Advances in Orthopedics最新文献

{"title":"Satisfactory Functional Outcome and Significant Correlation with the Length of Haglund's Deformity after Endoscopic Calcaneoplasty: A Minimum 4-Year Follow-Up Study","authors":"Hossam Fathi Mahmoud, Walid Feisal, Fahmy Samir Fahmy","doi":"10.1155/2022/7889684","DOIUrl":"https://doi.org/10.1155/2022/7889684","url":null,"abstract":"Background Haglund's syndrome is a posterosuperior calcaneal prominence with posterior heel pain causing functional disability to the patient. Operative treatment is indicated after failure of conservative measures and includes resection of the bony hump along with retrocalcaneal bursectomy. This study aimed to evaluate the functional outcome and degree of patient satisfaction after endoscopic resection of Haglund's deformity with assessment of correlation with the length of bony exostosis. Methods Seventeen patients (21 feet) with a mean age of 44.7 ± 5.1 years were included in this study. Six females and 11 males underwent endoscopic calcaneoplasty. Clinical outcome evaluation included the assessment of the visual analog scale (VAS) and the American Orthopedic Foot and Ankle Society score (AOFAS). The preoperative and postoperative lengths of bony exostosis were measured radiologically. The paired t test and the Wilcoxon signed-rank test compared the preoperative and final postoperative means. P < 0.05 was considered statistically significant. Results The mean follow-up period was 56.4 ± 5.1 months. Statistically significant improvements in the preoperative mean of AOFAS (from 55.7 ± 9.3 to 94.3 ± 7.1) and VAS (from 8.1 ± 1.4 to 0.7 ± 1.04) at the final follow-up were noted (P < 0.0001). There was a statistically significant correlation between clinical scores (AOFAS and VAS) and the final postoperative length of the bone above parallel pitch lines (PPLs). The patients were satisfied and returned to their previous activities without reporting major morbidities except one patient who had mild pain with exertion. Conclusion Endoscopic calcaneoplasty is a safe, less invasive surgical procedure for the management of Haglund's syndrome after failure of conservative treatment. It provided a satisfactory clinical result without serious complications at a minimum 4-year follow-up.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48464138","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":"Humeral Capitellum Fractures in Adolescents: A Study of 6 Cases Treated by Open Reduction and Internal Fixation with Bioabsorbable Nails","authors":"Łukasz Wiktor, R. Tomaszewski","doi":"10.1155/2022/4012125","DOIUrl":"https://doi.org/10.1155/2022/4012125","url":null,"abstract":"Purpose The purpose of our study was to evaluate the clinical outcome following open reduction and internal fixation of humeral capitellum fractures in adolescents and to assess the usefulness of bioresorbable implants in that procedure. Due to the rarity of these fractures, there are not many studies dealing with the problem in the literature. Methods We retrospectively evaluated a group of 6 skeletally immature patients aged 10.6–15.3 treated at our department from January 2015 to December 2021. Four type I and two type IV were diagnosed based on the Bryan and Morrey classification. Our patients underwent an open reduction and internal fixation of coronal shear fractures with the use of SmartNail®. Results All patients were satisfied with the treatment outcome and had full pronation and flexion after surgery. Two patients presented minor deficits of extension and supination compared with the contralateral elbow. At the one-year follow-up, all patients scored 100 on the Mayo Elbow Performance Score. Conclusions Correct diagnosis and early surgical intervention in humeral capitellum fractures are crucial. That fractures should be anatomically reduced with no articular cartilage damage in order to prevent osteoarthritis. Based on our experience, SmartNail® implant is accurate for the osteochondral fragment fixation.