Articles: fracture-fixation.
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Locking plate fixation remains the mainstay of surgical fixation of unstable proximal humerus fractures, however rates of failure remain high. The aim of this study was to identify risk factors that could be used to predict the likelihood of fixation failure. ⋯ Level II.
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Severe metaphyseal comminution and sizable bone defect of the distal femur are high risks of fixation failure. To date, no exact magnitude of comminution and bone loss is determined as an indication for augmentation of fixation construct. The present study aimed to investigate the influence of metaphyseal gap width, working length, and screw distribution on the stability of the fixation construct. ⋯ The 30-mm and wider metaphyseal gap width with a long working length presented a risk of varus collapse and fixation failure. Short working length with spreading screw provided low EQV stress, low bone stress, and high fracture stability.
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The global average life expectancy has been increasing steadily as the quality of healthcare continues to improve. However, there is a paucity of data looking at surgical fixation of thoracolumbar spine fractures in patients ≥80 years (super-elderly). Aim of this study is to look at whether there is higher rate of complications from surgical fixation of thoracolumbar fractures in this group of patients. ⋯ The super-elderly had a higher incidence of osteoporosis and worse comorbidities, but there was no significant difference regarding implant complications, revision surgery required, or all-cause mortality. Hence, surgical fixation of thoracolumbar spine fractures in people older than 80 years should be considered despite their advanced age.
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Eur J Trauma Emerg Surg · Jan 2025
Comparative StudyDoes a gentamicin-coated intramedullary nail prevent postoperative infection in Gustilo type I and II tibial open fractures? A comparative study and retrospective analysis.
Tibial open shaft fractures are very common and susceptible to infection, which can lead to significant morbidity especially infection and non-union. Antibiotic coated nail is one option for fixing open shaft tibial fractures to minimise infection. This study aimed to compare the clinical outcome of Gentamicin-coated tibial nails versus regular unreamed interlocking tibial nails in the treatment of type I and II tibial open fractures. ⋯ We hypothesized that Gentamicin-coated nail is effective in preventing infection in Gustilo type I and II open fractures compared to non-antibiotic-coated regular nails.
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Arch Orthop Trauma Surg · Jan 2025
Increased stiffness with medial column screw supplementation of lateral locking plate for distal femur fractures: a biomechanical study.
We propose and assess the biomechanical stability of medial column screw supplementation in a synthetic distal femur fracture model. ⋯ This is the first study to evaluate the contribution of a medial column screw in a distal femur fracture model. PWS had superior stiffness and few failures compared to PA. Applied clinically, a medial column screw can increase construct stability in the setting of complex distal femur fractures with minimal increase in operative time, patient morbidity and cost.