Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Apr 2019
Patient-reported quality of life and pain after permissive weight bearing in surgically treated trauma patients with tibial plateau fractures: a retrospective cohort study.
A Dutch survey among orthopedic surgeons and trauma surgeons showed that almost 90% of the surgeons do not follow protocols regarding the weight bearing aftercare for tibial plateau fractures. Clinical studies comparing permissive weight bearing (PWB) versus restricted weight bearing (RWB) after surgically treated tibial plateau fractures are not available. The aim of this study was to inventory potential differences in quality of life and pain, and number of complications in patients with surgically treated tibial plateau fractures who followed a PWB regime, relative to those that followed a RWB regime. ⋯ PWB after surgically treated tibial plateau fractures is safe and is related to a significantly reduced time to full weight bearing with no significant differences in patient-reported quality of life and pain or complication rates.
-
Increased age, obesity, and American Society of Anesthesiologists (ASA) Physical Status class III and IV have been reported as predictors for mortality and perioperative complications. High-volume institutions rely on central referral services as first contact point for patients. The current study reports on a simple four-step questionnaire to identify patients with ASA-physical status class III and IV to improve referral processes and optimize perioperative work ups. ⋯ This study revealed a simple four-step questionnaire to identify patients with ASA III or IV before a medical appointment. This helps to balance referrals between multiple providers in high-volume medical groups.
-
Arch Orthop Trauma Surg · Apr 2019
Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw-rod system: a retrospective study of 23 patients after 13.5 months.
Pelvic ring fractures are challenging injuries and require effective treatment due to the frequently compromised patient condition. The aim of this study was to evaluate the outcome of unstable pelvic ring injuries treated with a minimally invasive pedicle screw-rod system. ⋯ The INFIX appears to be a safe and minimally invasive surgical technique which can effectively be combined with posterior pedicle screw-rod fixation. It also can be applied for the definitive treatment of vertically and/or rotationally unstable pelvic ring injuries, especially in severely compromised patients with a high mortality risk.
-
Arch Orthop Trauma Surg · Apr 2019
Evaluating risk factors following surgery for periprosthetic fractures around hip and knee arthroplasties.
The increasing demand for arthroplasty has resulted in an inevitable rise in the number of periprosthetic fractures around implants. Survival factors looking into patient's comorbidities and how they influence outcome are rare. This study aims to identify correlations between survival post-injury and pre-existing comorbidities. ⋯ Periprosthetic fractures are associated with a high mortality risk (34.7%). Operative risks can be minimised with careful optimisation and surgical planning. ASA, age and comorbidities (dementia, CVA or TIA, osteoporosis) have a significant correlation with survival post-injury. Hence, careful patient selection for operative treatment is advised.
-
Arch Orthop Trauma Surg · Apr 2019
Pathoanatomy of Maisonneuve fracture based on radiologic and CT examination.
Although Maisonneuve fracture (MF) is a well-known type of ankle fracture-dislocation, there is still a lack of information about the epidemiology and the extent of all associated injuries. The aim of study is to describe MF pathoanatomy on the basis of radiographs, CT scans and intraoperative findings. ⋯ MF is a variable injury, always associated with rupture of the anterior and interosseous tibiofibular ligaments. CT examination should be employed widely in MF, and MRI should be considered under special circumstances.