Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2023
High-risk ankle fractures in high-risk older patients: to fix or nail?
Optimal treatment of high-risk ankle fractures in older, comorbid patients is unknown. Results of open reduction internal fixation (ORIF) versus tibiotalocalcaneal (TTC) fusion nailing for the treatment of high-risk geriatric ankle fractures were investigated. ⋯ ORIF and TTC fusion nailing result in comparable and acceptable reoperation, infection, and union rates in treating high-risk ankle fractures in patients over 50 with at least 1 major comorbidity for increased complications; further study is warranted.
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Arch Orthop Trauma Surg · Jul 2023
Fixed 6° distal femoral cut consistently achieves neutral alignment for Asians, Caucasians, and Native Hawaiian/Pacific Islanders.
Restoration of a neutral mechanical axis (MA) is important to the success of total knee arthroplasty (TKA). While known differences are present between Asians and Caucasians regarding native knee alignment, it is unknown whether such differences exist amongst Native Hawaiian/Other Pacific Islanders (NHPI) or if utilizing a fixed distal femoral cut of 6° can consistently achieve a neutral MA in these minority racial groups. This study examines the preoperative deformities presented by Asians, Caucasians, and NHPI, and the resulting knee alignment achieved following TKA when a fixed 6° distal femoral cut is targeted for all patients. ⋯ NHPI appear to have similar preoperative deformities to Asians with both groups having significantly more varus alignment than Caucasians. Despite a wide range of preoperative deformity, application of a fixed distal femoral cut of 6° valgus successfully established a neutral MA equally in the majority of patients across all three racial groups.
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Arch Orthop Trauma Surg · Jul 2023
Patient response to osteotomy around the knee joint at one year post-operation-fulfilment of expectations and current health status.
The aim of this study was to investigate patient satisfaction and fulfilment of expectations after osteotomy around the knee at one year postoperatively, using patient-related outcome measures. ⋯ Level II (Therapeutic study).
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Arch Orthop Trauma Surg · Jul 2023
Screw placement in arthroscopically assisted osteosynthesis of radial head fractures using a reference k-wire in the radiocapitellar joint: a cadaveric study.
The optimal screw placement in arthroscopically assisted fixation of radial head fractures is still an issue and no guiding methods have been evaluated in the recent literature. The study hypothesis was that using a "reference k-wire" percutaneously inserted in and parallel to the radiocapitellar joint would enable to achieve a trajectory more parallel to the radial head articular surface as compared to a free-hand k-wire placement. ⋯ IV, biomechanical cadaver study.
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Arch Orthop Trauma Surg · Jul 2023
Prediction of long-term mortality following hip fracture surgery: evaluation of three risk models.
Several prognostic models have been developed for mortality in hip fracture patients, but their accuracy for long-term prediction is unclear. This study evaluates the performance of three models assessing 30-day, 1-year and 8-year mortality after hip fracture surgery: the Nottingham Hip Fracture Score (NHFS), the model developed by Holt et al. and the Hip fracture Estimator of Mortality Amsterdam (HEMA). ⋯ The NHFS and the model by Holt et al. allowed for accurate identification of low- and high-risk patients for both short- and long-term mortality after a fracture of the hip. The HEMA performed poorly. When considering predictive performance and ease of use, the NHFS seems most suitable for implementation in daily clinical practice.