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Return to sport following scaphoid fractures:A systematic review and meta-analysis

World Journal of Orthopedics 2019年第2期10卷 101-114页

作者： Joaquim S Goffin Quintin Liao Gregory AJ Robertson Department of Orthopaedic and Trauma Surgery Ninewells Hospital Department of Orthopaedic and Trauma Surgery Forth Valley Royal Hospital Edinburgh orthopaedic trauma Unit Royal Infirmary of Edinburgh

BACKGROUND Scaphoid fracture is the most commonly fractured carpal bone in the athletic patient, accounting for over 85% of all sport-related carpal bone fractures, and is particularly common in sports involving high impact injuries to the wrist. The management of such injuries comprises both conservative and surgical techniques, as guided by fracture location and type. Athletes demonstrate a unique challenge with regards to the management of scaphoid fractures due to their requirement to return to sport, as soon as able.AIM To review systemically all studies recording return to sport following scaphoid fractures, to collate information on return rates to sport(RRS) and mean return times(RTS) to sport and to determine differences in sporting outcome for the various treatment methods.METHODS A systematic search of MEDLINE, EMBASE, CINAHAL, Cochrane, Google Scholar, Physiotherapy Evidence Database, SPORTDiscus, Web of Science and Scopus was performed in August 2018 using the keywords "scaphoid","fracture", "acute", "carpal", "athletes", "sports", "non-operative","conservative", "operative" and "return to sport". All studies that recorded RRS and RTS following scaphoid fractures were included. RTS was recorded as the length of time from commencement of either primary conservative management or primary surgical procedure to return to sport.RESULTS Eleven studies were included: Two randomised controlled trials, six retrospective cohort studies and three case series. Seven studies reported on conservative management(n = 77), and eight studies reported on surgical management(n =83). For conservative management, RRS was 90%(69/77), and the mean RTS was9.6 wk. Three studies allowed to return to sport in cast [RRS 89%(25/28); RTS 1.9 wk], and four studies required completion of cast treatment prior to returning to sport [RRS 90%(44/49); RTS 13.9 wk]. Four studies recorded fracture union data:Union rate 85%(47/55); mean time to union 14.0 wk. For surgical management,RRS was 98%(81/83), and RTS was 7.3 wk. Three studies repo

关键词： Acute Fracture Scaphoid Carpal Return Sport Rate Time

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Total knee arthroplasty in patients with Paget's disease of bone: A systematic review

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World Journal of Orthopedics 2018年第10期9卷 229-234页

作者： Ravi Popat Konstantinos Tsitskaris Steven Millington Sebastian Dawson-Bowling Sammy A Hanna department of trauma and orthopaedic surgery the Hillingdon Hospitals NHS Foundation Trust department of trauma and orthopaedic surgery Barts Health NHS Trust

AIM To determine the functional outcomes, complications and revision rates following total knee arthroplasty(TKA) in patients with Paget's disease of bone(PDB). METHODS A systematic review of the literature was performed. Four studies with a total of 54 TKAs were included for analysis. Functional outcomes, pain scores, complications and revision rates were assessed. The mean age was 72.0 years and the mean follow-up was 7.5 years.RESULTS All studies reported significant improvement in knee function and pain scores following TKA. There were 2 cases of aseptic loosening, with one patient requiring revision of the femoral component 10 years after the index procedure. Malalignment, bone loss, soft tissue contractures were the most commonly reported intraoperative challenges. There were five cases(9%) that were complicated by intra-operative patellar tendon avulsion.CONCLUSION The findings support the use of TKA in patients with PDB. The post-operative functional outcomes are largely similar to other patients, however there are specific perioperative challenges that have been highlighted, in particular the high risk for patellar tendon avulsion.

关键词： Total knee arthroplasty Paget’s disease of bone Revision Loosening Paget’s disease

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Managing extremely distal periprosthetic femoral supracondylar fractures of total knee replacements-a new PHILOS-ophy

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World Journal of Orthopedics 2017年第10期8卷 809-813页

作者： Kevin J Donnelly Adam Tucker Angel Ruiz Neville W Thompson department of trauma and orthopaedic surgery Altnagelvin Hospital

We report two cases where a proximal humeral locking plate was used for the fixation of an extremely distal, type Ⅲ peri-prosthetic femoral fractures in relation to a total knee replacement(TKR). In each case there was concern regarding the fixation that could be achieved using the available anatomic distal femoral plates due to the size and bone quality of distal fragment. The design of the Proximal Humeral Internal Locking System(PHILOS) allows nine 3.5-mm locking screws to be placed over a small area in multiple directions. This allowed a greater number of fixation points to be achieved in the distal fragment. Clinical and radiological short-term follow-up(6-12 mo) has been satisfactory in both cases with no complications. We suggest the use of this implant for extremely distal femoral fractures arising in relation to the femoral component of a TKR.

