Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jun 2024
Randomized Controlled Trial Comparative StudyComparison of virtual reality and computed tomography in the preoperative planning of complex tibial plateau fractures.
Preoperative planning is a critical step in the success of any complex surgery. The pur-pose of this study is to evaluate the advantage of VR glasses in surgical planning of complex tibial plateau fractures compared to CT planning. ⋯ The use of virtual reality for surgical planning of complex tibial plateau fractures resulted in significantly shorter planned operative time, while planning time was longer compared to CT planning. After VR planning, more surgeons felt (very) well prepared for surgery.
-
Arch Orthop Trauma Surg · Jun 2024
The Impact of Epidural Analgesia on Immobility and extended Hospital Stay After Periacetabular Osteotomy.
Early mobilisation after periacetabular osteotomy (PAO) represents an important goal after surgery. The purpose of this study was to determine whether the use of epidural aznalgesia (EA) is associated with prolonged immobility and an increased length of stay (LOS) after PAO surgery. ⋯ Opting against the use of EA in patients undergoing PAO is advisable, as it will result in extended postoperative immobility and the associated risks. Additionally, the active participation of the surgeon in the mobilisation process is strongly recommended.
-
Arch Orthop Trauma Surg · Jun 2024
Comparative StudyAnkle fracture surgery performed by orthopaedic residents without supervision has comparable outcomes to surgery performed by fellowship trained orthopaedic surgeons.
Unstable fractures often necessitate open reduction and internal fixation (ORIF), which generally yield favourable outcomes. However, the impact of surgical trainee autonomy on healthcare quality in these procedures remains uncertain. We hypothesized that surgery performed solely by residents, without supervision or participation of an attending surgeon, can provide similar outcomes to surgery performed by trauma or foot and ankle fellowship-trained orthopaedic surgeons. ⋯ Level III - retrospective cohort study.
-
Arch Orthop Trauma Surg · Jun 2024
Comparative StudyThe infraacetabular screw versus the antegrade posterior column screw in acetabulum fractures with posterior column involvement: a biomechanical comparison.
Traditionally, plate osteosynthesis of the anterior column combined with an antegrade posterior column screw is used for fixation of anterior column plus posterior hemitransverse (ACPHT) acetabulum fractures. Replacing the posterior column screw with an infraacetabular screw could improve the straightforwardness of acetabulum surgery, as it can be inserted using less invasive approaches, such as the AIP/Stoppa approach, which is a well-established standard approach. However, the biomechanical stability of a plate osteosynthesis combined with an infraacetabular screw instead of an antegrade posterior column screw is unknown. ⋯ Replacing the antegrade posterior column screw with an infraacetabular screw is not recommendable as it results in an increased interfragmentary motion, especially at the posterior hemitransverse component of an ACPHT fracture.
-
Arch Orthop Trauma Surg · Jun 2024
Propensity of the tight mid-flexion and loose flexion gap despite the adjustment of extension and flexion gaps in Oxford unicompartmental knee arthroplasty: retrospective study.
A well-balanced joint gap is necessary in Oxford unicompartmental knee arthroplasty (OUKA) to prevent mobile-bearing dislocation. While the gaps between 20° (extension) and 100° (flexion) are precisely adjusted using the incremental mill system, there has been insufficient evaluation of gaps in other angles. We hypothesized that the gap is not always the same in other angles. This retrospective study aimed to evaluate the gap in full-extension (0°), mid-flexion (60°) and deep flexion (130°) for comparison with those in extension and flexion gaps. ⋯ Our results highlight the propensity of tight mid-flexion and loose flexion gap despite the adjustment of extension and flexion gaps in OUKA. Although the effect of such a minor gap imbalance is still unknown, the pattern was more prevalent in patients with smaller-sized femoral components. Use of a larger femoral component may equalize the gap throughout the motion arc.