Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2023
A well performing medial fixed bearing UKA with promising survivorship at 15 years.
Unicompartmental knee arthroplasty (UKA) accounts for 10% of knee arthroplasty procedures in Europe. Fixed bearing UKA designs have shown favorable survivorship in registries when compared with mobile bearings. This study analyses long-term follow-up of patients with a medial fixed bearing metal backed tibial UKA and reports 15 years survivorship and clinical outcomes. ⋯ This Medial fixed bearing metal backed UKA demonstrates promising long-term survivorship and patient outcomes. It appears to be a suitable and reasonably lasting option for the treatment of medial compartment OA.
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Arch Orthop Trauma Surg · May 2023
Early results and complication rate of the LapiCotton procedure in the treatment of medial longitudinal arch collapse: a prospective cohort study.
Instability/collapse of the medial column has been associated with many conditions, particularly progressive collapsing foot deformity (PCFD), hallux valgus (HV), and midfoot arthritis (MA). Restoration of first ray length and sagittal plane alignment to restore the foot tripod is essential when treating these deformities. This study aimed to assess early results, healing, and complication rate of a distraction dorsal opening plantarflexion wedge allograft first tarsometatarsal joint fusion (LapiCotton Procedure) in patients with collapse/instability of the medial column. ⋯ Level II, prospective cohort study.
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Arch Orthop Trauma Surg · May 2023
Case ReportsComplete avulsion of the heel pad with talar and calcaneal fracture: salvage with multiple K-wire anchorage, internal fixation and free ALT flap.
Degloving of the sole of the foot is a rare and serious injury because the heel pad cannot be replaced by similar tissue. The management is challenging and only a few cases have been reported with different treatment regimens. ⋯ The unique tissue at the sole of the foot can be salvaged even in cases of full degloving at the hindfoot with the simple method of anchorage with multiple temporary K-wires. Traumatic defects of the vulnerable skin at the posterior aspect of the heel requires durable coverage with free flap coverage. With staged treatment of all bone and soft tissue injuries, a favorable result can be obtained even in case of a complex foot trauma.
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Arch Orthop Trauma Surg · May 2023
Clinical Trial25-Year experience with adult polytraumatized patients in a European level 1 trauma center: polytrauma between 1995 and 2019. What has changed? A retrospective cohort study.
To analyze the changes of the clinical characteristics, injury patterns, and mortality rates of polytraumatized patients within the past 25 years in a European Level I trauma center. ⋯ The number of polytraumatized patients remained constant over the 25-year study period. Also, the mortality rates remained stable over time, although a significant increase of the average age of polytraumatized patients could be seen with stable injury severity scores. Severe TBI and age beyond 65 years remained independent prognostic factors on the late-phase survival of polytraumatized patients.
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Arch Orthop Trauma Surg · May 2023
Occurrence of adjacent segment fractures after surgical treatment of an osteoporotic vertebral fracture: a retrospective comparison between two different treatment methods.
Osteoporotic vertebral fractures are a major healthcare problem. Vertebral cement augmentation (VCA) is frequently used as a minimally invasive surgical approach to manage symptomatic fractures. However, there is a potential risk of adjacent segment fracture (ASF), which may require second surgery. The addition of transcutaneous screw-fixation with cement augmentation superior and inferior to the fracture [Hybrid transcutaneous screw fixation (HTSF)] might represent an alternative treatment option to reduce the incidence of ASF. ⋯ Based on this single-center cohort study, HTSF appears to be a safe and effective option for the treatment of osteoporotic vertebral compression fractures. Surgical time and duration of hospital stay were longer in the HTSF-group, but the rate of ASF was significantly reduced with this approach. Further studies are required to ascertain whether HTSF results in superior long-term outcomes or improved quality of life.