Wen-Chieh Chang, Ming-Fai Cheng, Kuei-Hsiang Hsu, Yu-Ping Su
{"title":"Outcomes of coronoid-first repair through an anterior approach in patients with terrible triad injury of the elbow: a prospective study with a minimum 2-year follow-up.","authors":"Wen-Chieh Chang, Ming-Fai Cheng, Kuei-Hsiang Hsu, Yu-Ping Su","doi":"10.1186/s10195-024-00804-z","DOIUrl":"https://doi.org/10.1186/s10195-024-00804-z","url":null,"abstract":"<p><strong>Background: </strong>In the treatment of terrible triad injury of the elbow (TTIE), the indication and the appropriate approach and sequence for coronoid process (CP) fixation remain debatable. No gold standard protocol has been established for CP fixation. In this study, we evaluated the midterm outcomes of coronoid-first repair through an anterior approach in patients with unstable TTIE.</p><p><strong>Materials and methods: </strong>This prospective observational study included patients with TTIE who exhibited posterior or posterolateral subluxation/dislocation during examination under anesthesia (EUA) at our institute between January 2019 and December 2021. All patients underwent coronoid-first repair through an anterior approach, regardless of fragment size. After CP fixation, radial head fixation/replacement and lateral ulnar collateral ligament repair were performed through the lateral Kocher approach. Radiographic and functional (Mayo Elbow Performance Score [MEPS] and Disabilities of Arm, Shoulder, and Hand score [DASH]) assessments were performed 3, 6, 12, and 24 months after surgery. Complications such as recurrent subluxation/dislocation, synostosis, heterotopic ossification, traumatic arthritis, and stiffness were examined at the follow-up visits.</p><p><strong>Results: </strong>The analysis included 27 patients. The mean follow-up duration was 29.9 (range 24-44) months. At the 3-, 6-, 12-, and 24-month follow-up, the mean flexion-extension arcs were 88.7° ± 14.7°, 107.9° ± 11.9°, 128.3° ± 15.5°, and 130.9° ± 15.3°; the mean supination-pronation arcs were 143.7° ± 9.9°, 160.4° ± 7.6°, 165.0° ± 6.0°, and 167.9° ± 4.9°; the mean DASH scores were 18.7 ± 5.7, 4.5 ± 6.1, 2.7 ± 6.5, and 2.0 ± 6.8; and the mean MEPS were 79.1 ± 10.3, 90.2 ± 8.3, 94.8 ± 6.6, and 95.9 ± 5.7, respectively. At the 24-month follow-up, 26 patients had excellent and 1 patient had good results according to MEPS. Only one patient had a complication: they exhibited stiffness and did not have a 30-130° flexion-extension arc at 24 months postoperatively.</p><p><strong>Conclusions: </strong>The EUA findings, rather than fragment size alone, may be a good indicator of whether the CP needs to be repaired. Midterm follow-up results implied that coronoid-first repair through an anterior approach yields satisfactory functional outcomes with minimal complications.</p><p><strong>Level of evidence: </strong>Therapeutic level II.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"55"},"PeriodicalIF":3.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Novel perspectives on early diagnosis of acute compartment syndrome: the role of admission blood tests.","authors":"Tao Wang, Yubin Long, Qi Zhang","doi":"10.1186/s10195-024-00800-3","DOIUrl":"10.1186/s10195-024-00800-3","url":null,"abstract":"<p><strong>Purpose: </strong>The role of admission blood indicators in patients with acute compartment syndrome (ACS) remains debated. Our primary purpose was to observe variations of admission blood indicators in patients with ACS, while our secondary goal was to explore potential biomarkers related to ACS.</p><p><strong>Methods: </strong>We collected information on patients with tibial fracture between January 2013 and July 2023, and divided them into ACS and non-ACS groups. Propensity score matching (PSM) analysis was performed to lower the impact of potential confounding variables such as demographics and comorbidities. Admission blood indicators were analyzed using univariate, logistic regression, and receiver operating characteristic (ROC) curve analyses. Then, we established a nomogram prediction model by using R language software.