Archives of orthopaedic and trauma surgery
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New generation cephalomedullary nails are, currently, widely used for the treatment of trochanteric proximal femoral fractures. This study aims to compare the midterm outcomes and complication rates in patients with unstable 31A2 fractures treated with two different lengths of nails. ⋯ The present study comparing two lengths of the Gamma3 Nail in 31A2 fractures showed no overall differences in clinical and radiological outcomes, and complication rates. However, the use of LGN was associated with a statistically significant higher blood loss and operative time, and a tendency for increased need for transfusion, and anterior knee pain and reoperation rate. Therefore, we recommend the use of locked SGN in the treatment of 31A2 fractures.
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Arch Orthop Trauma Surg · Nov 2020
Arthroscopic transosseous rotator cuff repair: how to avoid damaging the axillary nerve-a cadaveric study.
Arthroscopic transosseous rotator cuff repair can be performed with an external guide, although the proximity to the axillary nerve raises safety concerns. The aim of this study is to determine the safety of different drilling angles regarding the axillary nerve. ⋯ Arthroscopic transosseous rotator cuff repair with an external guide does not pose a risk for the axillary nerve using angles of 60° or less.
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Arch Orthop Trauma Surg · Nov 2020
Comparative StudyCone beam-navigated core decompression of bone marrow edema syndrome.
The aim of the study was to compare decompression of bone-marrow edema or osteonecrosis of the proximal femur by means of a cone beam-based imaging and navigation system (cone beam-navigated decompression, CBND) with decompression by the conventional technique of drilling using fluoroscopy (FD). ⋯ Decompression by CBND can be carried out safely and without complications. The advantages of CBND over FD are the minimally invasive access and the ability to address the affected area precisely with only one drilling maneuver. The high radiation dose of CBND can be reduced using low-dose protocols.
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Arch Orthop Trauma Surg · Nov 2020
Review Meta AnalysisHemiarthroplasty versus total arthroplasty for displaced femoral neck fractures in the elderly: meta-analysis of randomized clinical trials.
Displaced femoral neck fractures (FNF) are complicated by high mortality rates and continue to represent an important cause of disability, having a negative impact on patient mobility and physical independence. The purpose of this study was to update and analyse current outcomes and evidence concerning hip hemiarthroplasty (HHA) versus total hip arthroplasty (THA) for displaced femoral neck fractures in the elderly. Thus, a meta-analysis of randomized clinical trials was conducted. ⋯ Level I, meta-analysis of randomized clinical trials.
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Although metallosis is a well-known complication after total hip arthroplasty, little is known about this phenomenon after total (TKA) or unicompartmental knee arthroplasty (UKA). The aim of the present work was to review the current knowledge about the reasons and the diagnostic as well as therapeutic management of metallosis after knee arthroplasty. ⋯ Metallosis after knee arthroplasty is a rare and perhaps underestimated or under published complication. A systematic diagnostic approach is necessary for the timely and correct diagnosis. A thorough debridement as well as a (sub)total synovectomy should be always performed. In cases with a damaged component, a partial/complete prosthesis exchange leads to the best results. Should a malalignment be the cause of the metallosis, then it should be corrected within the revision surgery.