Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Feb 2021
Trochanteric fixation nail advanced with helical blade and cement augmentation: early experience with a retrospective cohort.
Intra-articular screw cut-out is a potential complication of intertrochanteric femur fracture fixation with a cephalomedullary nail. Cement augmentation of fixation in the proximal segment offers the prospect of increased stability and fewer complications, but clinical experience with non-resorbable cement is limited. ⋯ In the patients treated with cement augmentation, at minimum 3-month follow-up, there were no instances of intra-articular cut-out, and no increase in re-operation compared to conventional fixation. Cement augmentation appears to be safe and effective in geriatric intertrochanteric femur fractures to mitigate risk of cut-out.
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Eur J Orthop Surg Tr · Feb 2021
Dislocation rate and its risk factors in total hip arthroplasty with concurrent extensive spinal corrective fusion with pelvic fixation for adult spinal deformity.
Though there are several reports on the high dislocation rates following total hip arthroplasty (THA) before or after spinal surgery, the literature specific to extensive spinal corrective fusion with pelvic fixation for adult spinal deformity is limited. This study determined the rate and risk of hip dislocation after THA and extensive spinal corrective fusion. ⋯ Total hip arthroplasty concurrent with extensive spinal corrective fusion with pelvic fixation for adult spinal deformity has an extremely high rate of posterior hip dislocation. The posterior surgical approach and prior THA were high risk factors for dislocation. Hip and spine surgeons need focused pre-surgical planning to account for this risk.
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Eur J Orthop Surg Tr · Jan 2021
A strategy to prevent complications of hyperextension type tibial plateau fracture.
Tibial plateau fractures (TPFs) are the most common among periarticular fractures. Mechanism of injuries is most from varus/valgus and flexion injury. Hyperextension type injuries are rare and easily to be overlooked. We reported 12 cases of this fracture type. Complications of early cases were reported, and treatment strategies of late cases were suggested. ⋯ Hyperextension bicondylar tibial plateau fractures show a special characteristic of changes in posterior tibial slope angle and are easy to be overlooked. Complication rate is high after injury and after ineffective fixation. Choosing correct approach with sufficient grafting and stable fixation for treatment of hyperextension bicondylar tibial plateau fractures should be used to improve patients' outcome.
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Eur J Orthop Surg Tr · Jan 2021
Is percutaneous screw fixation really superior to non-operative management after valgus-impacted femoral neck fracture: a retrospective cohort study.
The optimal management of valgus-impacted femoral neck fractures remains controversial. Internal fixation is associated with significant rates of re-operation, while historical non-operative management strategies consisting of prolonged bed rest also resulted in patient morbidity. Our hypothesis was that screw fixation would have comparable failure rates to non-operative treatment and immediate mobilization for valgus-impacted femoral neck fractures. ⋯ After controlling for weight-bearing restrictions, we found no difference in failure rates between non-operative treatment and screw fixation. Non-operative treatment with partial weight-bearing had low failure rates, comparable complication and mortality rates, and equivalent functional outcomes to operative treatment and is reasonable if a patient would like to avoid surgery and accepts the risk of subsequent arthroplasty. Overall, there were relatively high failure rates in all groups.
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Eur J Orthop Surg Tr · Jan 2021
The impact of the COVID-19 pandemic on orthopaedic services and training in the UK.
The novel coronavirus disease 2019 (COVID-19) was declared a pandemic by the World Health Organisation on 11 March 2020. The aim of this study is to assess the impact of COVID-19 on orthopaedic practice and training in the UK. ⋯ This is the first nationwide survey assessing the impact of the coronavirus disease 2019 on UK orthopaedic practice and training, during the peak of the pandemic. It highlights the scale of the challenge ahead for the specialty, including during the recovery phase and post-recovery phase of the pandemic.