Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Clinical evaluation of a new technique for custom-made spacers in septic two-stage revision of total hip arthroplasties.
In septic two-stage revision surgery, success depends on numerous factors. Key steps are the procedure of ex- and reimplantation and the choice of spacer in the interim phase. The latter is still a matter of debate. Recently, we showed the microbial non-inferiority of a spacer technique using prosthetic cemented implants with an individualized antibiotic mixture in the cement applying a mechanically inferior cementation method. The aim of the present study was to evaluate the clinical results of these spacers in view of either an endofemoral or a transfemoral procedure. ⋯ In this study, we were able to show good clinical results for the presented spacer technique. With no relevant difference in outcome, the decision for an endofemoral or transfemoral technique can be based on technical deliberations. Further prospective comparative studies are necessary to show the clinical benefit of this procedure.
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Arch Orthop Trauma Surg · Aug 2023
A recalibrated prediction model can identify level-1 trauma patients at risk of nosocomial pneumonia.
Nosocomial pneumonia has poor prognosis in hospitalized trauma patients. Croce et al. published a model to predict post-traumatic ventilator-associated pneumonia, which achieved high discrimination and reasonable sensitivity. We aimed to externally validate Croce's model to predict nosocomial pneumonia in patients admitted to a Dutch level-1 trauma center. ⋯ Level III, Prognostic/Epidemiological Study.
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Arch Orthop Trauma Surg · Aug 2023
The anatomical shape of the proximal femur correlates with the distal femur anatomy.
In the case of stemmed implants for lower limb joint arthroplasty procedures, implant stability and survivorship generally rely on the strength of fixation in the medullary canal regardless of whether the procedure is primary or revision surgery. This study aimed to investigate the relationship between the proximal (Dorr classification) and distal (Citak classification) femoral canal geometry classification systems. ⋯ In this study, the Dorr and Citak classifications are put into relation to each other for the first time. The morphology of the femur was investigated in its entirety and it was shown that there was a positive correlation between the anatomical shape of the proximal and distal medullary canals.
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Arch Orthop Trauma Surg · Aug 2023
Impact of aberrant beam paths on antero-posterior shoulder radiographs in proximal humeral fractures.
Accurate radiographic assessment of proximal humeral fractures (PHF) is important as it influences clinical decision-making and predicts clinical outcome. Since aberrant radiographic views might influence the assessment of fracture displacement, it was the goal of this study to investigate the impact of aberrant beam paths on radiographic assessment of PHF. ⋯ Humeral angulation and offset measurements on AP radiographs are more susceptible to aberrant beam paths in fractured humeri. Altered radiographic beam paths around the vertical axis showed the most substantial influence on the assessment of PHF, with angular measurements demonstrating larger differences then offset measurements. Beam path alterations of 30° can influence the Neer classification, and might influence fracture displacement-based decisions.
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Arch Orthop Trauma Surg · Aug 2023
Osteoscopic versus open surgery for the treatment of enchondroma in the foot.
The conventional treatment of enchondromas is the open surgery with curettage of lesions. Osteoscopic surgery is a minimally invasive endoscopic approach for lesions inside bone. The aim of this study was to evaluate the feasibility of the osteoscopic surgery in comparison with the conventional open surgery for patients with foot enchondromas. ⋯ The osteoscopic surgery is feasible to provide earlier functional recovery and fewer complications than the open surgery.