Orthop Traumatol Sur
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Orthop Traumatol Sur · Sep 2019
Observational StudyNon-operative treatment is a reliable option in over two thirds of patients with Garden I hip fractures. Rates and risk factors for failure in 298 patients.
Non-operative treatment for impacted femoral neck fractures is a now rarely used strategy whose indications are controversial. No outcome predictors have been convincingly identified, in part due to the small sizes of available studies. We conducted a large retrospective study with the following objectives: (1) to evaluate the percentage of patients older than 65 years of age with non-operatively treated Garden I femoral neck fractures who experience secondary displacement, (2) to identify predictors of secondary displacement, and (3) to determine the frequency of non-operative treatment failure due to any cause and requiring joint replacement surgery. ⋯ IV, retrospective cohort study.
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Orthop Traumatol Sur · Sep 2019
Complications after surgical treatment of distal clavicle fractures.
Distal clavicle fractures have low rates of union when treated with conservative measures. Operative treatment is generally recommended for Neer type II and V. Multiple fixation methods exist with no clear gold standard. The goal of the current study is to assess the outcomes and complications of distal clavicle fractures treated with one of three fixation methods: standard clavicular plate, hook plate or suture fixation about the coracoid. ⋯ This study compared the outcomes of three different fixation methods for unstable distal clavicle fractures. The overall union rate with any method of operative intervention was very high (98.6%), consistent with previous studies. Hook plates had a much higher re-operation rate, mostly owing to a higher incidence of hardware removal, an expected outcome owing to the prominence of these plates in the subacromial space. Contoured clavicular plates were associated with a lower incidence of irritation and hardware removal than hook plates, although one patient in this group experienced loss of fracture fixation and went on to asymptomatic radiographic non-union. Suture-only fixation methods had the lowest rate of re-operation, with only one of 21 procedures resulting in failure and requiring revision. However, there was a significantly higher rate of adhesive capsulitis in the suture fixation cohort, perhaps due to the tethering effect of the clavicle to the coracoid or violation of the rotator interval. While this study supports that most distal clavicle fracture fixation methods can achieve stable union, there is a highly variable complication profile associated with each fixation method. The routine use of hook plate fixation cannot be recommended.
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Orthop Traumatol Sur · Sep 2019
Surgical treatment of mid-shaft clavicle fractures by minimally invasive internal fixation facilitated by intra-operative external fixation: A preliminary study.
Mid-shaft clavicle fractures are common and may require surgery. The objective of this study in adults with high-risk mid-shaft clavicle fractures was to evaluate the clinical and radiological outcomes of a minimally invasive surgical technique involving a minimally invasive approach, fracture reduction, temporary intra-operative external fixation, and locking plate internal fixation. ⋯ IV, retrospective observational study.
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Orthop Traumatol Sur · Jun 2019
Observational StudyEffectiveness of closed reduction and percutaneous fixation of isolated sacral fractures. Functional outcomes and sagittal alignment after 3.6 years in 20 patients.
Displaced U- or H-shaped sacral fractures (Roy-Camille Grade II or III) are treated at our institution by early transcondylar traction and manual countertraction, hyperlordosis induced by a pad positioned under the lumbo-sacral junction, and percutaneous ilio-sacral screw fixation. The objective of this study was to evaluate the outcome of this technique used in a level 1 trauma centre. Hypothesis Our early reduction technique provides anatomical reduction of U- or H-shaped sacral fractures by correcting the sagittal malalignment due to the intra-sacral kyphosis, thereby obviating the need for decompression laminectomy and improving neurological outcomes. ⋯ IV, retrospective observational study.
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Orthop Traumatol Sur · Jun 2019
Outcome of surgical treatment of inter prosthetic fractures: A case series.
Interprosthetic fractures occur between a total knee replacement and a femoral stem of either a hemiarthroplasty or total hip replacement. The number of interprosthetic fractures will increase as the number of joint replacements rises. There is currently a paucity of literature looking at the outcomes of interprosthetic fractures. Therefore, we performed a retrospective study to: (1) determine fracture union in patients following surgical treatment of a femoral interprosthetic fracture, (2) measure outcomes included mortality and complications. ⋯ IV, retrospective case series.