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Orthopaedics & Traumatology, Surgery & Research: OTSR

Alain C Masquelet, Taka Kishi, Pierre E Benko
INTRODUCTION: The induced membrane technique for bone defect reconstruction is now well recognized, and short-term results for bone healing are consistent between published reports. OBJECTIVES: To assess very long-term functional results in post-traumatic reconstruction using the induced membrane technique. METHOD: Results for 18 patients undergoing bone defect reconstruction by induced membrane were retrospectively analyzed at 10 to 22years' follow-up...
January 10, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Thibaud Rodriguez, Aurélie Wolf-Mandroux, Jennifer Soret, Louis Dagneaux, François Canovas
BACKGROUND: The objective of this study was to contribute to an OR efficiency optimisation effort by comparing a trauma OR versus a scheduled surgery OR in a lower limb orthopaedic surgery department. HYPOTHESIS: The main hypothesis is that efficiency is lower in the trauma OR than in the scheduled surgery OR. The secondary hypothesis is that efficiency of the trauma OR is lower during weekends. MATERIAL AND METHODS: This prospective study was conducted in 2016 in the orthopaedic surgery department of a university hospital...
January 10, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Povilas Masionis, Valentinas Uvarovas, Giedrius Mazarevičius, Kiril Popov, Šarūnas Venckus, Karolis Baužys, Narūnas Porvaneckas
INTRODUCTION: Successful treatment starts by accurate classification of pathology, but there is no conclusive, reliable and universally accepted method for classification of intracapsular femoral neck fractures. As a perfect classification should have high intra- and interobserver agreement, this study aims to access reliability of three classification systems: Garden, AO and simple II stage classification. MATERIALS AND METHODS: Four orthopaedic trauma surgeons (two of them professors) and two senior orthopaedic trauma residents were invited to evaluated 136 blinded anterior-posterior and lateral X-rays of patients with femoral neck fractures...
January 9, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Esmee Wilhelmina Maria Engelmann, Stephen Roche, Sithombo Maqungo, DuPreez Naude, Michael Held
BACKGROUND: Upper extremity gunshot fractures are generally treated conservatively or surgically using open reduction and internal fixation (ORIF), intramedullary nails (IM) or external fixators. However, there is no gold standard for the management of these complex, multi-fragmentary upper extremity fractures. The aim was to describe and identify the injury patterns, management, complications and associated risk factors for upper extremity gunshot fractures. PATIENT AND METHODS: Data of patients with upper extremity gunshot injuries that presented to a Level I Trauma Unit in Cape Town, South Africa was collected prospectively over a ten-month period from June 2014 to April 2015...
January 9, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Alexandre Caubere, Thomas Demoures, Camille Choufani, Victor Huynh, Olivier Barbier
INTRODUCTION: Intramedullary (IM) nailing is the gold standard for treating long bone fractures in developed countries because of its minimally-invasive application and good biomechanical properties. In precarious conditions, external fixation or open plate fixation are often performed because surgeons do not have the means to carry out IM nailing. However, these procedures can lead to infection-related complications and mechanical failures. The aim of our study was to describe the outcomes and postoperative complications of IM nailing of closed, long bone fractures in patients operated in a French front-line combat surgical unit (role 2+)...
January 9, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Guo-Chun Zha, Jia Liu, Yong Wang, Shuo Feng, Xiang-Yang Chen, Kai-Jin Guo, Jun-Ying Sun
INTRODUCTION: Hemiarthroplasty (HA) using standard-length femoral stem with reconstruction of femoral calcar or using calcar replacing prosthesis for unstable intertrochanteric fractures in elderly patients is a viable option. However, both of the techniques increase the complexity of procedure, operative trauma and complication. This study evaluated the clinico-radiological results of the MP-Link cementless distal fixation modular prosthesis without reconstruction of femoral calcar for unstable intertrochanteric fracture in patients aged 75 years or more...
