Articles: fracture-fixation.
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Arch Orthop Trauma Surg · Dec 2024
Comparative StudyIncreased risk of adverse events following the treatment of associated versus elementary acetabular fractures: a matched analysis of short-term complications.
This retrospective cohort study aims to compare short-term complication rates between patients receiving open reduction and internal fixation (ORIF) for associated versus elementary acetabular fractures, with a secondary objective of identifying independent risk factors for adverse outcomes. ⋯ The findings of this study identify areas of greater risk of postoperative complications after ORIF in individuals with associated versus elementary acetabular fractures. Discussion of these heightened risks is critical to appropriate patient care. Understanding these risks plays an important role in the clinical decision-making process and may identify areas to monitor patients postoperatively.
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During the last two decades, extended scientific interest focused on quadrilateral plate (QLP) fractures as part of common acetabular fractures. The QLP corresponds to the medial wall of the acetabulum, and different fracture pattern of Letournel´s fracture types are associated with concomitant QLP fractures. Except anterior and posterior wall fractures, all other fracture types may be associated with QLP fractures. ⋯ Several new implants were development for optimal but often individual stabilization concepts. The gold-standard is still some medial buttressing during internal fixation predominantly using plates, but also screw fixation is considered an option. Additional dome impactions must be considered as an integral part in any QLP fracture analysis and stabilization.
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Arch Orthop Trauma Surg · Dec 2024
Comparative Study Observational StudyComparison of two surgical treatment strategies for fragility fractures of the pelvis based on early postoperative mobility outcomes using insole force sensors.
Increasing incidences for fragility fractures of the pelvis (FFP) have been reported and surgical treatment remains demanding. While conventional screw osteosynthesis is a common method, complications may arise due to altered bone morphology in the osteoporotic pelvic bone. The iFuse implant system is a novel implant, first introduced for treatment of degenerative sacroiliac joint dysfunction, which offers promising biomechanical characteristics with potential benefits for treatment of FFP. Yet data on the use for FFP is limited. The objective of this study is to compare early postoperative mobility of patients treated with screw osteosynthesis only versus patients treated with additional iFuse stabilization based on insole force sensor gait analysis. We hypothesized that additional iFuse implantation leads to superior postoperative mobility. ⋯ Comparison of early postoperative mobility showed similar mobility outcomes in both groups. Patients with additional iFuse implantation had a more balanced gait pattern, whereas no significance was found in peak force parameters. Additional iFuse implantation showed promising results regarding patient mobility, therefore our hypothesis was partly confirmed. In future long-term examinations with larger patient cohorts should be aimed for.
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It is unclear whether small plates are needed for augment fixation to provide a more stable mechanical environment in segmental fractures of the tibia treated with intramedullary nail. The purpose of this study was to investigate the efficacy of intramedullary nailing combined with locking plates in the treatment of segmental fractures of the tibia. This study included 41 patients with segmental tibia fractures between January 1, 2018 and January 1, 2023. ⋯ At the last follow-up, no statistically significant differences in walking ability were detected. Our results suggest that a locking plate combined with an intramedullary nail for segmental tibial fractures may require a longer surgical incision, but it has significant advantages such as a shorter operative time and time to union, a shorter fluoroscopy time, and a lower rate of malunion and nonunion. Intramedullary nail fixation assisted by a locking plate is an effective method for treating segmental fractures of the tibia.
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Quadrilateral plate fracture is one of the most complex and challenging pelvic lesions. Operative reduction and internal fixation are the gold standard management for displaced quadrilateral plate fractures. Traditional methods include various kinds of operative reduction and internal fixation through either anterior or posterior approaches using various combinations of plates and lag screws or acute total hip arthroplasty. ⋯ The biomechanical test showed the superiority of reconstruction plate combined with trans-plate quadrilateral screws over conventional titanium plate combined with 1/3 tube titanium plate in treating both-column quadrilateral plate fractures in standing position. Later finite element analysis confirmed the stabilities of the fractures under 1-legged stance. Thus, reconstruction plate combined with trans-plate quadrilateral screws provides an alternative method in treating quadrilateral plate fractures.