The Open Orthopaedics Journal最新文献

{"title":"Modular Versus Monoblock Hemiarthroplasty in Trauma: A 5-Year Retrospective Analysis of Radiographic and Clinical Outcomes","authors":"H. Kan, A. McBride, A. Mclean, W. O’Callaghan, H. Khan, P. Gallie","doi":"10.2174/1874325001913010053","DOIUrl":"https://doi.org/10.2174/1874325001913010053","url":null,"abstract":"\u0000 \u0000 Displaced intraarticular neck of femur fractures for low-demand patients are primarily managed with hemiarthroplasty. The optimal implant design for modularity is unclear. Globally and within Australia, the use of monoblock implants varies significantly by location; however, monoblock use is decreasing in Australia in favour of modular systems, with little evidence-based explanation. This study aimed to compare the radiological and clinical outcomes of monoblock and modular hemiarthroplasties.\u0000 \u0000 \u0000 \u0000 This retrospective cohort study involved patients who underwent hemiarthroplasty for neck-of-femur fractures between 2009 and 2013 at the Gold Coast University Hospital. Leg length and femoral offset were measured from post-operative pelvic radiographs. Revision and mortality rates were extracted from hospital medical records and Australian Joint Registry data.\u0000 \u0000 \u0000 \u0000 A total of 249 patients were evaluated (112 with modular and 147 with monoblock implants). Patient demographics were comparable between the treatment groups; however, the monoblock group comprised significantly older persons. No between-group differences in leg length discrepancies were identified. Femoral offset was under-restored on average by 5.86mm (p<0.05) compared to the uninjured side within the monoblock group. Mortality rates were significantly higher in the monoblock group (23% vs 12%, P=0.026) at the 1-year mark. No significant between-group differences were found in 30-day mortality, length of stay, or revision rates.\u0000 \u0000 \u0000 \u0000 Modular hemiarthroplasty was superior for restoring offset in our cohort, but no group differences were noted for leg length. While modular implants seemed better for restoring normal hip anatomy and were associated with a lower 1-year mortality rate, no other advantages were found.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81527622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Internal Fixation of Distal Radius and Bimalleolar Ankle Fractures Does Not Increase Surgical Time","authors":"Amandeep Chopra, P. Hoogervorst, M. Marmor","doi":"10.2174/1874325001913010042","DOIUrl":"https://doi.org/10.2174/1874325001913010042","url":null,"abstract":"\u0000 \u0000 It is commonly believed that delay in fracture fixation of more than two weeks results in increased Surgical Time (ST), due to scar and callus formation at the fracture site. Reducing ST can lower hospital costs and decrease radiation exposure. \u0000 \u0000 \u0000 \u0000 A retrospective chart review was conducted to investigate whether early fracture care (up to 2 days after injury) results in decreased ST and radiation exposure compared to delayed fracture care (> 14 days after injury) for distal radius and bimalleolar ankle fractures. A total of 581 radius and ankle fractures that underwent surgical fixation between 2014 and 2017 were identified from the OR registry. Cases with only a single volar locking plate for the distal radius and constructs consisting of 2 medial malleolar screws, third tubular plate, and up to 1 syndesmotic screw for the ankle were included. The mean ST for distal radius cases done up to 2 days after injury was significantly greater than ST for distal radius cases done > 14 days after injury (125.78±29.75 minutes versus 105.83±24.82 minutes respectively , p=0.06). The mean ST for ankle fracture cases done less than 2 days did not differ from ST for ankle fracture cases done > 14 days after injury (140.86±28.15 minutes versus 173.22±39.98 minutes respectively, p=0.06).\u0000 \u0000 \u0000 \u0000 There was no significant difference in radiation exposure. Delaying surgery for distal radius and bimalleolar ankle fractures > 14 days after injury does not seem to significantly affect the duration of surgery or radiation exposure.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89100079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in Physiological and Psychological Responses of Orthopaedic Surgeons and Clinical Fellows during Hip and Knee Arthroplasties","authors":"G. Nazari, J. Howard, B. Lanting","doi":"10.2174/1874325001913010060","DOIUrl":"https://doi.org/10.2174/1874325001913010060","url":null,"abstract":"\u0000 \u0000 Both physical and mental stress is present within the practice of healthcare professionals, which in turn negatively affects the quality of the services provided to the population and therefore, leading to mental exhaustion of the individuals involved.\u0000 \u0000 \u0000 \u0000 To track physiological and psychological responses to common hip and knee surgeries, and during clinic days, in a group of orthopaedic surgeons and their clinical fellows (trainees), and to compare the physiological and psychological results with baseline physiological stress tests.\u0000 \u0000 \u0000 \u0000 Heart Rate (HR), Breathing Rate (BR), and self-reported anxiety were recorded in 3 fellowship trained orthopaedic surgeons and 5 clinical fellows using a wearable Equivital EQO2 physiological monitor and the State-Trait Anxiety Inventory (STAI). Data was recorded for days in surgery as well as clinic for 6-8 hours/day. This data was compared to baseline physiological stress tests.