Advances in Orthopedics最新文献

{"title":"Functional and Radiological Outcome Analysis of Osteoperiosteal Decortication Flap in Nonunion of Tibia.","authors":"Vineet Kumar,&nbsp;Shah Waliullah,&nbsp;Sachin Avasthi,&nbsp;Swagat Mahapatra,&nbsp;Ajai Singh,&nbsp;Sabir Ali","doi":"10.1155/2021/7980602","DOIUrl":"https://doi.org/10.1155/2021/7980602","url":null,"abstract":"<p><strong>Introduction: </strong>The treatment of long bone shaft nonunions is challenging. The technique of osteoperiosteal decortications flap for approaching the nonunion site coupled with fixation modalities was first described by Judet in 1963. Despite promising clinical and radiological union, this technique is not popular among orthopaedic surgeons. Our study aimed to evaluate the radiological union and functional results of shaft tibia nonunions treated by the osteoperiosteal decortication approach.</p><p><strong>Methods: </strong>This retrospective study included all the cases with established tibial shaft nonunion following stringent inclusion and exclusion criteria and operated upon by following the principle of osteoperiosteal flap technique from April 2015 to July 2019. Further subgroups were made based on nonunions complexity based on nonunion scoring system (NUSS) score. The outcome measures included radiological union scale in tibial fractures (RUST) and lower extremity functional scale (LEFS). The preoperative scores for union and function were recorded, and the subsequent scores were obtained at three, six, and nine months and one year. Appropriate statistical analysis of the data was done.</p><p><strong>Results: </strong>Thirty-four cases were shortlisted for analysis, fulfilling our inclusion and exclusion criteria. There were 22 males (64.7%) and 12 females (35.3%) with a mean age of 34.17 ± 10.3 years. Subgroup analysis based on the complexity of nonunion (NUSS score) revealed 14 cases in group A, 10 cases in group B, 10 cases in group C, and 0 cases in group D. The average time from fracture to surgery in these cases was 14.6 months. The average time to achieve union was 9.6 months, with patients in groups A, B, and C, having a mean duration of 9, 10.5, and 12 months, respectively. Statistically, significant improvement was seen in both RUST scores and LEFS score. Complications included infection in seven cases, wound dehiscence in two cases, and four cases of persistent nonunion.</p><p><strong>Conclusion: </strong>Osteoperiosteal decortication remains a highly effective surgical technique in the management of nonunion of long bones. NUSS scoring is an essential tool for prognosticating nonunion cases. This score is inversely related to the radiological union (RUST score) of the bone and functional recovery (LEFS score) of the patient.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"7980602"},"PeriodicalIF":1.3,"publicationDate":"2021-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8318746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273458","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":"Robotic Assistance in Unicompartmental Knee Arthroplasty Results in Superior Early Functional Recovery and Is More Likely to Meet Patient Expectations.","authors":"Meredith P Crizer,&nbsp;Amer Haffar,&nbsp;Andrew Battenberg,&nbsp;Mikayla McGrath,&nbsp;Ryan Sutton,&nbsp;Jess H Lonner","doi":"10.1155/2021/4770960","DOIUrl":"https://doi.org/10.1155/2021/4770960","url":null,"abstract":"<p><p>Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (<i>n</i> = 39) or robotic methods (<i>n</i> = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score (KSS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS-JR.), VR/SF-12, Visual Analog Scale (VAS) pain scores, and perioperative opioid consumption. Patients in the robotic cohort had superior early functional outcomes, with greater LEFS (conventional = 23; robotic = 31) at 1 week post-op (<i>p</i>=0.015) and KOOS-JR (conventional = 74; robotic = 81) at up to 6 months post-op (<i>p</i>=0.037); these two values remained statistically significant after mixed-model regression analysis (<i>p</i>=0.010; <i>p</i>=0.023), respectively. At 1 year post-op, expectations were more likely to be met in those who received robotic assistance (<i>p</i>=0.06). No differences were reported with respect to postoperative opioid usage (<i>p</i>=0.320), reoperations (<i>p</i>=1.00), and complications (<i>p</i>=0.628). Robotic-assisted UKA resulted in more rapid recovery and less early postoperative pain and were more likely to meet expectations than conventional UKA, although functional differences equilibrated by 1 year postoperatively. Further follow-up is necessary to determine if implant durability is impacted by robotics.