Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"The Use of the Robotic Arm-Assisted System (MAKO) for Hip Revision Surgery.","authors":"Konstantinos Dretakis, Konstantinos Raptis, Christos Koutserimpas","doi":"10.22038/ABJS.2024.77543.3582","DOIUrl":"https://doi.org/10.22038/ABJS.2024.77543.3582","url":null,"abstract":"<p><p>The robotic arm-assisted system (MAKO) has pioneered a transformative approach to hip joint restoration, excelling in reinstating innate hip joint anatomy and biomechanics. This case represents the initial application of the system in revision surgery following a cut-out complication. A 69-year-old female, previously independent and mobile, presented with left hip pain. X-rays revealed a cut-out complication of the proximal nail, necessitating revision to total hip arthroplasty due to the patient's prior activity level and implant prominence. Utilizing the robotic system, preoperative planning accurately identified limb length discrepancy and guided implant sizing. The system facilitated precise acetabular reaming and optimal component placement. The patient regained functional independence. This report also underscores the system's potential for accurate acetabulum component placement and restoration of hip joint anatomy and biomechanics in revision cases. Future advancements in this technology may expand its role in complex reconstructions and revisions, further enhancing patient outcomes in hip arthroplasty.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 8","pages":"608-611"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11353149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113326","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":"A Comparison between Enoxaparin and Aspirin in Preventing Deep Vein Thrombosis after Spine Surgery: A Randomized Clinical Trial.","authors":"Amir Kavian, Hamid Rezaee, Seyedeh Fatemeh Darvari, Hassan Mehrad-Majd, Hossein Mashhadinejad","doi":"10.22038/ABJS.2024.74693.3458","DOIUrl":"10.22038/ABJS.2024.74693.3458","url":null,"abstract":"<p><strong>Objectives: </strong>Deep Vein Thrombosis (DVT) is a significant medical concern characterized by the formation of blood clots within the venous system. Surgical procedures are known to increase the risk of DVT. While enoxaparin has proven to be highly effective in treating DVT, concerns about bleeding and accurate dosage regulation may restrict its application. Recent research has focused on aspirin's potential in preventing DVT after various surgeries. This study aimed to determine whether aspirin was as effective as enoxaparin in preventing DVT after spine surgery.</p><p><strong>Methods: </strong>This randomized controlled trial enrolled study patients who underwent spine surgery at Shahid Kamyab Emergency Hospital in Mashhad, and had a Caprini score > 5, indicating a higher risk of DVT. In the control group, patients received subcutaneous injections of enoxaparin at a dosage of 40 mg, while the intervention group received oral aspirin tablets with a daily dosage of 81 mg. An experienced radiologist performed a Doppler ultrasound of the lower limbs' veins seven days after surgery to diagnose DVT. The outcomes of the two groups were then compared.</p><p><strong>Results: </strong>A total of 100 patients participated in the clinical trial and were equally assigned to the aspirin and enoxaparin groups. Both groups were homogeneous regarding the basic and clinical characteristics. The incidence of postoperative DVT was 4.0% in the aspirin group and 10.0% in the enoxaparin group (p=0.092). The incidence of hemorrhage was 2.0% in the aspirin group and 4.0% in the enoxaparin group (p=0.610).</p><p><strong>Conclusion: </strong>These findings indicate that aspirin may be a promising alternative to enoxaparin for DVT prevention after surgery, but additional research is essential to validate these results and further assess the benefits and risks associated with aspirin usage in this context.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 6","pages":"412-417"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451917","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":"Investigation of the History of Distal Radius Fractures in Patients Over 55 Years Old Suffering from Hip Fractures.","authors":"Hossein Ghafoori, Morteza Kazemi, Saleh Ghorbani","doi":"10.22038/ABJS.2023.75188.3477","DOIUrl":"10.22038/ABJS.2023.75188.3477","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the incidence of distal radius fractures in patients aged 55 and above who had also experienced hip fractures. Osteoporosis-associated fractures, particularly hip fractures, are common and serious in older individuals with reduced bone density. Previous research has suggested a relationship between hip fractures and distal radius fractures.