</p><p><strong>Results: </strong>After propensity PSM analysis, 127 patients were included in each group. Although numerous blood indicators were found to be relevant to ACS on univariate analysis, logistic regression analysis showed that monocytes (MON, p = 0.015), systemic immune-inflammation index (SII, p = 0.011), and creatine kinase myocardial band (CKMB, p < 0.0001) were risk factors for ACS. Furthermore, ROC curve analysis identified 0.79 × 10<sup>9</sup>/L, 1082.55, and 20.99 U/L as the cut-off values to differentiate ACS patients from patients with tibial fracture. We also found that this combination had the highest diagnostic accuracy. Then, we constructed a nomogram prediction model with AUC of 0.869 for the prediction model, with good consistency in the correction curve and good clinical practicality by decision curve analysis.</p><p><strong>Conclusions: </strong>We found that the levels of MON, SII, and CKMB were related to ACS and may be potential biomarkers. We also identified their cut-off values to separate patients with ACS from those with tibial fracture, helping orthopedists promptly evaluate and take early measures. We established a nomogram prediction model that can efficiently predict ACS in patients with tibial fracture.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"54"},"PeriodicalIF":3.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11561211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Filippo Migliorini, Nicola Maffulli, Marco Pilone, Daniel Kämmer, Ulf Krister Hofmann, Andrea Nobili, Erlis Velaj, Andreas Bell
{"title":"Subsidence of the Corail stem in total hip arthroplasty: no influence of bony contact.","authors":"Filippo Migliorini, Nicola Maffulli, Marco Pilone, Daniel Kämmer, Ulf Krister Hofmann, Andrea Nobili, Erlis Velaj, Andreas Bell","doi":"10.1186/s10195-024-00794-y","DOIUrl":"10.1186/s10195-024-00794-y","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated stem subsidence following primary total hip arthroplasty (THA) with a Corail stem in patients who underwent two-staged bilateral THA. The second outcome of interest was to investigate whether a specific single cortical bone contact point might reduce postoperative stem subsidence.</p><p><strong>Methods: </strong>The present study was conducted following the STROBE guidelines. The records of patients who underwent THA between 2016 and 2023 were accessed. All patients who underwent two-staged bilateral THA were retrieved. The direct contact between the stem and the cortical bone was assessed at various points in the metaphysis and the distal portion of the stem (diaphysis) in both anteroposterior radiographs of the pelvis (medial and lateral bone contact) and a Lauenstein view of the hip (anterior and posterior bone contact). The following parameters were measured and compared to assess stem subsidence: distance from the proximal femur at the stem bone interface and the tip of the lesser trochanter (distance A); distance from the tip of the lesser trochanter and the tip of the femoral stem (distance B).</p><p><strong>Results: </strong>In total, 250 patients were included, 45% (149 of 250 patients) were women and 61% (153 of 250 THAs) were implanted primarily on the right side. The mean age of patients at the time of the first THA was 64.3 ± 10.0 years and the mean body mass index (BMI) was 28.0 ± 4.9 kg/m<sup>2</sup>. The mean length of the follow-up was 14.1 ± 10.8 months. The overall stem subsidence following THA was 2.8 ± 0.7 mm (P < 0.006). A direct cortical bone-implant contact did not exert a statistically significant difference in subsidence of the THA stem at the metaphysis and diaphysis (P > 0.5). Stem subsidence following THA with a collarless cementless Corail stem was approximately 2.8 mm at 14 months.</p><p><strong>Conclusions: </strong>Direct cortical bone contact of the stem at diaphysis and metaphysis seems not to influence stem subsidence following THA using the Corail stem.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"53"},"PeriodicalIF":3.0,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11551085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Johannes Haslhofer, Victoria Anelli-Monti, Peter Hausbrandt, Christian Kammerlander, Antonio Klasan
