Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2015
Randomized Controlled TrialSingle dose intravenous tranexamic acid as effective as continuous infusion in primary total knee arthroplasty: a randomised clinical trial.
A randomised, double-blind clinical trial was conducted comparing the efficacy of tranexamic acid (TXA) as a single intravenous bolus or a continuous infusion to patients undergoing total knee arthroplasty (TKA). Study hypothesis was that a second dose of TXA would not offer any clinical benefits over the single infusion. ⋯ The study demonstrated that a single bolus of tranexamic acid 30 mg/kg is as effective as a continuous infusion in patients undergoing tranexamic acid. The single application of tranexamic acid as part of routine care is recommended.
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Arch Orthop Trauma Surg · Apr 2015
Multicenter StudySurvey on the management of acute first-time anterior shoulder dislocation amongst Dutch public hospitals.
The primary aim of this study was to record how orthopaedic surgeons are currently managing acute first-time anterior shoulder dislocation (AFASD) 8 years after introduction of the Dutch national guideline: "acute primary shoulder dislocation, diagnostics and treatment" in 2005. The second aim was to evaluate how these surgeons treat recurrent instability after AFASD. ⋯ Despite the introduction of the national guideline for the initial management of AFASD in 2005, still great variety among orthopaedic surgeons in the Netherlands was present. As for the surgical stabilization technique, the vast majority of the respondents are performing an arthroscopic shoulder stabilization procedure at the expense of the more traditional open procedure as a first treatment option for post-traumatic shoulder instability.
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Arch Orthop Trauma Surg · Apr 2015
Anatomy and classification of the posterior tibial fragment in ankle fractures.
The aim of this study was to analyze the pathoanatomy of the posterior fragment on the basis of a comprehensive CT examination, including 3D reconstructions, in a large patient cohort. ⋯ It is impossible to assess the shape and size of the posterior malleolar fragment, involvement of the fibular notch, or the medial malleolus, on the basis of plain radiographs. The system that we propose for classification of fractures of the posterior malleolus is based on CT examination and takes into account the size, shape and location of the fragment, stability of the tibio-talar joint and the integrity of the fibular notch. It may be a useful indication for surgery and defining the most useful approach to these injuries.
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Arch Orthop Trauma Surg · Apr 2015
Can we use intraoperative femoral tunnel length measurement as a clue for proper femoral tunnel placement on coronal plane during ACL reconstruction?
Successful anterior cruciate ligament (ACL) reconstruction is dependent on correct placement of both tibial and femoral tunnels. The purpose of this study is to investigate whether we can use intraoperative femoral tunnel length measurement to estimate the correct femoral tunnel placement on coronal plane. ⋯ Femoral tunnel length can be used as a clue for intraoperative evaluation of the femoral tunnel position. If the femoral tunnel length is greater than 41 mm, the coronal plane orientation of the femoral tunnel will be improper and not at a desired position.
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Arch Orthop Trauma Surg · Apr 2015
Can larger-bodied cemented femoral components reduce periprosthetic fractures? A biomechanical study.
The risk for late periprosthetic femoral fractures is higher in patients treated for a neck of femur fracture compared to osteoarthritis. It has been hypothesised that osteopaenia and consequent decreased stiffness of the proximal femur are responsible for this. We investigated whether a femoral component with a bigger body would increase the torque to failure in a biaxially loaded composite Sawbone model. ⋯ The use of large body polished tapered cemented stems for neck of femur fractures increases the torque to failure in a biomechanical model and therefore is likely to reduce late periprosthetic fracture risk in this vulnerable cohort.