Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
A novel classification based on magnetic resonance imaging for individualized surgical strategies of lumbar disc herniation.
Although the anatomy and pathology of lumbar disc herniation (LDH) have been clearly defined and classified in many studies, its imaging definition and classification still needs further clarification. This study intends to propose a novel classification and individualized surgical strategy for LDH based on preoperative magnetic resonance imaging (MRI). ⋯ We proposed a novel classification system and an individualized surgical strategy for LDH based on preoperative MRI. Further, the surgical suitable interventions guided by this system achieved good clinical outcomes and mild recurrence rates.
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Arch Orthop Trauma Surg · Aug 2023
Hospital transfer and delayed reduction of traumatic hip dislocations.
Native hip dislocations are high energy injuries that cause substantial patient morbidity. Expedient reduction has been demonstrated to improve patient outcomes. The objective of our study was to compare complication rates in patients with native hip dislocations who presented directly to a level-one trauma center with those transferred from an outside hospital (OSH). Our hypothesis was that those transferred from an OSH would experience a delay in reduction and subsequently would experience higher rates of avascular necrosis (AVN), post-traumatic arthritis (PTA), and need for secondary surgery. ⋯ Transfer status is not an independent risk factor for the development of AVN, PTA, or the need for a secondary surgery. However, transferred patients did experience an average delay of 8 h in time to reduction compared to those who presented directly to a trauma center. Of the 27 patients with a reduction delay greater than 12 h, 26 (96%) were transferred.
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Arch Orthop Trauma Surg · Aug 2023
Impact of social disadvantage among total knee arthroplasty places of service on procedural volume: a nationwide Medicare analysis.
As recent analyses have indicated that low-volume hospitals experience higher rates of complications following total knee arthroplasty (TKA), it remains important to evaluate how area deprivation index (ADI) of hospitals impacts the quantity of TKA performed. Our analysis sought to evaluate how the ADI of orthopedic surgeon's place of service influences TKA utilization. ⋯ Our findings suggest that resource deprivation contributes to disparities in TKA utilization. With the ongoing recognition of how social and neighborhood-level deprivation may influence access to end-stage osteoarthritis care and related perioperative outcomes, the present study serves to encourage continued efforts at ensuring equity in orthopedic care.
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Arch Orthop Trauma Surg · Aug 2023
Two fingerbreadths, one finger's width: on the proximity of the radial nerve to the deltoid tuberosity.
The aim of this study was to find a convenient technique to evaluate the location of the radial nerve (RN) with reference to the deltoid tuberosity (DT). ⋯ This study provides an easily applicable technique to localize the RN with reference to the DT.
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Arch Orthop Trauma Surg · Aug 2023
Comparison of balance and function in the long term after all arthroscopic ATFL repair surgery.
We compared the balance, ROM, clinical scores, kinesiophobia and functional outcomes of patients after all-arthroscopic ATFL repair surgery with the non-operated side and healthy control group. ⋯ Level III.