European Journal of Orthopaedic Surgery and Traumatology最新文献

{"title":"A tension system for angular correction of bent intramedullary nails: in vitro analysis.","authors":"Anderson Freitas, Vincenzo Giordano, Welington Ferreira Nunes, Kaio da Silva Santana, Fernanda Moura Viana, Robinson Esteves Pires, Rodrigo Sattamini Pires E Albuquerque, Pedro José Labronici","doi":"10.1007/s00590-024-04125-z","DOIUrl":"https://doi.org/10.1007/s00590-024-04125-z","url":null,"abstract":"<p><strong>Purpose: </strong>Although several techniques have been described for bent intramedullary nail removal, there is no universally accepted strategy. We hypothesized that a device based on the action principle of a three-point bend fixture could facilitate extraction of bent intramedullary nails; this paper describes its design and experimental testing.</p><p><strong>Methods: </strong>Five large synthetic left femurs and five steel intramedullary nails were used. The nails were bent in a manual hydraulic press and implanted into the model femurs, which had been previously sectioned as necessary. A device to correct the angular deformity imparted to the nails was designed, and a prototype fabricated from AISI 1045 steel. Specimens were secured in a vise and the device attached; manual tension was then applied to gradually correct the nail deformity. Plain radiographs were obtained, and the nails were removed. The model femurs and intramedullary nails were visually inspected for proper contact of the device tip, coronal and sagittal alignment, and points of failure.</p><p><strong>Results: </strong>Before device application, the angles of the specimens averaged 40.2° (38.27°-41.32°) in the coronal plane and 7.22° (8.5°-10.2°) in the sagittal plane. After device application, these angles averaged 15.04° (2.5°-32.3°) and 4.16° (0°-9.8°), respectively. There were no implant fractures, but in two models, peri-implant fractures (one catastrophic) occurred close to the proximal and distal locking screws.</p><p><strong>Conclusion: </strong>The proposed device for bent intramedullary nail extraction was effective, but homogeneous behavior in terms of angle correction was not observed in the tested specimens. Further development is needed.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"50"},"PeriodicalIF":1.4,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911249","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":"Postoperative dorsal step-off predicts olecranon osteotomy union: a retrospective cohort study.","authors":"Margaret A Sinkler, Jeremy M Adelstein, Mark M Kodsy, George Ochenjele, John K Sontich, Robert J Wetzel, Joshua K Napora","doi":"10.1007/s00590-024-04169-1","DOIUrl":"https://doi.org/10.1007/s00590-024-04169-1","url":null,"abstract":"<p><strong>Purpose: </strong>Olecranon osteotomy has been associated with loss of reduction, nonunion, implant failure, and migration of wires. We aim to evaluate quality of reduction of the osteotomy site as a predictor of olecranon osteotomy nonunion.</p><p><strong>Methods: </strong>One hundred and twenty-five distal humerus fractures that underwent open reduction internal fixation (ORIF) were reviewed. Amount of dorsal step-off was measured from the lateral radiograph from the second postoperative visit. A receiver operating curve (ROC) analysis was used to assess the predictability of nonunion based on dorsal displacement of the olecranon osteotomy.</p><p><strong>Results: </strong>Between 2014 and 2022, 36 patients underwent a chevron olecranon osteotomy (29%). Of the 36 patients, 7 (19%) failed to successfully unite at the osteotomy site. Two experienced aseptic nonunion, 2 were malreduced leading to nonunion, 2 malunited, and 1 had persistent fracture lines following poor osteotomy cut. Patients that developed nonunion had a mean dorsal displacement of 3.87 mm versus 1.15 mm (p < 0.001). The ROC demonstrated excellent prediction for nonunion based on displacement (AUC = 0.896, p = 0.002). Youden's index was determined at a sensitivity of 86% and a specificity of 73% corresponding to a dorsal step-off of 2.07 mm. This finding was confirmed on multivariate logistic regression showing a step-off over 2.07 mm is an independent predictor of olecranon osteotomy nonunion (p = 0.021).</p><p><strong>Conclusion: </strong>A malreduction resulting in a dorsal step-off larger than 2.07 mm is predictive of olecranon osteotomy nonunion or malreduction. Therefore, the success of the olecranon osteotomy approach is directly dependent on quality of anatomic reduction.</p><p><strong>Level of evidence: </strong>III; Retrospective Cohort Study.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"49"},"PeriodicalIF":1.