Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2019
Persistent postoperative step-off of the posterior malleolus leads to higher incidence of post-traumatic osteoarthritis in trimalleolar fractures.
Traditionally, size of the posterior fragment is considered the most important indicator for fixation in trimalleolar fractures. It remains unclear which factors contribute to worse functional and radiological outcome. This study was designed to determine predictors for the development of posttraumatic osteoarthritis and worse functional outcome in trimalleolar fractures. ⋯ Level IIB.
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Arch Orthop Trauma Surg · Mar 2019
Which lateral clavicle fractures can be treated by an arthroscopic-assisted endobutton procedure? An analysis of risk factors.
Arthroscopy-assisted treatment of lateral clavicle fractures with coracoclavicular stabilization and an endobutton device have gained popularity over recent years. There is little evidence to support which types of lateral clavicle fractures are suitable for this treatment. The primary aim of this study was to evaluate the clinical und radiological outcomes of this treatment and to identify which fracture types are suitable. The secondary outcome was to evaluate potential risk factors for complications MATERIAL/METHODS: A retrospective single center review of 20 unstable lateral clavicle fractures treated with an arthroscopy-assisted CC stabilization technique and Endobutton device between September 2012 and August 2016. The functional outcome was evaluated using Constant and DASH Scores, VAS and SSV. ⋯ Our study shows that arthroscopy-assisted CC stabilization using an endobutton technique delivers good functional results. Highly lateral unstable clavicle fractures seem to be especially suitable for this surgical technique. There was a high number of delayed unions. Analysis of risk factors showed that early mechanical stress, a lateral clavicular fragment larger than 3 cm and a time delay to surgery could be risk factors for nonunions.
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Arch Orthop Trauma Surg · Mar 2019
Outcome of short versus long interval in two-stage exchange for periprosthetic joint infection: a prospective cohort study.
A two-stage exchange is the standard treatment approach for chronic periprosthetic joint infection (PJI). While a 6-8 week interval is commonly used before reimplantation, the optimal length of the prosthesis-free interval has not yet been determined. We evaluated the influence of a short (< 4 weeks) and long (≥ 4 weeks) interval on reinfection rate and functional outcome of hip and knee PJI. ⋯ This study suggests that two-stage exchange with short interval has a similar outcome than with long interval, when highly active antibiotic therapy is used. Patient inconvenience and care costs due to immobilization were lower when strategies with a short interval were used.
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Arch Orthop Trauma Surg · Mar 2019
Arthroscopic excision of wrist ganglions: does trans-cystic or cystic-sparing portal technique affect clinical outcomes?
The preliminary results of arthroscopic wrist ganglionectomy were contradictory. The approach used for the arthroscopic excision of wrist ganglions may play an important role. We analyzed two surgical approaches for arthroscopic excision of wrist ganglions. ⋯ For performing arthroscopic resection of wrist ganglions, both techniques are safe regarding the complication rates. In recurrence rate, no significant difference was found between the two groups, but no recurrence was observed when the TCP technique was used.
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Arch Orthop Trauma Surg · Mar 2019
Meta AnalysisDoes unicompartmental knee arthroplasty have worse outcomes in spontaneous osteonecrosis of the knee than in medial compartment osteoarthritis? A systematic review and meta-analysis.
The role of unicompartmental knee arthroplasty (UKA) in spontaneous osteonecrosis of the knee (SONK) remains controversial, even though SONK involves only one compartment of the knee joint. We aimed to compare the survival rate and clinical outcomes of UKA in SONK and medial compartment osteoarthritis (MOA) via a meta-analysis of previous studies. ⋯ Cemented UKA has similar survival and clinical outcomes in SONK and MOA. Prospective studies designed specifically to compare the UKA outcomes in SONK and MOA are necessary.