</p><p><strong>Methods: </strong>The study included patients over 55 years old who had presented with hip fractures at Akhtar Hospital in the past five years. Patients with a history of hip fractures more than five years before experiencing the distal radius fracture were excluded. Personal information was extracted from medical records, and the collected data were analyzed in SPSS software using statistical methods, such as t-tests and paired t-tests.</p><p><strong>Results: </strong>This study involved 1,745 patients with hip fractures and 183 individuals without fractures. The average age of the patients was 75.8±10.4 years old, with the majority being female (59.6%). Among the hip fractures, 59.6%, 34.5%, and 5.9% were intertrochanteric fractures, neck of femur fractures, and subtrochanteric fractures, respectively. Overall, 15.8% of individuals with hip fractures also had distal radius fractures. The average age and gender distribution of the patients were similar in both groups, with no significant difference. However, the prevalence of distal radius fractures was significantly higher in the hip fracture group, compared to the control group.</p><p><strong>Conclusion: </strong>It was found that individuals over the age of 55 with distal radius fractures, especially females, are more susceptible to hip fractures. Distal radius fractures have a significant impact on the occurrence of hip fractures in patients. Therefore, older individuals with osteoporosis should be cautious and avoid high-risk activities that could lead to falls and fractures.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 6","pages":"418-422"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451922","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":"Unveiling Syndesmotic Malreduction: A Proof-of-Concept towards Portable Ultrasound Detection.","authors":"Samir Ghandour, Atta Taseh, Siddhartha Sharma, Matthias Peiffer, Bedri Karaismailoglu, Soheil Ashkani Esfahani, Gregory Waryasz, Daniel Guss","doi":"10.22038/ABJS.2023.75672.3503","DOIUrl":"https://doi.org/10.22038/ABJS.2023.75672.3503","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the utility and diagnostic performance of portable handheld ultrasound for evaluating fibular rotation at the distal tibiofibular articulation after syndesmotic disruption.</p><p><strong>Methods: </strong>Four above-the-knee cadaveric specimens were included. Syndesmotic disruption was precipitated by transecting the Anterior Inferior Tibiofibular Ligament, Interosseous Ligament, and Posterior Inferior Tibiofibular Ligament. Thereafter, a proximal fibular osteotomy was performed, and three conditions were modeled at the distal syndesmosis: 1) reduced, 2) 5 degree internal rotation malreduction, and 3) 5 degree external rotation malreduction. Two blinded observers performed separate ultrasonographic examinations for each condition at the level of both the anterior and posterior distal tibiofibular articular surfaces. Syndesmotic gap penetrance, defined as the ability of the P-US to generate signal between the distal fibula and tibia at the level of the incisura, was graded positive if the sonographic waves penetrated between the distal tibiofibular joint and negative if no penetrating waves were detected. The accuracy measures of the anterior and posterior gap penetrance were evaluated individually.</p><p><strong>Results: </strong>Our preliminary results showed that posterior gap penetrance showed good performance when detecting either internal or external rotational malreduction of the fibula with very good specificity (87.5%) and PPV (90.0%). On the other hand, the anterior gap penetrance showed limited performance when detecting either form of rotational malreduction.</p><p><strong>Conclusion: </strong>We introduced a novel sign, the \"gap penetrance sign\", best measured from the posterior ankle, which can accurately detect syndesmotic malreduction using P-US in a manner that does not require specific quantitative measurements and is readily accessible to early P-US users.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"198-203"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866491","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":"Elbow Injuries in Baseball Players: An Orthopedic Perspective.","authors":"Kassem Ghayyad, Daryl C Osbahr","doi":"10.22038/ABJS.2024.82871.3772","DOIUrl":"10.22038/ABJS.2024.82871.3772","url":null,"abstract":"","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 11","pages":"742-745"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030029","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":"Mortality Rates and Forensic Causes after Hip Fracture: A Retrospective Observational Study.","authors":"Serdar Menekse, Fatih Arslanoglu, Hakan Zora","doi":"10.22038/ABJS.2024.77489.3580","DOIUrl":"10.22038/ABJS.2024.77489.3580","url":null,"abstract":"<p><strong>Objectives: </strong>Despite the widely recognised high mortality rate among patients with hip fracture, the variation in death rates by gender and cause has been less explored. This study aimed to investigate mortality rates and causes of death in patients who underwent hip fracture surgery, and to compare them with those of the general population. A secondary objective was to compare the results of Internal Fixation versus Arthroplasty in these patients.