Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jul 2023
Development of a Frailty Index in the Irish Hip Fracture Database.
In older people, hip fracture can lead to adverse outcomes. Frailty, capturing biological age and vulnerability to stressors, can indicate those at higher risk. We derived a frailty index (FI) in the Irish Hip Fracture Database (IHFD) and explored associations with prolonged length of hospital stay (LOS ≥ 30 days), delirium, inpatient mortality and new nursing home admission. We assessed whether the FI predicted those outcomes independently of age, sex and pre-operative American Society of Anaesthesiology (ASA) score. ⋯ A 21-item FI in the IHFD was a significant predictor of outcomes and added value to traditional risk markers. The utility of a routinely derived FI to more effectively direct limited orthogeriatric resources requires prospective investigation.
-
Arch Orthop Trauma Surg · Jul 2023
Acetabular orientation in triple pelvic osteotomy: is intraoperative fluoroscopy reliable?
In pelvic osteotomies, unfavorable balancing of the anterior and posterior acetabular wall can affect the longevity of the natural joint. This raises the question, whether intraoperative fluoroscopy is sufficiently accurate. The objective was to assess the correlation between acetabular parameters [lateral center edge angle (LCEA), acetabular index (AI), anterior wall index (AWI), posterior wall index (PWI)] acquired on intraoperative fluoroscopic images and postoperative pelvic radiographs and to analyze intra- and interobserver reliability of these parameters. ⋯ In the surgical treatment of hip dysplasia by means of TPO, intraoperative fluoroscopic imaging has proven to be reliable and accurate. Intraobserver correlation was excellent for all parameters. The correlation between the intraoperative fluoroscopic images and postoperative radiographs ranged from good to excellent, with the lowest values for the acetabular wall indices (AWI and PWI).
-
Arch Orthop Trauma Surg · Jul 2023
Analysis of severe hand trauma injury frequency during "Munich's Oktoberfest" within the last 9 years in comparison to years with absence due to the COVID-19 pandemic.
Within its 2 week period, the Oktoberfest attracts around 6 million visitors yearly to Munich, Germany. Due to alcohol intake, congested halls, and disorderly activities, numerous accidents occur. Although many hand injuries are observed, the impact of Oktoberfest on severe hand trauma injury frequency is under investigated. ⋯ The risk of injuring relevant structures of the hand during Oktoberfest is extremely high as compared to other parts of the body due to beer stein and fall-associated injuries. These injuries can lead to lifelong impairments. Our data are the first that quantifies and pinpoints the risk of severe injury to the hand during Oktoberfest and therefore, it is of great interest for visitors, hand surgeons, paramedics and emergency department healthcare workers.
-
Arch Orthop Trauma Surg · Jul 2023
Double screw versus angular stable plate fixation of scaphoid waist nonunions in combination with intraoperative extracorporeal shockwave therapy (ESWT).
Over the past years, different fixation techniques focused on rotational stability in order to increase stability and stimulate union rates. Additionally, extracorporeal shockwave therapy (ESWT) has gained importance in the treatment of delayed and nonunions. Purpose of this study was to compare the radiological and clinical outcome of two headless compression screws (HCS) and plate fixation in scaphoid nonunions, in combination with intraoperative high energy ESWT. ⋯ Scaphoid nonunion stabilization by using two HCS or angular stable volar plate fixation and intraoperative ESWT results in comparable high union rates and good functional outcome. Due to the higher rate for a secondary intervention (plate removal), HCS might be preferable as first choice, whereas the scaphoid plate fixation should be reserved for recalcitrant (substantial bone loss, humpback deformity or failed prior surgical intervention) scaphoid nonunions.
-
Arch Orthop Trauma Surg · Jul 2023
A new accelerometer-based portable navigation system provides high accuracy of acetabular cup placement in total hip arthroplasty in both the lateral decubitus and supine positions.
No studies have compared the accuracy of acetabular cup placement in total hip arthroplasty (THA) in the supine and lateral decubitus positions using the same portable navigation system. Thus, this study aimed to compare the accuracy of acetabular cup placement using a new accelerometer-based portable navigation system combined with an infrared stereo camera and inertial measurement unit between the supine and lateral decubitus positions. ⋯ This new accelerometer-based portable navigation system may provide high accuracy of the cup placement in THA in the lateral decubitus and supine positions.