Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2025
Morphologic profiles of comminuted midshaft clavicle fractures: a preliminary study.
Previous literature lacks parametric analysis of clavicle fracture morphology. The aim of this study was to describe the features of comminuted midshaft clavicle fracture in surgically treated patients. ⋯ Comminuted midshaft clavicle fracture frequently had coronal plane fracture lines. Wedge-shaped or multifragmentary fragments were predominantly located anteriorly or inferiorly. In the posterior-superior portion of the clavicle, cortical contact was found to guide reduction.
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Arch Orthop Trauma Surg · Feb 2025
ReviewInternational, consensus-based, indications and treatment options for knee arthroplasty in acute fractures around the knee.
In the landscape of knee-related health issues there has been a notable shift in treatment protocols. Nowadays, there is a growing trend toward primary total knee arthroplasty (TKA) in the event of periarticular knee fractures. A review of the literature on TKA in acute knee fractures has been done in order to provide scientific evidence to the four statements submitted for voting to the members of the European Knee Society (EKS). ⋯ This discussion on the questions voted by the panel of experts has allowed for an in-depth exploration of a topic of interest, assessing indications, contraindications, types of possible treatment, and the critical aspects to consider when treating an acute fracture around the knee with a prosthesis. It is important to consider that the choice must be carefully weighed, evaluating the risks and benefits, with an increasingly need for a scoring system for selecting the most appropriate treatment.
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Arch Orthop Trauma Surg · Feb 2025
Meta AnalysisUnilateral versus bilateral pedicle screw fixation in minimally invasive transforaminal lumbar interbody fusion: a systematic review and meta-analysis of randomized controlled trials.
The minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) that adopts paramedian incisions and tubular retractors to perform the decompression and interbody fusion has been widely used in the surgery for lumber degenerative disease (LDD). Bilateral pedicle screw fixation (BPSF) and unilateral pedicle screw fixation (UPSF) are the primary fixing techniques in MIS-TLIF. We conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the efficacy and safety between UPSF and BPSF in patients undergoing MIS-TLIF surgery for LDD. ⋯ UPSF is better than BPSF when operation time and estimated blood loss are considered. BPSF may be considered for patients with single-level LDD without high-grade spondylolisthesis.
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Arch Orthop Trauma Surg · Feb 2025
ReviewTraumatic lumbosacral instability: part 2-indications and techniques for surgical management.
Traumatic lumbosacral instability (TLSI) refers to a traumatic disruption of the axial skeleton at the level of the lumbosacral motion segment and/or sacrum, resulting in mechanical separation of the caudal spinal column from the posterior pelvic ring. Managing TLSI and its four underlying conditions poses unique challenges among spinal and pelvic injuries. This second part of a two-part series focuses on treatment strategies and decision making in TLSI, with an emphasis on surgical stabilization techniques. The primary objectives of this article are to: (1) elucidate factors influencing clinical decision-making, (2) synthesize current treatment options for the injury patterns underlying TLSI, and (3) briefly outline expected outcomes and complications.
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Arch Orthop Trauma Surg · Feb 2025
Comparative StudyComparison of clinical outcomes among patients treated with high tibial osteotomy and meniscal repair of degenerative medial meniscal tear with mild varus deformity.
The clinical benefits of high tibial osteotomy (HTO) in patients with mild varus deformity with degenerative medial meniscal tear (DMMT) remain unclear. This study aimed to compare clinical outcomes among middle-aged patients with mild varus deformity who underwent arthroscopic meniscal repair and HTO for DMMT. ⋯ Retrospective comparative study, Level III.