Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2021
Risk adapted diagnostics and hospitalization following mild traumatic brain injury.
Traumatic brain injury (TBI) remains a leading cause of hospital admission and mortality, intracranial hemorrhage (ICH) presents a severe complication. Low complication tolerance in developed countries and risk uncertainty, often cause excessive observation, diagnostics and hospitalization, considered unnecessary and expensive. Risk factors predicting ICH, progression and death in patients hospitalized with mild TBI have not been identified yet. ⋯ Age, skull fracture and chronic alcohol abuse require vigilant observation. Repeated CT in initially ICH negative cases should only be considered in newly identified high-risk patients. Non-ICH cases aged < 65 years do not gain safety from observation or hospitalization. Recommendations from our data might, without impact on patient safety, reduce costs by unnecessary hospitalization and diagnostics.
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Arch Orthop Trauma Surg · Apr 2021
A single K-wire to prevent poor outcomes in closed soft-tissue mallet finger management due to patient non-compliance.
Soft-tissue mallet finger occurs due to loss of terminal extensor tendon secondary to rupture of distal phalanx. Although using noninvasive splints for 6-8 weeks is the gold standard for conservative treatment of closed soft-tissue mallet injuries, patient compliance is an important factor impacting on patient outcomes. In this study, we used a single Kirschner Wire (K-W) to fix the distal interphalangeal (DIP) joint in extension in those patients failed to comply with routine splinting. ⋯ Internal fixation via K-W may be a suitable treatment option compared to splint therapy for management of closed soft-tissue mallet finger in noncompliant patients. Using this treatment approach, the success rate for patients could satisfactorily be improved.
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Arch Orthop Trauma Surg · Apr 2021
Pathological fractures of the femur after radiation therapy for soft tissue tumor: a case series of seven patients treated with repeated internal fixation.
Pathological femoral fracture (PFF) after radiation therapy (RT) for soft tissue tumor is a debilitating complication with a high rate of nonunion that requires multiple subsequent procedures and hindrance of functional activity. We aimed to evaluate healing rate after repeated internal fixation in a case series of PFF after RT. ⋯ Our results suggest that bones within the RT field retain healing capacities, and that repeated internal fixation may be a viable option for the treatment of PFF after RT.
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Arch Orthop Trauma Surg · Apr 2021
Is limited shoulder abduction associated with poor scapulothoracic mobility after reverse shoulder arthroplasty?
The contribution of the glenohumeral joint to shoulder abduction is acknowledged as an important factor for reverse total shoulder arthroplasty (RTSA) patients. In contrast, the degree of scapulothoracic joint contribution and its relation to RTSA patients with poor to excellent shoulder abduction are unclear. ⋯ Limited shoulder abduction is not associated with insufficient scapulothoracic mobility, which rather provides a basic level of function for RTSA patients. Good to excellent shoulder abduction could only be achieved by increasing the glenohumeral contribution that was associated with postoperative abduction strength.
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Arch Orthop Trauma Surg · Apr 2021
Injury epidemiology in men's professional team sports: is media analysis helpful?
Epidemiological injury surveillance in professional sports is often based on online media analysis in order to collect necessary data. However, the validation of this study protocol is lacking. Therefore, this study aimed to identify the validity of injury surveillance in men's professional team sports based on media reports. ⋯ For severe injuries, media analysis may be a sufficient method for data collection in popular men's professional ball sports. An underestimation of true injury prevalence lies within the range of previous reported investigations concerning the validation of injury surveillance methods. Non-severe injuries could not be verified via media analysis in professional handball and basketball.