European journal of orthopaedic surgery & traumatology : orthopedie traumatologie最新文献

{"title":"Some outcomes of patients treated operatively for distal humerus fractures are affected by hand dominance.","authors":"Charlotte N Shields,&nbsp;Joseph R Johnson,&nbsp;Jack M Haglin,&nbsp;Sanjit R Konda,&nbsp;Kenneth A Egol","doi":"10.1007/s00590-021-02915-3","DOIUrl":"https://doi.org/10.1007/s00590-021-02915-3","url":null,"abstract":"<p><strong>Purpose: </strong>This study sought to compare postoperative outcomes and complications between patients with distal humerus fractures treated with open reduction and internal fixation (ORIF) of their non-dominant versus dominant arm.</p><p><strong>Methods: </strong>A retrospective review of all patients who sustained a distal humerus fracture treated operatively with ORIF at one academic institution between 2011 and 2015 was performed. Measured outcomes included complications, time to fracture union, painful hardware, removal of hardware, Mayo Elbow Performance Index (MEPI), and elbow range of motion. Differences in outcomes between patients who underwent surgery of their dominant upper extremity and those who underwent surgery of their non-dominant extremity were assessed.</p><p><strong>Results: </strong>Sixty-nine patients met inclusion criteria. Forty (58.0%) underwent ORIF of a distal humerus fracture on their non-dominant arm and 29 (42.0%) on their dominant arm. Groups did not differ with respect to demographics, injury information, or surgical management. Mean overall follow-up was 14.1 ± 10.5 months, with all patients achieving at least 6 months follow-up. The non-dominant cohort experienced a higher proportion of postoperative complications (P = 0.048), painful hardware (P = 0.018), and removal of hardware (P = 0.002). At latest follow-up, the non-dominant cohort had lower MEPI scores (P = 0.037) but no difference in elbow arc of motion (P = 0.314).</p><p><strong>Conclusion: </strong>Patients who sustained a distal humerus fracture of their non-dominant arm treated with ORIF experienced more postoperative complications, reported a greater incidence of painful hardware, underwent removal of hardware more often, and had worse functional recovery in this study. Physicians should emphasize the importance of physical therapy and maintaining arm movement especially when the non-dominant arm is involved following distal humerus fracture repair.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1507-1513"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-02915-3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25428395","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":"Percutaneous treatments of primary aneurysmal bone cysts: systematic review and meta-analysis.","authors":"Gabriel Schmitt Cruz, Carlos Enrique Cuevas-Suárez, Juan Pablo Aitken Saavedra, Rafael Giorgis, Matheus Ricardo Kishimoto Teixeira, Francisco Wilker Mustafa Gomes Muniz","doi":"10.1007/s00590-021-02893-6","DOIUrl":"10.1007/s00590-021-02893-6","url":null,"abstract":"<p><strong>Purpose: </strong>To systematically review the literature to determine recurrence rates of percutaneous treatments for primary aneurysmal bone cysts (ABC).</p><p><strong>Methods: </strong>Search strategies were performed in the following databases: PubMed, SCIELO, LILACS and BVS, using terms in English, Spanish and Portuguese (PROSPERO Registration Number: CRD42020170340). Longitudinal studies, either observational or clinical trials, with at least five patients and with a mean of 18 months of follow-up were included. Studies had to use any type of percutaneous treatments and report the recurrence rates of primary ABC treatment. Studies selection, data extraction and risk of bias assessment were performed independently by two researchers. A global meta-analysis was carried out to assess the proportion of recurrence. Studies were categorized into two subgroups: selective arterial embolization and sclerotherapy.</p><p><strong>Results: </strong>Thirteen studies were included in the present study. The average success rate of percutaneous treatments for ABC was 91.11%, with a total of 37 lesions recurrences in the 416 patients. The sex ratio was 1:1. The subgroup of sclerotherapies presented a lower proportion of recurrence. The proportion of recurrence in the subgroup of selective arterial embolization was 19% (95%IC 12.11-27.54) and that of sclerotherapies was 6% (95%IC 3.65-9.19).</p><p><strong>Conclusions: </strong>Both percutaneous treatments for ABC are effective, showing a lower rate of recurrence. Sclerotherapy treatments seem to be promising, but further clinical trials must be conducted with a longer follow-up.