Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · May 2018
Clinical outcomes and survival rate of cementless modular distal fixation femoral stem for revision hip arthroplasty: A minimum 6-year follow-up.
Revision hip arthroplasty is a very challenging procedure. Use of a modular distal fixation stem is one of the available options for revision arthroplasty in patients with proximal femoral bone deficiency. The purpose of this study was to evaluate mid- to long-term outcomes of cementless modular distal fixation femoral stem implantation in revision hip surgery. ⋯ Revision hip arthroplasty using a cementless modular distal fixation femoral stem showed satisfactory initial firm fixation and mid- to long-term survival rate. Complications can be minimized by careful surgical planning and meticulous procedure.
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J Orthop Surg (Hong Kong) · May 2018
The distribution of bone mineral density in the femoral heads of unstable intertrochanteric fractures.
Intertrochanteric fractures are usually treated with open reduction and internal fixation, but controversy still remains regarding the proper placement of the lag screw on the anteroposterior view. The stability of the lag screw has been shown to correlate with the bone quality around the screw, but the three-dimensional distribution of the bone mineral density (BMD) in the femoral head has not been studied in detail. Herein, the BMD along the femoral neck axis was measured to clarify the recommended position of the lag screw. ⋯ The BMD was higher in the center region of the femoral head than in the inferior region. Therefore, lag screws are recommended to be inserted into the center of the femoral head.
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J Orthop Surg (Hong Kong) · May 2018
Beyond comanaged inpatient care to community integration: Factors leading to surgical delay in hip fractures and their associated outcomes.
Early surgery for older adults with hip fracture has been shown to improve outcomes. We aim to study the factors contributing to delay in surgery (defined as surgery performed more than 48 h after admission) and its associated outcomes in a tertiary hospital in Singapore with an integrated hip fracture program. ⋯ Delayed hip fracture surgery in older adults is associated with worse short- and long-term outcomes, including early postoperative complications and poorer functional recovery.
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J Orthop Surg (Hong Kong) · May 2018
The Rockwood classification in acute acromioclavicular joint injury does not correlate with symptoms.
Rockwood classified acromioclavicular (AC) joint injuries by displacement of the joint on radiographs. This classification has driven the management dogma of acute AC dislocation. The correlation between Rockwood grade and symptoms has not been described in acute injury. This study assesses that relationship. ⋯ The Rockwood grade does not correlate with clinical symptoms in acute AC joint injury. Previous evidence demonstrates the Rockwood classification's limitations in predicting the structures injured. Therefore, the reliability of using the Rockwood grade as a decision-making tool in the management of acute AC joint dislocation is unclear.