Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2023
Neuraxial versus general anesthesia for perioperative outcomes and resource utilization following knee arthroplasty: experience from a large national database.
Attentions have been paid to the optimal anesthesia for knee arthroplasty (KA). We sought to investigate whether neuraxial anesthesia (NA) is superior to general anesthesia (GA) in terms of perioperative outcomes and resource utilization following KA. ⋯ Compared with GA, NA was associated with decreased incidence of blood transfusion, readmission, reduced length of stay, and total hospital charge following KA, suggesting the favorable role of NA for perioperative outcomes and resource utilization in KA.
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Arch Orthop Trauma Surg · Apr 2023
Factors influencing the outcome after surgical reconstruction of OTA type B and C tibial plateau fractures: how crucial is the restoration of articular congruity?
Only few and inconsistent data about the impact of articular congruity and tolerable residual intraarticular steps and gaps of the joint surface after tibial plateau fractures exist. Therefore, aim of this study was to investigate the correlation between OTA type B and C tibial plateau fracture outcomes and postoperative articular congruity using computed tomography (CT) data. ⋯ III.
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Arch Orthop Trauma Surg · Apr 2023
The radiographic outcome after plating for pubic symphysis diastasis: does it matter clinically?
Open reduction and internal fixation with plates is the most widespread surgery in traumatic pubic symphysis diastasis. However, implant failure or recurrent diastasis was commonly observed during follow-up. The aim of our study was to evaluate the radiologic findings and clinical outcomes. ⋯ A gradual increase in the symphysis distance and a high possibility of implant failure may be the distinguishing features of traumatic pubic symphysis diastasis fixation. The postoperative symphyseal distance achieved stability after 6 months, even after implant failure. Radiographic outcomes, such as increased symphysis distance, screw loosening, and plate breakage, did not affect clinical functional outcomes.
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Arch Orthop Trauma Surg · Apr 2023
High complication rates following revision first metatarsophalangeal joint arthrodesis: a retrospective analysis of 79 cases.
The most common indications for revision of first metatarsophalangeal joint (MTPJ) arthrodesis are symptomatic failures of prior arthrodesis, failed hallux valgus correction, and failed MTPJ arthroplasty implants. However, the outcomes of revision MTPJ arthrodesis have rarely been studied. The purpose of this study was to compare the clinical, radiographic, and patient-reported outcomes of revision MTPJ arthrodesis following different primary procedures. ⋯ III-Retrospective Cohort Study.
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Arch Orthop Trauma Surg · Apr 2023
Approach-related anatomical differences in patients with lumbo-sacral transitional vertebrae undergoing lumbar fusion surgery at level L4/5.
Lumbo-sacral transitional vertebrae (LSTV) are accompanied by changes in soft tissue anatomy. The aim of our retrospective study was to evaluate the effects of LSTV as well as the number of free lumbar vertebrae on surgical approaches of ALIF, OLIF and LLIF at level L4/5. ⋯ For patients with LSTV and five or four free lumbar vertebrae, the LLIF approach at L4/5 may be hindered due to a high riding iliac crest as well as anterior shift of the psoas muscle. Whereas less mobilization and retraction of the iliac veins may reduce the risk of vascular injury at this segment by ALIF and OLIF. For patients with 6LV, a lower relative height of the iliac crest facilitates lateral approach during LLIF. For ALIF and OLIF, a stronger vessel retraction due to the deeper-seated vascular bifurcation is necessary during ALIF and is therefore potentially at higher risk for vascular injury.