Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2022
Regional anesthesia does not decrease inpatient or outpatient opioid demand in distal femur fracture surgery.
Regional anesthesia (RA) is sometimes used to decrease pain and opioid consumption in distal femur fractures. However, the real-world impact of RA on inpatient opioid consumption and outpatient opioid demand is not well known. The hypothesis of this study is that RA would be associated with decreased inpatient opioid consumption and outpatient opioid demand. ⋯ Level III, retrospective, therapeutic cohort study.
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Arch Orthop Trauma Surg · Aug 2022
Treatment of grossly dislocated supracondylar humerus fractures after failed closed reduction: a retrospective analysis of different surgical approaches.
The supracondylar humerus fracture (SCHF) is one of the most common pediatric injuries. Highly displaced fractures can be very challenging. If closed reduction fails, the therapy algorithm remains controversial. ⋯ In the rare case of an irreducible SCHF, an anatomical reduction can be achieved by open approaches with excellent functional outcome and a high grade of patient satisfaction. All described open approaches can be utilized with a high safety-level.
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Arch Orthop Trauma Surg · Aug 2022
Mid and lower thoracic kyphosis changes during adulthood: the influence of age, sex and thoracic coronal curvature.
There is conflicting data on how thoracic kyphosis changes throughout adulthood. We evaluated mid and lower thoracic kyphosis (MTK) in various age groups and the influence of age, sex and coronal curve (CC) on MTK. ⋯ MTK increases with advancing age during adulthood in both genders; CC, but not sex, was an independent predictor of MTK.
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Arch Orthop Trauma Surg · Aug 2022
Lesion size and varus malalignment are the major determinants leading to poorer clinical outcomes after combined microfracture treatment for focal cartilage lesions during anterior cruciate ligament reconstruction.
The purposes of this study were to evaluate the clinical effects of microfracture (MFX) performed for Outerbridge grade 3 or 4 focal cartilage lesion during the same surgery with arthroscopic anterior cruciate ligament (ACL) reconstruction and to analyze the major determinants of these potential effects on the clinical outcome. The clinical and radiographic data of 119 patients were evaluated. The mean follow-up time was 32.6 ± 6 months. ⋯ Clinical outcomes were similar between isolated ACL reconstruction and combined procedure. On the other hand, according to lineer regression analysis, cartilage lesion size > 2 cm2 and > 5 degrees of varus alignment were detected as the major determinants leading to poorer outcomes in combined ACL reconstruction and MFX. Level of evidence: III - Retrospective Comparative Study.
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Arch Orthop Trauma Surg · Aug 2022
Comparison of postoperative knee flexion and patient satisfaction between newly and conventionally designed medial pivot total knee arthroplasty: a 5-year follow-up matched cohort study.
The medial pivot total knee arthroplasty (TKA) has good patients' satisfaction; however, there is likely the restriction of postoperative knee flexion. The 2nd generation medial pivot TKA prosthesis was designed to improve postoperative knee flexion. This study aimed to compare the clinical outcomes and patient satisfaction between the 2nd generation and 1st generation medial pivot TKA prostheses. ⋯ Compared to the 1st generation, the 2nd generation medial pivot prosthesis provides greater postoperative knee flexion and patient satisfaction.