Archives of orthopaedic and trauma surgery
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During the last two decades, extended scientific interest focused on quadrilateral plate (QLP) fractures as part of common acetabular fractures. The QLP corresponds to the medial wall of the acetabulum, and different fracture pattern of Letournel´s fracture types are associated with concomitant QLP fractures. Except anterior and posterior wall fractures, all other fracture types may be associated with QLP fractures. ⋯ Several new implants were development for optimal but often individual stabilization concepts. The gold-standard is still some medial buttressing during internal fixation predominantly using plates, but also screw fixation is considered an option. Additional dome impactions must be considered as an integral part in any QLP fracture analysis and stabilization.
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Arch Orthop Trauma Surg · Dec 2024
Comparative Study Observational StudyComparison of two surgical treatment strategies for fragility fractures of the pelvis based on early postoperative mobility outcomes using insole force sensors.
Increasing incidences for fragility fractures of the pelvis (FFP) have been reported and surgical treatment remains demanding. While conventional screw osteosynthesis is a common method, complications may arise due to altered bone morphology in the osteoporotic pelvic bone. The iFuse implant system is a novel implant, first introduced for treatment of degenerative sacroiliac joint dysfunction, which offers promising biomechanical characteristics with potential benefits for treatment of FFP. Yet data on the use for FFP is limited. The objective of this study is to compare early postoperative mobility of patients treated with screw osteosynthesis only versus patients treated with additional iFuse stabilization based on insole force sensor gait analysis. We hypothesized that additional iFuse implantation leads to superior postoperative mobility. ⋯ Comparison of early postoperative mobility showed similar mobility outcomes in both groups. Patients with additional iFuse implantation had a more balanced gait pattern, whereas no significance was found in peak force parameters. Additional iFuse implantation showed promising results regarding patient mobility, therefore our hypothesis was partly confirmed. In future long-term examinations with larger patient cohorts should be aimed for.
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Arch Orthop Trauma Surg · Dec 2024
Statistical shape models quantify acetabular defects in hip revision surgery: implications for classification and surgical planning.
The purposes of this study was to develop a novel therapy-oriented acetabular bone defects classification system based on Statistical shape models (SSMs) and evaluate the reliability and reproducibility of its application. ⋯ This classification system, which has demonstrated moderate to strong interobserver and intraobserver reliability, may be particularly useful to accurately evaluate acetabular defects and suggest surgical strategies, as a complement to the traditional Paprosky classification system in revision THA.
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Arch Orthop Trauma Surg · Dec 2024
Comparative StudyHow many knots are necessary to achieve knot security of two high strength suture tapes? A biomechanical comparative analysis.
According to current clinical practice, a minimum of 7 knots are required to provide secure hold in high-strength sutures. A new technology featuring a suture tape with a salt-infused silicon core has been recently developed, potentially reducing the number of needed knots. ⋯ In fatty-wet conditions-related to open surgery-the novel Dynatapetm suture tape requires 5 instead of 7 knots to achieve their security. In wet conditions-related to arthroscopic surgery-this number can be reduced to 4 knots. In contrast, the conventional SutureTapetm needs 6 knots to provide security in all conditions.
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Arch Orthop Trauma Surg · Dec 2024
Outcomes of Revision surgery for surgically treated insertional Achilles tendinopathy.
There is a clear roadmap for the treatment of primary insertional Achilles tendinopathy (IAT), but data on the outcome of revision surgery is missing. The current study aimed to analyze the outcome following revision surgery for surgically failed IAT. ⋯ IAT revision surgery results in an improvement of the patients' symptoms, but only one-third of the patients recover fully.