Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2022
Dose optimization of intravenous dexamethasone for total knee arthroplasty: when two is not better than one.
The optimal dose regimen of dexamethasone in total knee arthroplasty (TKA) has not been determined. This study was performed to evaluate the impact of a single preoperative high-dose dexamethasone compared with two perioperative low-dose dexamethasone in TKA. ⋯ I.
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Arch Orthop Trauma Surg · Apr 2022
Anatomical versus non-anatomical configuration of double coraco-clavicular tunnel technique in acromioclavicular joint reconstruction.
Horizontal instability is a common problem after acromioclavicular joint injuries. The aim of this study was to evaluate if there is a difference regarding horizontal stability between an anatomical and a non-anatomical configuration of the double tunnel coraco-clavicular ligament reconstruction of the acromioclavicular joint. ⋯ Reconstruction of the CC ligaments in an anatomical configuration with two suture devices results in a significantly higher stability of the AC joint in the horizontal plane than reconstruction of the CC ligaments in a non-anatomical configuration. Based on the results of this biomechanical in vitro study, the use of a double coraco-clavicular reconstruction should focus on an anatomically correct position of the suture devices.
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Arch Orthop Trauma Surg · Apr 2022
Does repair of deltoid ligament contribute to restoring a mortise in SER type IV ankle fracture with syndesmotic diastasis?
To analyze the radiographic and clinical outcomes of deltoid ligament repair, we studied 34 supination external rotation type IV ankle fracture patients with deltoid ruptures who required syndesmosis fixation. ⋯ In both groups, the postoperative and final follow-up radiographic measures were within normal ranges and the radiographic and clinical outcomes were not significantly different between the two groups. Syndesmotic reduction could be much more important than deltoid repair in regard to mortise restoration and medial stability.
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Given the relationship between psychological distress and activity tolerance (capability), a stressful life event might diminish accommodation, increase symptoms, and induce a person to seek specialty care. As a first step to investigate this possibility, this study addressed whether difficult life events are associated with greater activity intolerance and pain intensity. ⋯ When a musculoskeletal specialist identifies less activity tolerance (less capability) than anticipated for a given injury or pathology, they can anticipate a potential difficult life event, and expect alleviation of symptoms and improved capability as the stress is ameliorated with time and support. Specialists can be prepared to direct people to community or professional support if requested.
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Arch Orthop Trauma Surg · Apr 2022
The use of a non-biological, bridging, antiprotrusio cage in complex revision hip arthroplasty and periacetabular reconstructive oncologic surgery. Is still today a valid option?: A mid/long-term survival and complications' analysis.
Burch-Schneider-like antiprotrusio cages (B-SlAC) still remain helpful implants to bridge severe periacetabular bone losses. The purpose of this study was to evaluate outcomes and estimate both cages' failures and complication risks in a series of B-SlAC implanted in revision of failed total hip arthroplasties (THA) or after resection of periacetabular primary or secondary bone malignancies. Risk factors enhancing the chance of dislocations and infections were checked. ⋯ Burch-Schneider-like antiprotrusio cages are a classical non-biological acetabular reconstruction method that surgeons should bear in mind when facing gross periacetabular bone losses, independently of their cause. However, dislocation and infection rates are high. Whenever possible, we suggest preserving the proximal femur in revision THA, and to use a less-invasive postero-lateral approach to reduce dislocation rates in non-oncologic cases.