Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
Dislocation rate, revisions and other complications of primary cemented hemiarthroplasty for displaced femoral neck fractures: a single-center cohort study of 743 unselected hips with a mean 2.7-year follow-up.
Evidence of whether to use hemiarthroplasty (HA) or total hip arthroplasty for displaced femoral neck fractures (FNF) is still widely debated, especially when taking ambulatory status, age, and patient cognitive status into account. The current study aims to report the rates of dislocations, revisions and other complications for primary cemented HA in patients with displaced FNF. ⋯ Primary HA presents a safe and robust approach with acceptable complication rates in a genuine unselected cohort of displaced FNF, particularly for patients aged > 70.
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Arch Orthop Trauma Surg · Dec 2022
STRYDE versus PRECICE magnetic internal lengthening nail for femur lengthening.
Magnetic internal lengthening nails (MILNs) have been used for femoral lengthening to avoid complications associated with external fixation. The titanium version of the MILN (PRECICE®) has been in use since 2011 but had limitations (50-75 lb) in post-operative weight bearing. A new stainless-steel version of the MILN (STRYDE®) allows 150-250 lb of post-operative weight bearing. The aim is to compare the outcomes of using these two different MILNs for both unilateral and bilateral femoral lengthening. ⋯ Level III, Therapeutic study.
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Arch Orthop Trauma Surg · Dec 2022
First clinical results of 1-year follow-up of the femoral neck system for internal fixation of femoral neck fractures.
Closed reduction and internal fixation (CRIF) is the preferred treatment to retain the native joint and maintain optimal functionality in femoral neck fractures. Sliding hip screw (SHS) and cannulated hip screws (CHS) are established CRIF options. SHS offer high biomechanical stability, whereas CHS are minimally invasive. These established systems have a 17-21% failure rate. The Femoral neck system (FNS) was recently developed to combine the advantages of both predecessors. The aim of this study was to describe the first clinical experience with this novel implant with special emphasis on the safety and efficacy. ⋯ This study indicates that the FNS is a potential safe and effective CRIF modality. Age (< 65 years) is an important factor to keep in mind when selecting patients for CRIF as it is related to lower risk for failure. Future long-term follow-up studies with larger populations should indicate if functional results and risk factors for failure are comparable to SHS or CHS.
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Arch Orthop Trauma Surg · Dec 2022
Three-stage limb salvage in tibial fracture related infection with composite bone and soft-tissue defect.
Managing critical-sized tibial defects is one of the most complex challenges orthopedic surgeons face. This is even more problematic in the presence of infection and soft-tissue loss. The purpose of this study is to describe a comprehensive three-stage surgical protocol for the reconstruction of infected tibial injuries with combined bone defects and soft-tissue loss, and report the clinical outcomes. ⋯ A three-stage surgical approach to treat chronically infected tibial injuries with combined bone and soft-tissue defects yields high rates of infection eradication and successful limb salvage, with favorable functional outcomes and patient satisfaction.
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Arch Orthop Trauma Surg · Dec 2022
Litigations in orthopedics and trauma surgery: reasons, dynamics, and profiles.
In recent literature, the increasing number of medical litigations, both in terms of the number of cases being filed and the substantive costs associated with lawsuits, has been described. This study aims to provide an overview of the profile of litigation for orthopedic and trauma surgery to describe the differences and the development of the number of cases over time. ⋯ Our results could not confirm the often-stated trend of having more litigations against orthopedic and trauma surgeons. Although the absolute numbers increased, the number of litigations per 1000 patients treated declined. Patients who underwent elective surgery were more likely to file complaints than emergency patients.