Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Dec 2024
Comparative Study Observational StudyComparison of two surgical treatment strategies for fragility fractures of the pelvis based on early postoperative mobility outcomes using insole force sensors.
Increasing incidences for fragility fractures of the pelvis (FFP) have been reported and surgical treatment remains demanding. While conventional screw osteosynthesis is a common method, complications may arise due to altered bone morphology in the osteoporotic pelvic bone. The iFuse implant system is a novel implant, first introduced for treatment of degenerative sacroiliac joint dysfunction, which offers promising biomechanical characteristics with potential benefits for treatment of FFP. Yet data on the use for FFP is limited. The objective of this study is to compare early postoperative mobility of patients treated with screw osteosynthesis only versus patients treated with additional iFuse stabilization based on insole force sensor gait analysis. We hypothesized that additional iFuse implantation leads to superior postoperative mobility. ⋯ Comparison of early postoperative mobility showed similar mobility outcomes in both groups. Patients with additional iFuse implantation had a more balanced gait pattern, whereas no significance was found in peak force parameters. Additional iFuse implantation showed promising results regarding patient mobility, therefore our hypothesis was partly confirmed. In future long-term examinations with larger patient cohorts should be aimed for.
-
Arch Orthop Trauma Surg · Dec 2024
Statistical shape models quantify acetabular defects in hip revision surgery: implications for classification and surgical planning.
The purposes of this study was to develop a novel therapy-oriented acetabular bone defects classification system based on Statistical shape models (SSMs) and evaluate the reliability and reproducibility of its application. ⋯ This classification system, which has demonstrated moderate to strong interobserver and intraobserver reliability, may be particularly useful to accurately evaluate acetabular defects and suggest surgical strategies, as a complement to the traditional Paprosky classification system in revision THA.
-
Arch Orthop Trauma Surg · Dec 2024
Management of osteochondritis dissecans lesions of the elbow including return to sport remains variable among orthopaedic surgeons.
Management of osteochondritis dissecans (OCD) lesions of the capitellum is challenging. Historically, variability exists between surgeons in the evaluation, treatment, and return to sport criteria. The purpose of this study was to define the current trends regarding evaluation, nonoperative and surgical management, and return to sport criteria for capitellar OCD lesions among surgeons. ⋯ There is significant variability in the management of capitellar OCD in athletes. Small, centralized lesions are likely to be treated with debridement and microfracture with faster return to sport. Treatment of large, lateral lesions remains variable. Regarding OAT procedures, perceived morbidity, reimbursement, and limited evidence dissuade use. There is no consensus on return to sport, though lack of pain and time were most important; overhead athletes and gymnasts are restricted longer from returning to sport. Level of Evidence Level 5, diagnostic, cross-sectional survey.
-
Arch Orthop Trauma Surg · Dec 2024
Percutaneous calcaneal sliding osteotomy with the rising sun technique.
Calcaneal slide osteotomies represent a well-established component in the surgical treatment of joint-preserving hind foot corrections. The percutaneous technique aims to minimize the surgical morbidity and maximize surgical efficiency. There is a consensus that percutaneous calcaneal sliding osteotomy (PCSO), using a low-speed and hightorque burr, is generally performed in four steps corresponding to the four quadrants of the cross-section of the calcaneal tuber. We present a technique that allows a more efficient osteotomy by cutting the far cortex in one step using standard percutaneous equipment. The aim of this study is to present preliminary results and the surgical technique of a modification for percutaneous calcaneal sliding osteotomy. ⋯ Compared to traditional open calcaneal slide osteotomies, PCSO helps to reduce softtissue morbidity and may result in fewer surgery-related complications. The Rising Sun procedure of PCSO represents a safe and easy-to-perform alternative to the traditional 4-quadrants technique in the percutaneous correction of hindfoot malalignment. Our prospective case series showed a low rate of complications and reproducible surgery time and use of fluoroscopy.
-
Arch Orthop Trauma Surg · Dec 2024
Outcomes of Revision surgery for surgically treated insertional Achilles tendinopathy.
There is a clear roadmap for the treatment of primary insertional Achilles tendinopathy (IAT), but data on the outcome of revision surgery is missing. The current study aimed to analyze the outcome following revision surgery for surgically failed IAT. ⋯ IAT revision surgery results in an improvement of the patients' symptoms, but only one-third of the patients recover fully.