Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2017
Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty.
Fractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required. ⋯ The presented cage provides the possibility of early mobilization with full weight bearing which represents a valuable addition to the treatment spectrum in this challenging patient group.
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Arch Orthop Trauma Surg · Apr 2017
Rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: a mean follow-up of 20 years.
Rotational acetabular osteotomy (RAO), a joint-conserving surgery in which the femoral head coverage by autologous cartilage is improved to achieve joint stability, is one of the most common joint-conserving surgeries for acetabular dysplasia of the hip in adult patients. Favorable outcome of RAO for pre- and initial coxarthrosis has been reported with middle- to long-term observation; however, surgery should be selected for advanced coxarthrosis. The objective of this study was to investigate the long-term clinical outcomes and radiological arthritis changes in patients who were treated with RAO and could be followed for 15 years or longer, and to investigate the joint conservation rate by preoperative arthritis stage. ⋯ The outcome of rotational acetabular osteotomy in most hips with pre- or initial coxarthrosis was satisfactory. Rotational acetabular osteotomy is an effective surgery for treating symptomatic developmental dysplasia of the hip in selected patients.
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Arch Orthop Trauma Surg · Apr 2017
Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment.
This study aimed to evaluate the incidence of complications in elderly patients with a hip fracture following integrated orthogeriatric treatment. To discover factors that might be adjusted, in order to improve outcome in those patients, we examined the association between baseline patient characteristics and a complicated course. ⋯ After integrated orthogeriatric treatment, a complicated course was seen in 49.6% of the patients with a hip fracture. The in-hospital mortality rate was 3.8%. Important risk factors for a complicated course were increasing age, poor medical condition and delirium risk VMS Frailty score. Awareness of risk factors that affect the course during admission can be useful in optimizing care and outcomes. In the search for possible areas for improvement in care, targeted preventive measures to mitigate delirium, and healthcare-associated infections (HAIs), such as CAUTIs and pneumonia are important.
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Arch Orthop Trauma Surg · Apr 2017
Validity of computed tomography in predicting scaphoid screw prominence: a cadaveric study.
Studies of hardware protrusion into joint spaces following fracture fixation have been performed to address whether or not there is discrepancy between the actual and radiographic appearance of screw prominence. The purpose of our study was to prove that, with respect to the scaphoid, prominence as visualized on CT scan is real and not a result of metal artifact. ⋯ CT provides an accurate assessment of scaphoid screw head prominence. When a screw appears prominent on CT scan, it is likely to be truly prominent without contribution from metallic artifact.
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Arch Orthop Trauma Surg · Apr 2017
Ultra-short stem anchorage in the proximal tibial epiphysis after intercalary tumor resections: analysis of reconstruction survival in four patients at a mean follow-up of 56 months.
Tumors localized in the proximal tibial meta-diaphysis often lead to osteoarticular resections. ⋯ Therefore, we report this reconstruction technique to be considered for special indications where the functional outcome can be improved by preservation of the knee joint in tumors of the proximal meta-diaphyseal tibial region.