\u0000 \u0000 \u0000 \u0000 Mean HR and percentage of heart rate maximum (%HR-max) were not significantly different between staff and fellows throughout the surgery days regardless of the role occupied during both primary Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA). For Heart rate variability (HRV), there was no difference noted between staff and fellows at any moment around and during THA, however, fellows had significantly higher variability during TKA and maintained this increased variability in the postoperative period. In THA, staff failed to show any statistical difference between the HRV in the cases they were assuming the role of primary surgeon compared to the cases they were assisting and the clinic days. On the contrary, fellows showed significantly higher HRV when they were assisting during THA compared to when they were assuming the primary surgeon role or during their clinic days.\u0000 \u0000 \u0000 \u0000 Different stress patterns were noted in clinical fellows compared to the staff, especially showing a higher overall HRV during TKA.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75570450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Linear Metatarsal Osteotomy Combined with Akin Osteotomy for Hallux Valgus with Hallux Valgus Interphalangeus","authors":"Kazuki Kanazawa, I. Yoshimura, Tomonobu Hagio, Takuaki Yamamoto","doi":"10.2174/1874325001913010034","DOIUrl":"https://doi.org/10.2174/1874325001913010034","url":null,"abstract":"\u0000 \u0000 Minimally invasive distal linear metatarsal osteotomy is commonly performed to correct mild-to-moderate hallux valgus. The technique is easy to perform, fast, and has a low complication rate with satisfactory clinical results. However, it has so far not been applied to hallux valgus with concomitant hallux valgus interphalangeus deformity.\u0000 \u0000 \u0000 \u0000 We aimed to investigate the short-term clinical results of distal linear metatarsal osteotomy combined with Akin osteotomy in hallux valgus with concomitant hallux valgus interphalangeus deformity.\u0000 \u0000 \u0000 \u0000 We retrospectively reviewed 10 patients (10 feet) who underwent surgery for hallux valgus with hallux valgus interphalangeus between 2012 and 2016. Akin osteotomy was performed and fixated with a screw/K-wire, followed by distal linear metatarsal osteotomy and K-wire fixation. Clinical evaluations pre- and postoperatively used the Japan Society for Surgery of the Foot (JSSF) scale and the Visual Analog Scale (VAS). Radiography pre-and postoperatively assessed the hallux valgus, hallux valgus interphalangeus, and the intermetatarsal angle.\u0000 \u0000 \u0000 \u0000 The mean follow-up period was 20.2 months. Both the JSSF and VAS score improved significantly, from 64.5 to 90.0 and from 5.5 to 1.1, respectively. In all patients, bone healing was complete within four months with no osteonecrosis of the metatarsal head or malunion at the osteotomy site. The hallux valgus angle improved from 31.5° to 7.7°, the hallux valgus interphalangeus angle from 17.2° to 5.8°, and the intermetatarsal angle from 11.7° to 5.5°.\u0000 \u0000 \u0000 \u0000 Distal linear metatarsal osteotomy combined with Akin osteotomy safely and effectively corrects mild-to-moderate hallux valgus with hallux valgus interphalangeus deformity.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74738608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Bony Defects of the Shoulder Joint that Occur in Association with Dislocation","authors":"Fred Rt Nelson","doi":"10.2174/1874325001913010020","DOIUrl":"https://doi.org/10.2174/1874325001913010020","url":null,"abstract":"The authors give a comprehensive review of the wide range of bone and soft tissue disturbances resulting from both anterior and posterior shoulder dislocations wherein a defect in the humeral head often occurs [1]. They review the literature on physical examination and imaging techniques that help define the extent of the injury, acting as tools in both nonsurgical and surgical planning. In a few cases this is based on age and other demographics. There are several key concepts available for treatment planning. One is the glenoid tracking theory [2]. The theory is based on the shape and location of the humeral head defect relative to the glenoid bone and soft tissue lesions. This is supplemented by their review of the classification of Hill-Sachs lesion. This classification is based on the size and shape, but does not take into account the location of the posterior humeral head defect [3].","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79783518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hallux Osteoid Osteoma: A Case Report and Literature Review","authors":"A. Kurmis","doi":"10.2174/1874325001913010022","DOIUrl":"https://doi.org/10.2174/1874325001913010022","url":null,"abstract":"The management of symptomatic bony digital lesions is by no means a simple task or an insignificant undertaking. While malignant lesions are routinely managed by proximal transverse resection [3] (often a relatively simple procedure) – intending to limit remote spread and mortality – management of symptomatic benign lesions can pose great clinical challenges. Specifically considering osteoid osteomas, given anatomic barriers, the inability to safely offer modern RF ablation to digital extremities steers treating clinicians towards either aggressive (and likely prolonged) symptomatic management or consideration for surgical treatment [4]. Poor tolerance and efficacy limit the former in many instances [1, 5]. While amputation can seem an ‘easy’ option, the loss of a hand digit or (especially) a border digit of the foot can have major functional ramifications [6]. Driven by ever-increasing societal expectations of enduring function [7], and a general reluctance to take up digital prosthetics [8], patients continually push us to consider