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899733","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":"Trends in the surgical management of proximal humerus fractures over the last 20 years from Australian registry databases.","authors":"Joshua Xu, Brahman S Sivakumar, Haren Nandapalan, Terence Moopanar, Dylan Harries, Richard Page, Michael Symes","doi":"10.1007/s00590-024-04165-5","DOIUrl":"https://doi.org/10.1007/s00590-024-04165-5","url":null,"abstract":"<p><strong>Background: </strong>Proximal humerus fractures (PHF) are common with approximately 30% requiring surgical intervention. This ranges from open reduction internal fixation (ORIF) to shoulder arthroplasty (including hemiarthroplasty, total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA)). The aim of this study was to assess trends in operative interventions for PHF in an Australian population.</p><p><strong>Methods: </strong>Data was retrospectively collected for private patients with a PHF and requiring surgical intervention (2001-2020). Data for patients undergoing ORIF were extracted from the Medicare database, while those receiving arthroplasty for PHF were obtained from the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR).</p><p><strong>Results: </strong>Across the study period, ORIF was the most common surgical procedure for management of PHFs. While the number of RTSA procedures for PHF has increased, shoulder hemiarthroplasty has significantly reduced since 2008 (p < 0.001). Patients aged < 65 years were more likely to receive ORIF. Patients aged ≥ 65 years were more likely to receive RTSA or hemiarthroplasty compared to patients aged < 65 years.</p><p><strong>Conclusions: </strong>While the number of ORIF procedures has increased during the period of interest, it has diminished slightly as a proportion of overall procedure volume. RTSA is becoming increasingly popular, with decreasing utilization of hemiarthroplasty, and TSA for fracture remaining uncommon.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"48"},"PeriodicalIF":1.4,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899736","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":"Magnitude of infection and associated factors in open tibial fracture treated operatively, in Addis Ababa burn emergency and trauma center.","authors":"Cheru Beyene Tesso, Tuji Mohammed, Berhanu Teshome, Kalkidan Ayalew, Samuel Kebede","doi":"10.1007/s00590-024-04149-5","DOIUrl":"https://doi.org/10.1007/s00590-024-04149-5","url":null,"abstract":"<p><strong>Background: </strong>Due to the specific anatomical features of the tibia (limited soft tissue coverage), more than a quarter of its fractures are classified as open, representing the most common open long-bone injuries. Open tibial fractures frequently cause significant bone comminution, periosteal stripping, soft tissue loss, contamination and are prone to bacterial entry with biofilm formation, which increases the risk of deep bone infection. The main objective of this study was to determine prevalence of infection and its associated factors in surgically treated open tibial fracture, at Addis Ababa Burn Emergency and Trauma (AaBET) hospital.</p><p><strong>Method: </strong>A facility-based retrospective cross-sectional study was conducted among patient treated for open tibial fracture at AaBET hospital from September 2018 to September 2021. The data were collected from patient's chart using a structured data collection form and entered and analyzed using SPSS version 26. Binary logistic regression was fitted to determine risk factors associated with surgically treated open tibial fracture. Multicollinearity was checked using variance inflation factor and tolerance. Model adequacy was tested using the Hosmer-Lemeshow goodness-of-fitness test, and adjusted odds ratio (AOR) with a 95% CI at p value < 0.05 was reported statistically significant.</p><p><strong>Result: </strong>From a total of 235 patients enrolled in the study, 33.9% of the patients developed infection. Initial IV antibiotic time (AOR = 2.924, 95% CI 1.160-7.370) and time of wound closure from injury (AOR = 3.524, 95% CI 1.798-6.908), injury to admission time (AOR = 2.895, 95% CI 1.402-5.977) and definitive fixation method (AOR = 0.244, 95% CI 0.113-0.4508) were the factors found to had significantly increased the risk of the occurrence of infection.</p><p><strong>Conclusion: </strong>The high rate of infection in open tibial fractures indicates that there is a need to improve the management of open tibial fractures treated at AaBET hospital. Significant delay of patient with open tibial fracture was found from in injury time to presentation to trauma center since majority of the cases were from peripheral health facility without getting prophylactic antibiotics.