Archives of orthopaedic and trauma surgery
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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.
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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.
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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.
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Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients. ⋯ Beside angioembolization (AE) and Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), pelvic packing PP (predominantly extraperitoneal) with direct access to the pelvic bleeding sources, are potential options. The present overview represents the present status, results and the value of pelvic packing in treating these patients. Interpretation of these results must consider the difference between the initial European concept of pelvic ring stabilization followed by PP in contrast to the North American concept with a reduced rate of pelvic ring stabilizations.
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Arch Orthop Trauma Surg · Jan 2025
Stair climbing ability and postoperative activity in patient-reported outcomes after CR-TKA are more related to handgrip strength than sagittal knee stability.
Stair ascent and descent are physically demanding tasks requiring higher functional ability of the lower extremity muscles and joint range of motion than level walking, and are associated with patient satisfaction after total knee arthroplasty (TKA). This study aimed to investigate stair ascent and descent ability after cruciate-retaining (CR)-TKA using the patient-reported outcomes, and to examine the role of knee sagittal stability and handgrip strength in postoperative stair ascent and descent ability. ⋯ Handgrip strength was associated with stair ascent and descent ability and postoperative activity in the patient-reported outcomes, rather than CR-TKA knee sagittal stability.