Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2022
Retrospective comparison of conservative treatment and surgery for widely displaced olecranon fractures in low-demanding geriatric patients.
The aim of this study was to evaluate the difference of the clinical outcome of elderly patients who were treated surgically or conservatively for a displaced olecranon fracture (Mayo type IIA or IIB). ⋯ Widely displaced olecranon fractures can successfully be treated conservatively in low-demanding geriatric patients with a satisfactory outcome. Patient selection is essential as patients that are more active might benefit from surgical treatment. Yet, treatment risks and benefits need to be balanced carefully in regard to the patient`s demands and requests.
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Arch Orthop Trauma Surg · Oct 2022
Review Meta AnalysisAnatomical and reverse megaprosthesis in proximal humerus reconstructions after oncologic resections: a systematic review and meta-analysis.
Anatomic (AN) Endoprosthesis (EPR) reconstructions of the shoulder after intra-articular proximal humerus (Malawer type 1) resections are characterized by early recovery and low complications rate. However, shoulder instability and limited mobility can occur. Reverse shoulder (RS) EPR has been introduced to improve functional outcome. The aim of this systematic review is to evaluate shoulder reconstructions with AN or RS EPR after Malawer type 1 resection, comparing complications and functional results. ⋯ Anatomic and reverse shoulder EPR represent safe and effective implants for shoulder reconstruction, with similar implant stability and complication rates. RS EPR significantly improves post-operative ROM and functional outcomes, especially when at least a partial function of the abductor apparatus is preserved.
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Charcot arthropathy (CN) can ultimately lead to limb loss despite appropriate treatment. Initial conservative treatment is the accepted treatment in case of a plantigrade foot. The aim of this retrospective study was to investigate the mid- to long-term clinical course of CN initially being treated conservatively, and to identify risk factors for reactivation and contralateral development of CN as well as common complications in CN. ⋯ III, long-term retrospective cohort study.
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Arch Orthop Trauma Surg · Oct 2022
The application of an allogeneic bone screw for osteosynthesis in hand and foot surgery: a case series.
The allogeneic bone screw transplant is a new osteosynthesis device making the use of foreign fixation material obsolete for various kinds of indications. Moreover, it is integrated into the recipient bone by natural bone remodeling without harming the surrounding tissue. The aim of this study was to determine the efficacy and safety of the transplant for osteotomy and arthrodesis in hand and foot surgery and to evaluate the clinical importance of the device. ⋯ The application of the allogeneic bone screw resulted in a 100% fusion rate while the patient burden was low. The transplant is safe and suited for various kinds of osteosynthesis in hand and foot surgery.
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Arch Orthop Trauma Surg · Oct 2022
Observational StudyAcetabular cup position differs in spinopelvic mobility types: a prospective observational study of primary total hip arthroplasty patients.
Spinopelvic mobility was identified as a contributing factor for total hip arthroplasty (THA) instability. The influence of spinopelvic function on acetabular cup positioning has not yet been sufficiently investigated in a prospective setting. Therefore, our study aimed (1) to assess cup inclination and anteversion in standing and sitting based on spinopelvic mobility, (2) to identify correlations between cup position and spinopelvic function, (3) and to determine the influence of the individual spinal segments, spinal sagittal balance, and spinopelvic characteristics on the mobility groups. ⋯ The significantly different acetabular cup positions in sitting and in the ∆ between standing and sitting and the significantly altered spinopelvic characteristics in terms of stiff and hypermobile spinopelvic mobility underlined the consideration for preoperative functional radiological assessment. Identifying the patients with altered spinopelvic mechanics due to a standardized screening algorithm is necessary to provide safe acetabular cup positioning. The proximal spinal segments appeared not to be involved in the spinopelvic function.