Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyThe cementless taper wedge vs. fit-and-fill stem in primary total hip arthroplasty: risk of stem-related complication differs across Dorr types.
The choice between a cementless taper wedge stem and a fit-and-fill stem in total Hip arthroplasty (THA) for various proximal femoral morphological types has not been thoroughly evaluated. This study aimed to compare the risk of stem-related complications between these two stem types in Dorr type A, B, and C femurs. ⋯ Concerning the risk of stem-related complications, the taper wedge stem was a better choice in Dorr type C femurs. However, there was no difference in risk between the taper wedge stem and fit-and-fill stem in Dorr type A and B femurs.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyAnkle fracture surgery performed by orthopaedic residents without supervision has comparable outcomes to surgery performed by fellowship trained orthopaedic surgeons.
Unstable fractures often necessitate open reduction and internal fixation (ORIF), which generally yield favourable outcomes. However, the impact of surgical trainee autonomy on healthcare quality in these procedures remains uncertain. We hypothesized that surgery performed solely by residents, without supervision or participation of an attending surgeon, can provide similar outcomes to surgery performed by trauma or foot and ankle fellowship-trained orthopaedic surgeons. ⋯ Level III - retrospective cohort study.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyBiomechanical analysis of push-pull principle versus traditional approach in locking plates for proximal humeral fracture treatment.
Proximal humerus fractures are usually treated with locking plates, which could present recurrence, screw penetration, joint varization. The push-pull principle was introduced to prevent these risks and showed promising results; a dedicated design was then developed and this feasibility study aims to compare the biomechanical performances of such dedicated push-pull plate with the traditional locking plate using finite elements. ⋯ More homogeneous stress distribution is found with the push-pull plate in all three testing set-ups, showing lower unloaded areas (and thus lower stress-shielding) compared to the traditional plate; the screws implemented returned to be all loaded in at least one of the set-ups, thus showing that they all contribute to plate stability.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyThe infraacetabular screw versus the antegrade posterior column screw in acetabulum fractures with posterior column involvement: a biomechanical comparison.
Traditionally, plate osteosynthesis of the anterior column combined with an antegrade posterior column screw is used for fixation of anterior column plus posterior hemitransverse (ACPHT) acetabulum fractures. Replacing the posterior column screw with an infraacetabular screw could improve the straightforwardness of acetabulum surgery, as it can be inserted using less invasive approaches, such as the AIP/Stoppa approach, which is a well-established standard approach. However, the biomechanical stability of a plate osteosynthesis combined with an infraacetabular screw instead of an antegrade posterior column screw is unknown. ⋯ Replacing the antegrade posterior column screw with an infraacetabular screw is not recommendable as it results in an increased interfragmentary motion, especially at the posterior hemitransverse component of an ACPHT fracture.
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Arch Orthop Trauma Surg · Jun 2024
Comparative StudyNew dynamic suture material for tendon transfer surgeries in the upper extremity - a biomechanical comparative analysis.
Early mobilization after tendon surgery is crucial to avoid commonly observed postoperative soft tissue adhesions. Recently, a new suture was introduced (DYNACORD; DC) with a salt-infused silicone core designed to minimize laxity and preserve consistent tissue approximation in order to avoid gap formation and allow early mobilization. ⋯ From a biomechanical perspective, DC preserved tissue approximation and might be considered as a valid alternative to conventional high-strength sutures in tendon transfer surgery. DC might allow for a shorter interweaving zone and a more aggressive early postoperative rehabilitation program, possibly avoiding commonly observed postoperative soft tissue adhesions and stiffness.