Orthopaedics & Traumatology-Surgery & Research最新文献

{"title":"Repair of radial tears of the lateral meniscus on a stable knee: Results at a minimum follow-up of 2 years","authors":"Rayane Benhenneda,&nbsp;Mohammad Alajji,&nbsp;Adrien Portet,&nbsp;Bertrand Sonnery-Cottet,&nbsp;Jean-Marie Fayard,&nbsp;Mathieu Thaunat","doi":"10.1016/j.otsr.2024.103877","DOIUrl":"10.1016/j.otsr.2024.103877","url":null,"abstract":"<div><h3>Introduction</h3><p>In younger patients, meniscal repair is recommended for isolated lateral meniscus tears that are most often due to acute trauma. But there is little published data on the outcomes of repairing this specific type of lesion. The goal of this study was to evaluate the clinical outcomes, report the failure rate of repairing radial tears of the lateral meniscus in stable knees and determine the risk factors for failure.</p></div><div><h3>Materials and methods</h3><p>All patients who had a stable knee and underwent arthroscopic repair of a radial lateral meniscus tear between April 2013 and December 2019 were reviewed retrospectively. Failure was defined as revision surgery for recurrence of symptoms (pain, locking) with intraoperative confirmation that the meniscus did not heal. The following data were collected: demographics (age, sex, BMI), time to surgery, clinical outcome scores (Tegner, Lysholm, IKDC), surgical details (repair technique, lesion zone, number of sutures).</p></div><div><h3>Results</h3><p>Thirty patients were included having a mean age of 20.1<!--> <!-->years (14–31). The follow-up ranged from 24 to 110<!--> <!-->months (mean 66.8<!--> <!-->±<!--> <!-->25.2). An all-inside repair was done in 6 patients (20%); an outside-in technique was done in 17 patients (57%) and a combination of all-inside and outside-in was done in 7 patients (23%). Four patients (13%) had a recurrence of their symptoms later on, while participating in sports. All the recurrences were at the initial tear site. The time to revision surgery was 16, 19, 24 and 37<!--> <!-->months in these four patients (mean 24<!--> <!-->±<!--> <!-->9). All the other patients were able to resume sports at their pre-injury level. Significant improvement in the IKDC, Lysholm and Tegner functional scores were found between the preoperative and postoperative assessments. No statistically significant risk factors for failure were identified.</p></div><div><h3>Discussion</h3><p>The functional healing rate after repair of a radial lateral meniscus tear in a stable knee was 86% at a mean follow-up of 5<!--> <!-->years, with the surgical technique having no impact on the long-term result. Most of the failures occurred within 2<!--> <!-->years of the repair procedure. We recommend repairing these tears as they have considerable healing potential.</p></div><div><h3>Level of evidence</h3><p>IV; retrospective observational cohort study.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140581629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is there a femoral morphology at risk of a cervical or pertrochanteric fracture? Description and validation of the “Neck shaft ratio” and the “Intertrochanteric distal ratio” after analyzing a continuous cohort of 126 bilateral fractures of the proximal femur","authors":"Grégoire Rougereau ,&nbsp;Jean-Arthur Bourdier ,&nbsp;Tristan Langlais ,&nbsp;Philippe Boisrenoult ,&nbsp;Nicolas Pujol","doi":"10.1016/j.otsr.2024.103874","DOIUrl":"10.1016/j.otsr.2024.103874","url":null,"abstract":"<div><h3>Background</h3><p>Proximal femur fractures constitute a public health concern given their high frequency and the aging population. The frequency of a contralateral fracture occurring can reach up to 15% of cases. Certain historical or demographic factors constitute risk factors for refracture, but the type of fracture, either of the femoral neck (FN) or pertrochanteric (PT), cannot be predicted. The objectives of this retrospective study were: firstly, to analyze several anatomical markers in order to determine whether they predispose to a certain type of fracture in the event of contralateral refracture, and secondly, to determine the predictive power of these possible radiological markers for the type of contralateral fracture.