Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2024
Multicenter StudyTreatment and clinical outcome in patients with femoral head fractures: a long-term follow-up.
A femoral head fracture (Pipkin fracture) is a rare but severe injury. The optimal treatment is controversial, and there is a lack of research focusing on treatment strategies. The study aimed to analyze the treatment strategies in comparison to the outcome in patients after traumatic hip joint dislocation (THD) with concomitant femoral head fractures. ⋯ A femoral head fracture is a severe injury with overall limitations in activities of daily living and a high rate of post-traumatic osteoarthritis and osteonecrosis of the femoral head. Fragment fixation had no statistically significant impact on the outcome and PROMs. Treatment strategies should be guided by the fracture type, the patient's condition, and associated injuries. However, concomitant and life-threatening injuries may affect the treatment and limit the outcome.
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Arch Orthop Trauma Surg · Sep 2024
Lateral UKA can be a safe solution in a young patients' population: a 10-year follow-up report.
This study aimed to assess the long-term survivorship and functional outcomes of fixed-bearing lateral unicompartmental knee arthroplasty (UKA) in a young patients' population with osteoarthritis limited to the lateral compartment. ⋯ Lateral UKA proved to be an effective treatment option for osteoarthritis affecting the lateral compartment of the knee. The study demonstrated a high survivorship rate and favorable functional outcomes at a mean follow-up of 132.7 months. These findings highlight the potential benefits of fixed-bearing lateral UKA in selected patients with lateral compartment knee pathology.
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Arch Orthop Trauma Surg · Sep 2024
Comparative StudyCannulated compression screws with cable technique leads to a dramatic reduction in patella fracture fixation complications compared to tension band wiring.
The aim of this study was to compare the clinical, radiological and functional outcomes between cannulated compression screw with cable construct (CS) and tension band wiring (TBW) in transverse patella fractures. ⋯ The CS technique demonstrated lower complications, in particular, no CS patient had implant removals, wire migration or fracture displacement. Additionally, CS technique showed a faster return to ambulation and time to achieving full weight bearing status.
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Arch Orthop Trauma Surg · Sep 2024
Comparative StudyBetter restoration of joint line obliquity in tibia first restricted kinematic alignment versus mechanical alignment TKA.
In total knee arthroplasty (TKA), suboptimal restoration of joint line obliquity (JLO) and joint line height (JLH) may lead to diminished implant longevity, increased risk of complications, and reduced patient reported outcomes. The primary objective of this study is to determine whether restricted kinematic alignment (rKA) leads to improved restoration of JLO and JLH compared to mechanical alignment (MA) in TKA. ⋯ rKA-TKA results in high restoration accuracy of JLO and JLH, and demonstrates less pre- and post-operative JLO alteration compared to MA-TKA. With risen interest in joint line restoration accuracy with kinematic alignment, these findings suggest potential advantages compared to MA. Future investigation is needed to correlate between joint line restoration accuracy achieved by rKA and enhanced implant longevity, reduced risk of post-operative complications, and heightened patient satisfaction.
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Arch Orthop Trauma Surg · Sep 2024
Comparative StudyACL reconstruction demonstrates better stability compared to ACL repair for patients with Schenck III and IV knee dislocations.
This study compared mid-term outcomes of two anterior cruciate ligament (ACL) restoration techniques within an early total surgical care of acute knee dislocation: repair with additional internal bracing (ACLIB) and reconstruction with autograft (ACLR). Initial results at 12 months demonstrated that ACLR offered superior stability compared to ACLIB. ⋯ Retrospective cohort study, III.