local reconstructive options. These are often no mean feat. Equally, from a patient perspective, the cosmetic impact of surgical management weighs heavily [9].","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86167462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation and Prosthetic Design after Van Nes Rotationplasty of the Left Leg Due to Severe Burn Contractures in a Patient with Contralateral Amputated Right Femur: A Case Report","authors":"M. Tyllianakis, A. Panagopoulos, K. Fokas, Argyri Eleni, P. Megas","doi":"10.2174/1874325001913010013","DOIUrl":"https://doi.org/10.2174/1874325001913010013","url":null,"abstract":"\u0000 \u0000 Van Nes Rotationplasty (VNRP) is a biological reconstructive surgical method for pediatric sarcoma, complex trauma or severe lower limb deficiencies that often gets overlooked due to cosmetic reasons and psychological aspects. We report a unique case of knee stiffness and severe scarring from burns treated with this technique in a young patient who had also amputated contralateral femur.\u0000 \u0000 \u0000 \u0000 A 15-year-old boy was trapped in a fire 10 years ago and sustained extensive contractures on his left knee due to severe burns and also an above knee amputation on his right thigh. For 10 years the boy had never received rehabilitation or worn any prosthesis and he managed to move bearing mainly on his palms. On admission to our hospital Van Nes rotationplasty was preferred among other treatment options as the most suitable solution for him and was successfully performed without complications.\u0000 The patient had severe stiffness on his right hip and decreased muscle power in the VNRP leg but after intensive physiotherapy he was able to stand upright and walk again using custom made bilateral prostheses and crutches.\u0000 \u0000 \u0000 \u0000 VNPR is a reasonable option in severe contractures and scarring of the knee joint.\u0000","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76534782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative Treatment of Congenital Scoliosis – Case Report with a History of 22 Years","authors":"H. Weiss, D. Turnbull","doi":"10.2174/1874325001913010008","DOIUrl":"https://doi.org/10.2174/1874325001913010008","url":null,"abstract":"Congenital scoliosis is a three-dimensional deformity of the spine including a frontal plane deviation of the spine caused by malformations of vertebrae and ribs. Early surgery is suggested even in mild cases with formation failures in the first three years of life, although there are reports that, in this group of patients, a conservative approach might be beneficial. The purpose of this case report is to document the long-term outcomes of a patient with failures of formation and with a curve exceeding 50° over more than 20 years of his life.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91365042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the Optimal Reconstruction Option After the Resection of Proximal Humeral Tumors? A Systematic Review","authors":"F. Nelson","doi":"10.2174/1874325001913010032","DOIUrl":"https://doi.org/10.2174/1874325001913010032","url":null,"abstract":"The authors present a systematic review where 50 of 454 articles were selected on reconstruction for bone loss in both metastatic and primary proximal humerus tumors [1]. Described are a number of reconstruction options, the wide variation of patient demands for which options may be applied, and a number of neuromuscular variables. The review is not intended to be a procedural outline but is designed to show the options for post-tumor reconstruction surgery around the proximal humerus and glenoid. The undertaking of this review required members of a single center where many of these techniques are applied over time. Albeit the patient follow-up in the review is fairly long for some procedures, there is no discussion on specific management for treating more aggressive tumors or those with a high local recurrence rate. The authors do state that there are circumstances where it makes sense to pursue the simplest option with the least risk of complications. On the other hand, more complex procedures might be offered for specific anatomic scenarios along with consideration of the patient’s physical demands and tolerance for complications.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"102 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82744566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Devasting Course of an Iliopsoas Muscle Abscess Subsequently Leading to Septic Shock, Septic Hip Arthritis, and Extended Gluteal Soft Tissue Necroses in an Elderly Immunocompromised Patient with Multiple Carcinomas: A Case Report and Brief Review of Literature","authors":"E. Garcia-Rey, E. Garcia-Cimbrelo","doi":"10.2174/1874325001913010024","DOIUrl":"https://doi.org/10.2174/1874325001913010024","url":null,"abstract":"Clinical diagnosis of infectious back and hip anatomical regions are challenging. Although the “classic” triad for iliopsoas muscle abscess was described more than a hundred years ago, it is certainly not very frequent. Despite being a rare condition, most references are cases reports in the literature, and it is not clinically suspected very often. Due to the increasing number of immunocompromised patients nowadays in most countries, like the one with malignancies, the diagnostic difficulties are increasing. Painful back and hip conditions should be considered with caution in these patients in order to prevent severe septic cases like the one presented here.","PeriodicalId":23060,"journal":{"name":"The Open Orthopaedics Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83373675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}