Orthop Trauma Surg · May 2023
ReviewDynamic palmar dislocation of the ulnar head at the distal radioulnar joint (DRUJ) after radius shaft malunion.
Palmar instability of the distal radioulnar joint (DRUJ) is a rare condition, which is, in contrast to the dorsal dislocation, scarcely represented in the literature. This palmar instability can result from a dorsally angulated malunion of the radial shaft after forearm fracture in childhood. Treating such a condition is controversial in the literature and was described in small case series. This study represents the largest case series in the literature that dealt with this condition, alongside a review of the key papers in the English literature. ⋯ In this patient cohort, a simple corrective osteotomy of the radial shaft at the malunion site was adequate to treat the dynamic palmar instability of DRUG. A soft tissue procedure was not required. Forearm radiographs are the mainstay of diagnostic tools.
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Stiffness after elbow injuries can severely limit daily life. If adequate conservative treatment does not result in satisfactory improvement of elbow function, surgical intervention should be considered. Whether an open or arthroscopic procedure is preferable is still a topic of debate and a systematic review of functional outcomes is lacking. ⋯ Level IV; Systematic review.
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Arch Orthop Trauma Surg · May 2023
Increased length of stay following total joint arthroplasty based on insurance type.
Increased length of stay after total joint arthroplasty has been shown to be a risk factor for peri-operative complications. The purpose of this study was to determine if Medicaid insurance would be a risk factor for increased length of stay after total joint arthroplasty. ⋯ Patients with Medicaid insurance undergoing total joint arthroplasty have increased length of stay compared to patients with Medicare or Private insurance and have higher incidence of pre-operative narcotic use.