Archives of orthopaedic and trauma surgery
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Rib fractures are common injuries in trauma patients that often heal without intervention. Infrequently, symptomatic rib fracture nonunions are a complication after rib fractures. There is a paucity of literature on the surgical treatment of rib fracture nonunion. The purpose of this study was to describe the efficacy of rib fracture nonunion operative fixation with particular focus on surgical technique, healing rates, and complications. ⋯ This study concluded that operative fixation of symptomatic rib fracture nonunion demonstrated favorable outcomes with reduction in preoperative pain levels, decreased use of narcotic pain medication, minimal complications, and a high rate of fracture union. This described method provides symptomatic relief, reduction in pain, and promotes bony healing of the fracture nonunion without development of major complications. We suggest that operative fixation should be considered as the primary method of treatment of symptomatic rib nonunions.
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Arch Orthop Trauma Surg · Jun 2023
Can machine learning models predict failure of revision total hip arthroplasty?
Revision total hip arthroplasty (THA) represents a technically demanding surgical procedure which is associated with significant morbidity and mortality. Understanding risk factors for failure of revision THA is of clinical importance to identify at-risk patients. This study aimed to develop and validate novel machine learning algorithms for the prediction of re-revision surgery for patients following revision total hip arthroplasty. ⋯ Level III, case-control retrospective analysis.
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Arch Orthop Trauma Surg · Jun 2023
Treatment outcomes of patients with Cutibacterium acnes-positive cultures during total joint replacement revision surgery: a minimum 2-year follow-up.
Periprosthetic joint infection (PJI) is a devastating complication following total joint replacement (TJR). Cutibacterium acnes (C. acnes) is a low virulent skin commensal, commonly found during TJR revision surgery for "aseptic" causes. The purpose of the present study was to report the treatment outcomes of patients with C. acnes contamination or infection in the presence of a TJR treated with a revision surgery ± implant exchange ± prolonged (≥ 8 weeks) postoperative antibiotics. ⋯ Kantonale Ethikkommission Zürich, BASEC Nr.:2017-00567.
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Arch Orthop Trauma Surg · Jun 2023
Accuracy of pelvic measurements on virtual radiographic projections based on computed tomography scans compared to conventional radiographs pre- and postoperatively.
The anteroposterior (ap) radiograph of the pelvis is decisive in the diagnosis of different pathologies of the hip joint. Technical advantages have reduced the radiation dose of pelvic CT to levels comparable to radiographs. The purpose of this study was to validate if standard radiographic parameters (lateral center edge angle, medial center edge angle, acetabular index, acetabular arc, extrusion index, crossover sign and posterior wall sign) can accurately be determined on radiograph-like projections reconstructed from the CT dataset pre- and postoperatively. ⋯ Radiograph-like projections show comparable results to radiographs with regard to the important investigated parameters (lateral center edge angle, medial center edge angle, acetabular index, acetabular arc, extrusion index, crossover sign and posterior wall sign). Thus, ultra-low-dose CT scans may reduce the need for conventional radiographs in pre- and postoperative analyses of 3-dimensional hip pathologies in the future, as the advantages increasingly outweigh the disadvantages.
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Arch Orthop Trauma Surg · Jun 2023
Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases.
The treatment of ankle fractures and fracture-dislocations involving the posterior malleolus (PM) has undergone considerable changes over the past decade. The aim of our study was to identify risk factors related to the occurrence of complications in surgically treated ankle fractures with PM involvement. ⋯ Significant risk factors for the occurrence of complications following PM fracture treatment were identified. An individually tailored treatment regimen that incorporates all risk factors is important for a good outcome.