Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jul 2022
Review Case ReportsBosworth fracture complicated by unrecognized compartment syndrome: a case report and review of the literature.
Compartment syndrome (CS) is exceedingly rare in ankle fractures. However, the risk of CS development seems to be increased in the presence of a Bosworth fracture-dislocation (BF), a rare variant of locked dislocation of the fibula behind the tibia. ⋯ Given the extreme paucity of CS in malleolar fractures, CS in BF has a relatively high prevalence. Risk factors include severe dislocations, repeated attempts on closed reduction, and a long interval to definite surgery. A high index of suspicion is required because delayed diagnosis leads to lasting functional restrictions.
-
Arch Orthop Trauma Surg · Jul 2022
Review Meta AnalysisOutcomes and complications following flexible intramedullary nailing for the treatment of tibial fractures in children: a meta-analysis.
Tibial shaft fractures are common occurrence in children and surgical treatment is sometimes required, particularly in unstable or open fractures, and in polytrauma. The aim of this study was to investigate the available evidence on the efficacy and safety of flexible intramedullary nailing (FIN) for both open and closed tibia fractures in children, exploring the main surgical outcomes and rate of complications. ⋯ FIN offers excellent outcomes for the treatment of paediatric tibia shaft fractures. Patients presenting with an open fracture have a higher but acceptable complication rate. Comparative studies are needed to clarify if other treatments have superior outcomes.
-
Arch Orthop Trauma Surg · Jul 2022
ReviewThe value of radiologic diagnostics in evaluating deltoid integrity in isolated type B ankle fractures: a systematic review of the literature.
Excluding deep deltoid ligament (DDL) rupture in isolated type B ankle fractures is crucial in the decision-making process for surgical or conservative treatment. There is no consensus about the most accurate radiologic diagnostic test to determine medial injury. The aim of this study is to systematically review the literature concerning radiologic diagnostics that evaluate medial injury in adult patients with isolated type B ankle fractures. ⋯ The most accurate and available methods for diagnosing deltoid integrity seem to be the ultrasound and the GS radiograph. Further research is needed to confirm the results of this review.
-
Arch Orthop Trauma Surg · Jul 2022
ReviewThe value of radiologic diagnostics in evaluating deltoid integrity in isolated type B ankle fractures: a systematic review of the literature.
Excluding deep deltoid ligament (DDL) rupture in isolated type B ankle fractures is crucial in the decision-making process for surgical or conservative treatment. There is no consensus about the most accurate radiologic diagnostic test to determine medial injury. The aim of this study is to systematically review the literature concerning radiologic diagnostics that evaluate medial injury in adult patients with isolated type B ankle fractures. ⋯ The most accurate and available methods for diagnosing deltoid integrity seem to be the ultrasound and the GS radiograph. Further research is needed to confirm the results of this review.
-
Arch Orthop Trauma Surg · Jul 2022
ReviewConcomitant injuries in patients with thoracic vertebral body fractures-a systematic literature review.
The aim of this study was to give a systematic overview over the rate and location of concomitant injuries, the probability of suffering from neurological deficits, and to give evidence of the timing of surgery in severely injured patients with unstable thoracic vertebral body fractures. ⋯ The evidence of the available literature is low. The cited studies reveal that thoracic spinal fractures are associated with a high number of neurological deficits and concomitant injuries, particularly of the thoracic cage and the lung. Thereby, diagnostic algorithm should include computer tomography of the whole thoracic cage if there is any clinical sign of concomitant injuries. Patients with incomplete neurologic deficits benefit from early surgery consisting of decompression and long-segmental stabilization.