Archives of orthopaedic and trauma surgery
-
Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. ⋯ Particular attention must be given to the preoperative evaluation of both the iliosacral and transsacral corridors, as anatomical variations may restrict the available space for screw insertion. This review aims to highlight the essential aspects of sacroiliac osteosynthesis, with a focus on the critical role of thorough preoperative planning and its impact on achieving successful surgical outcomes.
-
Arch Orthop Trauma Surg · Jan 2025
Functional outcomes after ankle fracture-dislocation: a systematic review.
Ankle fractures represent a significant portion of orthopedic injuries, with fracture dislocations tending to have worse outcomes. Logsplitter fractures represent a subset of fracture dislocations in which the talus is axially wedged in the tibiofibular joint. We aim to comprehensively investigate and report on the complications and functional outcomes associated with ankle fracture-dislocations. ⋯ Ankle fracture-dislocations are high-energy injuries that affect a younger population compared to non-dislocated ankle fractures. Their functional outcomes resemble those of pilon fractures more than common ankle fractures. Logsplitter injuries are a subset of fracture dislocations that occur in even younger patients, with worse functional outcomes. This information can guide perioperative discussion and expectations for functional recovery. Additional studies are needed to evaluate the impact of these injuries on return to employment.
-
Arch Orthop Trauma Surg · Jan 2025
ReviewIndications for the addition of a patellofemoral joint arthroplasty following a previous unicondylar knee arthroplasty- a literature review and Delphi consensus.
The aim of this study was to establish an international consensus statement on the indications for the addition of a patellofemoral joint arthroplasty (PFJA) in patients with a unicondylar knee arthroplasty (UKA) and symptomatic progression of patellofemoral compartment osteoarthritis. ⋯ The simple addition of a PFJA to patients with an existing UKA and progression of patellofemoral compartment osteoarthritis is an attractive option. This EKS Delphi-derived consensus statement, which reached a strong consensus, can be used by clinicians to identify patients suitable for this procedure.
-
Arch Orthop Trauma Surg · Jan 2025
ReviewPrecision medicine in diagnosis, prognosis, and disease monitoring of bone and soft tissue sarcomas using liquid biopsy: a systematic review.
Liquid biopsy as a non-invasive method to investigate cancer biology and monitor residual disease has gained significance in clinical practice over the years. Whilst its applicability in carcinomas is well established, the low incidence and heterogeneity of bone and soft tissue sarcomas explains the less well-established knowledge considering liquid biopsy in these highly malignant mesenchymal neoplasms. ⋯ This systematic literature review provides an extensive up-to-date overview about the current and potential future uses of different liquid biopsy modalities as diagnostic, prognostic, and disease monitoring markers in sarcoma.
-
Arch Orthop Trauma Surg · Jan 2025
Diabesity is associated with a worse joint specific functional outcome following primary total knee replacement.
The combined effect of diabetes mellitus and obesity (Diabesity) on total knee replacement (TKR) outcomes is unclear. This study aimed to assess whether diabesity influenced functional outcomes and complication rate following primary TKR. ⋯ Diabesity was independently associated with a worse knee-specific function and Eq. 5D score pre-operatively, and diminished joint specific functional improvement following TKR. Patients with diabesity also experienced reduced post-operative satisfaction due to obesity independently.