Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2021
Surgical debridement of infected pubic symphysitis supports optimal outcome.
Infected pubic symphysitis (IPS) is a rare bacterial infection of the pubic symphysis that causes subpubic pain, disability and ultimately permanent immobility. Due to difficult diagnosis, patients present with long-standing complaints and consult several doctors. To date, no validated treatment protocol exists and most patients are treated conservatively with antibiotics. This study was aimed to assess the results after careful surgical debridement and pathogen-specific antibiotic treatment in IPS. ⋯ Surgical debridement is the keystone for treatment of IPS and should be combined with local and systemic antibiotic therapy.
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Arch Orthop Trauma Surg · Nov 2021
Revision osteosynthesis after primary treatment of atypical ulnar fractures associated with bisphosphonate usage - Nonunion after ordinary open reduction and internal fixation.
We performed revision surgeries to treat nonunion of bisphosphonate-associated ulnar fractures that had originally been treated, after misdiagnosis, using the typical open reduction/internal fixation (ORIF). ⋯ Therapeutic level IV.
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Arch Orthop Trauma Surg · Nov 2021
Comparative analysis of pathogen structure in patients with PJI after primary total hip and knee arthroplasty.
Microbiological profile of pathogens causing periprosthetic joint infection (PJI) after primary total hip (THA) and knee (TKA) arthroplasty varies in different regions, clinics and even departments. The objective of this study was to analyze the pathogen structure in patients with PJI after primary THA and TKA and its influence on the effectiveness of the infection eradication after two-stage reimplantation. ⋯ Comparative analysis showed significant differences in the structure of PJI pathogens in the hip and knee. These findings are useful when choosing treatment strategies and empirical antibiotics regimens, in the management of patients with PJIs after primary hip and knee arthroplasty.
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Arch Orthop Trauma Surg · Nov 2021
Meta AnalysisWound closure position in total knee arthroplasty: flexion versus extension-a meta-analysis of randomized controlled trials.
Total knee arthroplasty (TKA) is one of the most commonly used procedures in orthopedics. However, whether different would closure positions affect the clinical outcomes after TKA remains controversial. We conducted a meta-analysis of randomized controlled trials (RCT) to assess the effect of wound closure position on clinical TKA outcomes. ⋯ Level II.
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Arch Orthop Trauma Surg · Nov 2021
ReviewTreatment for tuberculosis of the subaxial cervical spine: a systematic review.
To systematically review the clinical manifestations and treatment outcomes of patients with subaxial cervical spinal tuberculosis (SCS-TB) and evaluate the current evidence for surgical or nonsurgical treatment. ⋯ Anti-TB therapy is necessary for all SCS-TB patients, including those underwent surgical management. For patients with neurological dysfunction, the surgical method with decompression and instrumentation could provide better cervical spinal alignment and stability. For adult, the radical debridement remains in debate, while for children, radical debridement may cause the development of progressive kyphosis during growth. Larger randomized comparative studies with longer follow-up times are needed.