Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2020
ReviewFracture fixation versus revision arthroplasty in Vancouver type B2 and B3 periprosthetic femoral fractures: a systematic review.
Hip arthroplasty (HA) is commonly performed to treat various hip pathologies. Its volume is expected to rise further due to the increasing age of the population. Complication rates are low; however, periprosthetic femoral fractures (PFF) are a rare, albeit serious, complication with substantial economic impact. While current guidelines propose revision with long-stemmed prostheses for all Vancouver B2 and B3 PFF, some recent research papers suggest that open reduction with internal fixation (ORIF) could lead to an equivalent outcome. Our aim was to summarize the evidence, elucidating under which circumstances ORIF leads to a favorable outcome after B2 and B3 PFF compared with revision surgery. ⋯ The choice of treatment modality for PFF depends on fracture, implant, and bone characteristics. Recent data show that successful outcome can be achieved without revising loose stems. ORIF may be a viable option if bone stock is adequate around uncemented or tapered polished stems with an intact cement mantle and the fracture geometry allows stable anatomic reconstruction. Conceptional considerations support this idea, but more data are needed to identify outcome predictors.
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Arch Orthop Trauma Surg · Oct 2020
Comparative StudyOutcomes of superior capsule reconstruction for massive rotator cuff tears and risk factors for postoperative retear.
Superior capsule reconstruction (SCR) has been used for the tendon grafting of massive rotator cuff tears when primary repair is difficult. We examined the postoperative outcomes of SCR for massive rotator cuff tears and the risk factors for postoperative retear. ⋯ While the postoperative outcomes of SCR are favorable, age, sex and degree of arthropathic change should be considered for surgical indications of SCR.
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Arch Orthop Trauma Surg · Oct 2020
Blood loss in primary total hip arthroplasty with a short versus conventional cementless stem: a retrospective cohort study.
To evaluate the impact of short cementless stem on several clinical and radiographic outcomes, with particular focus on blood loss, in comparison with conventional cementless stem in total hip arthroplasty (THA). ⋯ GTS short stem was not associated with a clinically significant lower blood loss in the immediately postoperative period. Unadjusted exploratory analyses show that GTS stem provides the same results of CLS stem in terms of HHS and rate of stem revision at 5 years of follow-up.
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Arch Orthop Trauma Surg · Oct 2020
Does cement augmentation of the screws in angular stable plating for proximal humerus fractures influence the radiological outcome: a retrospective assessment.
Screw-tip augmentation in angular stable plating offers new possibilities for the treatment of complex proximal humerus fractures. This retrospective analysis was performed to evaluate the radiological outcome of proximal humerus fractures treated with angular stable plates and additional screw-tip cement augmentation in patients over the age of 60. ⋯ Screw-tip augmentation in angular stable plating for proximal humerus fracture treatment showed a low secondary displacement rate of 4.2% in patients suffering from poor bone quality. Nevertheless, the occurrence of avascular necrosis of the humeral head with mainly severe fracture patterns observed in this study was higher compared to previously reported results in the literature. Cement augmentation in head-split fractures is not recommended, considering the high risk of an intraarticular cement leakage.
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Arch Orthop Trauma Surg · Oct 2020
Comparative StudyThe accuracy of external calibration markers in digital templating using the double marker and single marker method: a comparative study.
Digital templating is an essential step in the preoperative planning of total hip arthroplasty (THA). Previous studies have suggested that templating with the double marker method may be more accurate than a single marker method in the general population and in obese patients. The purpose of this study was to compare the accuracy in the preoperative component selection between the King Mark calibration device and the conventional metal ball method. Additionally, we examined whether King Mark offered any advantage over the standard metal ball in the preoperative selection of component sizes for obese patients. ⋯ Our study found no difference between the King Mark method and the conventional metal ball method in the ability to accurately predict component sizes. In the subgroup of obese patients, the King Mark technique offered no advantage for accurately predicting component sizes.