Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2018
Comparative StudyDoes discoid lateral meniscus have inborn peripheral rim instability? Comparison between intact discoid lateral meniscus and normal lateral meniscus.
Little is known about peripheral rim instability (PRI) of adult discoid lateral meniscus (DLM). We compared PRI of the intact DLM (iDLM) to those of intact normal lateral meniscus (LM) in adult patients and also investigated whether there was any association between PRI and DLM tears. ⋯ Level 3, comparative study of anatomical instability of living subjects.
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Arch Orthop Trauma Surg · Dec 2018
Relationships between Hoffa fragment size and surgical approach selection: a cadaveric study.
Fixation of a small Hoffa fragment requires a selection of the proper surgical approach for reduction and posterior to anterior screws fixation. However, currently there are no guidelines regarding how to select the best approach for small posterior Hoffa fractures. ⋯ When the Hoffa fragment is less than 18.3% of the AP diameter of medial condyle or 10.1% of lateral condyle, the fracture is invisible with the PPA. When the Hoffa fragment is more than 28.7% of the medial condyle or 19.9% of the lateral condyle, the PPA should be selected. If the Hoffa fragment is less than 28.7% of the medial condyle or 19.9% of the lateral condyle, the DMA or PLA with posterior-to-anterior screws is recommended. Combined approaches should be considered in some complex cases with articular comminution.
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Arch Orthop Trauma Surg · Dec 2018
Risk of neurological injury in posterior bone block surgery for recurrent glenohumeral instability: a cadaveric study.
Recurrent posterior glenohumeral instability poses a challenge for treatment. Bone block procedures have been advocated in cases where a bony defect is present. However, these techniques are not free of complications due to the proximity of neurovascular structures. The aim of this study is to measure the distance to the axillary and suprascapular nerves at the different steps of the procedure. ⋯ Not applicable (cadaveric study).
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Arch Orthop Trauma Surg · Dec 2018
Prevalence of posttraumatic arthritis following distal radius fractures in non-osteoporotic patients and the association with radiological measurements, clinician and patient-reported outcomes.
Outcomes of non-osteoporotic patients who sustained a distal radius fracture (DRF) have not gained much attention in recent literature. The aims of this study were to determine the prevalence of posttraumatic arthritis (PA), to analyze associations of radiological measurements, clinician-reported and patient-reported outcomes (CROs and PROs) with PA and gain insight into employment changes after DRF in non-osteoporotic patients. ⋯ Non-osteoporotic patients had a considerably high prevalence of PA following DRFs, despite a relatively short follow-up time. Patients with longer radial length more often had PA. Irrespective of AO/OTA fracture type, patients with PA had diminished range of motion, but no altered grip strength measurements. Non-osteoporotic patients following DRFs perceived diminished general functioning and dissatisfaction, which was impacted by the diminished active range of motion. Pain or impaired general health status was not reported. The PRO MHQ might be a valuable evaluation tool in this patient group. Change of occupation following DRFs should receive attention in further research.
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Arch Orthop Trauma Surg · Dec 2018
Cemented conical stems can be removed more easily than cylindrical stems, regardless of cone angle in revision knee arthroplasty.
According to literature, more than 30% of revised knee arthroplasties will require at least one re-revision. Practical experience has shown that there are considerable product-specific differences in the explantability of cemented long-stem prostheses. In the registers of successful implants, stem geometry varies considerably between the manufacturers. However, comparative data on explantability of the respective stems are missing. Objective of the present study was to identify a correlation between the geometry of a smooth cemented long stem and the necessary explantation energy required until failure of the implant-cement interface occurs. ⋯ Whereas smooth conical stems can mostly be removed easily, an early decision in favour of osteotomy or fenestration can be taken in the case of cylindrical cemented stems.