Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · May 2019
A modified tarsal sinus approach for intra-articular calcaneal fractures.
Plate fixation using traditional lateral L-shape approach for intra-articular calcaneal fractures is complicated by 30% of wound complications, and the lateral small incision techniques with a tarsal sinus approach cannot sufficiently address all the fragments. A modified tarsal sinus approach with combined advantages of traditional lateral L-shape and tarsal sinus approaches for the treatment of intra-articular calcaneal fractures was developed. ⋯ The modified tarsal sinus approach in the treatment of Sander's type II and III calcaneal fractures allowed adequate reduction and rigid fixation with low incidence of wound complications. Compared to sinus tarsi approach, this technique required shorter learning curve and was more easily mastered by young orthopedic surgeons. Thus, it was worthy of application clinically.
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J Orthop Surg (Hong Kong) · May 2019
An increase in the risk of excessive femoral anteversion for relatively younger age and types of femoral morphology in total hip arthroplasty with direct anterior approach.
Direct anterior approach (DAA) is known to diminish a dislocation risk and widely used for total hip arthroplasty (THA). On the other hand, anterior dislocation due to increasing stem anteversion and cup anteversion is an important complication. ⋯ The risk of excessive femoral anteversion increases for relatively younger age and for types of femoral morphology according to the Dorr classification, moreover with an increase of CA in DAA-THA with cementless tapered-wedge stem.
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J Orthop Surg (Hong Kong) · May 2019
After-hours elective spine deformity corrective surgery for patients with Adolescent Idiopathic Scoliosis: Is it safe?
The aim of this study was to compare the outcome of after-hours electively planned Posterior Spinal Fusion surgeries for Adolescent Idiopathic Scoliosis (AIS) patients with daytime surgeries. ⋯ After-hours elective spine deformity corrective surgeries for healthy ambulatory patients with AIS were as safe as when they were done during daytime.
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J Orthop Surg (Hong Kong) · May 2019
The influence of the CT scan in the evaluation and treatment of nondisplaced femoral neck fractures in the elderly.
The management of nondisplaced femoral neck fractures (FNFs) has evolved, with emphasis in radiographic features such as posterior displacement. However, the role of advanced imaging in this scenario is still not well defined. Therefore, our objective is to assess the impact of a computed tomography scan (CT) on interobserver agreement (IA) of fracture classification, posterior tilt measurement, and treatment decisions in nondisplaced FNF in elderly patients. ⋯ IA for fracture classification and posterior tilt evaluation in nondisplaced FNF was not altered by the usage of a CT. There is improvement in treatment agreement when a CT scan is added to conventional imaging, with changes in treatment in 21% of cases.
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J Orthop Surg (Hong Kong) · May 2019
Screw trajectory affects screw cut-out risk after fixation for nondisplaced femoral neck fracture in elderly patients.
Incidence of femoral neck fracture has risen with the aging of the population and has critical implications with regard to patient death, functional dependence, and social costs. Screw fixation using triangular configurations and calcar placement are still the preferred treatment for nondisplaced femoral neck fracture, to reduce the risk of loss of reduction and nonunion. However, this method is still controversial in terms of the effects of screw trajectory, including parallel or nonparallel configurations, on fixation of femoral neck fractures. This study aimed to compare the incidence of complications between patients who have undergone fixation with a parallel or a nonparallel screw trajectory. ⋯ Our results suggested that fixation with nonparallel screws for nondisplaced femoral neck fracture in elderly and osteoporotic patients might interfere with shortening of the femoral neck along with fracture healing, leaving patients at risk of postoperative screw cut-out from the femoral head.