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"46"},"PeriodicalIF":1.4,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883601","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":"Standardized protocol during acetabular fracture surgery results in low rates of heterotopic ossification.","authors":"Andrew P Collins, Max Coale, Annelise Chaparro, Reza Firoozabadi","doi":"10.1007/s00590-024-04144-w","DOIUrl":"https://doi.org/10.1007/s00590-024-04144-w","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the rate of heterotopic ossification (HO) following acetabular surgery with a standardized protocol via the Kocher-Langenbeck. Secondarily, to evaluate patient characteristics, injury variables, and perioperative data among patients with HO and no HO.</p><p><strong>Methods: </strong>This was a retrospective case series from an academic Level I trauma center. Included patients had displaced acetabular fractures treated via Kocher-Langenbeck approach with debridement of (1) gluteus minimus muscle (GMM) from the posterior wall and column up to the superior gluteal neurovascular bundle, (2) unhealthy appearing piriformis muscle without fascial disruption, and (3) superior and inferior gemelli in the location of implant placement. Those with posterior hip dislocations and gluteus medius injury received prophylactic indomethacin.</p><p><strong>Results: </strong>Fifty-seven patients met inclusion criteria. Thirteen patients (22.8%) developed HO, and 44 patients (77.2%) had no evidence of HO. Ten (17%) patients developed mild HO (Brooker classification (BC) I/II), 3 (5%) developed moderate HO (BC III), and no patients developed severe HO (BC IV). There were no differences in the prevalence of elementary versus associated acetabular fracture patterns or individual fracture patterns among cohorts. Patients with HO had longer times to surgical intervention (5.3 ± 5.1 days vs. 2.4 ± 1.6 days, p = 0.002) and length of intensive care unit (ICU) stay (6.7 ± 12.2 days vs. 1.5 ± 3.3 days, p = 0.013) compared with the no HO cohort. There was no difference in rates of HO prophylaxis use and subsequent HO among cohorts.</p><p><strong>Conclusion: </strong>This study describes a standardized protocol developed by the senior author that resulted in low rates of HO following acetabular fixation via the Kocher-Langenbeck approach. Patients with HO had a significantly longer time to surgical intervention and length of ICU level of care.</p><p><strong>Level of evidence: </strong>Therapeutic Level IV. See Instructions for Authors of a complete description of levels of evidence.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"47"},"PeriodicalIF":1.4,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883603","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":"Demonstration of the effectiveness of complete decongestive treatment in secondary lymphedema developing after total knee arthroplasty.","authors":"Cansın Medin Ceylan, Sedef Ersoy, Fatma Nur Kesiktas, Armagan Özokur","doi":"10.1007/s00590-024-04167-3","DOIUrl":"https://doi.org/10.1007/s00590-024-04167-3","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the current study is to demonstrate the treatment results of patients with lymphedema that developed after total knee arthroplasty (TKA) and to compare these results with those of patients with secondary lymphedema non-TKA.</p><p><strong>Methods: </strong>A total of 63 patients diagnosed with secondary lymphedema and who received complete decongestive treatment (MLD + bandaging + exercise) at the lymphedema treatment unit of Istanbul Physical Medicine and Rehabilitation Training Research Hospital between June 1, 2023, and February 1, 2024, were included in our retrospective study. The circumference of both metatarsophalangeal joints was measured, and leg diameter measurements were made from the lateral malleolus to the proximal 10th, 20th, and 30th centimeters.</p><p><strong>Results: </strong>Of the 63 patients included in this study, the average age in the TKA group (n = 17) was 69.23 ± 8.27 years, and the BMI was 38.60 ± 6.52. In the non-TKA group (n = 46), the average age was 63.50 ± 14.05 years, and the BMI was 34.57 ± 9.17. There was no statistical difference between the two groups in terms of demographic data, affected sides, and initial measurements of the patients (p > 0.05). The response to continued decongestive treatment was significantly higher in both the TKA and non-TKA groups (p < 0.05). However, there was no statistically significant difference in treatment response between the two groups (p > 0.05).</p><p><strong>Conclusion: </strong>Complete decongestive treatment is an effective method for treating lymphedema that develops after total knee arthroplasty. No difference in treatment response was found between patients with lymphedema following TKA and those with secondary lymphedema from other causes.