Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Sep 2023
Use of the iliac-outlet and iliac-inlet combined views in percutaneous posterior column retrograde screw fixation.
Posterior column fractures are common acetabular injuries. Although displaced fractures require open reduction and fixation, undisplaced patterns may benefit from percutaneous screw fixation. The combination of iliac oblique with inlet and outlet views offers an intuitive and panoramic rendering of the bony corridor into the posterior column; lateral cross table view completes the sequence of fluoroscopic projections. Herein we describe the use of outlet/inlet iliac views and a detailed procedure for percutaneous retrograde posterior column screw fixation.
-
Arch Orthop Trauma Surg · Sep 2023
The effect of reduced bone mineral density on elective total hip arthroplasty outcomes.
Reduced bone mineral density (BMD) and disruption of normal bony architecture are the characteristics of osteopenia and osteoporosis and in patients undergoing total hip arthroplasty (THA) may cause failure of trabecular ingrowth. The purpose of this study is to evaluate the impact of reduced BMD on outcomes following primary elective THA. ⋯ Patients with osteoporosis were older with reduced BMI and had increased PFx after non-cemented elective THA. Understanding this can help surgeons formulate an appropriate preoperative plan for the treatment of patients with osteoporotic bone undergoing elective THA.
-
Arch Orthop Trauma Surg · Sep 2023
Comparison of segmental lordosis gain of prone transpsoas (PTP) vs. lateral lumbar interbody fusion.
Lumbar interbody fusion is a standard method to treat certain degenerative conditions that are refractory to conservative treatments. LLIF reduces posterior muscle damage, can relieve neurological symptoms through indirect decompression, provides increased stability with its wider cages, and promotes more significant segmental lordosis than standard posterior techniques. However, the technique possesses its issues, such as unusual positioning, possible plexus-related symptoms, and median segmental lordosis correction. Trying to ease those issues, the idea of a prone transpsoas technique occurred. ⋯ The prone transpsoas approach can significantly enhance the correction of segmental lordosis proportionated to the traditional LLIF approach.
-
Arch Orthop Trauma Surg · Sep 2023
Extension osteotomy of the metacarpal I and ligamentoplasty of the trapeziometacarpal joint for the treatment of early-stage osteoarthritis and instability of the trapeziometacarpal joint.
Osteoarthritis (OA) is a common disease of the first carpo-metacarpal (CMC I) joint. Biomechanical factors promoting OA are the shape of the CMC I-joint, being a biconcave-convex saddle joint with high mobility and the increased instability caused by joint space narrowing, ligamentous laxity, and direction of force transmission of the abductor pollicis longus (APL) tendon during adduction. ⋯ We combine this closing wedge osteotomy with a ligamentoplasty to stabilize the joint. In this manuscript, we provide a detailed description of the indication, discuss biomechanical aspects and the surgical technique in detail.
-
Arch Orthop Trauma Surg · Sep 2023
Venous thromboembolism is rare after total hip and knee joint arthroplasty with long thromboprophylaxis in Finnish fast-track hospitals.
Pharmacological thromboprophylaxis effectively prevents venous thromboembolism (VTE) after total knee (TKA) and total hip arthroplasty (THA). Less is known about the influence of fast-track arthroplasty on VTE risk. We conducted a register-based study to determine the incidence of VTE after fast-track TKA and THA in Finland using long thromboprophylaxis. ⋯ VTE incidence is low in Finnish fast-track TKA and THA patients with long thromboprophylaxis.