Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2023
Retrospective analysis of mortality and quality of life after hip disarticulation or hemipelvectomy: a report on 15 patients.
Hip disarticulation and hemipelvectomy are defined as major ablative amputations of the lower limb. Due to the small number of patients, little is known about the outcome and follow-up. ⋯ Hip disarticulation and hemipelvectomy are followed by a high postoperative mortality. Quality of life of the affected patients is impaired in long-term follow-up. Especially amputations performed due to infections show high mortality within one month after surgery despite average young age and low CCI. Surgeons should be aware of this devastating outcome and extraordinary vigilant for these vulnerable patient cohorts.
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Arch Orthop Trauma Surg · Aug 2023
Reverse shoulder arthroplasty for proximal humerus fractures: a comparison of the deltoid split and deltopectoral approaches.
Reverse shoulder arthroplasty (RSA) is a common treatment for three- and four-part proximal humerus fractures. RSA is commonly performed through a deltopectoral (DP) surgical approach; however, a deltoid split (DS) approach has been described. The purpose of this study was to compare the intraoperative and postoperative outcomes of patients undergoing RSA for proximal humerus fractures through a DP and DS approach. ⋯ This study demonstrates that RSA for proximal humerus fractures performed through a DS or DP approach may result in similar intraoperative and postoperative outcomes, with no difference in reoperation or complication rates.
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Arch Orthop Trauma Surg · Aug 2023
Case ReportsTraumatic pancreas, kidney, liver, spleen, gastric and diaphragma rupture with enterothorax after blunt trauma caused by falling in an adolescent: a case report.
Injury of almost all intra-abdominal organs in blunt trauma without bone and brain injury is very rare. This is the case report of a 16-year-old adolescent with severe abdominal trauma who was hit on his abdomen by a falling maytree. After admission to a Level I trauma center, emergency room treatment according to ATLS and after this emergency surgery was performed. ⋯ Structured diagnostics and treatment were crucial in this case. The education of trauma surgeons should include general surgery skills. These skills and knowledge of blood coagulation diagnostics and therapy saved the patient's life in this case.
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Arch Orthop Trauma Surg · Aug 2023
Dual plate has better biomechanical stability than hook plate or superior single plate for the fixation of unstable distal clavicle fractures: a finite element analysis.
A variety of surgical techniques have been addressed for distal clavicle fractures, while none of these is considered to be gold standard fixation. Currently, dual plate fixation has been proposed and achieved satisfying clinical results. However, the biomechanical study about dual plate technique in treating unstable distal clavicle fractures is limited. Thus, the purpose of this study was to investigate the biomechanical properties of this technique by finite element analysis. ⋯ Dual plate fixation has better biomechanical stability with lower risk of implant failure. Thus, dual plate fixation is an alternative technique for unstable distal clavicle fracture. The complication of peri-implant fracture of dual plate technique should also be cautious in clinical practice, and more clinical evidence is needed.
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Arch Orthop Trauma Surg · Aug 2023
Does access through the pronator quadratus influence pronation strength in palmar plate fixation of distal radius fractures in elderly patients?
Palmar plate fixation of the distal radius fracture involves dissecting the pronator quadratus (PQ). This is regardless of whether the approach is radial or ulnar to the flexor carpi radialis (FCR) tendon. It is not yet clear whether and to what extent this dissection leads to a functional loss of pronation or pronation strength. The aim of this study was to investigate the functional recovery of pronation and pronation strength after dissection of the PQ without suturing. ⋯ The present study can show a recovery of pronation as well as pronation strength in a large patient population. At the same time, the pronation strength is still significantly lower 1 year after the operation than on the opposing healthy side. As the pronation strength recovers as the grip strength and is at all times on a par with the supination strength, we believe that we can continue to refrain from re-fixating the pronator quadratus.