</p></div><div><h3>Hypothesis</h3><p>The hypothesis was that the “Neck shaft ratio” (NSR) and the “Intertrochanteric distal ratio” (ITDR) made it possible to determine a proximal femoral morphology at risk of FN and/or PT fracture in the event of a second fracture.</p></div><div><h3>Material and methods</h3><p>This continuous retrospective single-center series from January 2011 to December 2019 of patients who presented with bilateral fractures of the proximal femurs was analyzed. Radiographs, taken after the first fracture, of the contralateral femur were studied. Morphological measurements previously described in the literature were carried out as well as the NSR (ratio of the medial cortical thicknesses of the femoral neck at its narrowest and basicervical level) and the ITDR (ratio of the medial diaphyseal cortical thicknesses at 5<!--> <!-->mm and 20<!--> <!-->mm from the distal portion of the lesser trochanter). One hundred and twenty-six patients were included: 46/126 (36.5%) had bilateral FN, 50/126 (39.7%) bilateral PT and 30/126 (23.8%) one of each.</p></div><div><h3>Results</h3><p>Only NSR and ITDR were significant predictive measures for FN or PT fracture type [0.54<!--> <!-->±<!--> <!-->0.11 vs. 0.81<!--> <!-->±<!--> <!-->0.16 (<em>p</em> <!-->&lt;<!--> <!-->0.0001) and 0. 85<!--> <!-->±<!--> <!-->0.1 vs. 0.68<!--> <!-->±<!--> <!-->0.1 (<em>p</em> <!-->&lt;<!--> <!-->0.0001), respectively]. These two ratios had an excellent predictive value for the type of fracture occurring on the contralateral side [NSR: AUC ROC = 0.91 (95% CI; 0.86–0.96); ITDR: AUC ROC = 0.81 (95% CI; %, 0.74–0.89)]. The NSR had excellent intra- and inter-observer reproducibility with an interclass correlation coefficient of 0.93 [95% CI: 0.86–0.97] and 0.91 [95% CI: 0.82–0.96] respectively, the same also applied for the ITDR with interclass correlation coefficient values of 0.93 [95% CI: 0.87–0.97] and 0.86 [95% CI: 0.73–0.93] respectively.</p></div><div><h3>Discussion</h3><p>The NSR and ITDR ratios offer a simple and reproducible means to predict a morphological predisposition to a certain fracture type, respectively an FN and PT on the side contralateral to an initial osteoporotic proximal femur fracture. A prospective cohort s","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the letter from Andreas Rehm, Azeem Thahir, Nicholas Judkins, Katerina Hatzantoni, Ayla C. Newton and Elizabeth Ashby","authors":"Si Heng Sharon Tan","doi":"10.1016/j.otsr.2024.103894","DOIUrl":"10.1016/j.otsr.2024.103894","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140868756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buried de-epithelialized flap: An original solution to fill dead space after sarcoma resection in the thigh. Surgical technique and results of 12 cases","authors":"Ramy Samargandi ,&nbsp;Rayane Benhenneda ,&nbsp;Philippe Rosset ,&nbsp;Audrey Bisson-Patoue ,&nbsp;Louis-Romée Le Nail","doi":"10.1016/j.otsr.2023.103748","DOIUrl":"10.1016/j.otsr.2023.103748","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Soft tissue sarcomas (STS) are often treated with </span>wide excision<span><span> in combination with adjuvant or neoadjuvant radiotherapy. This is currently the gold standard procedure for the treatment of STS that arise in the extremities. Wound healing complications frequently occur and negatively affect the prognosis. One of the options is to use a buried de-epithelialized flap as it can increase the </span>lymphatic flow, fill the dead space, and cover neurovascular structures and implants. This aim of this retrospective study were two-fold. 1) Describe the surgical technique for this buried de-epithelialized flap after STS removal in the thigh. 2)Evaluate the efficacy of the buried de-epithelialized flap for decreasing wound complications based on a small case series and compare it with previous publications.