Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2023
Lowest instrumented vertebrae selection in posterior fusion of Lenke 3C/6C adolescent idiopathic scoliosis: L3 versus L4, when LEV is L4.
In structural thoracolumbar/lumbar (TL/L) curves, lowest instrumented vertebra is selected mostly as the lower end vertebra (LEV). To save more lumbar mobile segments, fusion may be stopped one level proximal. This study aimed to compare the radiologic and functional outcomes of Lenke type 3C and 6C adolescent idiopathic scoliosis patients according to distal fusion level. ⋯ In TL/L curves which have L4 as LEV, satisfactory results can be achieved with stopping the fusion at L3, if a proper disc alignment below LIV can be obtained intraoperatively. Higher amount of LIV disc angle in L3 group did not cause coronal and sagittal imbalance. Although clinical outcomes are similar with stopping at L3 or L4, fusion to L3 may be prefered to save one more mobile disc.
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Arch Orthop Trauma Surg · Sep 2023
Extension osteotomy of the metacarpal I and ligamentoplasty of the trapeziometacarpal joint for the treatment of early-stage osteoarthritis and instability of the trapeziometacarpal joint.
Osteoarthritis (OA) is a common disease of the first carpo-metacarpal (CMC I) joint. Biomechanical factors promoting OA are the shape of the CMC I-joint, being a biconcave-convex saddle joint with high mobility and the increased instability caused by joint space narrowing, ligamentous laxity, and direction of force transmission of the abductor pollicis longus (APL) tendon during adduction. ⋯ We combine this closing wedge osteotomy with a ligamentoplasty to stabilize the joint. In this manuscript, we provide a detailed description of the indication, discuss biomechanical aspects and the surgical technique in detail.
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Arch Orthop Trauma Surg · Sep 2023
Safe zone of supraclavicular nerve during clavicle fixation and its anatomical variations, a cadaveric study.
Supraclavicular nerve injury is usually at risk during clavicular fracture fixation. This study aimed to examine the anatomical features and estimate the precise location of supraclavicular nerve branches related to adjacent structural landmarks and to evaluate the differences between sex and side. To highlight the clinical purposes and surgical relevance, this study attempted to define a surgical safe zone that would probably protect the supraclavicular nerve during clavicle fixation. ⋯ Basic Science Study, Anatomic Study.
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Arch Orthop Trauma Surg · Sep 2023
Randomized Controlled TrialA prospective randomised controlled trial of cemented and uncemented tibial baseplates: functional and radiological outcomes.
With the success of uncemented fixation in younger patients undergoing total hip arthroplasty and the growing demand for total knee arthroplasty (TKA) in a younger cohort of patients, there has been an increasing interest in cementless tibial baseplate fixation. We sought to determine whether there was a clear advantage to the use of three different forms of tibial baseplate fixation. The primary outcome of this study was survivorship and secondary outcomes were functional and radiological outcomes, up until 10 years. ⋯ Irrespective of tibial fixation method, functional and radiological outcomes remain similar at follow-up at 10 years, with no clear difference in outcome between each group. Each method of fixation also had excellent survivorship over this period and should reassure surgeons that whichever method of fixation they choose, long-term outcomes are likely to be satisfactory.
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Arch Orthop Trauma Surg · Sep 2023
ReviewCorynebacterium periprosthetic joint infection: a systematic review of 52 cases at 2.5 years follow-up.
While large progress has been achieved in identifying and treating the most common pathogens involved in periprosthetic joint infections (PJI), there remains limited knowledge on atypical pathogens such as Corynebacterium. For that reason, we analyzed infection and diagnostical characteristics, as well as treatment outcome in Corynebacterium PJI. ⋯ Corynebacterium PJI affects multimorbid and elderly patients, with one in three developing a reinfection at short term. Importantly, the relative majority of reinfections was for persistent Corynebacterium PJI.