January 9, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yueh Chen, Pei-Yuan Lee, Ming-Chou Ku, Nai-Yuan Wu, Chien-Sheng Lo
To reduce the damage to posteromedial knee capsule, we developed a direct extra-articular arthroscopic approach for excision of symptomatic popliteal cysts. This study aimed to demonstrate the surgical technique and present the 2-year follow-up results. Cystectomy is performed by extra-articular surgical approach through a high posteromedial portal. Twenty-one consecutive patients diagnosed of symptomatic popliteal cysts with failed initial conservative treatments were included. At a median follow-up of 29...
January 9, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Franck Remy
Patellofemoral arthroplasty (PFA) has seen its role validated over the last decade as a treatment for severe Iwano III or IV patellofemoral osteoarthritis (PFOA). The ideal indication is PFOA with femoral trochlear dysplasia. The accumulation of data on factors influencing the likelihood of PFA failure or success when using first- or second-generation implants has led to design changes, which have been incorporated into modern third-generation implants. These implants are positioned using anatomic cuts, with instrumentation kits that ensure accurate and reproducible alignment...
January 8, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Benjamin Bockmann, Philipp Lechler, Christoph Kolja Boese, Rene Aigner, Steffen Ruchholtz, Michael Frink
INTRODUCTION: The optimal treatment of isolated fractures of the greater tuberosity is an important topic of current surgical research. While non-displaced fractures are amenable to conservative treatment, displacement of the fragment can result in rotator cuff malfunction and impingement. For the present study, risk factors predicting secondary fragment displacement were analyzed. HYPOTHESIS: Certain risk factors determine a higher risk of secondary displacement in patients with greater tuberosity fractures...
January 8, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Marcelle Mercier, Antoine Dangin, Edouard Ollier, Nicolas Bonin
BACKGROUND: Arthroscopic management of femoroacetabular impingement (FAI) is classically contraindicated when acetabular dysplasia is associated, although this is controversial in case of moderate dysplasia or isolated cam effect. A case-control study was therefore conducted comparing borderline (center-edgeangle (CEA), 20-24°), moderate (15-19°) and severe dysplasia (<15°) (group D) versus a control group with normal acetabular cover (CEA, 25-30°). The aims were 1) to determine functional results and satisfaction, and 2) to correlate functional results with severity of dysplasia and of cam effect...
January 7, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
P Sautet, H Giorgi, P Chabrand, P Tropiano, J-N Argenson, S Parratte, B Blondel
No abstract text is available yet for this article.
January 7, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jean Charles Le Huec, Andreas Tsoupras, Amelie Leglise, Paul Heraudet, Gabriel Celarier, Bengt Sturresson
The sacro-iliac joint (SIJ) located at the transition between the spine and the lower limbs is subjected to major shear forces. Mobility at the SIJ is very limited but increases during pregnancy and the post-partum period. Familiarity with the anatomy and physiology of the SIJ is important. The SIJ is a diarthrodial joint that connects two variably undulating cartilage surfaces, contains synovial fluid, and is enclosed within a capsule strengthened by several ligaments. This lecture does not discuss rheumatic or inflammatory diseases of the SIJ, whose diagnosis relies on imaging studies and blood tests...
January 4, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Evelyne Poli, Tan-Sothea Ouk, Guislaine Barrière, Guillaume Lévèque, Vincent Sol, Eric Denes
BACKGROUND: Bacterial adhesion depends on surface materials. Recently it was suggested that ceramic-on-ceramic bearings could be less prone to infection than other bearings. We examined the possibility that porous alumina ceramic could be less susceptible to bacterial adhesion. HYPOTHESIS: As hydroxyl groups (OH) on material surface are a major factor governing the surface properties (for example: adsorption, first non-specific step of bacterial adhesion), we hypothesized that alumina had lower OH group density than other material...
January 3, 2019: Orthopaedics & Traumatology, Surgery & Research: OTSR
Terufumi Shibata, Teruaki Izaki, Satoshi Miyake, Nobunao Doi, Yozo Shibata, Yutaka Irie, Katsuro Tachibana, Takuaki Yamamoto
BACKGROUND: Reconstructing both coracoclavicular ligaments following acromioclavicular dislocation has recently been reported to restore the function of the acromioclavicular joint better than traditional procedures. Knowing the appropriate position and orientation of the bone tunnels and the potential risks of neurovascular injuries leads to safe reconstruction. We aimed to answer the following questions: what is the difference in the accurate clavicular bone tunnel positions (BTPs) during coracoclavicular ligament reconstruction between sex, and what are the potential risks for neurovascular injuries? HYPOTHESIS: The BTPs differ by sex at the site of coracoclavicular ligament reconstruction...