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1287-1295"},"PeriodicalIF":0.0,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25340366","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":"Correction to: The inverted Vancouver C fracture. Case series of unstable proximal femur fractures above a knee revision stem treated by short cephalomedullary nail and lateral submuscular overlapping plate.","authors":"José Vicente Andrés Peiró,&nbsp;Maria Jurado Ruiz,&nbsp;Jordi Tomás Hernández,&nbsp;Jordi Teixidor Serra,&nbsp;Jordi Selga Marsá,&nbsp;Juan Antonio Porcel Vázquez,&nbsp;Yaiza García Sánchez,&nbsp;Vicente Molero García","doi":"10.1007/s00590-021-03091-0","DOIUrl":"https://doi.org/10.1007/s00590-021-03091-0","url":null,"abstract":"","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1543"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-03091-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39327641","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":"2020 international practice patterns in adult joint reconstruction surgery: a survey of members of the International Society of Orthopaedic Centers.","authors":"Daniel C Santana,&nbsp;Alejandro Gonzalez Della Valle,&nbsp;Alison K Klika,&nbsp;Briana Bloom,&nbsp;Mathias Bostrom,&nbsp;Nicolas S Piuzzi","doi":"10.1007/s00590-021-02876-7","DOIUrl":"https://doi.org/10.1007/s00590-021-02876-7","url":null,"abstract":"<p><strong>Purpose: </strong>It is important to assess global trends in the practice of adult reconstruction orthopaedic surgery to understand how new evidence is being implemented. The International Society of Orthopaedic Centers (ISOC) is a consortium of academic orthopaedic centers whose members' practices likely reflect contemporary evidence and indicate how orthopaedic surgery residents and fellows are trained.</p><p><strong>Methods: </strong>We administered a 65 question, electronic survey of adult reconstruction surgeons across the ISOC centers in September 2020 to assess practice patterns. Results were assessed using descriptive statistics or by modeling the underlying response distribution, and the analysis was stratified by hospital region.</p><p><strong>Results: </strong>79 surgeons across 19 ISOC centers in 5 continents (Asia, Australia, Europe, North America, South America) completed the survey. Selected findings include: in total hip arthroplasty (THA), the posterolateral approach was used for 71 ± 42% of THA (mean ± standard deviation) and the direct anterior approach in 18% ± 34%. In total knee arthroplasty, posterior-stabilized (66% ± 39%) and cruciate-retaining (19  ± 33%) implants were most common. Robots were available in 56% (44 of 79) of surgeons' centers more commonly in Asia, Australia, and North America. Tranexamic acid was routinely used in arthroplasty by 99% (78 of 79) of surgeons. Eighty-six percent (68 of 79) submit data to joint or other registries. Virtual visits were used for 13% ± 16% of outpatient visits and by 82% (64 of 79) of surgeons overall.</p><p><strong>Conclusions: </strong>These findings may be of use now for surgeons to consider the practices of their peers at high-volume academic institutions, and in the future as we track temporal trends.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1297-1303"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-02876-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38850083","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":"Diabetes mellitus effect on rates of perioperative complications after operative treatment of distal radius fractures.","authors":"Chapman Wei,&nbsp;Nisha Kapani,&nbsp;Theodore Quan,&nbsp;Alex Gu,&nbsp;Safa C Fassihi,&nbsp;Michael-Alexander Malahias,&nbsp;Victoria Haney,&nbsp;Melina Recarey,&nbsp;Sam Moghtaderi","doi":"10.1007/s00590-021-02880-x","DOIUrl":"https://doi.org/10.1007/s00590-021-02880-x","url":null,"abstract":"<p><strong>Purpose: </strong>This study focuses on distal radius fractures that require surgical treatment. Patients with diabetes mellitus (DM) are at increased risk of bone fracture despite normal areal bone mineral density. The aim of this study is to identify the impact of DM on perioperative complications for patients undergoing operative treatment of distal radius fracture.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data collected through the National Surgical Quality Improvement Program database. All patients who underwent operative treatments for distal radius fractures from 2007 through 2018 were identified. Data collected include demographic information, comorbidities, and complications occurring within 30 days of initial surgical intervention. The incidence of adverse events following surgery was evaluated with univariate and multivariate analyses where appropriate.