Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2024
ReviewTechniques of core decompression in the treatment of idiopathic avascular necrosis of the femoral head.
Core decompression was developed as a joint-preserving procedure for patients with early-stage osteonecrosis of the femoral head. Previous studies indicated a high success rate that outperforms nonoperative management of pre-collapse hips. The traditional single-tunnel core decompression technique uses a cannulated drill bit inserted into the lateral cortex of the proximal femur. ⋯ Adjunctive therapeutics such as tantalum rods, bone-grafting, orthobiologic (e,g, bone marrow aspirate concentrate, mesenchymal stem cells, platelet-rich plasma, and human umbilical cord mesenchymal stem cell extracts) as well as electric stimulation have all been studied. No consensus regarding the ideal treatment has been reached. This review analyzes the advantages and disadvantages of current core decompression techniques to provide orthopaedic surgeons with direction in managing patients with avascular necrosis of the femoral head.
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Arch Orthop Trauma Surg · Dec 2024
ReviewChronic pelvic insufficiency fractures and their treatment.
Fragility and insufficiency fractures of the pelvis (FFP) and sacrum (SIF) are increasingly prevalent, particularly among the elderly, due to weakened bone structure and low-energy trauma. Chronic instability from these fractures causes persistent pain, limited mobility, and significant reductions in quality of life. Hospitalization is often required, with substantial risks of loss of independence (64-89%) and high mortality rates (13-27%). ⋯ Sacroplasty provides significant pain relief but has limited stabilizing capacity, while screw augmentation with polymethylmethacrylate improves fixation in osteoporotic bones. Anterior ring fractures may be treated with retrograde transpubic screws or symphyseal plating, with biomechanical stability and long-term outcomes depending on fixation techniques. FFP and SIF management requires a multidisciplinary approach to ensure stability, pain relief, and functional recovery, emphasizing early diagnosis, tailored surgical strategies, and secondary prevention of osteoporotic fractures.
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Arch Orthop Trauma Surg · Dec 2024
Short-term follow-up of single-port thoracoscopic rib fracture reduction and internal fixation for the treatment of multiple rib fractures.
The objective of this study was to evaluate the short-term outcomes of single-port thoracoscopic rib fracture reduction and internal fixation for the treatment of multiple rib fractures. ⋯ The use of a memory alloy reverse rib embrasure device for intrathoracic rib fracture fixation via single-port thoracoscopic surgery is safe and reliable. This method demonstrates a high success rate of internal fixation, excellent clinical fracture healing, and advantages such as minimal trauma, rapid recovery, and the simultaneous treatment of other intrathoracic conditions. It significantly reduces postoperative pain and enhances the quality of life.
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Arch Orthop Trauma Surg · Dec 2024
Long term functional outcome for the cubital tunnel syndrome after endoscopic assisted release of the ulnar nerve.
The endoscopic assisted release for cubital tunnel syndrome (CuTS) gained popularity in recent years with unclear long-term results. This study aims to evaluate long term results regarding functional and subjective outcomes after endoscopic assisted release for the CuTS. ⋯ This study found the endoscopic assisted release of the ulnar nerve to be an efficacious and safe method for the treatment of CuTS.
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Arch Orthop Trauma Surg · Dec 2024
Risk analyses for perioperative morbidities after aseptic knee revision arthroplasty.
Total lower limb arthroplasties are standard orthopedic surgeries that are steadily increasing in modern civilization. In proportion, the number of revision arthroplasties and the corresponding financial burden for healthcare systems will increase. The present clinical investigation analyzed morbidities after aseptic revision knee arthroplasty. ⋯ Aseptic knee revision arthroplasty is a complex procedure with perioperative morbidities that can significantly impact outcomes. Age and gender are crucial factors in managing complications during hospitalization and follow-up. Elderly patients, particularly those over 75 years, are more prone to aseptic loosening and require tailored preoperative preparation. The study underscores the importance of individualized patient care strategies to mitigate risks and improve outcomes in aseptic knee revision arthroplasty.