Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
Review Meta Analysis Comparative StudyPrimary arthrodesis versus open reduction internal fixation for acute Lisfranc injuries: a systematic review and meta-analysis.
The presence of a Lisfranc injury alone is considered a surgical indication in most patients. Indications for primary arthrodesis (PA) versus open reduction internal fixation (ORIF), however, is a topic of debate among surgeons. Conflicting data exists as to which treatment modality leads to improved patient-reported outcome measures (PROMs), reoperations, and complications. ⋯ I.
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Arch Orthop Trauma Surg · Dec 2024
Meta Analysis Comparative StudyDirect anterior vs other surgical approaches in patients with lumbar stiffness undergoing total hip arthroplasty: a systematic review and meta-analysis.
The effectiveness of the direct anterior approach (DAA) compared to other surgical approaches for total hip arthroplasty (THA) in patients with lumbar spine stiffness remains unclear. This systematic review and meta-analysis aimed to compare clinical outcomes, including dislocation rates and other complications, between DAA and other surgical approaches for THA in patients with lumbar spine stiffness. ⋯ The DAA was associated with lower dislocation rates compared to other surgical techniques in patients with lumbar spine stiffness undergoing THA.
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During the last two decades, extended scientific interest focused on quadrilateral plate (QLP) fractures as part of common acetabular fractures. The QLP corresponds to the medial wall of the acetabulum, and different fracture pattern of Letournel´s fracture types are associated with concomitant QLP fractures. Except anterior and posterior wall fractures, all other fracture types may be associated with QLP fractures. ⋯ Several new implants were development for optimal but often individual stabilization concepts. The gold-standard is still some medial buttressing during internal fixation predominantly using plates, but also screw fixation is considered an option. Additional dome impactions must be considered as an integral part in any QLP fracture analysis and stabilization.
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Arch Orthop Trauma Surg · Dec 2024
ReviewDoes the duration of antibiotic treatment following one-stage treatment of infected total knee arthroplasty influence the eradication rate? A systematic review.
The aim of this study was to perform a systematic review of the current literature to elucidate the optimal duration of systemic antibiotic therapy following one-stage revision TKA in the setting of PJI. ⋯ We demonstrated that short-term IV antibiotics followed by oral antibiotics had similar eradication rates to long-term IV antibiotics in long-term studies, which were both superior to short-term IV antibiotics alone. Nevertheless, there remains a need for prospective and randomized studies to further elucidate a patient-based protocol for the type and duration of antibiotic use following one-stage PJI treatment of the knee.
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Outcome evaluation is of major importance to provide data to analyze the value of the chosen treatment concept. Despite an increasing effort of analyzing outcome after treatment of different pelvic ring injuries, a mixture of different outcome parameters is in use. The Majeed score is most frequently used for mid- to long-term evaluation and the quality of life is analyzed using the SF-36 score. ⋯ Results of treatment of specific fracture types are sparse as a wide range of different injury types and different treatment concepts are analyzed within these analyses. A sufficient pelvic outcome instrument which addresses relevant pelvic outcome parameters is still missing. Thus, future evaluation of long-term results after pelvic ring. injuries should include prospective, multicenter outcome studies with comparable parameters.