关键词： Distal Femoral Periprosthetic Fracture PHILOS Open reduction and internal fixation

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Windsurfing vs kitesurfing:Injuries at the North Sea over a 2-year period

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World Journal of Orthopedics 2016年第12期7卷 814-820页

作者： Christiaan JA van Bergen Joris P Commandeur Rik IK Weber Daniel Haverkamp Roelf S Breederveld department of orthopaedic surgery Spaarne Gasthuis department of surgery Luzerner Kantonsspital department of orthopaedic surgery Slotervaartziekenhuis department of trauma surgery Red Cross Hospital

AIM To analyze all windsurfing and kitesurfing(kiteboarding) injuries presented at our coastal hospital over a 2-year period. METHODS Twenty-five windsurfers(21 male; aged 31 ± 8 years) and 32 kitesurfers(23 male; aged 29 ± 11 years) presented at our hospital during the 2-year study period. Various injury data were recorded,including transport to hospital and treatment. After a median follow-up of 16 mo(range,7-33 mo),18 windsurfers(72%) and 26 kitesurfers(81%) completed questionnaires on the trauma mechanisms,the use of protective gear,time spent on windsurfing or kitesurfing,time to return to sports,additional injuries,and chronic disability. RESULTS Most patients sustained minor injuries but severe injuries also occurred,including vertebral and tibial plateau fractures. The lower extremities were affected the most,followed by the head and cervical spine,the upperextremities,and the trunk. The injury rates were 5.2 per 1000 h of windsurfing and 7.0 per 1000 h of kitesurfing(P = 0.005). The injury severity was the same between groups(P = 1.0). Less than 30% of the study population used protective gear. Kitesurfers had a higher number of injuries,and required transport by ambulance,inpatient hospital stay and operative treatment more often than windsurfers,but these differences were not statistically significant(P > 0.05). The median time to return to windsurfing and kitesurfing was 5 and 4 wk,respectively(P = 0.79). Approximately one-third of the patients in each group experienced chronic symptoms.CONCLUSION Kitesurfing results in a significantly higher injury rate than windsurfing in the same environmental conditions but the severity of the injuries does not differ.

关键词： General sports trauma Extreme sports Surfing Epidemiology Prevention

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计算机辅助外科在创伤骨科中的目前观念

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中华创伤骨科杂志 2008年第3期10卷 201-206页

作者：王簕(译校) Yoram A. Weil Amal Khoury David L Helfet Meir Liebergall 南方医科大学南方医院创伤骨科 orthopaedic trauma Service The Hospital for Special Surgery New-York NY 10021 USA department of orthopaedic surgery Hadassah-Hebrew University Hospital Jerusalem ISRAEL

计算机辅助外科（computer assisted surger，CAS）技术已经开始对创伤骨科的临床实际操作产生了重要的影响。虽然计算机已广泛应用于患者的术前检查中，尤其是在影像学上的应用，但事实上将计算机辅助设备引入创伤骨科手术室始于20世... 详细信息

计算机辅助外科（computer assisted surger，CAS）技术已经开始对创伤骨科的临床实际操作产生了重要的影响。虽然计算机已广泛应用于患者的术前检查中，尤其是在影像学上的应用，但事实上将计算机辅助设备引入创伤骨科手术室始于20世纪90年代末。

关键词：计算机辅助外科创伤骨科 20世纪90年代末计算机辅助设备临床实际操作术前检查影像学手术室

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Should proximal ruptures of the anterior rectus femoris muscle be treated surgically?

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Chinese Journal of traumatology 2022年第4期25卷 232-236页

作者： Camille Choufani Frederic Khiami Olivier Barbier orthopaedic surgery and traumatology department Saint-Anne Military Teaching HospitalToulon83000France Toulon Mediterranean Orthopedic and Sport trauma Toulon83000France orthopaedic surgery department Pitie-Salp^etriere HospitalParisFrance

