Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2022
High Early-onset acromioclavicular secondary pathologies after acute arthroscopic joint reduction: a cohort study.
The research aim was to determine the prevalence and risk factors of early secondary acromioclavicular (AC) joint disease in patients undergoing acute arthroscopic AC joint reduction and fixation and early complications of acute surgical treatment in patients with high-grade AC joint dislocation. ⋯ Twenty-nine patients (28%) presented with a secondary AC joint pathology, with 24 and 5 cases of osteolysis and osteoarthritis, respectively. The main complication was a loss of reduction of ≥ 1 mm (78%). Patients aged > 55 years were more likely to develop a secondary AC joint disease (odds ratios (OR) = 10.1, 95% confidence interval (CI): 1.42 - 72.55, p = 0.021). Patients with osteolysis (OR = 3.2, 95% CI 1.16 - 9.27, p = 0.025) or loss of reduction of > 5 mm (OR = 7.4, 95% CI 2.31 - 24.08, p = 0.001) were more likely to develop AC joint pain. Patients with an initial over-reduction were less likely to develop a subluxated AC joint (OR = 0.033, 95% CI 0.0021-0.134, p = 0.001) CONCLUSION: Age > 55 years and female sex were identified as risk factors of early-onset secondary AC joint disease. Osteolysis and a loss of reduction of > 5 mm were risk factors of AC joint pain but not of revision surgery. The main early complication was a loss of reduction of ≥ 1 mm. An initial over-reduction of the distal clavicle was a protective factor to avoid AC joint subluxation.
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Arch Orthop Trauma Surg · Jul 2022
Supraacetabular osseous corridor: defining dimensions, sex differences, and alternatives.
The supraacetabular (SA) corridor extends from the anterior inferior iliac spine to the posterior ilium and can safely accommodate implants to stabilize pelvic and acetabular fractures. However, quantitative analysis of its dimensions and characteristics have not been thoroughly described. This study seeks to define the dimensions, common constriction points, and any alternative trajectories that would maximize the corridor diameter. ⋯ In men, the SA corridor allows for the safe passage of most hardware used in pelvic and acetabular fractures. However, in women, the SA corridor is restricted by a more S-shaped ilium. An alternative trajectory was found that has a significantly larger mean diameter in both sexes. Ultimately, the trajectory of hardware will be dictated by the clinical scenario. When large implants are needed, especially in women, we recommend considering the alternative SA corridor.
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Arch Orthop Trauma Surg · Jul 2022
High-stress distribution in the lateral region of the subtalar joint in the patient with chronic lateral ankle instability.
Chronic lateral ankle instability (CLAI) is associated with osteoarthritis (OA). However, the characteristics of patients with CLAI who progress to OA are not clear. Measurement of Hounsfield Unit (HU) value on computed tomography (CT) is reported to be useful to evaluate the stress distribution. We aimed to evaluate the stress distribution in the ankle and subtalar joints and factors enhancing it in patients with CLAI. ⋯ Level III, comparative series.
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Arch Orthop Trauma Surg · Jul 2022
Distal biceps tendon repairs and reconstructions-an analysis of demographics, prodromal symptoms and complications.
The purpose of this study was to evaluate the demographics, complications and prodromal symptoms (any pain or unpleasant sensation in the area distal biceps tendon preceding the injury) of distal biceps tendon tears (DBTTs) of patients treated with primary repair or Achilles allograft reconstruction. ⋯ DBTT is a condition that affects men predominantly. The observed bimodal incidence distribution was related to elite athletes, but in the normal population the peak occurs at the age typical to tendinopathies. LABCN neurapraxia was the most common adverse event, and graft use does not seem to predispose to adverse events.
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Arch Orthop Trauma Surg · Jul 2022
Tibiocalcaneal arthrodesis using the Ilizarov fixator in compromised hosts: an analysis of 19 patients.
Salvage of joint destruction of the tibiotalar and subtalar joint with necrosis or infection of the talus in compromised hosts is a challenging problem. In these cases, tibiocalcaneal arthrodesis using the Ilizarov external fixator represents a possible alternative to amputation. This retrospective study presents the results and complications of this salvage procedure. ⋯ Tibiocalcaneal arthrodesis using the Ilizarov fixator is a possible salvage procedure even in compromised hosts. However, the healing rates are below the rates reported in the literature for tibiotalar arthrodesis in comparable clinical situations.