Advances in Orthopedics最新文献

{"title":"Is Anterior Cruciate Ligament Reconstruction \"Silva Technique\" Equal to All-Inside Techniques? A Prospective Single-Center Study: An Alternative ACL All-Inside Reconstruction Technique Using a Tibial Tunnel and Bone Graft.","authors":"Panagiotis Karampinas, John Vlamis, Athanasios Galanis, Michail Vavourakis, Evangelos Sakellariou, Iordanis Varsamos, Ioannis Spyrou, Spiros Pneumaticos","doi":"10.1155/2024/2371242","DOIUrl":"10.1155/2024/2371242","url":null,"abstract":"<p><p><b>Background:</b> The development of less invasive all-inside techniques regarding anterior cruciate ligament (ACL) reconstruction surgery has been associated with various advantages, including fewer complications and reduced postoperative pain. Silva et al. described a quadruple semitendinosus graft construct and suspensory button fixation for ACL reconstruction as an alternative technique. At the end of this technique, the tibial tunnel is filled with a bone autograft plug. This paper aims to examine the incorporation of the autograft and thus evaluate whether the \"Silva technique\" provides the same benefits as all-inside techniques. <b>Methods:</b> A prospective study assessed 31 patients undergoing ACL reconstruction surgery using the \"Silva technique.\" The cases involved in the study were skeletally mature patients with no previous history of ACL surgery or multiligamentous instability. All patients followed the same rehabilitation program and were examined at three standardized follow-up visits: 4 months, 8 months, and 1 year postoperatively. Tegner-Lysholm knee score (TLKS), visual analog score (VAS) for pain, and the IKDC subjective knee score were completed at every visit. A knee MRI scan was performed at every scheduled visit to assess bone graft incorporation and remodeling. <b>Results:</b> TLKS scores revealed a considerable improvement compared to preoperative figures, from 57.2 points preoperatively to an average of 99.4 at the 12-month follow-up (<i>p</i> < 0.0001). VAS scores were substantially ameliorated after the operation and until the second follow-up visit, from 5 before surgery to zero 8 months after the operation, with no noteworthy alterations afterward (<i>p</i> < 0.0001). IKDC subjective knee score outcomes were found to have increased at the last follow-up, from 59.3 prior to surgery to 99.8 12 months postoperatively (<i>p</i> < 0.0001). Regarding the MRI features of the bone autograft, the tibial tunnel was entirely filled by bone formation at the last MRI scan, suggesting complete integration of the autograft in all patients. <b>Conclusions:</b> Bone autograft employed to seal the tibial tunnel was completely incorporated in all cases 1 year postoperatively. The \"Silva technique\" appears to feature all the avails of all-inside techniques, whilst it seems to be simpler and easier than them after the surgeon is familiarized with its particular aspects. It is a robust option in orthopedic surgeons' arsenal. However, further large-scale pertinent research is requisite to confirm the findings of this study.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566701","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":"Implant Survival of an Uncemented Modular Femoral Implant in Patients With Severe Femoral Bone Loss and 2-Stage Hip Revision.","authors":"Sebastian Winther, Naima Elsayed, Karen Dyreborg, Elinborg Mortensen, Michael M Petersen, Jens Stürup, Nikolaj S Winther","doi":"10.1155/2024/6158822","DOIUrl":"10.1155/2024/6158822","url":null,"abstract":"<p><p><b>Background and Purpose:</b> Revision total hip arthroplasty (rTHA) is a challenging procedure especially in the presence of severe bone loss where implant fixation is compromised. The aim of this study was to evaluate implant survival, clinical outcome, and midterm results in a group of complex patients after femoral revision using an uncemented modular implant design. <b>Patients and Methods:</b> We performed a retrospective study including 100 patients (101 hips) treated with revision THA using an uncemented modular implant design. We identified 51 hips as Paprosky types I-II and 50 hips as Paprosky III-IV bone defects. We reviewed operative reports and radiographs. Patients underwent a clinical examination to assess the Harris Hip Score (HHS) and completed patient-reported outcome measures (PROM), including the Oxford Hip Score (OHS) and the EQ-5D Visual Analog Scale (VAS). Minimum follow-up was 2 years (average, 5.8 years; range, 2.0-9.4 years). <b>Results:</b> Among the cases, 46 hips were revised for infection in a 2-stage procedure and 44 hips for aseptic loosening. 