Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2021
Failure analysis of infection persistence after septic revision surgery: a checklist algorithm for risk factors in knee and hip arthroplasty.
Several studies describe risk factors for primary periprosthetic joint infection (PJI) and general treatment outcome factors like microbe spectrum or patient-specific risk factors. However, these general and patient dependent findings cannot solely explain all cases of infection persistence after a prior septic revision. This study analyzes possible specific and patient independent reasons for failure after revisions for PJI in knee and hip arthroplasty. ⋯ In the majority of failed revisions with subsequent infection persistence at least one possible patient independent failure cause could be identified. The entire previous therapy should be critically reviewed following failing revisions to optimize the outcome of septic revisions. By using a checklist algorithm, high rates of infection freedom were achieved.
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Arch Orthop Trauma Surg · Apr 2021
Acromioclavicular joint separation treated with clavicular hook plate: a study of radiological and functional outcomes.
ACJ separation is a common shoulder injury. A variety of surgical techniques for high-grade ACJ separations have been described. A commonly used technique represents open reduction and fixation by a hook plate. Goal of the present study was to evaluate radiographic and functional outcome in patients with high-grade ACJ separations following surgical treatment with a hook plate before and after surgery as well as after hook plate removal. ⋯ In contrast to a significant higher CCD after hook plate removal, nearly all patients achieved good to excellent functional results for DASH and CMS. This indicates that loss of reduction does not necessarily lead to poor functional outcome after ACJ separation surgery.
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Arch Orthop Trauma Surg · Apr 2021
ReviewRadial nerve palsy associated with closed humeral shaft fractures: a systematic review of 1758 patients.
Humeral shaft fractures are often associated with radial nerve palsy (RNP) (8-16%). The primary aim of this systematic review was to assess the incidence of primary and secondary RNP in closed humeral shaft fractures. The secondary aim was to compare the recovery rate of primary RNP and the incidence of secondary RNP between operative and non-operative treatment. ⋯ Level IV; Systematic Review.
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Arch Orthop Trauma Surg · Apr 2021
Outcome of revision surgery for adverse local tissue reactions in patients with recalled total hip arthroplasty.
Recalls of total hip arthroplasty (THA) implants, including metal-on-metal (MoM) THA and dual taper stems, due to increased risk of adverse local tissue reaction (ALTR), represent a challenge for both surgeons and patients. This study aims to analyze the revision surgery outcomes for ALTR in patients with recalled THA implants. ⋯ Level III, case control retrospective analysis.
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Arch Orthop Trauma Surg · Apr 2021
Comparative StudyOutcome of older hip fracture patients on anticoagulation: a comparison of vitamin K-antagonists and Factor Xa inhibitors.
Older hip fracture patients are still challenging in daily clinical practice. Due to the high prevalence of osteoporosis and atrial fibrillation in this age group, the number of fragility fracture patients under oral anticoagulation (OAC) increases. The outcome is still disappointing, short- and long-term mortality and morbidity is high. The impact of pre-existing OAC is not yet clear, especially regarding new OAC drugs like Factor Xa inhibitors (FXa). The purpose of our study was to compare the short-term outcome of older hip fracture patients, without OAC (controls), on Vitamin K antagonists (VKA) and on FXa. ⋯ In our study OAC was significantly associated with worse outcome compared to controls. Marginal differences were observed between patients on FXa or VKA. Further studies involving a higher number of patients are necessary to confirm our results. At that time, some our results have to interpreted carefully and need confirmation.