Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Nov 2020
Midshaft clavicle fracture following osteosynthesis with a hook plate: a retrospective case analysis.
The clavicle hook plate has been commonly used to treat distal clavicle fractures and acromioclavicular (AC) joint dislocations; however, midshaft clavicle fracture at the medial end of the hook plate remains an underestimated complication. We aimed to discover the risk factors for this complication and the influence of these risk factors on patients and to suggest preventive surgical techniques. ⋯ The incidence of midshaft clavicle fractures following osteosynthesis with a clavicle hook plate was not negligible, especially in elderly patients. This complication may impair shoulder function and quality of life. Awareness of this complication and the risk factors for this complication reminds us to perform such operations with caution.
-
Arch Orthop Trauma Surg · Nov 2020
Characteristics of medial condyle sagittal fracture of distal femur involving intercondylar notch in geriatric patients.
Unicondylar femoral fractures are uncommon injuries, known to occur primarily in young people, with high energy trauma. However, according to our experiences, unicondylar femoral fractures in geriatric patients generally involved the medial femoral condyle, unlike previously reported. In addition, the fractures of medial femoral condyle (FMFC) showed a characteristic fracture pattern. To date, there has been no published article focusing on the FMFC in geriatric patients. Thus, the aim of this study was to determine the characteristics of FMFC in geriatric patients and to present their outcomes. ⋯ FMFC caused by low-energy trauma in geriatric patients tend to have a characteristic pattern. We believe that anatomic reduction and firm fixation with Tomofix MDF plate and cannulated screw for low-energy trauma FMFC in geriatric patients would yield good outcomes.
-
Arch Orthop Trauma Surg · Nov 2020
Tibial plateau fractures are associated with a long-term increased risk of mortality: a matched cohort study of 7950 patients.
Disregarding proximal femoral fractures, the current literature includes only limited information regarding mortality following lower extremity fractures. Information regarding risk of mortality related to specific fracture patterns is essential when planning treatment modalities. The primary aim of this study was to report the long-term cumulative survival rate in patients with a tibial plateau fracture compared to an age- and gender-matched reference population. ⋯ Patients with a proximal tibial plateau fracture have a higher cumulative risk of death during the mean 13.9-year observational period compared to an age- and gender-matched reference population.
-
Arch Orthop Trauma Surg · Nov 2020
Development of an intraoperative 3D C-arm technique for torsion control of femur fractures: a cadaver study.
This study aims to test the accuracy and feasibility of a measurement of femoral torsion of a 3D C-arm system (Linea aspera method) in a cadaver setting. ⋯ Intraoperative estimation of femoral antetorsion using a 3D C-Arm system and the Linea aspera method seems to be an accurate and feasible method. Nevertheless, more studies with higher patient numbers, comparison to CT seems to be the next step and can be recommended.
-
Arch Orthop Trauma Surg · Nov 2020
Difficult to treat: are there organism-dependent differences and overall risk factors in success rates for two-stage knee revision?
Failure after two-stage procedure for periprosthetic joint infection (PJI) is a rare, but devastating complication. Some authors assume a correlation of underlying organisms and recurrence rate. Methicillin-resistant Staphylococci (MRS) and other organisms (quinolone-resistant Gram-negative bacteria, rifampicin-resistant Staphylococcus, Enterococcus, and Candida) are meant to be "difficult to treat" (DTT) with an inferior outcome for two-stage revision. In addition to the type of bacteria, some more risk factors seem to be present. The aim of this study was (1) to detect a difference of reinfection rates between reinfection-causing groups of bacteria ["difficult to treat" (DTT), "easy to treat" (ETT) and methicillin-resistant staphylococci (MRS)] after a two-stage procedure, and (2) find overall risk factors for reinfection in a standardized long (spacer insertion for at least 6 weeks) two-stage procedure for periprosthetic knee infection. ⋯ Revision needed during or after a two-stage exchange, numbers of surgeries and alcohol abuse are risk factors for recurrence, a different recurrence rates between organism-groups cannot be shown. The absence of significant differences in recurrence rates points to the importance of the individuality of each periprosthetic infection case: a reduction of necessary surgeries (with a thorough debridement, appropriate antibiotic addition to spacers) and the control of comorbidities (alcohol abuse) appear to be essential components of a two-stage exchange.