</span></p></div><div><h3>Hypothesis</h3><p>We hypothesized that the complication rate of this flap is not higher than the published complication rate for traditional flaps.</p></div><div><h3>Materials and methods</h3><p>Twelve patients (7 women and 5 men) with a mean age of 62<!--> <!-->±<!--> <!-->12<!--> <!-->years (38–76), who underwent surgical removal of an STS in the thigh with coverage by a buried de-epithelialized flap were reviewed at a mean follow-up of 15.8<!--> <!-->months (range 8–24).</p></div><div><h3>Results</h3><p>Two patients presented with a postoperative wound infection<span><span><span><span> (17%): one superficial and one deep at the surgical site. Neither required an additional plastic surgery procedure<span>. Another patient had a dislocation of their total hip arthroplasty that was managed by </span></span>closed reduction. One patient died from metastatic progression. There was no </span>skin necrosis of the superficial skin edges, no hematoma or </span>seroma in the other 10 patients. The flap was still visible on cross-sectional imaging at 1 month postoperative with no fluid between the tissue planes or signs of necrosis. The rate of wound healing complications that required surgical treatment was 17% in our case series, versus 16 to 56% in previous publications reporting the results of suture closure only.</span></p></div><div><h3>Conclusion</h3><p>A buried de-epithelialized flap reduces the risk of skin complications by filling dead space, improving lymphatic flow and covering critical structures. It is a reliable and reproducible option after wide local excision of STS in the thigh, with no additional morbidity.</p></div><div><h3>Level of evidence</h3><p>IV, retrospective study.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71489037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors of developmental dysplasia of the hip in infants: A meta-analysis based on cohort studies","authors":"Xingguang Chen ,&nbsp;Jue Liu ,&nbsp;Mingfeng Xue ,&nbsp;Chengda Zou ,&nbsp;Jialing Lu ,&nbsp;Xiaodong Wang ,&nbsp;Yiqun Teng","doi":"10.1016/j.otsr.2024.103836","DOIUrl":"10.1016/j.otsr.2024.103836","url":null,"abstract":"<div><h3>Introduction</h3><p>Developmental dysplasia of the hip (DDH) is a prevalent condition in children. Currently, the exact etiology of DDH remains uncertain. The objective of this study was to conduct a meta-analysis to investigate the risk factors associated with DDH in infants. The findings would provide a theoretical foundation for targeted early screening and diagnosis.</p></div><div><h3>Hypothesis</h3><p>Several indicators, such as gender, intrauterine position, family history of DDH, gestational age, delivery mode, amniotic fluid levels, swaddling, parity, fetus number, combined musculoskeletal deformities, birth weight, and physical examination results, may serve as risk factors for DDH.</p></div><div><h3>Materials and methods</h3><p>Cohort studies investigating the risk factors of DDH in infants through logistic regression analysis were searched in the Wanfang, VIP citation, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc, Excerpta Medica Database (Embase), PubMed, and Cochrane Library databases up to May 2023. After extracting the data from eligible literature and assessing them using the Newcastle-Ottawa Scale (NOS), articles were selected based on pre-established inclusion and exclusion criteria.</p></div><div><h3>Results</h3><p>A total of eleven literature reports covering 979,757 infants were included in this meta-analysis. The publication bias did not significantly influence the results. The incidence rate of DDH was 47.99‰ among infants with risk factors compared to 3.21‰ in the general population. Risk factors for DDH included being female (OR<!--> <!-->=<!--> <!-->6.97, 95% CI: 5.18–9.39, <em>p</em> <!-->&lt;<!--> <!-->0.001), breech delivery (OR<!--> <!-->=<!--> <!-->4.14, 95% CI: 3.09–5.54, <em>p</em> <!-->&lt;<!--> <!-->0.001), positive family history (OR<!--> <!-->=<!--> <!-->4.07, 95% CI: 2.20–7.52, <em>p</em> <!-->&lt;<!