Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"Indirect Decompression in Lumbar Degenerative Pathology: Analysis of Imaging Changes at 48 Hours with One-year Follow-up.","authors":"Matias Leonardo Cullari, Juan Pablo Taleb, Lucio Gutierrez, Facundo Martín Aguirre, Santiago Alejandro Aguer, Ruy Lloyd, Glenda Ernst","doi":"10.22038/ABJS.2024.79458.3637","DOIUrl":"10.22038/ABJS.2024.79458.3637","url":null,"abstract":"<p><strong>Objectives: </strong>Investigate the immediate resonance magnetic image changes undergone by the lumbar canal after indirect decompression and compare them at one-year post-intervention. We also investigate the clinical outcome of indirect decompression at one-year follow-up.</p><p><strong>Methods: </strong>Imaging changes in patients who underwent indirect lumbar decompression and percutaneous posterior fixation were analyzed with one-year follow-up. Radiographic measurements were performed preoperatively and postoperatively (at one year), and the area of lumbar canal occupation and yellow ligament by nuclear magnetic resonance was compared preoperatively, at 48 hours post-surgery, and at one year. Radiographic measurements included disc height, foraminal height, total lumbar lordosis, and segmental lordosis. The VAS lumbar and lower limb scales and the Oswestry Disability Index (ODI) were used to assess clinical outcomes.</p><p><strong>Results: </strong>A total of 21 male and 23 female patients underwent indirect decompression at 64 lumbar levels. A significant improvement was observed in the clinical evaluation of all patients' post-surgery (p < 0.001) in all radiographic parameters. There was an immediate increase in the lumbar canal at 48 hours (p < 0.001), which continued to increase at one year post-intervention (p < 0.05). The yellow ligament occupation area decreased at 48 hours (p < 0.001) and continued to decrease until one year (p < 0.01). Four complications were recorded, one of which was a posterior tract infection requiring open decompression.</p><p><strong>Conclusion: </strong>Indirect decompression for degenerative lumbar disease provided successful clinical outcomes, including indirect expansion of the dural sac at 48 hours post-procedure, with progressive increase in the lumbar canal area at one-year follow-up.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 11","pages":"779-788"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Fibula Pro-Tibial Screws in Salvage Fixation of Bimalleolar Ankle Fractures in Osteoporotic Bone - A Novel Technique.","authors":"Mostafa Beshr, James Dixon, Iain Stevenson","doi":"10.22038/ABJS.2024.76119.3515","DOIUrl":"10.22038/ABJS.2024.76119.3515","url":null,"abstract":"<p><p>Here we present a novel adaptation of the previously described fibula pro-tibial fixation in a case requiring salvage fixation of a bimalleolar ankle fracture in an osteoporotic patient. Unstable osteoporotic ankle fractures are a challenging injury to manage and typically occur in a frail and comorbid subgroup of patients. Various techniques have been described in the evolution of managing these injuries, e.g. hindfoot nailing and anatomical locking plates, however in this uniquely challenging case a novel strategy was required to mitigate bone loss in the distal fibular fracture fragment. There is some evidence to suggest fibular protibial fixation offers a lower complication profile to its alternatives. The novel use of distal fibula pro-tibial screws offers a new alternative to hindfoot nailing of bimalleolar ankle fracture in osteoporotic bone with compromised distal fibular fragment bone purchase. Further research is required to investigate the compatibility of this technique with early weightbearing.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 5","pages":"361-364"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Hip Arthroplasty in Hemophilic Patients: are their Results Similar to those of Nonhemophilic Patients?","authors":"E Carlos Rodriguez-Merchan","doi":"10.22038/ABJS.2024.76984.3555","DOIUrl":"10.22038/ABJS.2024.76984.3555","url":null,"abstract":"<p><p>Total hip arthroplasty (THA) is the mainstay therapy for patients with terminal hemophilic arthropathy of the hip. However, the largest case series published between 2017 and 2023 in the literature on THA in patients with hemophilia have found a higher 1-year infection rate (8.1% versus 3.4%) in hemophilia patients than in the general population, a higher rate of in-hospital bleeding complications (38.7% versus 16.1%), a higher length of stay (6 days versus 3 days) and a higher 30-day readmission rate (22.6% versus 4.1%). Finally, a lower 5-year survival rate has also been observed in hemophilia patients than in the general population (91.9% versus 95.3%). In the last decade there have been dramatically positive improvements in implant designs and hematological treatment, and therefore it does not seem that THA in hemophilia is so far from that in osteoarthritic patients.