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44514340","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":"A Cost-Utility Analysis of Robotic Arm-Assisted Total Hip Arthroplasty: Using Robotic Data from the Private Sector and Manual Data from the National Health Service","authors":"N. Clement, P. Gaston, D. Hamilton, A. Bell, P. Simpson, G. Macpherson, J. Patton","doi":"10.1155/2022/5962260","DOIUrl":"https://doi.org/10.1155/2022/5962260","url":null,"abstract":"Purpose The aim was to assess the cost-effectiveness of robotic arm-assisted total hip arthroplasty (rTHA) compared with manual total hip arthroplasty (mTHA) and to assess the influence of annual volume on the relative cost-effectiveness of rTHA. Methods A database of both rTHA (n = 48 performed in a private centre) and mTHA (n = 512 performed in the National Health Service) was used. Patient demographics, preoperative Oxford hip score, forgotten joint score, EuroQol 5-dimensional 3-level (EQ-5D), and postoperative EQ-5D were recorded. Two models for incremental cost-effectiveness ratios using cost per quality-adjusted life year (QALY) for rTHA were calculated based on a unit performing 100 rTHAs per year: 10-year follow-up and a lifetime time horizon (remaining life expectancy of a 69-year-old patient). Results When adjusting for confounding factors, rTHA was independently associated with a 0.091 (p=0.029) greater improvement in the EQ-5D compared to mTHA. This resulted in a 10-year time horizon cost per QALY for rTHA of £1,910 relative to mTHA, which increased to £2,349 per QALY when discounted (5%/year). When using the 10-year time horizon cost per QALY was approximately £3,000 for a centre undertaking 50 rTHAs per year and decreased to £1,000 for centre undertaking 200 rTHAs per year. Using a lifetime horizon, the incremental unadjusted cost per QALY gained was £980 and £1432 when discounted (5%/year) for rTHA compared with mTHA. Conclusions Despite the increased cost associated with rTHA, it was a cost-effective intervention relative to mTHA due to the associated greater health-related quality of health gain, according to the EQ-5D outcome measure.","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2022-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41572345","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":"Sacroiliitis: A Review on Anatomy, Diagnosis, and Treatment.","authors":"Anderson Lee,&nbsp;Monik Gupta,&nbsp;Kiran Boyinepally,&nbsp;Phillip J Stokey,&nbsp;Nabil A Ebraheim","doi":"10.1155/2022/3283296","DOIUrl":"https://doi.org/10.1155/2022/3283296","url":null,"abstract":"<p><strong>Introduction: </strong>Sacroiliitis is an inflammation of one or both of the sacroiliac (SI) joints, most often resulting pain in the lower back that can extend down the legs. Pain arising from the SI joint can be difficult to diagnose and treat due to the intricate surrounding ligamentous structure, nerve innervation, and its role in transferring weight from the upper body to the lower limbs. SI joint dysfunction accounts for up to 25% of cases of lower back pain and has a debilitating effect on patient functionality. This review aims to provide comprehensive coverage of all aspects of SI joint pain, with a specific focus on differential diagnosis and treatment.</p><p><strong>Methods: </strong>Current literature on SI joint pain and inflammation, other etiologies of lower back pain, and new treatment options were compiled using the databases PubMed and Cochrane and used to write this comprehensive review. There were no restrictions when conducting the literature search with regard to publication date, study language, or study type.</p><p><strong>Results: </strong>The diagnosis protocol of SI joint pain arising from sacroiliitis usually begins with the presentation of lower back pain and confirmatory diagnostic testing through fluoroscopy joint block. Reduction in pain following the anesthetic is considered the golden standard for diagnosis. The treatment begins with the conservative approach of physical therapy and analgesics for symptom relief. However, refractory cases often require interventional methods such as corticosteroid injections, prolotherapy, radiofrequency ablation, and even SI joint fusion surgery.</p><p><strong>Conclusion: </strong>SI joint pain is a complex problem that can present with varying patterns of pain due to uncertainty regarding its innervation and its prominent surrounding structure. It is therefore especially important to obtain a thorough history and physical on top of diagnostic tests such as a diagnostic block to properly identify the source of pain. Conservative treatment options with physical therapy and analgesics should be attempted first before interventional strategies such as ablation, injections, and prolotherapy can be considered. SI joint fusion surgery is a solution to cases in which previous methods do not provide significant relief.