--> <!-->0.001), cesarean section (OR<!--> <!-->=<!--> <!-->1.11, 95% CI: 1.01–1.21, <em>p</em> <!-->=<!--> <!-->0.032), oligohydramnios (OR<!--> <!-->=<!--> <!-->3.93, 95% CI: 1.29–12.01, <em>p</em> <!-->=<!--> <!-->0.016), swaddling (OR<!--> <!-->=<!--> <!-->6.74, 95% CI: 1.25–36.31, <em>p</em> <!-->=<!--> <!-->0.026), firstborn status (OR<!--> <!-->=<!--> <!-->1.84, 95% CI: 1.49–2.53, <em>p</em> <!-->&lt;<!--> <!-->0.001), combined musculoskeletal malformations (OR<!--> <!-->=<!--> <!-->2.27, 95% CI: 1.58–3.27, <em>p</em> <!-->&lt;<!--> <!-->0.001), and physical signs of DDH (OR<!--> <!-->=<!--> <!-->8.71, 95% CI: 2.44–31.07, <em>p</em> <!-->=<!--> <!-->0.001). Premature delivery (OR<!--> <!-->=<!--> <!-->0.91, 95% CI: 0.88–0.95, <em>p</em> <!-->&lt;<!--> <!-->0.001) was a protective factor for DDH. The relationship between multiple pregnancies (OR<!--> <!-->=<!--> <!-->0.58, 95% CI: 0.33–1.02, <em>p</em> <!-->=<!--> <!-->0.060) and low birth weight (OR<!--> <!-->=<!--> <!-->0.62, 95% CI: 0.14–2.76, <em>p</em> <!-->=<!--> <!-->0.529) in relation to DDH remained uncertain.","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limb schwannoma: Factors for postoperative neurologic deficit and poor functional results","authors":"Corentin Raj,&nbsp;Thomas Amouyel,&nbsp;Carlos Maynou,&nbsp;Christophe Chantelot,&nbsp;Marc Saab","doi":"10.1016/j.otsr.2024.103839","DOIUrl":"10.1016/j.otsr.2024.103839","url":null,"abstract":"<div><h3>Introduction</h3><p>Neurologic complications after limb schwannoma resection are not unusual, but there is no consensus on risk factors for neurologic deficit or poor functional results. We therefore conducted a retrospective study, to screen for factors predicting, firstly, postoperative neurologic deficit and, secondly, poor functional results.</p></div><div><h3>Hypothesis</h3><p>Certain pre- and intraoperative features predict risk of failure, poor results or aggravation.</p></div><div><h3>Patients and methods</h3><p>A single-center retrospective study was conducted in the University Hospital of Lille, France, for the period January 2004 to March 2020, including 71 patients. Preoperative variables (gender, age, symptoms, progression, tumor location and size) and operative data (type of surgery) were collected as possible risk factors for postoperative sensory deficit (Weber) and/or motor deficit [Medical Research Council (MRC)] and poor functional result [Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH); Lower Extremity Functional Scale (LEFS) and <em>douleur neuropathique</em> (neuropathic pain) 4 (DN4)].</p></div><div><h3>Results</h3><p>Results were assessed a mean 69.4<!--> <!-->±<!--> <!-->38.5 months’ follow-up (range, 6–180 months). In total, 21 patients (29.6%) had deficits (21 sensory, 1 motor) preoperatively and 25 patients (35.2%) postoperatively (20 sensory, 9 motor) (<em>p</em> <!-->=<!--> <!-->0.689). Fourteen patients (19.7%) showed functional aggravation. Fascicular resection was associated with risk of postoperative deficit [OR = 4.65 (95% CI: 1.485–15.543); <em>p</em> <!-->=<!--> <!-->0.004] and functional deterioration [OR = 3.9 (95% CI: 1.143–13.311); <em>p</em> <!-->=<!--> <!-->0.042]. Thirteen patients (18.3%) showed no improvement on DN4. Preoperative pain was a factor for improvement on DN4 [OR = 3.667 (95% CI: 1.055–12.738); <em>p</em> <!-->=<!--> <!-->0.0409].</p></div><div><h3>Discussion</h3><p>The study identified fascicular resection as a risk factor for postoperative deficit and functional deterioration after limb schwannoma resection. Patients with preoperative neuropathic pain showed alleviation. Resection should be precise, under magnification, avoiding fascicular resection. Preoperative patient information is essential.</p></div><div><h3>Level of evidence</h3><p>IV; retrospective series.