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 5","pages":"357-360"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11134255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141180711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthotic Intervention with Custom-made Thermoplastic Material in Acute and Chronic Mallet Finger Injury: A Comparison of Outcomes.","authors":"Erfan Shafiee, Maryam Farzad, Hadi Beikpour","doi":"10.22038/ABJS.2023.60506.2985","DOIUrl":"https://doi.org/10.22038/ABJS.2023.60506.2985","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the effect of using custom-made orthosis on improving extension lag and reducing disability in acute and chronic mallet fingers.</p><p><strong>Methods: </strong>We recruited 51 patients with acute or chronic Doyle type-1 mallet fingers, who were provided with a custom-made thermoplastic anti-mallet finger orthosis to wear full-time for 6 weeks and an additional 2 weeks at nighttime. The primary outcome, extension lag, was assessed at enrollment as well as six- and twelve-week follow-ups. Secondary outcomes included disability and satisfaction, which were evaluated using the Disability of the Arm, Shoulder, and Hand questionnaire at enrollment and 12 weeks, and a satisfaction scale at 12 weeks follow-up. Data analysis was conducted using univariate analysis of variance (ANOVA), one-way repeated measure mixed model analysis of covariance (ANCOVA), and independent sample t-test.</p><p><strong>Results: </strong>A total of 43 participants, 25 acute and 18 chronic mallet fingers, completed the 12-week evaluation. The study found no significant difference between the two groups in terms of improvement in extension lag at either follow-up time point (P=0.21). Disability improved in both the acute and chronic groups at follow-up (P<0.05). Additionally, both groups expressed satisfaction with the treatment outcome, and no statistically significant difference was observed (t=0.173, P=0.51). We could not identify any clinically significant difference between the two groups in regard to extension lag, disability, or satisfaction at follow-up. Notably, 96% of the patients in the acute group and 88% of the patients in the chronic group demonstrated good to excellent outcomes.</p><p><strong>Conclusion: </strong>Orthotic intervention with custom-made thermoplastic material in acute and chronic mallet fingers improved extension lag and disability, and both groups were satisfied with the treatment outcomes. The findings of our study indicated that patients with chronic mallet fingers benefited from orthotic interventions in the same way that patients with acute mallet fingers did.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"176-182"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraosseous Regional Administration of Vancomycin Prophylaxis for Primary and Revision Total Knee Arthroplasty.","authors":"E Carlos Rodriguez-Merchan, Carlos A Encinas-Ullan","doi":"10.22038/ABJS.2023.71420.3337","DOIUrl":"https://doi.org/10.22038/ABJS.2023.71420.3337","url":null,"abstract":"<p><p>The advantages of prophylaxis with intraosseous regional administration (IORA) of vancomycin for periprosthetic joint infection (PJI) in primary and revision total knee arthroplasty (TKA) include the ability to deliver antibiotics directly to the surgical bed and avert systemic delivery; the ability to precisely time and quickly administer vancomycin to achieve the highest concentrations at the beginning and throughout the surgical procedure; and the ability to avert several common and potentially serious adverse effects of intravenous vancomycin. Indications for IORA of vancomycin prophylaxis include the following clinical scenarios: revision TKA; obesity; diabetes; beta-lactam allergy; known colonization with methicillin-resistant Staphylococcus aureus (MRSA); individuals coming from institutions with a high MRSA incidence; previous ligamentous surgical procedure or osteotomy; current or recent smokers; in the primary TKA setting if the individual is considered high-risk as defined by the criteria above; and during reimplantation following 2-stage exchange for PJI.