</p><p><strong>Results: </strong>Patients with DM were found to have a low rate of complications postsurgical repair of distal radius fractures. Preoperative comorbidity analysis showed that the diabetic group had significantly higher rates of chronic obstructive pulmonary disease, hypertension, congestive heart failure, renal failure, steroid use, bleeding disorders, dyspnea, and poorer functional status. Diabetes was found to be an independent predictor for unplanned intubation, sepsis, and septic shock. Diabetes was not found to be an independent predictor of other postoperative complications.</p><p><strong>Conclusion: </strong>Complications after surgical repair of distal radius fracture are low except when it comes to reintubation, sepsis, and septic shock. While the risks of independent complications remain relatively low, diabetes remains an important factor to consider when selecting surgical candidates and to ensure appropriate pre-operative risk assessment.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"1329-1334"},"PeriodicalIF":1.7,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-021-02880-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38857572","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":"The role of patient positioning on the outcome of acetabular fractures fixation through the Kocher-Langenbeck approach.","authors":"Motasem Salameh,&nbsp;Mohammad Hammad,&nbsp;Elhadi Babikir,&nbsp;Abdulaziz F Ahmed,&nbsp;Bivin George,&nbsp;Ghalib Alhaneedi","doi":"10.1007/s00590-020-02793-1","DOIUrl":"https://doi.org/10.1007/s00590-020-02793-1","url":null,"abstract":"<p><strong>Background: </strong>Open reduction and internal fixation through the Kocher-Langenbeck approach is the treatment of choice for selected acetabular fracture patterns. Patient positioning (lateral vs prone) can affect the outcome and post-operative complications.</p><p><strong>Methods: </strong>A retrospective cohort of seventy-three adult patients' with acetabular fractures treated with open reduction and internal fixation through the Kocher-Langenbeck approach in either prone or lateral position. Primary outcome was the quality of radiographic fracture reduction; secondary outcomes included operative time, intra-operative estimated blood loss and pre-operative complications.</p><p><strong>Results: </strong>The demographics and fracture type were similar between the two groups. There was no difference in the quality of reduction using the Matta radiographic grading. Laterally positioned group demonstrated significant shorter surgical time and lower incidence of iatrogenic sciatic nerve injury. There was no difference in estimated blood loss, heterotopic ossification or infection.</p><p><strong>Conclusion: </strong>This study showed no difference in the quality of fracture reduction, intraoperative blood loss, post-operative infection and heterotopic ossification between both groups. Hence, patients' condition, surgeon experience and preference are important factors for deciding patient positioning in the Kocher-Langenbeck approach for acetabulum fracture fixation.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"503-509"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-020-02793-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38532143","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":"How are peri-implant fractures below short versus long cephalomedullary nails different?","authors":"L Henry Goodnough,&nbsp;Brett P Salazar,&nbsp;Jamie Furness,&nbsp;James E Feng,&nbsp;Malcolm R DeBaun,&nbsp;Sean T Campbell,&nbsp;Justin F Lucas,&nbsp;William W Cross,&nbsp;Philipp Leucht,&nbsp;Kevin D Grant,&nbsp;Michael J Gardner,&nbsp;Julius A Bishop","doi":"10.1007/s00590-020-02785-1","DOIUrl":"https://doi.org/10.1007/s00590-020-02785-1","url":null,"abstract":"<p><strong>Background: </strong>Cephalomedullary nails are a commonly used implant for the treatment of many pertrochanteric femur fractures and are available in short and long configurations. There is no consensus on ideal nail length. Relative advantages can be ascribed to short and long intramedullary nails, yet both implant styles share the potentially devastating complication of peri-implant fracture. Determining the clinical sequelae after fractures below nails of different lengths would provide valuable information for surgeons choosing between short or long nails. Thus, the purpose of the study was to compare injury patterns and treatment outcomes following peri-implant fractures below short or long cephalomedullary nails.