{"title":"No difference in surgical time and total theatre time between robotically assisted and computer assisted total knee arthroplasty.","authors":"David Johannes Haslhofer, Victoria Anelli-Monti, Peter Hausbrandt, Christian Kammerlander, Antonio Klasan","doi":"10.1186/s10195-024-00798-8","DOIUrl":"10.1186/s10195-024-00798-8","url":null,"abstract":"<p><strong>Introduction: </strong>A number of studies have demonstrated a significant reduction of surgical time for robotically assisted surgery (RAS) total knee arthroplasty (TKA) after the learning curve between 6 and 43 cases. It is unknown if the logistics of RAS produce a longer total theatre time since published literature only reflects the surgical time. It is also unknown how RAS surgical and total theatre times compare with computer assisted surgery (CAS) TKA.</p><p><strong>Methods: </strong>This is a prospective study of 524 consecutive patients undergoing a CAS or a RAS TKA using the same cementless implant. We recorded age, sex, body mass index (BMI), incision time of the first case, total surgical time, total theatre time, length of stay and 90-day complication and readmission rate.</p><p><strong>Results: </strong>During the study period, 205 CAS and 199 RAS TKA were performed. There was no difference at baseline in age (p = 0.546), sex (p = 0.920) or BMI (p = 0.791). Surgical time for CAS was 78.3 (± 22.2) min and for RAS was 80.1 (± 25.7) min, p = 0.451. Total theatre time for CAS was 117.4 (± 27.8) min and 119.3 (± 30.7) min for RAS, p = 0.515. There was no difference in length of stay (p = 0.674), 90-day complication (p = 0.530) or readmission rate (p = 0.930). There was a difference in skin-incision average time for the first case (p = 0.022).</p><p><strong>Conclusions: </strong>Although theatre set-up for the first case is 5 min longer, RAS-TKA does not prolong the surgical time or total theatre time when compared with CAS-TKA. There was no reduction in case volume since the introduction of robotics.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"52"},"PeriodicalIF":3.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matthias Luger, Sandra Feldler, Clemens Schopper, Tobias Gotterbarm, Christian Stadler
{"title":"Is there a difference in pelvic and femoral morphology in early periprosthetic femoral fracture in cementless short stem total hip arthroplasty via an anterolateral approach?","authors":"Matthias Luger, Sandra Feldler, Clemens Schopper, Tobias Gotterbarm, Christian Stadler","doi":"10.1186/s10195-024-00795-x","DOIUrl":"10.1186/s10195-024-00795-x","url":null,"abstract":"<p><strong>Background: </strong>The pelvic and femoral morphology are associated with the occurrence of early periprosthetic femoral fractures (PFFs) in cementless total hip arthroplasty (THA). Differences exist depending on the performed approach and implanted stem design. Therefore, this study was conducted to analyze the pelvic and femoral morphology in cementless short stem THA via a minimally-invasive (MIS) anterolateral approach.</p><p><strong>Methods: </strong>A retrospective, single-center, multi-surgeon, comparative propensity-score matched study of a cohort of 1826 short stem THAs was conducted. A total of 39 PFFs within the first 90 days after surgery was matched on a 2:1 ratio to non-fracture patients. The morphology of the proximal femur was analyzed with canal flare index (CFI), canal-calcar ratio (CCR), canal-bone ratio (CBR), morphological cortical index (MCI), and femoral cortical index (CI). The pelvic morphology was analyzed with ilium-ischial ratio (IR), distance anterior superior iliac spine to the tip of the greater trochanter (AGT). Both groups were analyzed regarding several parameters for femoral and pelvic morphology in non-parametric testing and univariate regression analysis.</p><p><strong>Results: </strong>A significantly higher AGT was detected in the fracture group (104.5 mm ± 18 versus 97.4 mm ± 9.8; p = 0.016). All other femoral and pelvic parameters did not differ between both groups, also when compared depending on the Vancouver type of the PFF.</p><p><strong>Conclusions: </strong>The morphology of the proximal femur and the pelvis do not differ in several radiological parameters in patients sustaining a PFF in cementless short stem THA via an anterolateral approach compared with matched non-fracture group. The findings are controversial to other studies with different stem types and approaches. Future studies should focus on analyzing the influence of the pelvic geometry and the shape of the proximal femur in the occurrence of PFFs in different approaches with the same stem type and vice versa. Level of Evidence Level III case-controlled study.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"51"},"PeriodicalIF":3.0,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peiyuan Tang, Masoud Rahmati, Wenfeng Xiao, Ting Wen, Dong Keon Yon, Lee Smith, Jingyue Su, Shengwu Yang, Yusheng Li, Zhenhan Deng
