Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2019
Prevalence and quantification of contamination of knitted cotton outer gloves during hip and knee arthroplasty surgery.
Knitted cotton outer gloves offer protection against surgical glove perforation and provide improved grip on instruments. These gloves absorb blood and other fluids during surgery, and may therefore also accumulate contaminating bacteria. To date, there is no published data on microbial contamination of such gloves during surgery. ⋯ While contamination of surgical latex gloves is a well-known issue, no study has examined so far contamination of knitted cotton outer gloves. No or very low microbial contamination could be identified in the majority of the knitted cotton outer gloves assayed. However, a relevant proportion showed contamination far higher than estimated minimal thresholds for implant-associated infection. Clinical relevance of these findings remains to be established.
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Arch Orthop Trauma Surg · Apr 2019
Patient-reported quality of life and pain after permissive weight bearing in surgically treated trauma patients with tibial plateau fractures: a retrospective cohort study.
A Dutch survey among orthopedic surgeons and trauma surgeons showed that almost 90% of the surgeons do not follow protocols regarding the weight bearing aftercare for tibial plateau fractures. Clinical studies comparing permissive weight bearing (PWB) versus restricted weight bearing (RWB) after surgically treated tibial plateau fractures are not available. The aim of this study was to inventory potential differences in quality of life and pain, and number of complications in patients with surgically treated tibial plateau fractures who followed a PWB regime, relative to those that followed a RWB regime. ⋯ PWB after surgically treated tibial plateau fractures is safe and is related to a significantly reduced time to full weight bearing with no significant differences in patient-reported quality of life and pain or complication rates.
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Arch Orthop Trauma Surg · Apr 2019
Biomechanical comparison of the proximal interphalangeal joint arthrodesis using a compression wire.
Arthrodesis of the proximal interphalangeal joint of the finger is a common procedure for the treatment of osteoarthritis. The aim of this biomechanical study was to compare the primary stability of one, respectively, two compression wires to intraosseous wiring and tension band wiring for the arthrodesis. ⋯ The primary stability of the compression wires was statistically significant superior to intraosseous wiring. In comparison to tension band wiring which showed an intermediate stability. The application of a compression wire could be considered for further clinical testing in the arthrodesis of interphalangeal joints.
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Arch Orthop Trauma Surg · Apr 2019
Evaluation of the permissible maximum angle of the tibial tunnel in transtibial anatomic posterior cruciate ligament reconstruction by computed tomography.
Excessive angle of the tibial tunnel may cause breakage of the posterior cortex in transtibial anatomic posterior cruciate ligament (PCL) reconstruction. However, a few studies have determined the permissible maximum angle of the tibial tunnel. The purpose of this study was to determine the permissible maximum angle of the tibial tunnel relative to the tibial plateau in transtibial anatomic PCL reconstruction and characterize the anatomic parameters of the tibial PCL attachment position. ⋯ There should be a limit to the angle of the tibial tunnel in transtibial anatomic PCL reconstruction to prevent the fracture of posterior tunnel wall. The permissible maximum angle (PMA) of the 10 mm-diameter tibial tunnel relative to the tibial plateau was 48.2°. Besides, the determination of the value of OTD, APD, PPED, and PSA could provide a clinical reference to insertion site, depth, and angle of the tibial drill guide in PCL reconstruction.
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Arch Orthop Trauma Surg · Apr 2019
Minimally invasive internal fixator for unstable pelvic ring injuries with a pedicle screw-rod system: a retrospective study of 23 patients after 13.5 months.
Pelvic ring fractures are challenging injuries and require effective treatment due to the frequently compromised patient condition. The aim of this study was to evaluate the outcome of unstable pelvic ring injuries treated with a minimally invasive pedicle screw-rod system. ⋯ The INFIX appears to be a safe and minimally invasive surgical technique which can effectively be combined with posterior pedicle screw-rod fixation. It also can be applied for the definitive treatment of vertically and/or rotationally unstable pelvic ring injuries, especially in severely compromised patients with a high mortality risk.