11 hips had periprosthetic fractures of Vancouver type B2 or B3. A total of 5 hips required revision with removal of the femoral implant and 11 patients experienced complications resulting in fracture (<i>n</i> = 1), dislocation (<i>n</i> = 10), and soft tissue revision (<i>n</i> = 1). The 5-year implant survival estimated by Kaplan-Meier survival analysis was 95% (95%-CI: 91%-99%). All hips had radiographic evidence of osseointegration and no one with subsidence greater than 5 mm. Additionally, 80% showed radiographic evidence of restoration of proximal femoral bone. Mean HHS was 78. <b>Conclusion:</b> In complex cases of revision THA, using a modular revision femoral system yielded promising results. The 5-year implant survival estimated by Kaplan-Meier survival analysis was 95% (95%-CI: 91%-99%), with all hips demonstrating radiographic evidence of osseointegration and no one with subsidence greater than 5 mm. Notably 80% showed radiographic evidence of restoration of proximal femoral bone.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566677","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":"Regular Nonsteroidal Anti-Inflammatory Drug Use Increases Stress Fracture Risk in the General Population: A Retrospective Case-Control Study.","authors":"Alexandra Ciuciu, Christopher Mulholland, Michael A Bozzi, Chris C Frymoyer, Leonardo Cavinatto, David Yaron, Marc I Harwood, Jeremy D Close, Christopher J Mehallo, Ryan E Tomlinson","doi":"10.1155/2024/7933520","DOIUrl":"10.1155/2024/7933520","url":null,"abstract":"<p><p>Previous studies have shown that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with increased stress fracture risk. This phenomenon has been studied predominantly in high-activity individuals, so data regarding the general population are limited despite the substantial economic and resource burden of stress fracture injuries within the general US population. Furthermore, our preclinical studies demonstrate that regular use of NSAIDs also diminishes the intrinsic ability of bone to resist fracture. To determine the association of regular NSAID use with stress fractures in the general population, we surveyed subjects presenting with either stress fracture or uncomplicated ankle sprain to assess their use of NSAIDs over the three months before their injury. We hypothesized that subjects with stress fractures would have increased regular NSAID usage as compared to controls. Subjects diagnosed with a stress fracture (<i>n</i> = 56) and subjects with uncomplicated ankle sprains (<i>n</i> = 51; control) were surveyed about their NSAID use at the time of their diagnosis and in the previous three months using a questionnaire based on the National Health and Nutrition Examination Survey (NHANES). Subjects were surveyed in person on the day of their injury diagnosis or by phone within 30 days of their diagnosis. Fisher's exact test was used to determine significant differences in NSAID usage between stress fracture and control subjects. Subjects diagnosed with stress fractures had a statistically significant increase in both current use (<i>p</i>=0.03) and regular use (<i>p</i>=0.04) of ibuprofen/naproxen/celecoxib as compared to control subjects. There were no significant differences in the use of aspirin, acetaminophen, or prescription medications containing acetaminophen between groups. Consistent with previous clinical reports, we observed a strong correlation between regular ibuprofen/naproxen/celecoxib use and stress fracture incidence in the general population. These results indicate that patients at high risk of stress fracture should avoid regular use of ibuprofen, naproxen, or celecoxib.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11490349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455756","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":"From Etiology to Intervention: A Holistic Review of Bunion Pathophysiology and Care.","authors":"Danielle Barnes, Paige Matijasich, Aidan Maxwell, David Yatsonsky, Audrey Ballard, Nabil Ebraheim, Osama Elattar","doi":"10.1155/2024/9910410","DOIUrl":"10.1155/2024/9910410","url":null,"abstract":"<p><p>In this review paper, we present the common etiology, presentation, diagnosis, and management of the following three common bunion formations: dorsal bunion, tailor's bunion, and hallux valgus (HV). Bunions are common pathologies that present to a variety of clinics, so it is important for providers to have a base understanding of these in order to provide the best care to patients. Many of these bunion formations have a variety of causes which allow providers to manage them before surgical intervention is required. The aim of this review paper is to bring attention and expanded insight on these common bunion presentations in order to minimize morbidity early on. The information provided in this review will allow both primary care and subspecialty physicians with the knowledge to accurately diagnose and optimally manage these bony deformities of the lower extremity.