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study that identified 33 patients referred for treatment of peri-implant fractures below short and long cephalomedullary nails (n = 19 short, n = 14 long). We compared fracture pattern, treatment strategy, complications, and outcomes between these two groups.</p><p><strong>Results: </strong>Short nails were associated with more diaphyseal fractures (odds ratio [OR] 13.75, CI 2.2-57.9, p 0.002), which were treated more commonly with revision intramedullary nailing (OR, infinity; p 0.01), while long nails were associated with distal metaphyseal fractures (OR 13.75, CI 2.2-57.9, p 0.002), which were treated with plate and screw fixation (p 0.002). After peri-implant fracture, there were no differences in blood loss, operative time, weight bearing status, or complication rates based on the length of the initial nail. In patients treated with revision nailing, there was greater estimated blood loss (EBL, median 300 cc, interquartile range [IQR] 250-1200 vs median 200 cc, IQR 100-300, p 0.03), blood product utilization and complication rates (OR 11.1, CI 1.1-135.7, p 0.03), but a trend toward unrestricted post-operative weight-bearing compared to patients treated with plate and screw constructs.</p><p><strong>Conclusion: </strong>Understanding fracture patterns and patient outcomes after fractures below nails of different lengths will help surgeons make more informed implant choices when treating intertrochanteric hip fractures. Revision to a long nail for the treatment of fractures at the tip of a short nail may be associated with increased patient morbidity.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"421-427"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-020-02785-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38362342","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":"Validation of a prospective mortality prediction score for hip fracture patients.","authors":"Jordan Etscheidt,&nbsp;Michael McHugh,&nbsp;Joanne Wu,&nbsp;Mark E Cowen,&nbsp;James Goulet,&nbsp;Mark Hake","doi":"10.1007/s00590-020-02794-0","DOIUrl":"https://doi.org/10.1007/s00590-020-02794-0","url":null,"abstract":"<p><strong>Purpose: </strong>Although mortality prediction tools are the subject of significant interest as components of comprehensive hip fracture protocols, few have been applied or validated to prospectively inform ongoing patient management. Five regional hospitals are currently generating real-time mortality risk scores for all adults at the time of admission using available laboratory and comorbidity data (Cowen et al. J Hosp Med 9(11):720-726, 2014). Although results for aggregated conditions have been published, the primary aim of this study is to determine how well prospectively calculated scores predict mortality for hip fracture patients specifically.</p><p><strong>Methods: </strong>Using a five-hospital database, 1376 patients who were prospectively scored on admission were identified from January 2013 to April 2017, cross-referencing ICD9/10 diagnosis and procedure codes for AO/OTA 31A1 through 31B3 fractures. Prospective mortality scores have been previously divided into 5 risk categories to facilitate ease of clinical use. Vital status was determined from hospital data, Social Security and Michigan Death Indices.</p><p><strong>Results: </strong>Prospective scores demonstrated good mortality prediction, with AUCs of 0.80, 0.73, 0.74 and 0.74 for in hospital, 30-, 60- and 90-day mortality, respectively. Patients in the top 2 mortality risk categories represented 30% (410/1376) of the cohort and accounted for 78% (25/32) of the inpatient and 59% (57/97) of the 30 day deaths.</p><p><strong>Conclusions: </strong>Implementation of this real-time mortality risk tool is feasible and valid for the prediction of short- to medium-term mortality risk for hip fracture patients, and potentially offers valuable information to guide ongoing patient management decisions such as admitting service or level of care.