Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Femoral neck shortening as a sequela of internal fixation for femoral neck fractures and its effect on the coronal alignment of the limb: a pilot study.
Femoral neck shortening is a common phenomenon following osteosynthesis for femoral neck fractures, which was shown to have a negative effect on hip function. There is paucity of literature on the effect of shortening on the ipsilateral limb mechanical axis and knee coronal alignment. We hypothesized that postoperative femoral neck shortening can alter the limb's mechanical axis into valgus. ⋯ We found a more lateralized mechanical axis in limbs that demonstrated post-operative ipsilateral femoral neck severe shortening. These findings may provide a possible explanation and rationale for knee pain and perhaps for the development of knee osteoarthritis as a sequalae of femoral neck shortening. Further investigation and larger cohort, long-term studies are needed to further explore this hypothesis.
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Arch Orthop Trauma Surg · Feb 2024
Suprapatellar intramedullary nail combined with screw fixation has comparable surgical outcomes to minimally invasive locking plate fixation in ipsilateral tibial plateau and shaft fractures.
To compare union rate, union time, alignment, and complication rate in ipsilateral tibia plateau and shaft fractures treated via suprapatellar intramedullary nailing with screw fixation and minimally invasive locking plate fixation. ⋯ Level III.
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Arch Orthop Trauma Surg · Feb 2024
Minimally invasive arthroscopy-assisted arthrodesis for thumb carpometacarpal osteoarthritis.
Arthrodesis is a reliable surgical procedure for treatment of thumb carpometacarpal (CMC) osteoarthritis that provides hand strength and pain relief. Locking plate fixation is a common technique that provides rigid fixation and a high rate of bone union; however, it requires extensive surgical exploration of the first metacarpal and trapezium. Here, we report the surgical outcome of minimally invasive arthroscopy-assisted thumb CMC arthrodesis that preserves soft tissue supplying the blood flow to the bones. ⋯ Arthroscopy-assisted arthrodesis is a valuable procedure for thumb CMC osteoarthritis. However, the learning curve for this procedure must be overcome before the operative time can be shortened and successful bone union and satisfactory outcomes achieved.
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Arch Orthop Trauma Surg · Feb 2024
First 100 total hip arthroplasties performed by a young surgeon using the direct anterior approach: learning curve and complications.
Most of the reported discussions about the learning curve for the direct anterior approach (DAA) in total hip arthroplasty (THA) have been by experienced surgeons. The study's aim was to describe the learning curve, short-term outcomes, complications, and adaptations to the DAA used in the first 100 THA cases experienced by a young surgeon who had received DAA training for trauma surgeries. ⋯ Even after receiving training on the DAA for trauma surgeries, the young surgeon experienced a steep learning curve and more complications in the first 50 cases. The DAA for THA is a technically demanding procedure and may require guidance from an experienced surgeon to manage unexpected complications.
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Arch Orthop Trauma Surg · Feb 2024
Primary arthrodesis versus open reduction and internal fixation following intra-articular calcaneal fractures: a weight-bearing CT analysis.
To compare primary arthrodesis (PA) versus open reduction and internal fixation (ORIF) in displaced intra-articular calcaneal fractures (DIACFs), based on clinical outcome and 2D and 3D geometrical analyses obtained from weight-bearing (WB) cone-beam CT images. ⋯ Three-dimensional WB CT imaging enables functional 2D and 3D analyses under natural load in patients with complex calcaneal fractures. Based on clinical outcome, both PA and ORIF appear viable treatment options. Clinical correlation with geometrical outcomes remains to be established.