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"4770960"},"PeriodicalIF":1.3,"publicationDate":"2021-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8298171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273457","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 Functional Outcome of Total and Unicompartmental Knee Arthroplasty Using Computer-Assisted Patient-Specific Templating.","authors":"Atef Mohamed Morsy,&nbsp;Emad Gaber Elbana,&nbsp;Ahmed Gaber Mostafa,&nbsp;Mark Ashraf Edward,&nbsp;Mahmoud A Hafez","doi":"10.1155/2021/5524713","DOIUrl":"https://doi.org/10.1155/2021/5524713","url":null,"abstract":"<p><strong>Background: </strong>Knee arthroplasty surgeries are in ever-increasing demand. With unicompartmental knee arthroplasty (UKA), patients may benefit from a higher range of flexion and a better Knee Society Score (KSS).</p><p><strong>Aim: </strong>In this study, we compared the short-term clinical outcomes of total knee arthroplasty (TKA) and UKA using the patient-specific templating (PST) technique.</p><p><strong>Methods: </strong>Two groups of 20 knees each were divided into UKA and TKA groups depending on the Oxford criteria of UKA. Only patients with medial compartmental osteoarthritis were included. KSS, functional knee score (FKS), and ROF were assessed preoperatively and at 6 months postoperatively.</p><p><strong>Results: </strong>The TKA group has shown a significant improvement compared to the UKA group in KSS (MD = 39.35 vs. 31.2, respectively, <i>p</i>=0.003). Both TKA and UKA have shown no significant difference concerning both the FKS (MD = 32 and 31.75, respectively, <i>p</i>=0.926) and ROF (MD = 10.25 and 7.25, respectively, <i>p</i>=0.072). <i>Discussion</i>. The higher improvement of KSS in the TKA group can be attributed to the fact that patients in the TKA had significantly worse KSS preoperatively. Also, the small improvement in ROF in the UKA group might be related to their wider preoperative ROF.</p><p><strong>Conclusion: </strong>Preoperatively, the TKA group had lower KSS and ROF compared to UKA. The improvement of KSS from preoperative to postoperative was more significant in TKA. However, the TKA group has shown less range of flexion postoperatively.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5524713"},"PeriodicalIF":1.3,"publicationDate":"2021-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8253625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39181850","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":"Predicting Fracture Risk in Patients with Metastatic Bone Disease of the Femur: A Pictorial Review Using Three Different Techniques.","authors":"Shannon M Kaupp,&nbsp;Kenneth A Mann,&nbsp;Mark A Miller,&nbsp;Timothy A Damron","doi":"10.1155/2021/5591715","DOIUrl":"https://doi.org/10.1155/2021/5591715","url":null,"abstract":"<p><p>One of the key roles of an orthopedic surgeon treating metastatic bone disease (MBD) is fracture risk prediction. Current widely used impending fracture risk tools such as Mirels scoring lack specificity. Two newer methods of fracture risk prediction, CT-based structural rigidity analysis (CTRA) and finite element analysis (FEA), have each been shown to be more accurate than Mirels. This case series illustrates comparative Mirels, CTRA, and FEA for 8 femurs in 7 subjects. These cases were selected from a much larger data set to portray examples of true positives, true negatives, false positives, and false negatives as defined by CTRA relative to the fracture outcome. Case illustrations demonstrate comparative Mirels and FEA. This series illustrates the use, efficacy, and limitations of these tools. As all current tools have limitations, further work is needed in refining and developing fracture risk prediction.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5591715"},"PeriodicalIF":1.3,"publicationDate":"2021-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8221853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39147774","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":"Quality of Life and Clinical Evaluation of Calcaneoplasty with a Balloon System for Calcaneal Fracture at 5 Years of Follow-Up.","authors":"Giuseppe Maccagnano,&nbsp;Giovanni Noia,&nbsp;Giuseppe Danilo Cassano,&nbsp;Antonio Luciano Sarni,&nbsp;Raffaele Quitadamo,&nbsp;Costantino Stigliani,&nbsp;Francesco Liuzza,&nbsp;Raffaele Vitiello,&nbsp;Vito Pesce","doi":"10.1155/2021/5530620","DOIUrl":"https://doi.org/10.1155/2021/5530620","url":null,"abstract":"<p><p>Calcaneal fractures are a challenging clinical problem. Management of this type of injury remains