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"525-532"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-020-02794-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38472551","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":"Incidence of tensor fascia lata muscle atrophy after using the modified Watson-Jones anterolateral approach in total hip arthroplasty.","authors":"Ryohei Takada,&nbsp;Tetsuya Jinno,&nbsp;Kazumasa Miyatake,&nbsp;Masanobu Hirao,&nbsp;Toshitaka Yoshii,&nbsp;Atsushi Okawa","doi":"10.1007/s00590-020-02806-z","DOIUrl":"https://doi.org/10.1007/s00590-020-02806-z","url":null,"abstract":"<p><strong>Background: </strong>Post-operative tensor fascia lata (TFL) muscle atrophy due to superior gluteal nerve (SGN) injury during total hip arthroplasty (THA) can affect patients' post-operative hip function. This study aimed to determine the incidence of TFL muscle atrophy in THA performed via the modified Watson-Jones anterolateral approach and the risk factors for TFL atrophy.</p><p><strong>Methods: </strong>We reviewed pre- and post-operative magnetic resonance imaging (MRI) data of 164 patients who underwent cementless THA via the modified Watson-Jones approach at one institution. TFL atrophy was defined as worsening of ≥ 2 grades in the Goutallier classification or > 40% decrease in the cross-sectional area (CSA) of the TFL on post-operative MRI compared to that on preoperative MRI. Patients' backgrounds were compared between those with or without TFL atrophy to determine the risk factors of TFL atrophy. Fatty atrophy grade and CSA of the gluteus minimus and medius were also evaluated.</p><p><strong>Results: </strong>Thirteen (8.0%) cases of TFL atrophy were detected. The mean body mass index (BMI) in the cases with TFL atrophy was significantly higher than in those without TFL atrophy (p = 0.012). The fatty atrophy grade was worse post-operatively than preoperatively; moreover, the CSA of the gluteus minimus decreased.</p><p><strong>Conclusions: </strong>We found a low incidence of TFL atrophy due to SGN injury after THA using the modified Watson-Jones approach. High BMI can be a risk factor for nerve injury. The gluteus minimus can be injured directly during surgery. We suggest that overexposure of the surgical site should be avoided, especially in patients with high BMI.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"533-540"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-020-02806-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38477721","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":"Clinical, functional and prognostic results after repair of peripheral lesions of the triangular fibrocartilage complex: a retrospective study of 21 patients.","authors":"Alexandre Cornu,&nbsp;Thomas Amouyel,&nbsp;Christophe Chantelot,&nbsp;Marc Saab","doi":"10.1007/s00590-020-02805-0","DOIUrl":"https://doi.org/10.1007/s00590-020-02805-0","url":null,"abstract":"<p><strong>Objectives: </strong>The main objective of this study was to assess the clinical and functional outcomes of arthroscopic TFCC repair in patients with an isolated Atzei type 1, 2 or 3 lesion or after a distal radius fracture. The secondary objective was to identify which factors could contribute to poor functional outcome.</p><p><strong>Methods: </strong>A retrospective study was conducted from November 2017 to May 2019. The inclusion criteria were patients with an Atzei type 1, 2 or 3 TFCC lesion who underwent arthroscopic repair and with a minimum of 6-month follow-up. Wrist motion, grip and pronation-supination strength were noted. QuickDASH, MMWS and PRWE scores were performed. An analysis was conducted to search for poor outcomes predictive factors (MMWS < 80).</p><p><strong>Results: </strong>Twenty-one patients were included with a mean follow-up of 26 months. Seventeen patients (80%) had an Atzei 1 lesion, one (4.8%) had an Atzei 2, and 3 (14%) had an Atzei 3. Wrist motion significantly decreased compared to contralateral. Only pronation and supination were not significant. Grip strength was 73.4% compared to the contralateral (p = 0.002). Mean PRWE was 29.14 (1.5-70.5), QuickDASH was 30.72 (2.3-70.5), and MMWS was 79.3 (35-100). In all patients with a MMWS ≥ 80, none had lunotriquetral lesions when it was the case for 5 of 9 patients with a MMWS < 80 (p = 0.006). Except a story of workplace injury, no other prognosis factor was significant.</p><p><strong>Conclusion: </strong>Patients with Atzei 1, 2 or 3 TFCC who underwent arthroscopic repair seem to have good outcomes. However, an associated lunotriquetral lesion appears to worsen the functional prognosis.</p>","PeriodicalId":520619,"journal":{"name":"European journal of orthopaedic surgery & traumatology : orthopedie traumatologie","volume":" ","pages":"557-562"},"PeriodicalIF":1.7,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1007/s00590-020-02805-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38481004","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}