</p><p><strong>Methods: </strong>A population-based study collected records of 356 consecutive cases of hip fracture. For comparison purposes, data from the general population were also collected, which included residents of Adana city of 65 years and older. Causes of mortality were classified as cancer, dementia, heart disease, lung disease, and digestive disorders, among others. The average follow-up period was 4.2 years, ranging from 0 to 5 years.</p><p><strong>Results: </strong>105 (29.49%) of the surgical patients perished in one year. At the end of the follow-up, n = 308 (86.52%) of the hip fracture patients had died. Age-adjusted mortality rates after hip fracture surgery were higher for men than for women, with a risk ratio (HR) of 1.48 and a 95% confidence interval (CI) between 1.07 and 2.15. Complications from heart, lung, or blood vessel diseases were the leading causes of death after hip replacement surgery, followed by Alzheimer's disease and dementia. Men were more susceptible to respiratory diseases, cancer, and heart and blood vessel diseases than women. After hip fracture, both the overall mortality rate and the gender-standardised death rate were three times that of the general population for each cause of death.</p><p><strong>Conclusion: </strong>During the study period, the mortality risk for hip fracture patients was three times that of the general population for the primary causes of death.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 11","pages":"789-797"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030033","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":"The Utility of Kapandji Technique in Closed Reduction and Percutaneous Pinning Of Completely Displaced Pediatric Supracondylar Fracture of Humerus: Technical Note.","authors":"Bhava Rj Satishkumar, Mallesh Mahadevappa, Frank Lester","doi":"10.22038/ABJS.2024.80084.3664","DOIUrl":"10.22038/ABJS.2024.80084.3664","url":null,"abstract":"<p><p>The standard treatment for displaced pediatric supracondylar fracture of humer us (PSCFH) is closed reduction and percutaneous pinning under image intensifier guidance. This technical note describes Kapandji intrafocal pinning technique (KIPT) for achieving optimal fracture reduction and stable fixation in Gartland Type III or IV extension type PSCFH. In KIPT, a K wire was introduced into the fracture site from the posterior aspect, fracture manipulation was done by levering with wire reducing the posterior displacement of the distal fragment and the wire was fixed to the anterior cortex of the proximal fragment. After this sagittal plane reduction and stabilization with intrafocal wire , coronal plane reduction could be carried out easily. This was followed by pinning of columns: all lateral or crossed (medial and lateral). In completely displaced extension type PSCFH, KIPT achieves ideal fracture reduction without vigorous manipulation in short surgical time and enables easy column pinning.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 12","pages":"869-873"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886247","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":"A Large Ankle Mass in a Figure Skater: A Case Report.","authors":"Richard David James Smith, Dale Davis, Jeremy T Smith","doi":"10.22038/ABJS.2023.74241.3436","DOIUrl":"10.22038/ABJS.2023.74241.3436","url":null,"abstract":"<p><p>A 19-year-old male competitive figure skater presented to clinic with a 3-year history of right ankle swelling. Exam demonstrated a ~6cm diameter mass over the medial malleolus. MRI revealed a well-circumscribed fluid-filled mass. After failing conservative management, the patient underwent surgical excision. Anatomic pathology revealed a pseudocyst with pseudosynovial metaplasia, consistent with malleolar bursitis. Competitive figure skaters can develop significant medial malleolar bursitis due to excessive shear forces from ill-fitting skates. If non-operative management is ineffective, patients can be managed successfully with surgical excision. The patient made a full recovery and has returned to competitive skating without recurrence.