{"title":"Differences in the effectiveness of leukocyte-rich platelet-rich plasma compared with leukocyte-poor platelet-rich plasma in the treatment of rotator cuff surgery: an umbrella review of meta-analyses.","authors":"Peiyuan Tang, Masoud Rahmati, Wenfeng Xiao, Ting Wen, Dong Keon Yon, Lee Smith, Jingyue Su, Shengwu Yang, Yusheng Li, Zhenhan Deng","doi":"10.1186/s10195-024-00791-1","DOIUrl":"10.1186/s10195-024-00791-1","url":null,"abstract":"<p><strong>Background: </strong>An umbrella review of meta-analyses was conducted to evaluate the use of platelet-rich plasma (PRP) in arthroscopic surgeries of rotator cuff injury. The effectiveness of leukocyte-poor PRP and leukocyte-rich PRP in the treatment of rotator cuff surgery was also compared.</p><p><strong>Methods: </strong>Web of Science, Embase, PubMed/MEDLINE, and the Cochrane Library were searched from inception to May 2024. Literature screening, quality evaluation, and data extraction were performed according to the inclusion and exclusion criteria. The Jadad decision algorithm was used to ascertain which meta-analysis represented the best evidence.</p><p><strong>Results: </strong>A total of 11 meta-analyses with evidence level ranging from level 1 to 2 were included in this umbrella review. Leukocyte-poor PRP was effective in reducing rotator cuff retear rates, alleviating pain, and increasing Constant scores compared with non-PRP treatments. However, it did not show improvement on the University of California Los Angeles (UCLA) score, the American Shoulder and Elbow Surgeons (ASES) score, and the Simple Shoulder Test (SST) compared with the non-PRP treatment group. Meanwhile, the leukocyte-rich PRP group improved the SST but showed no different results when compared with the non-PRP treatment group.</p><p><strong>Conclusion: </strong>Compared with no use of PRP, leukocyte-poor PRP was able to alleviate postoperative pain, reduce the retear rate, and improve the postoperative Constant score. Leukocyte-rich PRP could effectively enhance postoperative SST outcomes, leading to improvement of patient satisfaction and quality of life. Future researches should prioritize long-term follow-up studies and evaluate the durability of these results.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"50"},"PeriodicalIF":3.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arno A Macken, Ante Prkic, Iris Koenraadt-van Oost, Geert A Buijze, Bertram The, Denise Eygendaal
{"title":"Can a single question replace patient-reported outcomes in the follow-up of elbow arthroplasty? A validation study.","authors":"Arno A Macken, Ante Prkic, Iris Koenraadt-van Oost, Geert A Buijze, Bertram The, Denise Eygendaal","doi":"10.1186/s10195-024-00790-2","DOIUrl":"https://doi.org/10.1186/s10195-024-00790-2","url":null,"abstract":"<p><strong>Background: </strong>To assess the results after elbow arthroplasty it is essential to gather patient-reported outcome measures (PROMs). However, the acquisition of PROMs poses a challenge because of potential low literacy, lengthiness and diversity of questionnaires, and questionnaire fatigue. Instead of a questionnaire, patient-reported outcomes can be collected using a single assessment numeric evaluation (SANE), the subjective elbow value (SEV). The aim of this pilot study is to assess the correlation between the SEV and conventionally used patient reported outcome measures (PROMs) after elbow arthroplasty.</p><p><strong>Materials and methods: </strong>The SEV was added to our follow-up system in 2021, consisting of a scale from 0 to 10 in which the patients are asked to rate the overall functionality of their elbow, 0 corresponds to very poor functionality and 10 to a perfectly functional or healthy elbow. All patients who underwent elbow arthroplasty (total or radial head) and responded to the SEV question were retrospectively identified and included. The correlation between the SEV at the final follow-up and the Oxford Elbow Score (OES), and between the SEV and the Quick Disbailities of the Arm, Shoulder, and Hand (quickDASH) score was assessed using Pearson's r.