Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2022
Quality of life, infection control, and complication rates using a novel custom-made articulating hip spacer during two-stage revision for periprosthetic joint infection.
Two-stage revision remains the gold standard treatment for most chronically infected and complex total hip arthroplasty infections. To improve patient outcome and reduce complication rates, we have developed a novel custom-made articulating hip spacer technique and present our short-term results. ⋯ Our two-stage approach for periprosthetic joint infection shows high infection eradication and implant survivorship rates at short-term follow-up. Spacer-related complication rates were low, and we achieved high patient satisfaction rates and low pain levels already during the spacer period. To further simplify comparison between different spacer designs, we propose a new hip spacer classification system.
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Arch Orthop Trauma Surg · Dec 2022
Arc center distance as a novel quantitative radiographic parameter for volar Barton fractures.
The aims of this study were to investigate conventional radiographic parameters and introduce a novel parameter (arc center distance, ACD) for volar Barton fractures. ⋯ The mean values of conventional parameters (VTA, APD, TDA and CARD) in volar Barton fractures were presented. The ACD can be useful parameter for quantitatively evaluating volar Barton fractures.
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Arch Orthop Trauma Surg · Dec 2022
Optimal blocking screw placement for retrograde IM nail fixation of distal femur fracture: a standardized biomechanical study of "osteoporotic" synthetic bone.
Intramedullary (IM) nail use for metaphyseal fracture management is problematic in long bones like the femur because the larger medullary cavity allows increased fracture motion and potentially increased implant failure and malunion/nonunion risk; Achieving effective distal femur fracture fixation is even more difficult in osteoporotic bone. Blocking screws to control IM nail movement are known to be effective for tibia fracture management. Few studies have evaluated IM nail and blocking screw use efficacy for distal femur fracture fixation in osteoporotic bone. ⋯ Use of one or two blocking screws on the medial and lateral sides of the IM nail decreased coronal plane movement in the intramedullary canal. Combining retrograde IM nail implantation with blocking screws reduced medial-lateral IM nail movement and increased fracture stability. These characteristics may help prevent fixation failure, malunion, and even nonunion in patients with a distal femur fracture in osteoporotic bone.
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Arch Orthop Trauma Surg · Dec 2022
Radiologic restoration inaccuracy increases postoperative dislocation in primary total hip arthroplasty: a retrospective study with propensity score matching.
Dislocation is a complicated process and associated with multivariate etiology and risk factors. The purpose of this study was to verify if radiologic restoration inaccuracy increases postoperative dislocation in primary total hip arthroplasty (THA) individually or synergistically. ⋯ Hip offset (HO) restoration inaccuracy increased the risk of dislocation following primary THA. Multivariate radiologic restoration accuracy is critical for the prevention of dislocation and needs to be valued by surgeons.
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Arch Orthop Trauma Surg · Dec 2022
Prospective clinical results of an additive ligament bracing for stabilizing simple and complex elbow instabilities.
Ligament bracing augments ligament repair using a non-absorbable suture tape. Although biomechanically an increase in primary stability has been proven, there is a lack of clinical evidence. Purpose of this study was to evaluate clinical results of patients treated with ligament bracing due to primary elbow instability, including an analysis of complications. Furthermore, clinical results for patients treated with and without early functional mobilization were compared. ⋯ III.