controversial, especially in the context of intra-articular fractures. Surgical treatment with open reduction and internal synthesis (ORIF) is considered the standard treatment for CF, but it is associated with many complications. Several minimally invasive techniques such as balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation have been proposed to avoid the frequent and recurrent postoperative problems related to these fractures. We retrospectively examined 20 patients (mean age was 54.5), all undergoing minimally invasive calcaneoplasty surgery at our Department of Orthopaedics and Traumatology between 2012 and 2016. X-ray and CT scan were performed preoperatively and at 5 years of follow-up (57.9 ± 6 months). The American Orthopaedic Foot and Ankle Society (AOFAS) score was used for clinical examination, and the Short-Form (36) Health Survey (SF-36) score and Visual Analogue Scale (VAS) were used to assess the Health-Related Quality of Life (HRQoL). All 20 patients were available at the final follow-up. The mean AOFAS score was 82.25/100. The VAS results attest an overall average of 2.7/10 (0-9). The average of the parameters \"Physical Health\" and \"Mental Health\" was, respectively, 81.25 and 83.55. In terms of postoperative complications, we observed no cases of superficial or deep infections. Clinical response after balloon-assisted reduction, pin fixation, and tricalcium phosphate augmentation has shown a comparable or better outcome according to the AOFAS and VAS score. Quality-of-life scores, obtained according to the SF-36 questionnaire, are considered high. From both a clinical and quality-of-life point of view, our study highlights that there is not gender distinction. Further comparative studies with a higher number of patients are needed which assess the quality of life in the various techniques used to treat calcaneal fractures.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5530620"},"PeriodicalIF":1.3,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8208879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39139898","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":"Influence of Timing on Surgical Outcomes for Acute Humeral Shaft Fractures.","authors":"Ryogo Furuhata,&nbsp;Yusaku Kamata,&nbsp;Aki Kono,&nbsp;Yasuhiro Kiyota,&nbsp;Hideo Morioka","doi":"10.1155/2021/8977630","DOIUrl":"https://doi.org/10.1155/2021/8977630","url":null,"abstract":"<p><p>Surgical treatment for humeral shaft fractures has been reported to yield satisfactory results; however, there may be complications, such as delayed bone union, nonunion, iatrogenic radial nerve injury, and infection. The risk factors for postoperative complications remain largely unknown. This study aimed to investigate the influence of timing of surgery on the incidence of postoperative complications of acute humeral shaft fractures. We retrospectively reviewed 43 patients who underwent osteosynthesis for acute humeral shaft fractures between 2006 and 2020. The patients were divided into early (21 patients) and delayed (22 patients) treatment groups based on the timing of the surgical intervention (within or after four days). Outcomes were the incidences of complications (delayed union, nonunion, iatrogenic radial nerve injury, and infection) and postoperative fracture gaps. We evaluated the outcomes using plain radiographs and clinical notes. In addition, we performed subgroup analyses on outcomes in a subgroup of patients who underwent intramedullary nailing and one who underwent plate fixation. The frequency of delayed union was significantly higher in the delayed group (<i>P</i>=0.046), and the postoperative fracture gap size was also significantly greater in the delayed group (<i>P</i>=0.007). The subgroup analyses demonstrated a significant association between the increased incidence of delayed union and delayed surgical interventions only in the intramedullary nailing subgroup (<i>P</i>=0.017). This study suggests that performing surgery within four days after acute humeral shaft fracture is recommended to reduce the occurrence of delayed union, particularly in cases requiring intramedullary nailing fixation.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"8977630"},"PeriodicalIF":1.3,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8189780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39089182","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":"Clinical and Radiological Outcomes of Total Knee Arthroplasty Performed with Midvastus and Medial Parapatellar Approaches in Obese Patients.","authors":"Olcay Guler,&nbsp;Gürkan Gümüşsuyu,&nbsp;Hakan Sofu,&nbsp;Hüseyin Bahadır Gökçen","doi":"10.1155/2021/5512930","DOIUrl":"https://doi.org/10.1155/2021/5512930","url":null,"abstract":"<p><strong>Background: </strong>The use of total knee arthroplasty (TKA) for primary osteoarthritis of the knee has remarkably increased recently. We aimed to compare the clinical and radiological outcomes of TKA in obese patients (>30 kg/m²) operated with midvastus (MV) or medial parapatellar (MPP) approaches.