Archives of orthopaedic and trauma surgery
-
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.
-
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.
-
Arch Orthop Trauma Surg · Feb 2025
No influence of patient age on operative treatment outcome of osteochondral lesions of the talus: data from the German Cartilage Registry (GCR, KnorpelRegister DGOU).
The influence of patient age on the clinical outcome of surgically treated osteochondral lesions of the talus (OCT) is controversial. Aim of this study was to evaluate the 24 months follow-up data of the German Cartilage Registry (KnorpelRegister DGOU, GCR) regarding the influence of patient age on clinical outcomes after surgical OCT treatment. ⋯ Results of surgical therapy of OCTs are independent from patient age. There is no superiority of a specific surgical technique depending on patient age.
-
Arch Orthop Trauma Surg · Jan 2025
Autologous minced cartilage implantation in osteochondral lesions of the talus-does fibrin make the difference?
Implantation of minced cartilage is a one-step-procedure that leads to satisfactory results in osteochondral defects. ⋯ Autologous minced cartilage implantation seems to be sufficient as a viable, one-step treatment for osteochondral lesions of the talus. It leads to low complication rates and excellent AOSS values within a 12-month period whereas the application of fibrin as the last fixation layer seems to be advisory, which demands further investigation.
-
Arch Orthop Trauma Surg · Jan 2025
What does the patients' perception of alignment tell us about alignment targets in total knee arthroplasty?
Knee alignment significantly impacts the outcome of total knee arthroplasty (TKA). Understanding patient perceptions of their knee alignment in relation to objective measurements is essential to ensure optimal surgical outcomes and to meet patients' expectations. This study reports patients' perception of pre- and postoperative knee alignment in relation to radiographic alignment measurements. ⋯ Patients predominantly desire a straight knee postoperatively, however, most patients tend to perceive some varus alignment as straight. This is most common in patients with up to 5 degrees of varus deformity and suggests that a restricted or inverse kinematic alignment with up to 5 degrees of varus can meet the expectations of most patients. In contrast, patients with valgus deformity are sensitive to any remaining valgus deformity and leaving the knees in more than 2 deg. of valgus will unlikely satisfy the patients' overall desire for a straight knee after surgery.