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"219-222"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of Sports Medicine and Successful Career in Orthopedic Sports Medicine.","authors":"James R Andrews, Mohammadreza Abbasian","doi":"10.22038/ABJS.2024.79208.3656","DOIUrl":"10.22038/ABJS.2024.79208.3656","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"679-682"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142550099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brand Videos among Orthopedic Surgery Residency Programs.","authors":"Quincy T Cheesman, Johnlevi S Lazaro, Hope S Thalody, Danielle Y Ponzio, Zachary D Post, Alvin C Ong","doi":"10.22038/ABJS.2024.76143.3522","DOIUrl":"10.22038/ABJS.2024.76143.3522","url":null,"abstract":"<p><strong>Objectives: </strong>The use of brand videos has provided residency programs with another platform to showcase themselves and attract potential applicants. Despite the rise in brand videos following the COVID-19 pandemic, not all orthopedic surgery residency programs have developed one. This study aimed to determine the prevalence of brand videos on orthopedic surgery residency program websites and evaluate their contents.</p><p><strong>Methods: </strong>This was a cross-sectional analysis of all orthopedic surgery residencies participating in the National Resident Matching Program (NRMP) in November 2022. The presence of a brand video was reviewed on each program's website and data was collected from the contents of existing videos.</p><p><strong>Results: </strong>Forty-seven percent (90/192) of programs had a brand video with an average length of 6 minutes and 13 seconds. The top two program qualities highlighted were a family friendly atmosphere with camaraderie (83%; 75/90) and early hands-on surgical experience (72%; 65/90). Despite brand videos being tailored to an audience of prospective residents, only 9% (8/90) of programs noted qualities they look for in prospective residents. Furthermore, only 19% (17/90) of programs displayed a closing slide containing contact information or links to social media accounts.</p><p><strong>Conclusion: </strong>Only 47% of orthopedic surgery residency programs have established a brand video. The absence of a brand video may be due to programs not perceiving them as important, shortage of resources, or unfamiliarity with video marketing. Based on our findings, we propose recommendations to assist programs in their development of a brand video.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 9","pages":"652-659"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Calculation of the Forearm and Hand Three-Dimensional Anthropometry Based on Two-Dimensional Image Feature Extraction: An Approach for Cock-up Splint Design.","authors":"Mahla Daliri, Mahla Rajabi, Sedigheh Rastaghi, Mehdi Ataei, Mona Meybodi, Nafiseh Jirofti, Mohadeseh Mohadesi, Afsaneh Jahani, Ali Moradi","doi":"10.22038/ABJS.2024.73439.3435","DOIUrl":"10.22038/ABJS.2024.73439.3435","url":null,"abstract":"<p><strong>Objectives: </strong>An alternative to both the time-consuming traditional and the expensive three-dimensional (3D) methods for splint design is to use two-dimensional (2D) images. The present study utilized image processing to achieve an automatic and practical method of anthropometry measurement to design and build a personalized and remote cock-up splint. This method is applicable for patients unable to personally attend clinic appointments.</p><p><strong>Methods: </strong>The defined landmarks of the cock-up splint of 100 adult participants were measured manually. Each individual had a 2D image taken of their upper limb using a customized imaging device. The 2D image portions that corresponded to the manual measurements were then identified, and their sizes were retrieved in pixels using MATLAB software. To find equations between manual 3D measurements and 2D image processing ones, multiple linear regression analysis was performed on landmark variables.</p><p><strong>Results: </strong>We were able to determine equations to estimate manual dimensions based on 2D image data. In the men's group, we could predict the third finger length, forearm circumference at three levels, and the largest forearm circumference. In the women's group, in addition to variables predicted for men, hand circumference at the distal palmar crease and first web levels, as well as arm circumference, could be predicted using the identified equations.</p><p><strong>Conclusion: </strong>Based on the findings, 2D image processing could be an appropriate method for designing personalized cock-up splints.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 9","pages":"622-630"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complication Rates in Intertrochanteric Fractures: A Database Analysis Comparing Sliding Hip Screw and Cephalomedullary Nail.","authors":"Kamil M Amer, Dominick V Congiusta, Kunj Jain, Robert L Dalcortivo, Joseph Benevenia, Michael M Vosbikian, Irfan H Ahmed","doi":"10.22038/ABJS.2024.64188.3081","DOIUrl":"10.22038/ABJS.2024.64188.3081","url":null,"abstract":"<p><strong>Objectives: </strong>In the treatment of closed intertrochanteric fractures, the two most common treatment options are intramedullary medullary nail (IMN) and dynamic hip screw (DHS), yet the best treatment method remains controversial. The purpose of this study is to determine the difference in mortality and morbidity between IMN and DHS. Secondarily, this study determines which pre-operative risk factors affect rates of morbidity and mortality.