Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2024
Clinical TrialPercutaneous transverse pinning for metacarpal fractures: a clinical trial.
Metacarpal fractures account for 25%-50% of all hand fractures and may negatively impact hand function and ability to work. Percutaneous transverse pinning of non-articular metacarpal fractures allows mobilisation immediately after the procedure. ⋯ II, prospective cohort study.
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudySimilar outcomes in collision athletes with subcritical glenoid bone loss and on-Track Hill Sachs lesion versus off-track Hill Sachs lesion managed with open Bankart repair plus inferior capsular shift.
Open Bankart repair plus inferior capsular shift has not yet been tested under the concept of glenoid track as a predictor of failure. The aim of this study was to compare the subjective and objective outcomes in collision athletes with subcritical glenoid bone loss and on-track Hill Sachs lesions versus those with off-track Hill Sachs lesions, all treated with open Bankart repair. ⋯ We found no differences between the outcomes of the two groups. According to the surgeon's preference, we recommend performing open Bankart repair plus inferior capsular shift as a treatment alternative in collision athletes with SGBL ≤ 10% independently of the type of Hill Sachs lesion.
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudyAre social determinants of health associated with an increased length of hospitalization after revision total hip and knee arthroplasty? A comparison study of social deprivation indices.
Length of stay (LOS) has been extensively assessed as a marker for healthcare utilization, functional outcomes, and cost of care for patients undergoing arthroplasty. The notable patient-to-patient variation in LOS following revision hip and knee total joint arthroplasty (TJA) suggests a potential opportunity to reduce preventable discharge delays. Previous studies investigated the impact of social determinants of health (SDoH) on orthopaedic conditions and outcomes using deprivation indices with inconsistent findings. The aim of the study is to compare the association of three publicly available national indices of social deprivation with prolonged LOS in revision TJA patients. ⋯ The varying relationship observed between the length of stay and socioeconomic markers in this study indicates that the selection of a deprivation index could significantly impact the outcomes when investigating the association between socioeconomic deprivation and clinical outcomes. These results suggest that ADI is a potential metric of social determinants of health that is applicable both clinically and in future policies related to hospital stays including bundled payment plan following revision TJA.
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Arch Orthop Trauma Surg · Jul 2024
The predictive value and reliability of ultrasound-guided synovial aspiration and biopsies for diagnosing periprosthetic shoulder infections.
Preoperative diagnosis of periprosthetic shoulder infections (PSI) is difficult. Infections are mostly caused by low virulence bacteria and patients do not show typical signs of infection. The aim of this study was to determine the diagnostic value and reliability of ultrasound-guided biopsies for cultures alone and in combination with multiplex polymerase chain reaction (mPCR), serum markers, and/or synovial markers for the preoperative diagnosis of PSI in patients undergoing revision shoulder surgery. ⋯ Diagnostic study level II.
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudyMaximum in-vivo joint contact forces double during active compared to assisted motion in the glenohumeral joint and decline long-term due to rotator cuff pathologies.
Rehabilitation programs advocate early passive and assisted motion after rotator cuff repair to induce healing und maintaining range of motion while avoiding excessive strain on the repaired tendons. In-vivo glenohumeral joint contact forces reflect the compressive forces generated by the rotator muscles. In the present study, maximum in-vivo joint contact forces (FresMax) were determined to compare active and assisted execution of a single movement and the long-term development of joint compression forces. ⋯ These results support current rehabilitation protocols recommending early passive and assisted motion to limit activation of the rotator muscles generating compressive forces. Following degeneration of the rotator cuff, active joint contact forces decrease over time. Level of evidence: III.