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 ","pages":"3283296"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9812593/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10507396","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":"Comparison of the Hook Plate versus TightRope System in the Treatment of Acute Type III Acromioclavicular Dislocation.","authors":"Abdulrahim Dündar,&nbsp;Deniz İpek","doi":"10.1155/2022/8706638","DOIUrl":"https://doi.org/10.1155/2022/8706638","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this study is to compare the effectiveness of the clavicular hook plate (HP) technique and the minimally invasive coracoclavicular (CC) fixation with a TightRope (MITR) procedure in treating acute unstable distal clavicle dislocation.</p><p><strong>Method: </strong>MITR (minimally invasive TightRope) group had 21 patients, and the open reduction and internal fixation (HP) group included 23 patients. Researchers compared MITR and HP (hook plate) outcomes for the treatment of acute type III AC joint dislocation in a retrospective analysis. The patients were followed up at 1 3, 6, and 12 months postoperatively. Complications were analyzed such as redislocation, fractures, implant-related complications, or subacromial erosion. For the clinical outcomes, the visual analog scale (VAS) (0: no pain, 10: worst possible pain), Constant-Murley score (CMS) (100: no pain, 0: maximum pain), the average satisfaction score with their current shoulder function (range: 0-10), and the University of California at Los Angeles Shoulder score (UCLA) (>27 good/excellent <27 fair/poor) were recorded at the last follow-up.</p><p><strong>Result: </strong>There were 21 sufferers in the MITR group, which comprises 19 males and 2 females and 23 individuals in the HP group (20 men and 3 women), with average ages of 43.9 and 39.2, respectively. Age, sex, laterality, and the interval between injury and surgery did not significantly differ between the two groups (0.357, 0.792, 0.432, and 0.55, respectively). No statistically significant difference was found between the groups in terms of the VAS score and CMS score at one year postoperatively. The mean CCD at the initial trauma and last follow-up was not significantly different between the MITR and HP groups (<i>p</i>=0.365, <i>p</i>=0.412 respectively).</p><p><strong>Conclusion: </strong>For treating acute type III AC dislocations, the minimally invasive TightRope (MITR) system and the hook plate technique were great options. However, the minimally invasive TightRope system showed further benefits such as reduced reoperation for implant removal and reduced risk of subacromial distal clavicle osteolysis.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 ","pages":"8706638"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10363067","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":"Kinematic and Radiographic Evaluation of Acromioclavicular Reconstruction with a Synthetic Ligament.","authors":"Rafael F Escamilla,&nbsp;Chad Poage,&nbsp;Scott Brotherton,&nbsp;Toran D MacLeod,&nbsp;Charles Leddon,&nbsp;James R Andrews","doi":"10.1155/2022/7144209","DOIUrl":"https://doi.org/10.1155/2022/7144209","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal surgical technique for unstable acromioclavicular (AC) and coracoclavicular (CC) joint injuries has not yet been established. The biomechanical and radiographic effect of the LockDown device, a synthetic ligament for AC joint reconstruction, was evaluated to assess the optimal surgical technique for unstable AC and CC joint injuries. It was hypothesized that the LockDown device would restore AC joint kinematics and radiographic stability to near native values.</p><p><strong>Methods: </strong>Three fresh frozen cadaveric torsos (6 shoulders) modelled CC joint motion in their \"native,\" \"severed,\" and \"reconstructed\" states. The effects of stressed and unstressed native, severed, and reconstructed conditions on AC separation and CC distances in anteroposterior, mediolateral, and inferosuperior directions during shoulder abduction, flexion, and scaption were assessed. The analysis of variance (<i>p</i>, 0.05) was used to compare CC distance and peak AC distance in anteroposterior, mediolateral, and inferosuperior directions during shoulder flexion, abduction, and scaption measurements among native, severed, and reconstructed states with unstressed and stressed Zanca radiographic views.