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139736714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the retear rate 2 years after ACL reconstruction with the Tape Locking Screw short graft system and the STG technique: A case control study with propensity score matching","authors":"Pierre-Alban Bouché ,&nbsp;Nicolas Lefevre ,&nbsp;Yoann Bohu ,&nbsp;Antoine Gerometta ,&nbsp;Alain Meyer ,&nbsp;Olivier Grimaud ,&nbsp;Alexandre Hardy","doi":"10.1016/j.otsr.2024.103848","DOIUrl":"10.1016/j.otsr.2024.103848","url":null,"abstract":"<div><h3>Purpose</h3><p>Theoretically, short semitendinosus grafts result in less pain and morbidity while providing greater knee flexion strength and sparing the gracilis tendon. They often require the use of blind bone tunnels as well as fixation at both ends of the graft with suspensory cortical buttons. The “Tape Locking Screw” (TLS) system is another option. There are few studies comparing ACL reconstruction with a short graft using the 4-strand semitendinosus graft (ST4-TLS) technique with that of the semitendinosus-gracilis (STG) procedure. This study was designed: (1) to compare the retear rate following these two technics after 2<!--> <!-->years of follow-up, (2) to compare the clinical scores, complications and return to sport times between the two procedures Q1, Q2.</p></div><div><h3>Hypothesis</h3><p>Our hypothesis was that there would be no differences in retear rates between the two techniques.</p></div><div><h3>Methods</h3><p>This single center case control study included 290 patients who underwent STG reconstruction that were paired by propensity score matching to 299 patients who underwent ST4-TLS reconstruction. The main evaluation criterion was the retear rate 2<!--> <!-->years after surgery. Secondary criteria were the two-year postoperative complication rate, the time to return to sport, to pivot sports and to running, as well as the complication rates and clinical scores 6<!--> <!-->months, 1<!--> <!-->year and 2<!--> <!-->years after surgery.</p></div><div><h3>Results</h3><p>At the final follow-up, the overall retear rate in our series of ACL ligament reconstruction was 6.0% (36/596). There was no difference in retear rates between the groups 2<!--> <!-->years after ligament reconstruction [ST4-TLS: 6.7% (20/299) vs. STG: 5.4% (16/297); <em>p</em> <!-->=<!--> <!-->0.47]. The postoperative KOOS symptom score and the Tegner score were found to be better in the STG group at 1<!--> <!-->year (81 vs. 78, <em>p</em> <!-->=<!--> <!-->0.008) and 2<!--> <!-->years (5.64 vs. 5.10, <em>p</em> <!-->=<!--> <!-->0.016), respectively, representing the minimally clinically important difference (MCID) for the latter. No difference was found in the other clinical scores 6<!--> <!-->months, 1<!--> <!-->year or 2<!--> <!-->years after surgery. There was no significant difference in the return to sport [TLS: 93.0% (164/299) vs. STG: 93.0% (158/297) <em>p</em> <!-->=<!--> <!-->0.99] or the complication rate [TLS: 8.7% (26/299) vs. STG: 7.4% (22/297) <em>p</em> <!-->=<!--> <!-->0.89] between the groups.</p></div><div><h3>Discussion</h3><p>The ST4-TLS ACL ligament reconstruction technique was found to be as reliable as the standard STG procedure 2<!--> <!-->years after surgery for the retear rate and the return to sport, although the results of certain postoperative clinical scores seem to be lower.</p></div><div><h3>Level of evidence</h3><p>III; case control study.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Induced-membrane technique for lower limb reconstruction after malignant bone tumour resection in paediatric patients: Complication and re-operation rates","authors":"Thibault Marty-Diloy ,&nbsp;Grégoire Rougereau ,&nbsp;Pierre Mary ,&nbsp;Raphael Vialle ,&nbsp;Franck Fitoussi ,&nbsp;Raphael Pietton ,&nbsp;Tristan Langlais","doi":"10.1016/j.otsr.2024.103875","DOIUrl":"10.1016/j.otsr.2024.103875","url":null,"abstract":"<div><h3>Background</h3><p>The objective of this study was to assess the complication and re-operation rates, evaluate the risk of non-union, and describe the functional outcomes at last follow-up in children and adolescents after lower-limb malignant tumour resection and reconstruction using the induced-membrane technique.