Articles: fracture-fixation.
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Eur J Trauma Emerg Surg · Jan 2025
Comparative StudyTemporal comparison of radiological and functional outcomes in calcaneal fracture surgery with and without iliac crest graft application: Mid- to long-term results.
The standard approach for addressing intra-articular calcaneal fractures involves open reduction with plate and screw fixation, with ongoing discourse regarding the application of grafts to address bone gaps. The aim of this study is the temporal comparison of the radiological and functional outcomes in patients undergoing surgery for intra-articular calcaneal fractures, with a specific focus on the use of bone grafts. ⋯ A retrospective cohort study.
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Background and Objectives: A basicervical femoral fracture is a relatively uncommon type of proximal femoral fracture. However, as the proportion of proximal femoral fractures rises in conjunction with the aging of society, the absolute number of patients with basicervical femoral fractures is also increasing. Nevertheless, the optimal surgical methods for the treatment of basicervical femoral fractures remain a topic of debate. ⋯ Group A exhibited a significantly higher incidence of fixation failure (0% vs. 44.4%, p =0.037) compared to Group E. Conclusion: In the treatment of low-energy basicervical femoral fractures with cephalomedullary nails, extramedullary reduction demonstrated a lower rate of fixation failure compared to anatomical reduction in this study. While definitive conclusions regarding its superiority cannot be drawn due to the limited sample size, extramedullary reduction may serve as a promising alternative to reducing the high fixation failure rate associated with this challenging fracture type.
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Background and Objectives: The study aimed to evaluate a newly designed semicircular implant for the fixation of Vancouver Type B1 periprosthetic femoral fractures (PFFs) in total hip arthroplasty (THA) patients. To determine its strength and clinical applicability, the new implant was compared biomechanically with conventional fixation methods, such as lateral locking plate fixation and a plate combined with cerclage wires. Materials and Methods: Fifteen synthetic femur models were used in this biomechanical study. ⋯ Conclusions: Compared to traditional fixation methods, the newly designed semicircular implant demonstrated superior biomechanical performance in stabilizing Vancouver Type B1 periprosthetic femoral fractures. It withstood higher physiological loads, offered better structural stability, and could be an alternative to existing fixation systems in clinical practice. Further studies, including cadaveric and in vivo trials, are recommended to confirm these results and assess the long-term clinical outcomes.
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Iliosacral screw osteosynthesis is a widely recognized technique for stabilizing unstable posterior pelvic ring injuries, offering notable advantages, including enhanced mechanical stability, minimal invasiveness, reduced blood loss, and lower infection rates. However, the procedure presents technical challenges due to the complex anatomy of the sacrum and the proximity of critical neurovascular structures. ⋯ Particular attention must be given to the preoperative evaluation of both the iliosacral and transsacral corridors, as anatomical variations may restrict the available space for screw insertion. This review aims to highlight the essential aspects of sacroiliac osteosynthesis, with a focus on the critical role of thorough preoperative planning and its impact on achieving successful surgical outcomes.
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Eur J Trauma Emerg Surg · Jan 2025
Assessment of the proficiency level of novices in distal intramedullary nail interlocking achieved through training with Digitally Enhanced Hands-on Surgical Training (DEHST).
Digitally Enhanced Hands-on Surgical Training (DEHST) platform was introduced to overcome the lack of training capabilities for the challenging task of freehand distal interlocking of intramedullary nails. It demonstrates high perceived realism for surgeons, and novices perform significantly better after DEHST training. However, characterization of how performance improves remained unexplored. The aim of this study was to evaluate the training progression of novices in freehand distal interlocking during five training rounds with DEHST and to compare their performance in a simulated operation against experienced surgeons. ⋯ DEHST appears to be a useful tool to gradually improve the proficiency level of novices and to train relevant practical surgical skills needed for distal interlocking of intramedullary nails. However, further investigations are needed to demonstrate the performance under the conditions of a real operation.