December 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Charles Rivière, Ciara Harman, Anthony Leong, Justin Cobb, Cedric Maillot
BACKGROUND: Mobile bearing unicompartmental knee arthroplasty (UKA) Oxford™ components are recommended to be systematically and mechanically aligned (MA) for restoring the constitutional lower-limb alignment. Good long-term clinical outcomes have been generated with the medially implanted MA Oxford™, but some sub-optimal biomechanical-related complications still remain. Kinematic Alignment (KA) is a personalised technique for anatomically and kinematically implanting components (total knee, fixed bearing partial knee, total hip) aimed at creating more physiological prosthetic joint biomechanics...
December 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Steven Roulet, Louis-Romée Le Nail, Gualter Vaz, Antoine Babinet, Valérie Dumaine, Aurélie Sallot, Philippe Rosset
INTRODUCTION: Tumor resection is the gold standard treatment for soft tissue and bone sarcomas. In the pelvis, this may require a hemipelvectomy that can compromise primary skin closure. Flaps are essential in this context; however the vascularization of potential pedicled flaps may have been removed during tumor excision. Using healthy tissue from the amputated limb as a free flap is an excellent coverage option. HYPOTHESIS: The free fillet flap from an amputated lower limb is a simple and reliable coverage technique after hemipelvectomy or hip disarticulation...
December 27, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Louis Dagneaux, Stanislas Marouby, Cedric Maillot, François Canovas, Charles Riviere
INTRODUCTION: The pelvic incidence is an anatomical and biomechanical pelvic parameter determining spine sagittal morphology and kinematics. Stiffening of the lumbo-pelvic complex, a result of degeneration, affects the functional cup positioning, putting prosthetic hip patients at risk of instability. The anti-dislocation dual mobility (DM) device may be clinically advantageous by reducing the risk of prosthetic instability for older patients with spine ageing. Our study aims to answer the following questions: (1) is there a relationship between prosthetic hip instability and the standing cup position, (2) is there a relationships between prosthetic hip instability and the pelvic incidence, (3) is there a relationships between prosthetic hip instability and the severity of the spine degeneration?, (4) is the DM cup device an effective option for reducing the risk of prosthetic instability related to spine degeneration? HYPOTHESIS: There is a relationship between prosthetic hip instability and the standing cup position and pelvic parameters...
December 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ryota Nakaya, Masaki Takao, Hidetoshi Hamada, Takashi Sakai, Nobuhiko Sugano
BACKGROUND: The Dorr classification is widely used to evaluate femoral bone quality, but it has no clear quantitative criteria. This study aimed to evaluate the reproducibility of the Dorr classification and examine its quantitative indices on plain radiographs, which are suitable for objective classification. HYPOTHESIS: Reproducibility of the Dorr classification is influenced by the clinical experience of the examiners, and radiographic indices are required for this classification...
December 26, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Nicolas Reina
Information is everywhere in the surgeon's life. It can improve medical practice and allow for personalized care. To answer the question, "How should the surgeon be connected?" we must assess the role and limitations of digital information in daily practice, particularly through mobile applications or mHealth. These tools and their scope must be defined in order to measure their impact on our clinical practice. New regulations on medical data have been introduced imposing that privacy be maintained...
December 24, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Antoine Schmitt, Hoel Letissier, Sergii Poltaretskyi, Damien Babusiaux, Philippe Rosset, Louis-Romée Le Nail
BACKGROUND: The curvature of the femoral shaft is generally considered as residing in the sagittal plane. While many studies have measured the femur's radius of curvature, very few have studied the orientation of the plane in which it resides. The orientation of this plane may affect the rotation of intramedullary nails or revision stems with diaphyseal locking. This led us to conduct a three-dimensional (3D) anatomical study to: 1) analyze the 3D curvature of the femoral diaphysis by specifying the orientation of the plane in which it resides, 2) look for relationships between the curvature's orientation and anatomical parameters of the femur...
December 24, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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