Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Observational StudyPostoperative cognitive dysfunction after beach chair positioning compared to supine position in orthopaedic surgery in the elderly.
Postoperative cognitive dysfunction (POCD) occurs in up to 26% of patients older than 60 years 1 week after non-cardiac surgery. Intraoperative beach chair positioning (BCP) is advantageous for some types of shoulder surgery. However, this kind of positioning leads to a downward bound redistribution of blood volume, with possible hypoperfusion of the brain. We hypothesized that patients > 60 years undergoing orthopaedic shoulder surgery in a BCP might experience more POCD than patients operated in the supine position (SP). ⋯ POCD at 1 week after surgery tended to occur more often in patients operated in beach chair position compared to patients in supine position without being statistically significant.
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Arch Orthop Trauma Surg · Feb 2024
The effects of length and width of the stem on proximal humerus stress shielding in uncemented primary reverse total shoulder arthroplasty.
To preserve humeral bone during RTSA, stems have been made shorter and cement avoided whenever possible. However, with the increased use of uncemented RTSA, a phenomenon comparable to the stress shielding of the hip has been described for the proximal humerus. The aim of this study was to investigate the influence of stem length and width on proximal humeral bone resorption after primary uncemented RTSA. ⋯ III.
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Arch Orthop Trauma Surg · Feb 2024
Clinical outcomes following tibiotalocalcaneal arthrodesis with intramedullary nailing combined with partial fibulectomy and onlay bone graft.
Although intramedullary nailing is a popular method for tibiotalocalcaneal arthrodesis, nonunion is one of the most commonly reported complications. This study aimed to evaluate the fusion rate, improvement in functional outcomes, and occurrence of complications in tibiotalocalcaneal arthrodesis using retrograde intramedullary nailing with partial fibulectomy and onlay bone graft technique. ⋯ Our technique of tibiotalocalcaneal arthrodesis with partial fibulectomy and onlay bone grafting could be a good option where both the tibiotalar and subtalar joints need to be fused.
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Arch Orthop Trauma Surg · Feb 2024
The distal tibiofibular syndesmosis is a reliable landmark for 3° varus tibial resection in total knee arthroplasty: a radiological evaluation on 1296 cases.
The purpose of this study was to evaluate the reproducibility and the accuracy of distal tibiofibular syndesmosis (DTFS) as landmark to perform controlled varus tibial resections during total knee arthroplasty (TKA). The hypothesis was that DTFS can be used to perform an accurate 3° varus tibial cut. ⋯ IV, retrospective case series.
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Arch Orthop Trauma Surg · Feb 2024
Utility of 3D reformatted images in the diagnosis of sternoclavicular joint injury.
The purpose of this study is to evaluate the ability of musculoskeletal radiologists to diagnose sternoclavicular joint injuries in the standard CT imaging planes compared to 3D volume rendered images to define the most accurate plane to improve prospective diagnosis. ⋯ 3D volume renderings of the sternoclavicular joints have the potential to improve radiologist accuracy for detection of sternoclavicular joint injury/dislocation in the setting of chest well trauma, which could decrease instances of missed or delayed diagnosis.