</p><p><strong>Methods: </strong>This retrospective study was performed using data derived from 80 patients (70 women; 10 men) with an average age of 66.17 ± 5.42 (range: 54 to 77). Patients were allocated into 2 groups as for the type of approach conducted during TKA: group I (<i>n</i> = 41) underwent TKA by MV approach, while the MMP technique was used in group II (<i>n</i> = 39).</p><p><strong>Results: </strong>Demographic, clinical, and radiological parameters included age, side of involvement, sex, BMI, diameters of thigh and calf, length of incision, duration of operation, amount of bleeding and transfusion, duration of hospitalization and follow-up, complications, and range of motion, as well as Knee Society Score (KSS) and Knee Society Function Score (KSFS). Patients with a higher BMI (≥35 kg/m²) experienced more profound bleeding and needed more transfusion of erythrocyte suspension. The range of motion was more favorable in groups with BMI <35 kg/m². The functional outcomes as reflected in KSS and KSFS were much better in patients with BMI <35 kg/m².</p><p><strong>Conclusions: </strong>Our data indicated that obesity can adversely influence the clinical and radiological outcomes after TKA performed by both MV and MPP approaches. A careful analysis of patient characteristics and selection of appropriate operative procedures is critical. Further randomized, controlled trials on larger series must be designed to elucidate the relationship between obesity and therapeutic outcomes after TKA with different approaches.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5512930"},"PeriodicalIF":1.3,"publicationDate":"2021-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8552017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39579827","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":"Prospective, Multicenter Evaluation of a Polyherbal Supplement alongside Standard-of-Care Treatment for Mild Knee Osteoarthritis.","authors":"Zbigniew Żęgota,&nbsp;Joanna Goździk,&nbsp;Joanna Głogowska-Szeląg","doi":"10.1155/2021/5589597","DOIUrl":"https://doi.org/10.1155/2021/5589597","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to provide clinical information on general and joint performance from individuals taking Tregocel® (containing curcuminoid and extracts of the herbs <i>Harpagophytum procumbens</i>, <i>Boswellia serrata, Apium graveolens</i>, and <i>Zingiber officinale</i>) alongside a standard therapy of symptomatic mild knee osteoarthritis (OA).</p><p><strong>Methods: </strong>This was a multicenter, open-label, prospective, single-arm study, in which Tregocel® was supplemented for 36 weeks. Participants with symptomatic mild knee OA requiring pharmacologic treatment for pain were enrolled. Physical performance (6-minute walk test, WOMAC-pain and functional domain, and heel-thigh distance flexion test), general performance (WOMAC questionnaire), and VAS (Visual Analogue Scale) assessment of knee pain, as well as anti-inflammatory and analgesic medication consumption, were assessed.</p><p><strong>Results: </strong>Between January and April 2019, 107 participants were enrolled and analysed in per protocol population. Mean age was 59.7 (SD 10.8) years, and there were 68.2% women. Mean observation time was 291.1 (SD 7.7) days. Mean increase in 6MWT result observed at the end of the study was 26.0 (SD 30.4) m (<i>p</i> < 0.001). Median VAS score decreased from 60.0 (IQR 50-72) mm at the beginning of the study to 21.0 (IQR 14-30) mm after 36 weeks of product administration (<i>p</i> < 0.001). Regular knee OA medications were taken in 99.1% of subjects at baseline decreasing to 55.1% at the end of the Tregocel® supplementation.</p><p><strong>Conclusions: </strong>During Tregocel® supplementation, participants observed improved functional capacity confirmed in the distance in 6MWT and in the heel-thigh distance flexion test, decreased level of pain, and improved WOMAC scores for all domains.