Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2024
Suprapatellar intramedullary nail combined with screw fixation has comparable surgical outcomes to minimally invasive locking plate fixation in ipsilateral tibial plateau and shaft fractures.
To compare union rate, union time, alignment, and complication rate in ipsilateral tibia plateau and shaft fractures treated via suprapatellar intramedullary nailing with screw fixation and minimally invasive locking plate fixation. ⋯ Level III.
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Arch Orthop Trauma Surg · Feb 2024
Cortical bone thickness on preoperative CT scans as predictor of bone quality in distal femur fractures: a retrospective study in Caucasians.
Distal femur fractures (DFF) are rare, but associated with high complication rates and mortality, particularly in patients with osteoporosis. To improve preoperative assessment, we analyzed if cortical bone thickness on CT and AP radiographs is associated with clinical parameters of bone quality. ⋯ Our results showed that cortical thickness of the distal femur correlates with clinical parameters of bone quality and is therefore an excellent tool for assessing what surgical care should be provided. Interestingly, our findings indicate that cortical thickness on CT is more strongly correlated with clinical data than AP radiograph measurements.
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Arch Orthop Trauma Surg · Feb 2024
The effects of length and width of the stem on proximal humerus stress shielding in uncemented primary reverse total shoulder arthroplasty.
To preserve humeral bone during RTSA, stems have been made shorter and cement avoided whenever possible. However, with the increased use of uncemented RTSA, a phenomenon comparable to the stress shielding of the hip has been described for the proximal humerus. The aim of this study was to investigate the influence of stem length and width on proximal humeral bone resorption after primary uncemented RTSA. ⋯ III.
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Arch Orthop Trauma Surg · Feb 2024
Patient disposition after discharge following primary total hip arthroplasty: home versus skilled nursing facility-a study based on national inpatient sample database.
In view of the shortened length of hospital stay following THA, an increasing proportion of patients have required transfer to "extended-care" (ECF) or "skilled nursing" facilities (SNF) over the past years. As a result, the expenditure related to postoperative care facility has been acknowledged as a crucial component of total economic burden associated with THA. In this context, the clinical and demographic factors leading to the need for transfer of patients to SNF following primary THA need to be clearly understood. ⋯ We could observe that 0.2% of patients required transfer to SNF following primary THA. Comorbidities such as Parkinson's disease, previous H/O dialysis, legal blindness and H/O colostomy had the highest odds of necessitating patient disposition to SNF. The occurrence of one or more systemic complications including pneumonia, DVT, ARF, MI, PE, and blood loss anaemia (or need for blood transfusion) or local prosthesis-related complications (dislocation, fracture or infections) substantially increased the chances of requiring transfer to a specialised care facility.
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Arch Orthop Trauma Surg · Feb 2024
First 100 total hip arthroplasties performed by a young surgeon using the direct anterior approach: learning curve and complications.
Most of the reported discussions about the learning curve for the direct anterior approach (DAA) in total hip arthroplasty (THA) have been by experienced surgeons. The study's aim was to describe the learning curve, short-term outcomes, complications, and adaptations to the DAA used in the first 100 THA cases experienced by a young surgeon who had received DAA training for trauma surgeries. ⋯ Even after receiving training on the DAA for trauma surgeries, the young surgeon experienced a steep learning curve and more complications in the first 50 cases. The DAA for THA is a technically demanding procedure and may require guidance from an experienced surgeon to manage unexpected complications.