Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2021
ReviewLateral retinacular release combined with MPFL reconstruction for patellofemoral instability: a systematic review.
The role of the lateral retinaculum in patellofemoral instability is still debated. Lateral retinacular release (LRR), has been extensively performed in combination with different surgical procedures, including reconstruction of medio-patellofemoral ligament (MPFL). Despite controversial indications, the results from these studies seem promising. The present study conducts a systematic review about current biomechanical and clinical evidence concerning the role of LRR in combination with MPFL reconstruction. We performed a comprehensive literature research, comparing the outcomes of MPFL reconstruction with and without LRR. ⋯ IV, Systematic review.
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Arch Orthop Trauma Surg · Feb 2021
Impact of duration of perioperative antibiotic prophylaxis on development of fracture-related infection in open fractures.
Infection is a common complication of open fractures potentially leading to nonunion, functional loss, and even amputation. Perioperative antibiotic prophylaxis (PAP) is standard practice for infection prevention in the management of open fractures. However, optimal duration of PAP remains controversial. The objectives were to assess whether PAP duration is independently associated with infection in open fractures and if administration of PAP beyond the commonly-recommended limit of 72 h has any effect on the infection rate. ⋯ This study found no evidence that administration of prophylactic antibiotics beyond 72 h in patients with long-bone open fractures is warranted. Analyses adjusted for known confounders even revealed a higher risk for FRI for longer PAP. However, this effect cannot necessarily be considered as causal and further research is needed.
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Arch Orthop Trauma Surg · Feb 2021
Cutibacterium acnes infections in revision surgery for persistent shoulder complaints: a retrospective cohort study.
Low-grade Cutibacterium acnes (C. acnes) infections after shoulder surgery usually result in unexplained complaints. The absence of clinical signs of infection makes the incidence unclear and underreported. This study aimed to determine the incidence of C. acnes infections in patients with artificial material and unexplained persistent shoulder complaints. We hypothesized that the incidence of C. acnes infections would be higher in patients with artificial material. Risk factors and associations between culture time and contaminations/infections were also assessed. ⋯ The incidence of C. acnes infections was 42.6% in patients with artificial material and 42.2% in patients without artificial material. Younger age and lower BMI are risk factors. Low-grade C. acnes infections should be considered in patients with unexplained persistent complaints following shoulder surgery.
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Arch Orthop Trauma Surg · Feb 2021
Observational StudyAn observational study of complications in patients with established multiple compartments syndrome of the leg.
Established multiple compartments syndrome of the leg (EMCSL) is defined as permanent ischemic lesions of muscles and nerves of the compartment, leading to multiple muscle contractions, muscle weakness and wasting and reduced limb sensation. The leg is seriously affected and the patient is unable to return to prior activities. The objective of this research is to quantify long-term consequences, morbidity and socioeconomic impact of established multiple compartments syndrome of the leg MATERIALS AND METHODS: 28 patients suffering from complications from EMCSL were referred to our clinic for secondary management between January 2012 and April 2016 and were followed for mean 41.4 months. Reconstructive procedures to address multiple conditions following established tibia compartment syndrome were performed. The number of reconstructive procedures, days of hospitalization, relationship, educational and employment status per patient were recorded. Preop and postop SF-12 score at final follow-up was documented for the 21 patients who were operated on. ⋯ Despite advancements in surgical reconstructive intervention, patients with established compartment tibia syndrome experience permanent grave residual disability with personal and social implications.
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Arch Orthop Trauma Surg · Feb 2021
Short stem humeral components in reverse shoulder arthroplasty: stem alignment influences the neck-shaft angle.
Shorter humeral reverse total shoulder arthroplasty (RTSA) stems may reduce stress shielding, however, potentially carry the risk of varus/valgus malalignment. This radiographic study's purpose was to measure the incidence of stem malalignment and thus the realized neck-shaft angle (NSA). The hypothesis was that malalignment of the stem is a frequent postoperative radiographic finding. ⋯ Level IV, retrospective study.