Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2025
Local infiltration anesthesia with high dose ropivacaine and dexmedetomidine in major knee surgery is safe.
The role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine. Dexmedetomidine has recently received attention for decreasing demand for anesthetic agents and prolonged effect of anesthesia. The purpose of this study was to demonstrate safety of dexmedetomidine and ropivacaine as LIA. ⋯ LIA in a combination of single high-dose ropivacaine and dexmedetomidine is safe in knee surgery. Further studies evaluating pain relief with this LIA combination are needed.
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Arch Orthop Trauma Surg · Jan 2025
Do perilunate dislocations and fracture-dislocations result in different radiological outcomes following wrist alignment reconstruction? A single-center retrospective study including 51 patients with perilunate injuries.
Perilunate dislocations (PLD) and perilunate fracture-dislocations (PLFD) are high-energy wrist injuries often linked to significant post-traumatic osteoarthritis. This study aims to determine whether PLD and PLFD yield different radiological outcomes following surgical treatment while identifying prognostic factors for worse outcomes. ⋯ PLD and a greater number of wrist transfixations were associated with a higher risk of wrist arthrosis. Limiting wrist pinning to essential procedures may help prevent additional iatrogenic chondral lesions.