Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jul 2022
Reliability and validity of the modified McGowan grade in patients with cubital tunnel syndrome.
This study aimed to assess the reliability and validity of the modified McGowan grading system and to determine its ability to distinguish the severity of cubital tunnel syndrome (CuTS) between the different grades. ⋯ The modified McGowan grade has a moderate inter- and intra-observer reliability. This grading system moderately correlates with objective sensory-motor functions and MCV of patients with CuTS. However, the modified McGowan grade does not reflect the patient's perceived disabilities and has a weakness in distinguishing the severity of patients' conditions among the different grades.
-
Arch Orthop Trauma Surg · Jul 2022
The inter-and intra-observer reliability of volar angulation measurements in a fifth metacarpal neck fracture.
The fifth metacarpal neck fracture is the most common metacarpal fracture. The palmar angulation from the fracture displacement is critical for determining treatment, yet there is no consensus regarding the angulation measurement method or the surgical cut-off value. This study aimed to identify a reliable measurement method for assessing palmar angulation. We evaluated inter-observer and intra-observer validation of measuring palmar angulation in oblique plain X-ray and computed tomography (CT) sagittal cuts. ⋯ The palmar angulation measurement in 45° pronated oblique X-ray using the MNSC angle method had good-to-excellent reliability, with superior results to sagittal CT radiograms. Although the angle is likely overestimated, the MNSC method is reliable for judging the fracture degree and reduction adequacy after surgery compared to the non-fractured hand physiologic angulation.
-
Arch Orthop Trauma Surg · Jul 2022
Review Case ReportsBosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature.
Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia. ⋯ Given the extreme paucity of CS in malleolar fractures, CS in BF has a relatively high prevalence. Risk factors include severe dislocations, repeated attempts on closed reduction, and a long interval to definite surgery. A high index of suspicion is required because delayed diagnosis leads to lasting functional restrictions.
-
Arch Orthop Trauma Surg · Jul 2022
Randomized Controlled TrialA neck-preserving short stem better reconstructs the centre of rotation than straight stems: a computed tomography-based cadaver study.
Short femoral hip stems with a metaphyseal anchoring concept have been designed to treat younger patients with good bone quality. The aim of this study was to reconstruct the centre of rotation and soft tissue balancing and preserve bone in the long-term perspective. ⋯ In this cadaver study, we found that the metaphyseal anchoring, partially neck-preserving short hip stem best reconstructs the ante-torsion and the ante-tilt of the femoral neck. Therefore, it can be a useful stem in younger or active middle-aged patients.