</p><p><strong>Results: </strong>From radiographic analyses, the CC distance was significantly greater (<i>p</i>=0.001) across the surgical state in stressed versus unstressed views. Mean difference between stressed and unstressed views was 1.8 mm in native state, 4.1 mm in severed state, and 0.9 mm in reconstructed state. The CC distance was significantly greater in the \"severed\" state (10.4 mm unstressed; 14.5 mm stressed) compared to the \"native\" state (<i>p</i>=0.016) (6.5 mm unstressed; 8.3 mm stressed) and compared to the \"reconstructed\" state (<i>p</i>=0.005) (3.1 mm unstressed; 4.0 mm stressed) and significantly less (<i>p</i>=0.008) in the \"reconstructed\" state compared to the \"native\" state. CC distances decreased from native to reconstructed, an average of 3.3 mm for unstressed and 4.3 mm for stressed. On average, peak AC joint separation distance in anteroposterior, mediolateral, and inferosuperior directions during shoulder-abduction, flexion, and scaption was shown to be restored to 11.5 mm of native values after reconstruction with LockDown device.</p><p><strong>Conclusion: </strong>Reconstruction of AC joint with LockDown synthetic ligament restores motion of clavicle and acromion to near native values, thereby decreasing scapular dyskinesis and enhancing AC joint stability.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 ","pages":"7144209"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9167124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10601616","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":"Efficacy of a Combined Intramedullary, Periarticular Injection, and Intraarticular Tranexamic Acid Application on Postoperative Bleeding in Total Knee Arthroplasty: A Retrospective Case-Matched Study.","authors":"Theerawit Hongnaparak,&nbsp;Khanin Iamthanaporn,&nbsp;Pakjai Tuntarattanapong,&nbsp;Varah Yuenyongviwat","doi":"10.1155/2022/9175189","DOIUrl":"https://doi.org/10.1155/2022/9175189","url":null,"abstract":"<p><strong>Background: </strong>Topical tranexamic acid (TXA) has been widely used to reduce postoperative blood loss following total knee replacement (TKA). This study aimed to evaluate the effect of combined intramedullary, periarticular injection, and intraarticular TXA application in patients who underwent TKA as compared to those who did not.</p><p><strong>Methods: </strong>This was a retrospective case-matched study of 111 patients. We evaluated the transfusion rate and postoperative drainage of 56 patients who underwent TKA using combined topical tranexamic acid application (directly pushed into the femoral intramedullary canal and tibia base, with periarticular soft tissue injection and injected into the knee cavity via a drain tube) and the control group of 55 patients.</p><p><strong>Results: </strong>In the control and TXA groups, 7.14% and 1.81% of the patients received blood transfusions, respectively (<i>p</i>=0.176). The closed-suction drainage output at 0-8 h and total drainage output were significantly lower in the TXA group than those in the control group (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Application of topical TXA with the combined method (intramedullary, periarticular injection, and intraarticular) in TKA decreases postoperative suction drainage and may reduce the need for postoperative blood transfusion.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2022 ","pages":"9175189"},"PeriodicalIF":1.3,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9759377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402046","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":"Health-Related Quality of Life and Outcome after Total Knee Replacement: Results from a Cross-Sectional Survey in Jordan.","authors":"Yazan Al Thaher,&nbsp;Othman A Alfuqaha,&nbsp;Ahmed Dweidari","doi":"10.1155/2021/5506809","DOIUrl":"https://doi.org/10.1155/2021/5506809","url":null,"abstract":"<p><p>Total knee replacement (TKR) is a common procedure that is considered cost-effective with excellent long-term survivorship. This cross-sectional study, which includes 118 selected patients in Jordan from January 2020 to January 2021, aims to assess health-related quality of life (HQOL), functional status, and associated factors before and after 3 to 12 months of TKR. Furthermore, several demographical factors were included in this study to evaluate the potential association with the procedure's outcome. Western Ontario and McMaster Universities Osteoarthritis Index scale (WOMAC) and Short Form-36 (SF-36) scale were used in this study. It was found that the main change occurred 