Journal of orthopaedic surgery (Hong Kong)
-
J Orthop Surg (Hong Kong) · Sep 2019
Categorization of single cuneiform fractures and investigation of related injuries: A 10-year retrospective study.
The purpose of this study was to define the fracture type and investigate the injuries related to single medial, intermediate, or lateral cuneiform fracture. ⋯ 4.
-
J Orthop Surg (Hong Kong) · Sep 2019
Randomized Controlled TrialComparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy.
This study aimed to compare clinical efficacy and safety of chloroprocaine and lidocaine in epidural anesthesia for outpatient knee arthroscopy. Eighty patients undergoing knee arthroscopy were randomly allocated to receive 3% 2-chloroprocaine (group C, n = 40) or 2% lidocaine (group L, n = 40) for epidural block. Latency to anesthesia onset, highest block level, time to achieve peak effect, time to complete sensory and motor block regression, vital signs including respiration and hemodynamics, and complications during follow-up were recorded. ⋯ No adverse effects or neurologic complications were found in both groups. In conclusion, epidural chloroprocaine elicits rapid anesthetic effects, fast sensor and motor block, and faster recovery of motor function compared to lidocaine. These characteristics make chloroprocaine better than lidocaine as the choice of epidural anesthesia in short clinical operations such as knee arthroscopy.
-
J Orthop Surg (Hong Kong) · Sep 2019
Multicenter StudyThe acceptance of CIRS among orthopedic and trauma surgeons in Germany-Significant gap between positive perception and actual implementation in daily routine.
Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. ⋯ The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.
-
J Orthop Surg (Hong Kong) · Sep 2019
Posterior wall acetabular fracture fixation: A mechanical analysis of fixation methods.
Stable, anatomical fixation of acetabular fractures gives the best chance of successful outcome, while penetration of the acetabular articular surface with screws is associated with poor outcomes. Spring plates are an alternative to interfragmentary lag screws when penetration is a concern. A mechanical study comparing fracture stability and construct stiffness of three fixation methods for posterior wall acetabular fractures with transverse comminutions was performed. ⋯ The rim plate was the stiffest construct 10,962 N/mm, followed by the spring plate model 5637 N/mm and the buttress plate model 4882 N/mm. Based on data obtained in this study, where possible a rim plate with interfragmentary lag screws should be used for isolated posterior wall fractures as this is the stiffest and most stable construct. When this method is not possible, spring plate fixation is a safe and a superior alternative to a posterior buttress plate method.
-
J Orthop Surg (Hong Kong) · Sep 2019
Subsidence and perioperative periprosthetic fractures using collarless hydroxyapatite-coated stem for displaced femoral neck fractures according to Dorr type.
Hydroxyapatite (HA)-coated stem has been introduced to decrease complications and eventually achieve quicker implant ingrowth and long-term stability. The aim of this study was to determine subsidence rate and incidence of perioperative periprosthetic fracture (PPF) of uncemented collarless Corail stem for displaced femoral neck fractures according to Dorr type. ⋯ Dorr type C had higher risk of subsidence when using uncemented collarless HA-coated stem. Dorr canal type had no bearing on risk of PPFs. Women did not have significantly higher risk of both subsidence and PPFs compared to men. A collarless fully HA-coated Corail stem had 3.6% of radiological subsidence and 5.0% of PPF risk.