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11489004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142455755","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":"Treatment of Brachial Plexus Injuries following Gunshot Injuries: A Systematic Review.","authors":"Rohun Gupta, Isabel Herzog, Lauren Phung, Jacquelyn Roth, Joseph Weisberger, Margaret Luthringer, Edward S Lee, Ashley Ignatiuk","doi":"10.1155/2024/7708192","DOIUrl":"10.1155/2024/7708192","url":null,"abstract":"<p><strong>Introduction: </strong>Brachial plexus injuries (BPI) from gunshot injuries are uncommon but usually severe and can cause chronic pain, loss of function, and permanent nerve damage. Multiple surgical techniques including neurolysis, end-to-end suture repair, and graft repair have been described for the treatment of these injuries. However, surgical indication, timing, and technique for these injuries remain controversial. This systematic review aims to investigate the treatment modalities for patients with BPI due to gunshot-related injuries.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology was employed for this review. PubMed, Cochrane Reviews, Embase, and CINAHL databases were included. The following keywords constituted our search criteria: gun-shot-wounds, brachial plexus, traum^∗, and management.</p><p><strong>Results: </strong>A total of 90 studies were imported for screening, from which 9 papers met our final inclusion/exclusion criteria. The most common studies utilized in this review were retrospective chart reviews followed by case series. In total, there were 628 patients that suffered from gunshot wounds to the brachial plexus. Most patients underwent some form of delayed nerve repair consisting of neurolysis, end-to-end epineural repair, or graft repair with a sural or antebrachial cutaneous nerve graft. Several patients suffered from complications, with neuroma being the most common long-term complication that required reoperation.</p><p><strong>Conclusion: </strong>The optimal timing for surgeries involving BPIs should be determined after examining the level of nerve damage, associated injuries, operative risks, and electrophysiological workup for indications of spontaneous regeneration. Early surgical interventions were indicated for patients presenting with associated vascular or thoracic injuries, compressive masses, and nerve transection by sharp instruments in most selected papers.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11379507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142152979","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":"Finite Element Analysis of Protective Measures against Lateral Hinge Fractures in High-Tibial Osteotomy.","authors":"Emre Özmen, Alican Baris, Esra Circi, Serdar Yuksel, Ozan Beytemür","doi":"10.1155/2024/5510319","DOIUrl":"10.1155/2024/5510319","url":null,"abstract":"<p><strong>Background: </strong>Opening wedge high-tibial osteotomy (OWHTO) is widely used for correcting mechanical axis deviations and offloading the medial compartment in unicompartmental osteoarthritis. However, lateral hinge fractures (LHFs) pose a significant complication. This study investigates protective measures to mitigate these fractures, guided by prior observations of mechanical stress impact on LHFs.</p><p><strong>Purpose: </strong>The study aims to assess the effectiveness of different protective measures, specifically the use of varying sizes of Kirchner wires and drill holes, in reducing the incidence of LHFs during OWHTO. <i>Study Design</i>. The study employs a quantitative, comparative analysis using a finite element method (FEM) based on computed tomography (CT) scans.</p><p><strong>Methods: </strong>Using CT-based FEM, the study compares the impact of different sizes of K-wires (1.6 mm, 2.0 mm, and 2.5 mm) and drill holes (3.2 mm and 4.5 mm) on the mechanical stresses around the hinge area in OWHTO. The models were created from a CT scan of a healthy 33-year-old male, focusing on the force required to open the osteotomy gap and the incidence of cracked shell elements.</p><p><strong>Results: </strong>The study found that thicker K-wires increased the force required to open the osteotomy gap, whereas larger apical holes decreased it. The 4.5 mm apical hole model demonstrated significantly fewer cracks compared to the 2.0 mm K-wire model, with no significant difference observed compared to the 2.5 mm K-wire model. Models using a 1.6 mm K-wire or a 3.2 mm drill hole did not significantly reduce cracks compared to the base model.</p><p><strong>Conclusions: </strong>The findings suggest that a 4.5 mm drill hole may be more effective in reducing the risk of LHFs compared to thinner diameter K-wires or smaller apical holes. Both a 2.5 mm K-wire and a 4.5 mm drill hole reduce the number of cracked elements, but the 4.5 mm drill hole also significantly decreases the average and maximum principal stresses as well as the average tensile strength ratio at the hinge area. These findings may be important for surgical planning, particularly in cases requiring increased osteotomy distraction.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103360","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":"Risk Factors Associated with Pyogenic Spinal Infections among Intravenous Drug Users and Nonusers.","authors":"Vivek K Bilolikar, Brendan Gleason, Lee Kripke, Robert Merrill, Colin Whitaker, Jon Handal","doi":"10.1155/2024/9938159","DOIUrl":"10.1155/2024/9938159","url":null,"abstract":"<p><strong>Purpose: </strong>To identify the differences in patient factors, presentation, treatment course, and outcomes of intravenous drug users (IVDA) vs. nonusers (non-IVDA) presenting with pyogenic spinal infections. <i>Study Design/Setting</i>. Retrospective case series.