</p><p><strong>Methods: </strong>American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) 2006-2016 database was used to search for patients with a closed intertrochanteric hip fracture. Bivariate analysis was performed using Pearson's Chi Square test to determine pre-operative risk factors associated with complications in fixation with IMN and DHS. Significant variables in this analysis, as well as demographic data, were analyzed via binary logistic regression. The results were recorded as odds ratio (OR) and significant differences were based on a P<0.05.</p><p><strong>Results: </strong>After adjusting for demographics and clinical covariates, patients who underwent fixation with IMN had higher 30-day mortality, reintubation, UTI, bleeding, prolonged length of stay, and non-home discharged destination rates compared to DHS. Mortality risk was increased by ascites, disseminated cancer, impaired functional status, history of congestive heart failure, and hypoalbuminemia. Bleeding risk was increased by previous percutaneous coronary (PCI) and transfusions and was decreased by impaired functional status. Myocardial infarction risk was increased by female gender.</p><p><strong>Conclusion: </strong>Our study found that IMN fixation increased risk of mortality, UTI, reintubation, bleeding, prolonged length of stay, and a non-home discharge destination compared to DHS. This study also identified patient risk factors associated with several postoperative complications. These data may better inform orthopaedic surgeons treating closed intertrochanteric fractures.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 7","pages":"506-514"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Development of Thigh Compartment Syndrome Following Subtrochanteric and Diaphyseal Femoral Fractures.","authors":"Christopher Rivera-Pintado, Manan Patel, Giselle Hernandez, Daniel Gloekler, Krystal Hunter, Haley Tornberg, Kenneth Graf","doi":"10.22038/ABJS.2024.74322.3441","DOIUrl":"10.22038/ABJS.2024.74322.3441","url":null,"abstract":"<p><strong>Objectives: </strong>Acute compartment syndrome of the thigh (CST) is an ongoing challenge for orthopaedic surgeons as the diagnosis is often difficult to establish. Currently, there is a shortage of studies investigating risk factors for the development of thigh compartment syndrome following subtrochanteric and diaphyseal femoral fractures. This study aimed to identify risk factors associated with the development of CST following femoral fractures.</p><p><strong>Methods: </strong>Retrospective review performed in a level one trauma center from January 2011 to December 2020 for all patients with non-pathological acute subtrochanteric or diaphyseal femoral fractures. Variables collected included demographics, injury severity score (ISS) scores, mechanism of injury, classification of femoral fracture, open versus closed injuries, development of compartment syndrome, time to compartment syndrome diagnosis, number of subsequent surgeries, and primary wound closure versus split-thickness skin graft. The statistical analysis of this study included descriptive analysis, simple logistic regression, paired T-test, and Wilcoxon Signed Rank.</p><p><strong>Results: </strong>Thirty-one (7.7%) patients developed thigh compartment syndrome following 403 subtrochanteric or diaphyseal femoral fractures. The mean (SD) age for those who developed CST was 27.35 (8.42). For every unit increase in age, the probability of developing CST decreased. Furthermore, male gender had 18.52 times greater probability of developing CST (P <0.001). AO/OTA 32-C3 and subtrochanteric femoral fracture patterns demonstrated 15.42 (P = 0.011) and 3.15 (P <0.001) greater probability of developing CST, respectively. Patients who presented to the hospital following a motor vehicle accident (MVA) or gunshot wound (GSW) had 5.90 (P= 0.006) and 14.87 (P < 0.001) greater probability of developing CST, respectively.</p><p><strong>Conclusion: </strong>Patients who were male, younger in age, and had a 32-C3 and subtrochanteric femoral fractures were at increased probability of developing CST. High energy trauma also increased the risk of developing CST. A high index of suspicion should be expressed in patients with these risk factors.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 7","pages":"515-521"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}