</p><p><strong>Results: </strong>In total, 82 patients responded to the SEV question and were included in the study, with a median follow-up of 5 years [interquartile range (IQR) 3-7]. Of these patients, 17 (21%) underwent radial head arthroplasty and 65 (79%) total elbow arthroplasty. The Pearson's r for the correlation between SEV and OES was 0.502 (p < 0.001) and between the SEV and the QuickDASH -0.537 (p < 0.001), which correspond to a moderate correlation.</p><p><strong>Conclusions: </strong>The SEV shows a moderate correlation with conventional PROMs, demonstrating its potential in simplifying the follow-up of elbow arthroplasty, possibly decreasing time, costs, and patients' questionnaire fatigue compared with conventional PROM questionnaires.</p><p><strong>Evidence level: </strong>III.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"49"},"PeriodicalIF":3.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11496479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Are the costs of 3D printing for surgical procedures yet to be definitively assessed?","authors":"Ranran Li, Sitian Niu, Jingzhi Wang","doi":"10.1186/s10195-024-00783-1","DOIUrl":"https://doi.org/10.1186/s10195-024-00783-1","url":null,"abstract":"","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"47"},"PeriodicalIF":3.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Fidanza, Gianfilippo Caggiari, Alessio Giannetti, Manuel G Mazzoleni
{"title":"The extensive use of 3D printing in trauma does not yet fit the value-based healthcare era.","authors":"Andrea Fidanza, Gianfilippo Caggiari, Alessio Giannetti, Manuel G Mazzoleni","doi":"10.1186/s10195-024-00789-9","DOIUrl":"https://doi.org/10.1186/s10195-024-00789-9","url":null,"abstract":"","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"48"},"PeriodicalIF":3.0,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11470872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David J Haslhofer, Stefan M Froschauer, Tobias Gotterbarm, Manfred Schmidt, Oskar Kwasny, Matthias Holzbauer
{"title":"Comparison of surgical and conservative therapy in older patients with distal radius fracture: a prospective randomized clinic al trial.","authors":"David J Haslhofer, Stefan M Froschauer, Tobias Gotterbarm, Manfred Schmidt, Oskar Kwasny, Matthias Holzbauer","doi":"10.1186/s10195-024-00788-w","DOIUrl":"10.1186/s10195-024-00788-w","url":null,"abstract":"<p><strong>Introduction: </strong>The distal radius fracture is considered the most common fracture in humans. For fractures classified as Arbeitsgemeinschaft für Osteosynthese (AO) 23-C1 + C2, there is no consensus on treatment in older patients due to inconsistent study results. The aim of this study was to compare conservative and surgical treatment in relation to wrist function and satisfaction in patients older than 65 years.</p><p><strong>Methods: </strong>In this prospective randomized clinical trial, patients aged older than 65 years who suffered an isolated AO-classified C1 or C2 distal radius fracture were randomized to surgical treatment using palmar plate osteosynthesis or conservative treatment. Patient-rated wrist evaluation (PRWE) score and disabilities of arm, shoulder, and hand (DASH) was assessed 3, 6 and 12 months post-interventionally. Satisfaction, range of motion (ROM) and pain scores were evaluated at 6 weeks and 3, 6 and 12 months post-interventionally.</p><p><strong>Results: </strong>A total of 80 patients with a mean age of 77.3 years (± 6.1 years) in the conservative group and 72.5 years (± 5.3 years) in the surgery group were included. Both the PRWE score, and the DASH score showed a statistically significant difference between the two groups after 3 months, 6 months and 12 months (p < 0.001). Patients in the surgical cohort showed a statistically significant higher satisfaction at the 6-week, 6-month and 12-month follow-up (p < 0.001 6 weeks + 12 months; p = 0.004 6 months).</p><p><strong>Conclusion: </strong>In this prospective randomized study, surgical treatment proved to be superior to conservative treatment in terms of the primary outcome variable PRWE score. Satisfaction was significantly better in the surgical group.</p>","PeriodicalId":48603,"journal":{"name":"Journal of Orthopaedics and Traumatology","volume":"25 1","pages":"46"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11445208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}