</p><p><strong>Methods: </strong>We identified all cases involving spinal infections at our institution between May 2017 and January 2023. Postsurgical infections were excluded, and patients were separated into IVDA and non-IVDA groups. The patient charts were reviewed and analyzed for statistical or clinically significant differences using RStudio (2019 version 3.6.2). Our institutional review board approved this study, IRB# 2020-277, iRISID-2023-1384.</p><p><strong>Results: </strong>Fifty patients (29 males and 21 females) with primary pyogenic spinal infections were included in our study. There were fourteen patients (28.0%) in the IVDA group. The mean age in the IVDA group was 50.6 vs. 61.9 years (<i>p</i> < 0.05) in the non-IVDA group. The average length of stay (LOS) in the IVDA group was 15.8 vs. 14.0 days (<i>p</i> = 0.54) in the non-IVDA group, with no significant difference in readmissions or disposition. Twenty-three non-IVDA patients were diagnosed with diabetes, while eight IVDA patients had a psychiatric diagnosis (other than substance abuse). There were no significant differences in microbial isolate or the duration of antibiotics.</p><p><strong>Conclusion: </strong>In our study population, there is a high incidence of intravenous drug abuse (IVDA), psychiatric disease, diabetes, and chronic kidney disease. Analysis shows a trend of two distinct patient populations. Patients without a history of IVDA were significantly older than those with IVDA and significantly more likely to have medical comorbidities including hyperlipidemia, diabetes, chronic kidney disease, and malignancy than those with IVDA history. Patients with IVDA were younger with significantly higher rates of smoking and psychiatric disorders. IVDA patients struggled to receive continued psychiatric/addiction treatment after discharge, an area for significant improvement. Due to a small sample size and single urban institution setting, this study may be underpowered to demonstrate differences in healthcare resource consumption.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141892621","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":"Current Trends in the Surgical Treatment of Fibular Fractures: A National Database Study of Intramedullary vs. Plate Fixation Practice Patterns, Complications, and Cost.","authors":"Douglas Zhang, Audrey Litvak, Nicholas Lin, Sean Pirkle, Jason Strelzow, Kelly Hynes","doi":"10.1155/2024/7506557","DOIUrl":"10.1155/2024/7506557","url":null,"abstract":"<p><p>Existing primary evidence comparing fibular intramedullary fixation (IMF) with traditional plate fixation (PF) for the treatment of distal fibular fractures remains limited by modest sample sizes. Using a large national database, this study aims to compare use rates, fracture patterns, patient characteristics, time to surgery, complication rates, and cost between fibular IMF and PF within the United States. Adults treated with fibular IMF or PF between October 2015 and October 2021 were identified within the PearlDiver Database. The ratio of IMF-treated to PF-treated patients was tracked temporally to compare use rates. Fracture patterns were determined using fracture diagnoses within one-month preceding surgery. Further comparisons of IMF- and PF-treated groups only included patients with at least 12 months of follow-up, and patients with upper tibia or tibia shaft fractures were excluded. An analysis of cohorts matched at a 1 : 4 (IMF: PF) ratio to control for risk factors was performed to compare time to surgery, complication rates (infection, nonunion, malunion, revision, hardware removal, pulmonary embolism, and deep vein thrombosis), and cost. 39329 patients (2294 IMF and 37035 PF) were identified. IMF use trended upwards relative to PF use over time. Tibia and fibula shaft fractures were the most common injuries in IMF patients versus bimalleolar and trimalleolar fractures in PF patients. A higher proportion of IMF patients had open fractures. IMF patients were younger, with higher mean ECI, fewer female patients, and higher rates of CKD. Percutaneous approaches were more common among IMF patients. There were no significant differences in time to surgery or complication rates. IMF was less costly. The popularity of IMF trended upwards across the study period. IMF was used more commonly in injuries involving higher energy trauma and soft tissue disruption. Overall, IMF patients were younger with more comorbidities. When used in similar populations, IMF appears to be a cost-effective alternative to PF.