Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2024
Comparative StudyComparative analysis of tension band wiring and hook plate fixation in ulnar styloid fractures: a focus on fracture type.
Various surgical techniques for ulnar styloid fractures (USFs) fixation have recently been developed, the actual clinical outcomes have not been discussed in detail. This study aimed to compare the outcomes of tension band wiring (TBW) and hook plate fixation in the treatment of USFs and to explore effective management strategies for these fractures. ⋯ TBW offers slight ROM benefits for type 2 USFs, whereas hook plate fixation provides superior stability for complex types 3 and 4 USFs. Despite the minimal differences in ROM, the enhanced advantages of the hook plate fixation make it the preferred choice for severe fractures, ensuring faster healing.
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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.
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Arch Orthop Trauma Surg · Jul 2024
ReviewFracture sonography-review of literature and current recommendations.
Over a span of more than two years, a collaborative expert group consisting of 9 professional societies has meticulously crafted the S2e guideline on fracture sonography. This publication encapsulates the essential insights pertaining to specific indications. A thorough and systematic literature search, covering the period from 2000 to March 2021, was conducted across PubMed, Google Scholar, and the Cochrane Database of Systematic Reviews, complemented by an evaluation of bibliographies. ⋯ Out of the initial pool of 520 literature sources, a meticulous screening and content assessment process yielded 182 sources (146 clinical studies and 36 meta-analyses and systematic reviews) for evaluation. The comprehensive analysis identified twenty-one indications that substantiate the judicious use of fracture sonography. Ultrasound emerges as a pragmatic and user-friendly diagnostic method, showcasing feasibility across a diverse range of indications.
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Arch Orthop Trauma Surg · Jul 2024
ReviewSingle bundle hamstrings autograft preparation techniques for anterior cruciate ligament reconstruction: current concepts.
Anterior cruciate ligament reconstruction (ACLR) is one of the most common orthopedic procedures, and huge variation exists in the surgical technique. Single bundle hamstrings autograft reconstruction is a common method and has good clinical outcomes. A criticism of the hamstrings autograft is a small graft diameter, often less than 8-mm, which has been associated with increased re-rupture rates. ⋯ Awareness of the minimum tendon and graft length required to produce each graft variation is necessary to avoid common pitfalls. However, intraoperative graft modification is possible to maximize graft diameter, and obtain proper fixation. The objective of this current concepts review is to describe the indications, surgical anatomy, technique, intraoperative tips, clinical outcomes, and complications for single bundle hamstrings autograft preparation techniques in ACLR.
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Arch Orthop Trauma Surg · Jul 2024
Randomized Controlled Trial Comparative StudyEqual rates of bone healing and reduced surgical time with iliac crest allograft compared to autograft in medial opening wedge high tibial osteotomy: a randomized controlled clinical trial.
Iliac crest autograft is frequently used to fill in bone defects after osteotomies. Nonetheless, surgery for bone autograft procurement is associated with morbidity and pain at the donor site. Alternatives to it have been explored, but there is no consensus to guide their application as a routine practice in several orthopedic procedures. Thus, this study was designed to compare the efficacy and safety between iliac crest autograft and allograft in medial opening wedge high tibial osteotomy. ⋯ Iliac crest allografts can be safely and effectively used in medial opening wedge high tibial osteotomy as it promotes the same rates of bone union as those achieved by autologous grafts, with the benefits of a shorter operative time.