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 1","pages":"66-68"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693219","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":"Single Bone Intramedullary Fixation of the Radius in Pediatric Both Bone Forearm Fractures Using Straight Stainless Steel Kirschner Wire: A Cross-sectional Study on Radiological and Clinical Feature.","authors":"Saeed Kokly, Alessandro Castagna, Mehdi Aarabi","doi":"10.22038/ABJS.2023.71219.3335","DOIUrl":"https://doi.org/10.22038/ABJS.2023.71219.3335","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to report radiological and clinical features of single bone intramedullary fixation of the radius in pediatric both bone forearm fractures using straight stainless steel Kirschner (K) wire.</p><p><strong>Methods: </strong>Fifty-eight children (42 boys and 16 girls) referred to our hospital with both bone diaphyseal forearm fractures were operated on by using the single bone rigid K-wire intramedullary fixation and mini-open technique. The mean follow-up time was 8.9 months (6-12).</p><p><strong>Results: </strong>The mean age of the patients was 7.4 years (4-12). More than 2/3 of the fractures were in the right hand. Around 63% of the fractures were in the middle third, 28% in the distal third, and 9% in the proximal third. Moreover, 12% were open type I Gustilo-Anderson fractures. The mean time from injury to surgery was two days (1-4), and the mean length of hospital stay was 2.8 days (2-5). The mean duration of surgery was 24.7 minutes (18-38), and the mean follow-up time was 8.9 months (6-12). All fractures united within 4-16 weeks (mean: 7.62). The cast and implant were removed simultaneously as the radiographic fracture union. There was no serious complication. Superficial infection of the pin track and loosening of the pin occurred in three cases (5%), all controlled by antibiotics and timely removal of the pins. Mild restriction of elbow extension (less than 20 degrees) was observed in three cases, which returned to normal at the last follow-up. Limitation of dorsiflexion of the wrist by more than 20° occurred in two patients (35° and 45°), which reverted to 25° and 25°, respectively, at the last follow-up.</p><p><strong>Conclusion: </strong>In both bone forearm fractures in children, open reduction and internal fixation of only the radius with a stainless steel straight Kirschner wire could be a promising method with good results. This retrograde technique of intramedullary fixation is a simple and cost-effective method with minimal complications and acceptable outcomes in children aged 4-12 years.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"167-175"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867157","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":"Comparison Static and Dynamic Ultrasound Techniques of DDH: The Role of the Patient's Position.","authors":"Mohammad Reza Yousefi, Mojgan Yazdanprast, Hashem Neshati, Reza Abdi, Mohammad Hasanian, Seyed Ali Alamdaran","doi":"10.22038/ABJS.2023.69347.3264","DOIUrl":"https://doi.org/10.22038/ABJS.2023.69347.3264","url":null,"abstract":"<p><strong>Objectives: </strong>The ultrasound examination of the hip joint is performed in the static (Graf) technique in the lateral recumbent position and in the dynamic technique in the supine position. This study compares the two static and dynamic techniques and assesses the role of the patient's position in the examination of DDH.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in 2020-2021 at Akbar Hospital, Mashhad University of Medical Sciences, Iran. 126 patients suspected of having DDH (199 hip) infants were enrolled in the study. All ultrasound examinations were performed with two static and dynamic techniques by a pediatric radiologist.</p><p><strong>Results: </strong>In the static and dynamic ultrasound examinations, the average alpha angle was 51.57 ± 6.41 degrees, and 53.41 ± 6.94 degrees, respectively. These changes were not statistically significant (P = 0.312). The relationship and agreement between instability with dynamic technique and instability with static technique (IIC unstable, D, III, and IV) were investigated. Significant agreement (Kappa=0.77 (95% CI: 0.66-0.87) with excellent clinical significance was obtained between the two ultrasound examination method. Also, in terms of DDH types in the static method with instability types in the dynamic method, a substantial agreement was found between the two examination methods (Kappa =0.67; (95% CI: 0.59-0.75) with good clinical significance.</p><p><strong>Conclusion: </strong>In the ultrasound examination of DDH with static and dynamic techniques, the change in the alpha angle was not statistically significant. Therefore, the hand of the radiologist is open in measuring alpha angles and there is no need to emphasize a specific position. The type of DDH in the static technique completely corresponded to the type of stability or instability in the dynamic technique.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 3","pages":"191-197"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10989724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869394","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}