Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2020
Surgeon-stratified cohort analysis of 1976 cementless Zweymüller total hip arthroplasties from a single hospital with 23,255 component years of follow-up.
The third-generation Zweymüller hip endoprosthesis has been used for decades with excellent results in arthroplasty registries, but surgeon-stratified reports on this implant are still scarce. The aim of the presented single-hospital cohort analysis of the third-generation Endoplus-Zweymüller primary total hip arthroplasty was to determine implant survival rates until the first revision/removal at 10/15/20/25 years after implantation and to find out whether implant survival depended on the operating surgeon, patient's age and gender, operated side (right/left), season of the year and the set of implanted components (SL-PLUS femur, BICON-PLUS acetabulum or both components). ⋯ The study presents the largest published third-generation Zweymüller BICON/SL-PLUS total hip arthroplasty cohort from a single non-developmental hospital with 23,255 component years of observation. Study findings indicate the impact of environmental factors at primary implantation and variability between different surgeons on the long-term implant survival.
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Arch Orthop Trauma Surg · Sep 2020
Postoperative results of Ogawa type IIB meta-acromion fracture fixation with a 90° twisted reconstruction plate.
Acromion fractures are rare and difficult to treat. There is no consensus on type of fixation. Due to the rarity of the injury, it is difficult to compare different techniques of osteosynthesis. ⋯ The use of 3.5-mm reconstruction plate with a 90° twist for open reduction internal fixation (ORIF) of meta-acromion fractures presents satisfactory results and could be technically a more stable biomechanical construct in comparison to the existing surgical techniques.
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Arch Orthop Trauma Surg · Sep 2020
Case ReportsPosterior wall acetabular fracture in a 13-year-old boy treated by open reduction and mini-plate internal fixation: long-term follow-up of 17 years.
Acetabular fractures are uncommon in children and adolescents, mainly because of predominant cartilaginous component and strong surrounding ligaments. Although acetabular fractures at this age can lead to significant disability, there is no consensus regarding management, which continues to be controversial. Particularly, long-term outcome after operative management has not been evaluated. ⋯ We report a case of a 13-year-old boy skeletally immature who presented with an isolated acetabular fracture involving the posterior wall secondary to a traumatic hip dislocation. A Kocher-Langenbeck approach with a surgical luxation of the hip was used for reduction and mini-plate internal fixation of the fracture. Long-term (17-year) follow-up showed a good clinical outcome and a good congruence of the. The patient has bilateral beginning osteoarthritis due to a cam configuration of both hips CONCLUSION: We describe a case of successful operative management of an acetabulum fracture in a skelettaly immature child with a long-term follow-up. Aggressive management of this rare type of fractures may lead to durable positive outcome.
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Arch Orthop Trauma Surg · Sep 2020
Radial collateral ligament repair of the thumb: long-term outcomes and predictive factors of postoperative deficits.
The thumb's radial collateral ligament (RCL) plays an important role in stabilizing the first metacarpophalangeal joint (MCP-1). RCL injuries are rare and treatment recommendations are inconsistent in the current literature. The aim of this study was to report on long-term outcomes following surgical repair of thumb RCL tear and to identify prognostic risk factors for treatment failure. ⋯ Long-term follow-up has proven that surgical repair of RCL enables the patient to regain adequate stability and strength of the MCP-1 joint and minimizes disability. Predictive risk factors of pain persistency after surgery are surgical delay and palmar subluxation of the MCP-1 joint.
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Arch Orthop Trauma Surg · Sep 2020
Extracorporal shock wave therapy for the treatment of arthrodesis non-unions.
Non-union is a regular complication of arthrodeses. Standard treatment includes revision surgery with frequent need for re-revision due to persistent non-union. Particularly patients with concomitant diseases are at risk of secondary complications. There is a need for evaluation of alternative treatment options. The aim of this study is to provide first evidence on union-rate and pain course after focussed extracorporeal shock-wave therapy of arthrodesis non-unions. ⋯ Level IV.