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5589597"},"PeriodicalIF":1.3,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38936893","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":"Optimal Correction of Adult Spinal Deformities Requires Restoration of Distal Lumbar Lordosis.","authors":"S Pesenti,&nbsp;S Prost,&nbsp;A Muñoz McCausland,&nbsp;K Farah,&nbsp;P Tropiano,&nbsp;S Fuentes,&nbsp;B Blondel","doi":"10.1155/2021/5572181","DOIUrl":"https://doi.org/10.1155/2021/5572181","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study is to analyze results according to postoperative pelvic incidence-lumbar lordosis (PI-LL) mismatch in the management of adult spine deformity (ASD) patients. Recently, it has been reported that in addition to lumbar lordosis amount, lordosis repartition between its proximal and distal parts was crucial.</p><p><strong>Methods: </strong>We enrolled 77 consecutive ASD patients who underwent posterior spinal fusion and deformity correction between 2015 and 2018. On preoperative and 1-year follow-up radiographs, we analyzed different parameters such as L1-S1 lumbar lordosis, L1-L4 proximal lordosis (PLL), L4-S1 distal lordosis (DLL), pelvic tilt (PT), sagittal vertical axis (SVA), and PI-LL mismatch. Comparisons were performed according to postoperative PI-LL mismatch (defined as \"aligned\" when PI-LL was <10°). The relationship between lordosis distribution and postoperative alignment status was investigated.</p><p><strong>Results: </strong>On the whole series, average lumbar lordosis, SVA, and PI-LL improved (28.2° vs.43.5°, 82 vs. 51 mm, and 26°vs. 14°, all <i>p</i> < 0.001, respectively). On the other hand, PT remained unchanged (30° vs. 28°, <i>p</i> > 0.05). 35 patients were classified as \"aligned\" and 42 as \"not aligned.\" Patients from the \"aligned\" group had a significantly lower PI than patients from the \"not aligned\" group (52° vs. 61°, <i>p</i>=0.009). Postoperative PLL was not different between groups (18° vs. 16° <i>p</i> > 0.05), whereas DLL was significantly higher in the \"aligned\" group (31° vs. 22°, <i>p</i>=0.003). PI-LL was significantly correlated to DLL (rho = 0.407, <i>p</i> < 0.001) but not with PLL (rho = 0.110, <i>p</i>=0.342).</p><p><strong>Conclusions: </strong>Our results revealed that in ASD patients, postoperative malalignment was associated with a lack of DLL restoration. \"Not aligned\" patients had also a significantly higher pelvic incidence. Specific attention must be paid to restore optimal distal lumbar lordosis in order to set the amount and the distribution of optimal postoperative lumbar lordosis.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"5572181"},"PeriodicalIF":1.3,"publicationDate":"2021-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8121594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38940902","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":"A Single Intramedullary K-Wire Is Sufficient for the Management of Nonthumb Metacarpal Shaft Fractures.","authors":"Mohamed I Abulsoud,&nbsp;Mohammed Elmarghany,&nbsp;Tharwat Abdelghany,&nbsp;Mohamed Abdelaal,&nbsp;Mohamed F Elhalawany,&nbsp;Ahmed R Zakaria","doi":"10.1155/2021/9963186","DOIUrl":"https://doi.org/10.1155/2021/9963186","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the outcome after the internal fixation of diaphyseal metacarpal fractures by a single intramedullary K-wire.</p><p><strong>Methods: </strong>In this prospective case series study, conducted from July 2017 to June 2019 in 23 adult patients with a single, unstable, diaphyseal metacarpal fracture, outcomes after internal surgical fixation using a single antegrade intramedullary K-wire were evaluated. The outcomes were evaluated by union rate, time to union, handgrip measurements at 6 and 12 months, and the modified Disabilities of the Arm, Shoulder, and Hand (DASH) score at 12 months.</p><p><strong>Results: </strong>The study population consisted of 17 males and 6 females, with a mean patient age of 28.4 ± 8.5 years (range, 16-45 years). The median time to final follow-up was 14 ± 1.8 months (range: 12-24 months). The mean duration of the union was 7.3 ± 1.6 weeks (range: 5-11 weeks), with a union rate of 95.7% (22 cases). The mean handgrip strength was 68% ± 12.8% of the strength of the uninjured hand after 6 months and 92.7% ± 6.9% after 12 months. The mean modified DASH score was 2.6 ± 0.26 after 12 months (range: 0-5.8). There were no cases of malrotation or infection. In conclusion, using a single 1.8-2.0 mm K-wire gives excellent functional outcomes and union rate without significant complications when used to treat an unstable metacarpal shaft fracture.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2021 ","pages":"9963186"},"PeriodicalIF":1.3,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8112946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39032807","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}