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"45"},"PeriodicalIF":1.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877182","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":"Comparison of software-assisted and freehand methods of rotational assessment for diaphyseal femur fractures.","authors":"Christian Blough, Kevin Huang, John Garlich, Milton Little, Charles Moon, Geoffrey Marecek","doi":"10.1007/s00590-024-04121-3","DOIUrl":"10.1007/s00590-024-04121-3","url":null,"abstract":"<p><strong>Objective: </strong>Accurate rotational reduction following femoral shaft fracture fixation is absent in up to 28% of cases yet is critical for lower extremity biomechanics. The objective of this cadaveric study was to compare the results of freehand methods of rotational reduction with software-assisted rotational reduction.</p><p><strong>Methods: </strong>Four fellowship-trained orthopedic trauma surgeons attempted rotational correction in a cadaveric model with fluoroscopic assistance using (1) their method of choice (MoC) and (2) software assistance (SA). After correction, deviation from baseline rotation was calculated.</p><p><strong>Results: </strong>The mean difference between the two methods (MoC-SA) was 1.1 which was not significant when comparing all raters and between raters individually. SA had significantly less variability compared to MoC. The rate of clinically relevant rotational deformity (> 15°) was 28% using MoC and 11% using SA.</p><p><strong>Conclusion: </strong>Rotational assessment of diaphyseal femur fractures in this cadaveric model was not significantly different when compared between method of choice and software augmentation.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"43"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873189","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 impact of pathogen sensitivity to antibiotics loaded in cement on the number of revisions and costs in the treatment of periprosthetic knee infection.","authors":"Cumhur Deniz Davulcu, Mete Özer, Muhammed Yusuf Afacan, Cansu Elibollar, Gökhan Kaynak, Mehmet Can Ünlü","doi":"10.1007/s00590-024-04166-4","DOIUrl":"https://doi.org/10.1007/s00590-024-04166-4","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the impact of the pathogen's sensitivity to the loaded antibiotics on infection resolution, the number of revisions, and the associated costs in patients undergoing revision total knee arthroplasty (rTKA) due to PJI.</p><p><strong>Material and methods: </strong>We reviewed the treatment and follow-up processes of 61 patients who underwent rTKA for late-stage PJI following primary total knee arthroplasty in our clinic. The study included 11 patients in the resistant group and 50 in the sensitive group in line with the power analysis results. Patients' demographic characteristics and comorbidities were recorded. All patients received dual antibiotic-loaded cement. Microbiological examinations of patients were analyzed, and the number of revision surgeries each patient underwent was determined. We analyzed all surgeries related to infection treatment, including open irrigation, debridement, polyethylene exchange, implant extractions, antibiotic-loaded cement spacer placements, spacer changes, and debridements, and the implantation of revision prostheses, including tumor prostheses. The total number of surgeries each patient underwent was recorded. We also reviewed hospital system records of total protocol costs during patient admissions.</p><p><strong>Results: </strong>Of 61 patients undergoing revision total knee arthroplasty (rTKA) for periprosthetic joint infection, 11 had antibiotic-resistant infections and 50 had antibiotic-sensitive infections. The groups had similar demographics. Polymicrobial infections were more frequent in the resistant group (p = 0.017), with all resistant cases showing gentamicin resistance and two showing teicoplanin resistance. The resistant group required more surgeries (average 3.91 ± 2.7 vs. 2.34 ± 1.3, p = 0.043) compared to the sensitive group, with teicoplanin resistance doubling revision surgeries (p = 0.005). Costs were similar between groups, averaging $6536.96. Gram-negative infections led to more revisions (p = 0.013). Polymicrobial infections did not significantly affect the number of surgeries or costs compared to single strain infections.</p><p><strong>Conclusions: </strong>Our study demonstrates that in rTKA surgeries using dual antibiotic-loaded bone cement, infections caused by antibiotic-resistant microorganisms are more challenging and time-consuming to treat. This underscores the necessity of exploring new methods to enhance local efficacy by loading cement with antibiotics based on specific pathogen culture and sensitivity results, while also providing clinical evidence of the effectiveness of current treatment methods against sensitive microorganisms.