</p></div><div><h3>Hypothesis</h3><p>Weight-bearing resumption 6 weeks after the second stage of the induced-membrane procedure promotes bone healing.</p></div><div><h3>Material and methods</h3><p>The study included 13 patients (9 with osteosarcoma, 3 with Ewing's sarcomas, and 1 with alveolar sarcoma) managed between 2000 and 2020 by oncological femoral or tibial resection followed, at a distance from adjuvant chemotherapy, by reconstruction using the induced-membrane technique. Non-union was the primary outcome measure and the MusculoSkeletal Tumor Society (MSTS) lower-limb functional score was the secondary outcome measure. Mean follow-up was 6.1 years (range, 2.0–12.7). At last follow-up, mean age was 18.1 years (range, 11.0–26.0) and the mean MSTS score was 66.6% (37.0–93.0%).</p></div><div><h3>Results</h3><p>After the second reconstruction stage, 8 complications developed in 6 patients (46%). Either a complication or limb-length inequality required 12 re-operations in 8 patients (61.5%). Non-union occurred after reconstruction in 5 (38.5%) patients. Early resumption of 50% weight-bearing 6 weeks after reconstruction was associated with bone healing (<em>p</em> <!-->=<!--> <!-->0.02).</p></div><div><h3>Conclusion</h3><p>The non-union rate was 38.5%. Partial, 50% weight-bearing with two elbow crutches and an orthosis, if allowed by construct stability, may promote bone healing.</p></div><div><h3>Level of evidence</h3><p>IV.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140332288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resurgence of slope osteotomies: A new chapter in anterior cruciate ligament surgery?","authors":"Pierre-Alban Bouché ,&nbsp;Jean-Marie Fayard","doi":"10.1016/j.otsr.2024.103902","DOIUrl":"10.1016/j.otsr.2024.103902","url":null,"abstract":"","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140900306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of old femoral neck fractures in young adults with a medial buttress plate combined with three cannulated screws and iliac autograft: Surgical technique and preliminary results","authors":"Guanglei Zhao ,&nbsp;Wenjun Chen ,&nbsp;Jianguo Wu ,&nbsp;Tiancong Ma ,&nbsp;Siqun Wang ,&nbsp;Yibing Wei ,&nbsp;Jun Xia ,&nbsp;Gangyong Huang","doi":"10.1016/j.otsr.2024.103853","DOIUrl":"10.1016/j.otsr.2024.103853","url":null,"abstract":"<div><h3>Objectives</h3><p>Whether the application of MBP plus cannulated screws works for old femoral neck fractures (OFNF) is unknown. The purpose of this study is to present a case series of OFNF in young adults using calcar buttress plate and three cannulated screws with autologous iliac bone grafts.</p></div><div><h3>Methods</h3><p>We conducted a retrospective study of eleven young patients (6 males and 5 females) with femoral neck fractures who were treated with open reduction and internal fixation at a single center between 2013 and 2021. The subjects had trauma-to-surgery intervals longer than 3<!--> <!-->weeks and all were fixed with a calcar buttress plate combined with three cannulated screws, which were supplemented by autologous iliac bone grafts.</p></div><div><h3>Results</h3><p>All eleven cases achieved radiological union under the surgery technique, which occurred on average at 4.46<!--> <!-->±<!--> <!-->1.29<!--> <!-->months after surgery. Complications included femoral neck shortening in all cases, heterotopic ossification in three cases, and osteonecrosis of the femoral head in two cases. One patient with osteonecrosis of the femoral head received total hip arthroplasty. In follow-ups of 24–52<!--> <!-->months, the median Harris hip score was 81.64<!--> <!-->±<!--> <!-->15.39.</p></div><div><h3>Conclusions</h3><p>The medial buttress plate in combination with three cannulated screws and iliac autograft may be a good choice for treating old femoral neck fractures in young adults.</p></div><div><h3>Level of evidence</h3><p>IV, case series.</p></div>","PeriodicalId":54664,"journal":{"name":"Orthopaedics & Traumatology-Surgery & Research","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}