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11260212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733279","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":"Results of Total Hip Replacement Surgery Using Short-Stem Spiron Prosthesis in Vietnamese Adults.","authors":"Mai Duc Thuan, Nguyen Quoc Dung","doi":"10.1155/2024/4623071","DOIUrl":"10.1155/2024/4623071","url":null,"abstract":"<p><strong>Introduction: </strong>Total hip arthroplasty with traditional stem joints, although bringing many benefits to patients indicated for hip replacement, faces many difficulties in reoperations in young patients due to the limited lifespan of the artificial joint. Recently, the short-stem joint was introduced to help overcome this problem. This study aims to evaluate the results of short-stem implants for primary total hip arthroplasty in Vietnamese adults.</p><p><strong>Materials and methods: </strong>The study design is retrospective longitudinal. The study subjects were 91 patients with aseptic necrosis of the femoral head who underwent short-shaft cementless total hip replacement surgery from February 2012 to December 2018. Outcomes that were assessed included implant survivorship, Harris hip scores, thigh pain, periprosthetic fracture, subsidence, proximal stress shielding, the prevalence of stem malalignment, and inappropriate implant sizing.</p><p><strong>Results: </strong>Our research group has 119 hips of 91 patients (28 patients had hip replacements on both sides), with the average follow-up time of 67.1 months. Seven cases of early joint loosening required replacing the traditional stem. The survival rate is 94.1%. The average Harris hip score 24 months after surgery was statistically significantly higher than before (92.00 ± 4.47 and 45.56 ± 3.22, respectively, <i>p</i> < 0.001). The average leg length discrepancy between the two limbs before surgery was 9.5 ±mm and 24 months after surgery was 3.4 ± 2.9 mm. There were 12 cases (10.1%) of partial bone loss around the femoral stem; 12 cases of joint displacement of more than 2 mm, accounting for 10.1%; and 1 case of acetabular fracture, accounting for 0.8%.</p><p><strong>Conclusion: </strong>The Spiron short stem has certain advantages suitable for young patients, restoring the hip anatomy and significantly improving postoperative hip function. However, this is a complex technique that needs to be performed by experienced surgeons who have practiced for a long time. We encourage using the short-stem implant during primary total hip arthroplasty in Vietnamese adult patients.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11251800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141625675","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":"Fixation of Olecranon Fractures Using a Hybrid Intramedullary Screw and Tension Band Construct.","authors":"Kaitlin Rush, John Fisher, Neil Jain, Caleb Gottlich, Cyrus Caroom","doi":"10.1155/2024/6471544","DOIUrl":"10.1155/2024/6471544","url":null,"abstract":"<p><strong>Introduction: </strong>Olecranon fractures are common injuries that require surgical intervention for optimal outcomes. Various fixation methods have been described in the literature, including the use of intramedullary proximal ulna screws in combination with tension band augmentation. Limited research has compared this hybrid technique to other established methods of fixation. This study compared complication and reoperation rates between multiple groups.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients with olecranon fractures who underwent internal fixation at a level 1 trauma center between January 1st, 2013, and April 22nd, 2023. Data was collected using CPT codes, and patients were categorized into five groups based on the method of fixation received: no implant, tension band only, locking olecranon plate, intramedullary screw and tension band hybrid, and others. Variables such as patient demographics, Mayo fracture classification, open vs. closed injury, implant type, reoperation rates, and postoperative complications were recorded.</p><p><strong>Results: </strong>A total of 217 patients were included in the study. No difference was found with implant choice and reoperation rate (<i>p</i> = 0.461). There was a significant difference found with reoperation and fracture type (<i>p</i> = 0.027) and open fracture (<i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The primary findings of this study indicate no significant difference in implant choice and reoperation rates among the various fixation methods used for olecranon fractures. These findings suggest that the hybrid fixation technique, utilizing intramedullary proximal ulna screws in combination with tension band augmentation, is a viable and comparable treatment option when evaluated against other well-documented methods of fixation. This study also reiterates that severity of initial injury is often the most important factor related to poorer outcomes. Further discussion and analysis of the data will provide a comprehensive understanding of implications and recommendations for olecranon fracture fixation.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11156510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141282673","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}