</p><p><strong>Level of evidence: </strong>Level 3 (a retrospective cohort study).</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"42"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873221","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":"Crush injuries to the lower limbs at a major UK trauma centre: a retrospective observational study.","authors":"Essam Rama, Saania Jayawant, James Zhang, Matija Krkovic","doi":"10.1007/s00590-024-04164-6","DOIUrl":"10.1007/s00590-024-04164-6","url":null,"abstract":"<p><strong>Purpose: </strong>Crush injuries result from the physical compression of muscles and may lead to crush syndrome. Early fluid resuscitation and surgical intervention is key. Few studies have reported the outcomes of crush injuries in the non-disaster setting. This retrospective study aims to characterise such cases.</p><p><strong>Methods: </strong>Patients with lower limb crush injuries were identified from an internal database. Non-crush injuries and patients under the age of 18 were excluded. Types of injuries, management, and complications were extracted.</p><p><strong>Results: </strong>27 patients were included. The right leg (n = 10) was the most frequently injured site. Mechanisms included being run over by vehicles (n = 10) and being crushed by, between, or inside vehicles (n = 8). Fractures were the most common acute injuries (n = 16), while other injuries included rhabdomyolysis, compartment syndrome and degloving. Fluid resuscitation was required in 17 patients. 58 surgeries were performed on 18 patients, with wound debridement and amputations being common. Complications such as acute kidney injury, hyperkalaemia, and sepsis were noted during hospitalisation. Individuals with injuries to the leg or thigh experienced a greater burden of injury and incidence of in-hospital complications compared to those with isolated injuries to the foot.</p><p><strong>Conclusion: </strong>Crush injuries in the non-disaster setting show distinct mechanisms and injury patterns. Those with crush injuries to the leg or thigh more closely resemble a patient cohort seen in the disaster setting compared to those with isolated foot injuries.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"44"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663160/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873193","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":"Re-rupture rate and complications after percutaneous Tenolig® repair in acute midsubstance rupture of Achilles tendon.","authors":"Pierre Capdevielle, Alexandre Couraudon, Laurie Steinmuller, Camille Fabbri, Mathias Kirsch, Didier Mainard","doi":"10.1007/s00590-024-04115-1","DOIUrl":"https://doi.org/10.1007/s00590-024-04115-1","url":null,"abstract":"<p><strong>Purpose: </strong>Acute midsubstance Achilles tendon ruptures are the most common tendon injuries in adults and the choice of surgical technique is still debated. The objective of this study is to evaluate the rate of iterative ruptures and postoperative complications at a minimum follow-up of one year of percutaneous sutures of the Achilles tendon, as well as to investigate the risk factors for rupture.</p><p><strong>Methods: </strong>In this single-center retrospective study, 142 patients (119 men and 23 women, mean age of 46 years) were reviewed at a mean follow-up of 24 (12-38) months. Percutaneous sutures with the Tenolig® device was performed by several senior surgeons. We studied the rate of re-ruptures, scar-related complications, sural nerve damage, and thromboembolic complications. The mechanism leading to the rupture was also identified, as were the risk factors.</p><p><strong>Results: </strong>3 patients (2.11%) presented a re-rupture. No damage of the sural nerve was found. Three superficial skin ulcerations were identified, and three patients presented superficial venous thrombosis of the lower limb. Football was the highest risk activity (34.51%). The risk factors for a first episode of rupture were smoking and a BMI over than 25 kg/m². Nevertheless, no statistically significant risk factors could be identified for re-ruptures.</p><p><strong>Conclusion: </strong>Percutaneous sutures of the Achilles tendon using Tenolig® provides a low risk of re-rupture, a low complication rate, particularly scar-related complications, and a respect for tendon vascularization.</p><p><strong>Level of clinical evidence: </strong>3.</p>","PeriodicalId":50484,"journal":{"name":"European Journal of Orthopaedic Surgery and Traumatology","volume":"35 1","pages":"41"},"PeriodicalIF":1.4,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873204","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}