Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2022
Potential pitfalls of lateral radiographic assessment of the nail position in the distal femur.
Antegrade nailing of proximal femur fractures is a widely accepted treatment that relies on lateral radiographs to assess distal nail positioning. However, the distal femur is trapezoidal in cross section, consequently standard lateral radiographs may be insufficient. This study aimed to utilise 3D modelling to virtually assess the accuracy of lateral radiographs in defining the position of a femoral nail in the distal femur, specifically considering distal cortical encroachment. ⋯ Femoral nails are often anteriorly located in the distal femur and reviewed using lateral radiographs. However, this research demonstrates that owing to the geometry of the distal femur, a lateral radiograph may be inadequate for determining the true position of a femoral nail within the distal femur. Accurately assessing the position of femoral nails may help to address and prevent thigh pain, and iatrogenic fracture or perforation which have been associated with anterior positioning.
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Arch Orthop Trauma Surg · Jul 2022
The influence of bone quality on radiological outcome in 50 consecutive acetabular fractures treated with a pre-contoured anatomic suprapectineal plate.
To investigate the range of indications of an anatomical-preshaped three-dimensional suprapectineal plate and to assess the impact of the bone mass density on radiologic outcomes in different types of acetabular fractures. ⋯ A preshaped suprapectineal plate provides good radiological outcomes in a variety of indications in a predominantly geriatric cohort. Impaired bone quality has a significantly higher risk of poor reduction results. In cases with extensive joint destruction, the combination with total hip arthroplasty was a valuable option.
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Arch Orthop Trauma Surg · Jul 2022
No increased injury incidence in the German Bundesliga after the SARS-CoV-2 virus lockdown.
The coronavirus lockdown in 2020 resulted in a worldwide suspension of professional sports. The first major professional football league to restart after the lockdown was the German Bundesliga. This study investigates whether the injury incidence increased after the restart of the season with only 9 days of regular preparation time and without any friendly matches in comparison to three control periods. ⋯ The period after the unexpected break in the 2019-2020 season due to the coronavirus lockdown and the rapid return to competition showed no increase in the injury rate compared to the pre-lockdown period and a lower injury rate than in the previous season final. The unintentional mid-season rest with its potential for physical recovery and individual fitness training seems to have had a positive effect on injury occurrence.
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Arch Orthop Trauma Surg · Jul 2022
Orthopaedic residents' autonomy in hip fracture surgery: what is the effect on patient outcomes?
In the context of growing prevalence of hip fractures and hip fracture surgery in the elderly, it is unknown if surgical trainee autonomy in the operating room conflicts with optimal health care provision and safety of patients. We hypothesized that surgery performed solely by residents, without supervision or participation of an attending surgeon, can provide similar outcomes to surgery performed by trauma or joint reconstruction fellowship-trained orthopaedic surgeons. ⋯ Level III-retrospective cohort study.
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Arch Orthop Trauma Surg · Jul 2022
Using a patella reduced technique while balancing a TKA results in restored physiological strain in the collateral ligaments: an ex vivo kinematic analysis.
Poor soft tissue balance in total knee arthroplasty (TKA) often results in patient dissatisfaction and reduced joint longevity. Patella-in-place balancing (PIPB) is a novel technique which aims to restore native collateral ligament behavior without collateral ligament release, while restoring post-operative patellar position. This study aimed to assess the effectiveness of this novel technique through a detailed ex vivo biomechanical analysis by comparing post-TKA tibiofemoral kinematics and collateral ligament behavior to the native condition. ⋯ Balancing a TKA with the PIPB technique resulted in reduced joint laxity, while restoring collateral ligament strains. The technique also seemed to restore kinematics and strains, especially in passive flexion.