6-12 months after the procedure. Gender and age were found to be the primary predictor of quality of life among TKR patients. Patients before the TKR procedure experienced severe pain, joint stiffness, physical impairment, and psychological demand issues. After the TKR procedure, all symptoms were improved significantly. The TKR procedure can improve the quality of life for patients, which can be detected for several months after the procedure. Function and pain are the most critical indicators of improvement in quality of life. Assessing the quality of life is a key indicator for identifying patients without improvement, as well as improving the health care process and comparing other alternative interventions.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5506809"},"PeriodicalIF":1.3,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8763549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39834025","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":"Autologous Bone Marrow-Derived Chondrocytes for Patients with Knee Osteoarthritis: A Randomized Controlled Trial.","authors":"Mir Sadat-Ali,&nbsp;Abdallah S AlOmran,&nbsp;Sulaiman A AlMousa,&nbsp;Hasan N AlSayed,&nbsp;Khalid W AlTabash,&nbsp;Mohammed Q Azam,&nbsp;Tarek M Hegazi,&nbsp;Sadananda Acharya","doi":"10.1155/2021/2146722","DOIUrl":"https://doi.org/10.1155/2021/2146722","url":null,"abstract":"<p><strong>Results: </strong>There were a total of 60 patients who were followed up. Three patients in Group II were removed from the analysis as they underwent total knee arthroplasty (TKA). A notably significant improvement was noticed in the ABMDC group on all scores of VAS and MKSSSF with <i>P</i> < 0.0001. The control group continued to be dissatisfied with the treatment they were taking.</p><p><strong>Conclusions: </strong>This study reveals that a single injection of 5 million of ABMDC was efficient in reducing the symptoms, improving the functional score and betterment of QOL.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"2146722"},"PeriodicalIF":1.3,"publicationDate":"2021-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39677814","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 Necessity of CT Hip Scans in the Investigation of Occult Hip Fractures and Their Effect on Patient Management.","authors":"Thomas Gatt,&nbsp;Daniel Cutajar,&nbsp;Lara Borg,&nbsp;Ryan Giordmaina","doi":"10.1155/2021/8118147","DOIUrl":"https://doi.org/10.1155/2021/8118147","url":null,"abstract":"<p><p>The diagnostic challenge of negative plain radiography in the context of a previously ambulatory patient is increasing with the rise in geriatric trauma. These patients are often diagnosed with small undisplaced fractures of the pelvis and femur which may not alter management. This study aims to assess the frequency at which computed tomography (CT) hip scans altered patient management and whether two X-ray projections of the hip affected fracture detection rate. All CT hip scans performed over a three-year period were identified retrospectively. Only CT hips pertaining to the identification of occult fractures were included in the study. A total of 447 (63.6%) CT hips were performed to exclude an occult fracture, which was only detected in 108 (24.1%) of the scans requested. The majority were subcapital (<i>n</i> = 58, 53.7%) or intertrochanteric (<i>n</i> = 39, 36.1%). There was no significant difference between fracture detection rates when comparing one and two views of the pelvis. 82.4% (<i>n</i> = 89) of occult hip fractures were managed operatively. CT imaging led to a change in patient management in 20% of cases. The frequency at which CT scan detects and alters management in occult hip fractures confirms the justification for its use. Increasing the number of X-ray projection views does not decrease the reliance on CT. Pelvic ring fractures are common in nonambulatory patients following trauma, and if confirmed on initial imaging, subsequent imaging to exclude a concurrent occult hip is unnecessary. The focus of further research should be towards the development of investigation algorithms which decrease the reliance on CT and defining the optimal surgical criteria for occult hip fractures.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"8118147"},"PeriodicalIF":1.3,"publicationDate":"2021-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8616705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39673996","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}