Archives of orthopaedic and trauma surgery
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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.
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Arch Orthop Trauma Surg · Feb 2025
Reliability and utility of the new Belt et al. classification for revision of infected total knee arthroplasty.
The frequency of revisions in total knee arthroplasty (TKA) is rising. Various classifications of bone defects exist, each with its own limitations. Recently, Belt et al. have proposed a new classification for TKA revisions based on X-ray imaging. We evaluated the Belt et al. classification and verified if this new classification is reliable, and if it correlates with the implant used during revision surgery for periprosthetic joint infection. ⋯ The Belt at al. classification is reliable, but a classification which can predict the implant neded have to be developed.
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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
Calculation of CT ideal screw path and safety angle before percutaneous sacroiliac screw placement.
Percutaneous sacroiliac screw placement is the main surgical approach to treat unstable posterior pelvic ring injuries. Intraoperative fluoroscopic imaging is an important part of safe sacroiliac screw placement. However, how to determine the right perspective view is challenging. We developed a trigonometric algorithm to verify how preoperative pelvic computed tomography (CT) can be used to predict ideal screw path and safety angle. ⋯ During preoperative planning, trigonometric calculations were used to determine the ideal screw placement angles and safety angle at the inlet and outlet of the screw path. Combined with intraoperative C-arm fluoroscopy, individualized screw insertion can help orthopedic surgeons quickly and accurately obtain intraoperative images and accurately determine the direction of screw insertion.
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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.