Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2020
Analysis of computed tomography-based infra-acetabular morphometry to assess the feasibility of infra-acetabular screws.
The number of pelvic fractures based on osteoporosis has been increasing. The infra-acetabular screw (IAS), which connected both osseous columns, is a safe method of screw placement going through the infra-acetabular corridor (IAC). However, the specifics of the anatomy of IAC have been far from completely understood, especially in the Asian population. The purpose of our study was to reveal the details of the IAC using computed tomography (CT) data. ⋯ Surgeons should pay attention to the fact that over 20% of IACs are not feasible for infra-acetabular screw placement even with the perfect reduction of fragments when treating acetabular fractures.
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Arch Orthop Trauma Surg · Mar 2020
Intramedullary nailing of abnormally bowed atypical femoral shaft fractures: surgical technique.
The treatment of atypical femoral shaft fractures with abnormal bowing provides a unique challenge for surgeons. Whilst intramedullary fixation of atypical femoral shaft fractures affords both mechanical and biological benefits, the mismatch between standard intramedullary devices and the abnormal femoral bowing in these patients makes this method of fixation challenging for the surgeon. ⋯ The critical factors we identified include lateral positioning of the patient for reduction, the use of a piriformis-start nail, and an entry point that was anterior in the sagittal profile and lateral in the coronal profile. This technique was easily replicable, facilitated more anatomical reduction and aided in avoiding complications.
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Arch Orthop Trauma Surg · Mar 2020
Observational StudyLow acceptance of osteoanabolic therapy with parathyroid hormone in patients with fragility fracture of the pelvis in routine clinical practice: a retrospective observational cohort study.
A recent randomized controlled trial has reported full patient compliance and no adverse events from therapy with parathyroid hormone (PTH) for osteoporosis and accelerated healing of fragility fractures of the pelvis. The purpose of the presented study was to evaluate if similar results can be achieved with comprehensive PTH therapy in routine clinical practice. We hypothesised that patients' burden of PTH therapy is underestimated in the literature. ⋯ The experiences with PTH therapy in FFP patients with respect to, implementation rate, frequency of side effects and of pathological findings in laboratory controls as reported from a previous RCT could not be reproduced in routine clinical practice.