Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2022
ReviewConcomitant injuries in patients with thoracic vertebral body fractures-a systematic literature review.
The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures. ⋯ The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.
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Arch Orthop Trauma Surg · Jul 2022
Meta AnalysisShort versus long cephalomedullary nailing of intertrochanteric fractures: a meta-analysis of 3208 patients.
The purpose of the study was to compare treatment outcomes after short or long cephalomedullary nailing for intertrochanteric femur fractures. ⋯ Meta-analysis; Level III, therapeutic.
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Arch Orthop Trauma Surg · Jul 2022
Factors associated with mortality in older patients sustaining pelvic or acetabular fractures.
This study aimed to investigate potential factors, including delay to surgical stabilisation, affecting mortality in older patients sustaining pelvic or acetabular (PA) fractures. ⋯ Surgical intervention within 72 h of injury did not result in decreased mortality in older patients with PA fractures. The 1-year mortality rate between older PA fractures and hip fractures was comparable. Consideration should be given to a combined multidisciplinary approach between orthogeriatric and expert PA surgeons for these patients.
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Arch Orthop Trauma Surg · Jul 2022
Multicenter Study Observational StudyReverse total shoulder arthroplasty in massive rotator cuff tears: does the Hamada classification predict clinical outcomes?
Reverse total shoulder arthroplasty (RTSA) is a widely recognized treatment to reduce pain and improve shoulder function for patients in various disease stages of cuff tear arthropathy (CTA). However, it remains unclear whether outcomes after RTSA depend on the preoperative stage of CTA. Therefore, this study evaluated whether the Hamada classification influences midterm clinical outcomes after RTSA. ⋯ Inverted bearing RTSA was found to be an effective treatment with similarly good midterm clinical outcomes, similar revision rates, and high implant survival rates in every stage of massive rotator cuff tears. Overall, the preoperative Hamada classification did not influence clinical outcomes or complications after RTSA.
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Arch Orthop Trauma Surg · Jul 2022
Observational StudyHigh risks of failure observed for A1 trochanteric femoral fractures treated with a DHS compared to the PFNA in a prospective observational cohort study.
Both the DHS and the PFNA are common and well-studied treatment options for stable trochanteric fractures. The aim of the current study was to compare the implant failure rates of these two implants in 31A1 type trochanteric femoral fractures. ⋯ Significantly more implant failures were observed for the DHS compared the PFNA within 1 year after surgery. Despite the fact that this did not result in differences in revision surgery, we conclude that the PFNA, considering the minimal number of implant-related fractures is a viable implant for A1 type trochanteric fractures.