Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2021
Severity of valgus knee osteoarthritis has no effect on clinical outcomes after total knee arthroplasty.
Advanced valgus osteoarthritis (OA) is one of the most challenging indications for total knee arthroplasty (TKA). There is no information in the literature about the optimal timing of surgery. The current study investigates the impact of the preoperative deformity and degree of arthritis on postoperative outcome after TKA. ⋯ The degree of valgus deformity and the grade of osteoarthritis do not predict the outcome of TKA in patients with valgus OA. Since the risk of complication and the need for implant constraint increases with increasing deformity and instability of the knee, surgery appears to be justified in patients with advanced OA that failed nonoperative treatment, regardless of the degree of deformity.
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Arch Orthop Trauma Surg · Aug 2021
Results following prolonged recovery show satisfactory functional and patient-reported outcome after intramedullary nailing of a tibial shaft fracture: a prospective 5-year follow-up cohort study.
Although a large number of previous studies have investigated the outcome in patients following tibial shaft fractures, the literature provides limited information on prospectively reported patients with mid- to long-term follow-up. The present study aimed to investigate prospectively the 5-year development in patient-reported quality of life after intramedullary nailing of a tibial shaft fracture. ⋯ Patient-reported quality of life among patients treated with intramedullary nailing following a tibial shaft fracture increased significantly between the 1-year and 5-year follow-up. In contrast to the 1-year patient-reported quality of life, results are comparable to those of a reference population at the 5-year follow-up. In a clinical setting, these results highlight that patients may expect a prolonged period to recover. However, of most importance is that patients can expect a satisfactory outcome years after fracture and treatment.
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Arch Orthop Trauma Surg · Aug 2021
Case ReportsThumb metacarpophalangeal joint palmar plate chronic avulsion in children: diagnosis and treatment.
Thumb metacarpophalangeal joint instability can have a considerable functional impairment. Acute injuries are usually overlooked in children due to the high pain threshold and the presence of ligamentous laxity. Chronicity of the injury results in failure of conservative treatment. Literature is poor in defining such injuries. The purpose of our study is to determine the clinical and radiological tools for the diagnosis of metacarpophalangeal joint instability and we propose a simple surgical technique for their management. ⋯ Chronic post-traumatic thumb metacarpophalangeal joint instability results in functional impairment. Clinical suspicion and sonographic assessment can verify the diagnosis. Surgical repair with transosseous sutures or anchors yields satisfactory results in the paediatric age group with the preservation of normal range of motion.
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Arch Orthop Trauma Surg · Aug 2021
Can a simple iPad app improve C-arm based component position in anterior THA?
Correct acetabular component positioning improves hip biomechanics, impingement free range of motion and may lead to a reduced risk of postoperative dislocation. The C-arm is a simple and cost-effective tool for THA in a supine position, however, evaluation of the images can be challenging due to parallax. The current study aimed to investigate whether a software app-based measurement technique can control acetabular component position and leg length in anterior THA. ⋯ The software app used in the current study allowed for a simple and accurate measurement of intraoperative cup position and leg length in direct anterior THA.
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Arch Orthop Trauma Surg · Aug 2021
Minimally invasive lumbopelvic stabilization of sacral fragility fractures in immobilized geriatric patients: feasibility and early return to mobility.
In an aging society, the incidence of sacral fragility fractures is increasing and diagnosis is often delayed. Immobilization has devastating consequences especially in elderly patients. Short-term mobilization of these patients is crucial. The aim of this study is to evaluate the early return to mobility of immobilized geriatric patients with sacral fragility fractures treated with minimally invasive lumbopelvic stabilization. ⋯ Minimally invasive lumbopelvic stabilization of sacral fragility fractures is feasible in geriatric patients. Early mobilization of these patients is possible after surgery. The rate of complications is acceptable.