Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2024
Digitally enhanced hands-on surgical training (DEHST) enhances the performance during freehand nail distal interlocking.
Freehand distal interlocking of intramedullary nails remains a challenging task. Recently, a new training device for digitally enhanced hands-on surgical training (DEHST) was introduced, potentially improving surgical skills needed for distal interlocking. ⋯ II.
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Arch Orthop Trauma Surg · Apr 2024
Valgising angular stable plate fixation in the treatment of multifragmentary proximal humeral fractures in elderly patients.
The frequency of proximal humeral fractures shows an increasing tendency, especially in the elderly, who are frequently affected by osteoporosis. The adequate treatment of complex, displaced fractures poses a serious challenge. Among surgical treatment options, osteosynthesis with an angular stable plate is preferred, however, the implant-related complication rate may be exceptionally high. In our present study, we report the short-term outcomes of our new method of valgising angular stable plate fixation which we use for multifragmentary, displaced proximal humeral fractures in elderly patients. ⋯ Valgising angular stable plate fixation that we apply for proximal humeral fractures provided favourable functional outcomes and a low postoperative complication rate due to the optimal head and plate placement. The method is especially effective for the treatment of displaced three- and four-part fractures with weakened, osteoporotic bone structure.
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Arch Orthop Trauma Surg · Apr 2024
In vivo study to assess fat embolism resulting from the Reamer-Irrigator-Aspirator 2 system compared to a novel aspirator-based concept for intramedullary bone graft harvesting.
Fat embolism (FE) following intramedullary (IM) reaming can cause severe pulmonary complications and sudden death. Recently, a new harvesting concept was introduced in which a novel aspirator is used first for bone marrow (BM) aspiration and then for subsequent aspiration of morselized endosteal bone during sequential reaming (A + R + A). In contrast to the established Reamer-Irrigator-Aspirator (RIA) 2 system, the new A + R + A concept allows for the evacuation of fatty BM prior to reaming. In this study, we hypothesized that the risk of FE, associated coagulopathic reactions and pulmonary FE would be comparable between the RIA 2 system and the A + R + A concept. ⋯ The use of the RIA 2 system and the novel A + R + A harvesting concept which consists of BM evacuation followed by sequential IM reaming and aspiration of endosteal bone, resulted in only minor fat intravasation, coagulopathic reactions and pulmonary FE, with no significant differences between the groups. Our results, therefore, suggest that both the RIA 2 system and the new A + R + A concept are comparable technologies in terms of FE-related complications.
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Arch Orthop Trauma Surg · Apr 2024
Varus osteotomy as a salvage procedure for young patients with symptomatic patellofemoral arthritis and valgus malalignment at short- to mid-term follow-up: a case series.
The purpose of the study was to report the clinical, functional and radiological outcome following varus osteotomy as a salvage procedure in young to middle-aged patients with patellofemoral arthritis (PFA) and associated valgus malalignment. It was hypothesized that a significant improvement in knee function and reduction in pain would be achieved. Moreover, no conversion to patellofemoral joint arthroplasty could be observed. ⋯ Retrospective case series, Level IV.
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Arch Orthop Trauma Surg · Apr 2024
Joint-preserving treatment for global irreparable rotator cuff tears: combined anterior Latissimus dorsi and Teres major tendon transfer.
Treating global irreparable rotator cuff tears (GIRCTs) that involve both antero-and postero-superior cuff tendon tears could be a challenging problem. There has been limited joint-preserving treatment options in high-demand patients with minimal glenohumeral arthritis. The study aims to assess the clinical outcome of combined anterior latissimus dorsi and teres major tendon (aLDTM) transfer for patients with both GIRCTs and minimal glenohumeral arthritis. ⋯ IV.