Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Can surface landmarks help us identify the gibson interval during surgical hip dislocation: a study of 617 hips.
The Gibson approach, used in hip-preserving surgery, is intermuscular and develops the space anteriorly to the gluteus maximus. Reliable anatomical landmarks for the development of this interval do not exist, but the interval is marked by perforating vessels (PV) of the inferior gluteal artery. The aim of this study was to provide reference values for the relationship between palpable anatomical landmarks on the femur/pelvis and the anterior border of the gluteus maximus using CT scans of the proximal femur. ⋯ The Gibson interval is located more anteriorly in female patients and patients under 40 years of age. It is located more posteriorly in patients over 60 years of age. In addition, the interval moves anteriorly with increasing femoral torsion, most notably in patients with very high femoral torsion (> 35°).
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Arch Orthop Trauma Surg · Dec 2024
Internal brace augmentation in elbow varus posteromedial rotatory instability (VPMRI) allows early rehabilitation and prevents stiffness.
Varus posteromedial rotatory instability (VPMRI) involves anteromedial coronoid fracture (AMCF), lateral ulnar collateral ligament (LUCL), and medial collateral ligament (MCL) injury. There is no general consensus regarding the surgical treatment, but most surgeons recommend internal fixation of the coronoid along with primary ligament repair. This methodology involves postoperative immobilization to allow ligament healing, occasionally associated with stiffness. Augmentation of one/or both collateral ligaments using a non-absorbable suture tape as an internal brace in VPMRI cases was the subject of the presented study. This method allows brace-free initiation of full elbow range of motion while protecting bony and soft tissue healing. ⋯ Internal brace augmentation with a non-absorbable suture tape in the setting of VPMRI is a safe and helpful adjunct to coronoid repair/reconstruction and primary ligament repair and allows early mobilization and recovery of elbow stability and range of motion.
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Arch Orthop Trauma Surg · Dec 2024
Comparative StudyHow many knots are necessary to achieve knot security of two high strength suture tapes? A biomechanical comparative analysis.
According to current clinical practice, a minimum of 7 knots are required to provide secure hold in high-strength sutures. A new technology featuring a suture tape with a salt-infused silicon core has been recently developed, potentially reducing the number of needed knots. ⋯ In fatty-wet conditions-related to open surgery-the novel Dynatapetm suture tape requires 5 instead of 7 knots to achieve their security. In wet conditions-related to arthroscopic surgery-this number can be reduced to 4 knots. In contrast, the conventional SutureTapetm needs 6 knots to provide security in all conditions.
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Arch Orthop Trauma Surg · Dec 2024
Randomized Controlled Trial Comparative StudyProspective comparison of two different surgical technique in the treatment of deep osteochondral lesions of the talus: mosaicplasty versus all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond.
There are various surgical techniques applied for the treatment of osteochondral lesions of the talus (OLT). The mosaicplasty technique is one of the most commonly used methods for deep lesions. The all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond is a novel method as an alternative to the mosaicplasty. This study aims to compare the clinical and radiological results of these two different surgical techniques in the treatment of deep OLT. ⋯ In terms of clinical and radiological scores, similar results were obtained in the treatment groups. Both surgical techniques were found to be effective in the treatment of deep OLT.
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Arch Orthop Trauma Surg · Dec 2024
Tissue adhesive for wound closure, as adjunct to staples, reduces postoperative wound drainage after total knee arthroplasty.
Wound drainage after total knee or hip arthroplasty is a relatively frequent complication. It results in delayed mobilization, prolonged hospital stay, increased costs and is associated with an increased risk of infection. In this study, tissue adhesive was administered as an adjunct to skin closure with staples. ⋯ This study proves that tissue adhesive as an adjunct to staples for wound closure after total knee arthroplasty reduces wound drainage and is cost effective. Besides, this could potentially lead to lower rates of periprosthetic joint infection. Therefore, the use of tissue adhesive in total knee arthroplasty would be recommended.