Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
Litigations in orthopedics and trauma surgery: reasons, dynamics, and profiles.
In recent literature, the increasing number of medical litigations, both in terms of the number of cases being filed and the substantive costs associated with lawsuits, has been described. This study aims to provide an overview of the profile of litigation for orthopedic and trauma surgery to describe the differences and the development of the number of cases over time. ⋯ Our results could not confirm the often-stated trend of having more litigations against orthopedic and trauma surgeons. Although the absolute numbers increased, the number of litigations per 1000 patients treated declined. Patients who underwent elective surgery were more likely to file complaints than emergency patients.
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Arch Orthop Trauma Surg · Dec 2022
Peri-implant fracture: a rare complication after intramedullary fixation of trochanteric femoral fracture.
Trochanteric femoral fractures are among the most common operatively treated fractures. Intramedullary fixation has become the treatment of choice in many centers around the world. Nevertheless, the knowledge of rare complications of these fractures is limited. In this study, the incidence and treatment strategies for peri-implant fractures (PIF) were assessed. ⋯ A PIF is a rare complication of intramedullary fixation of trochanteric fractures. It can be treated with either locking plates or exchange nailing with sufficient results. There are no grounds for favoring long nails to avoid PIFs.
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Arch Orthop Trauma Surg · Dec 2022
ReviewAre we staying up too late? Timing of surgery of displaced supracondylar fractures in children. Clinical audit in a paediatric tertiary UK trauma centre and literature review.
The British Orthopaedic Association (BOA) guidelines in managing supracondylar humerus fractures in children, outline indications for urgent fixation of these fractures. We present our data from a regional paediatric trauma centre before and after implementing a change in practice as per these guidelines. ⋯ When there is no indication for same night operating out of hours, delaying treatment until the next day seems to be a safe way of treating these difficult fractures. Our data show that there is no increase in complications when these fractures are managed the next day.
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Arch Orthop Trauma Surg · Dec 2022
Stem-bone contact patterns of a long straight tapered uncemented stem for primary THA.
Despite excellent long-term survival, total hip arthroplasty (THA) can fail due to aseptic loosening, dislocations, sepsis and periprosthetic fractures, all of which remain considerably burdensome. Aseptic loosening is one of the main causes of THA failure, often due to osteolysis, stress shielding and/or lack of primary stability. This study aimed to investigate stem-bone contact patterns of a long straight-tapered uncemented stem following primary THA, and to determine whether these contact patterns are related to preoperative femoral morphology and whether they influence postoperative outcomes. ⋯ The stem-bone contact patterns of a long straight-tapered uncemented stem are related to preoperative femoral morphology, but do not influence short-term postoperative outcomes. Contact patterns were related to preoperative femoral offset, NSA, and sagittal CFI, but not coronal CFI. Surgeons should, therefore, consider sagittal morphology for surgical planning and templating, in addition to the conventional parameters of coronal morphology.
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Arch Orthop Trauma Surg · Dec 2022
Femoral morphology affects postoperative alignment of the lower extremities in hybrid closed-wedge high tibial osteotomy.
This study aimed to determine correction error predictors of lower extremitiy alignment after hybrid closed-wedge high tibial osteotomy (HCWHTO). ⋯ Preoperative mLDFA is significantly associated with postoperative alignment in HCWHTO. While postoperative MPTA is important, disregarding the preoperative mLDFA may bears a high risk of malcorrection. Varus alignment of the knee with larger mLDFA may be an indication for not only HCWHTO, but also for distal femoral osteotomy.