Purpose:No therapeutic consensus has been established about proximal ruptures of the rectus femoris muscle.The objective of this literature review is to determine a therapeutic course of action.Methods:We conducted a literature review on the PubMed database using the following keywords(in French and English,respectively):"quadriceps/quadriceps","droit antérieur/rectus femoris","proximal/proximal","chirurgie/surgical","avulsion/avulsion".We collected 266 articles,36 of them were selected,which were related to our topic:proximal rupture of the anterior rectus femoris.Patients with a proximal rupture of the rectus femoris,minor or major patient of traumatic origin were included in this study.Patients injured at another lesion level,or non-traumatic lesions of the proximal rectus femoris(tendinitis without ruptures,tumor or others)were excluded.For each patient,the indications,the type of treatment and the functional result were analyzed,with the time to recovery and the level of recovery from sports and professional activities(same sport/profession or not,same level or not)as the main criterion of judgment.Fisher exact test was used for statistical comparison.Results:The aims of conservative treatment are to be pain free for the patient,to fight hematoma and to rehabilitate the injury as quickly as possible.The surgical techniques are varied,with most consisting of either a reinsertion of the musculo-tendon stump or a resection of the scar tissue with myo-tendinoaponeurotic suture in place.The functional results are good for the majority of the treatments proposed,but the conservative treatment has a shorter recovery time(3 months vs.4 months for the best surgical results).Highly displaced bone avulsion is the only indication for first-line surgical treatment.Conslusion:The main disadvantage of conservative treatment is the risk of residual pain beyond 3 months(10%),justifying an MRI to guide secondary surgical treatment.We propose a treatment plan for proximal rupture of the proximal rectus femoris rupture.

关键词： Avulsion fractures Quadriceps muscle surgery

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Cost-analysis of inpatient and outpatient parenteral antimicrobial therapy in orthopaedics: A systematic literature review

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World Journal of Clinical Cases 2019年第14期7卷 1825-1836页

作者： Christoph Kolja Boese Philipp Lechler Michael Frink Michael Hackl Peer Eysel Christian Ries Department of Orthopaedic and Trauma Surgery University Hospital of CologneCologne 50931Germany Clinic for trauma and Hand surgery KreisklinikenAltotting 84503Germany Center for orthopaedics and trauma surgery University Hospital Giessen and MarburgMarburg 35043Germany

BACKGROUND Increasing numbers of total joint arthroplasties and consecutive revision surgery are associated with the risk of periprosthetic joint infections (PPJI). Treatment of PPJI is complex and associated with immense socio-economic burden. One treatment aspect is parenteral antiinfective therapy, which usually requires an inpatient setting [Inpatient parenteral antibiotic therapy (IPAT)]. An alternative is outpatient parenteral treatment [Outpatient parenteral antibiotic therapy (OPAT)]. To conduct a health economic cost-benefit analysis of OPAT, a detailed cost analysis of IPAT and OPAT is required. So far, there is a lack of knowledge on the health economic effects of IPAT and OPAT for PPJI. AIM To review an economic comparison of IPAT and OPAT. METHODS A systematic literature review was performed through Medline following the PRISMA guidelines. RESULTS Of 619 identified studies, 174 included information of interest and 21 studies were included for quantitative analysis of OPAT and IPAT costs. Except for one study, all showed relevant cost savings for OPAT compared to IPAT. Costs for IPAT were between 1.10 to 17.34 times higher than those for OPAT. CONCLUSION There are only few reports on OPAT for PPJI. Detailed analyses to support economic or clinical guidelines are therefore limited. There is good clinical evidence supporting economic benefits of OPAT, but more high quality studies are needed for PPJI.

关键词： Antibiotic therapy Outpatient parenteral antibiotic therapy Inpatient parenteral antibiotic therapy Cost analysis Periprosthetic joint infection Parenteral

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Total hip arthroplasty in patients with Paget's disease of bone: A systematic review

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World Journal of Orthopedics 2017年第4期8卷 357-363页

作者： Sammy A Hanna Sebastian Dawson-Bowling Steven Millington Rej Bhumbra Pramod Achan department of trauma and orthopaedic surgery Royal London HospitalBarts Health NHS Trust

AIM To investigate the clinical and functional outcomes following total hip arthroplasty(THA) in patients with Paget's disease.METHODS We carried out a systematic review of the literature to determine the functional outcome, complications and revision rates of THA in patients with Paget's disease. Eight studies involving 358 hips were reviewed. The mean age was 70.4 years and follow-up was 8.3 years. There were 247 cemented THAs(69%), 105 uncemented THAs(29%) and 6 hybrid THAs(2%). RESULTS All studies reported significant improvement in hip function following THA. There were 19 cases of aseptic loosening(5%) at a mean of 8.6 years. Three cases occurred in the uncemented cohort(3%) at a mean of 15.3 years and 16 cases developed in the cemented group(6%) at a mean of 7.5 years(P = 0.2052). There were 27 revisions in the 358 cases(8%) occurring at a mean of 7 years. Six revisions occurred in the uncemented cohort(6%) at a mean of 8.6 years and 21 in the cemented cohort(9%) at a mean of 6.5 years(P = 0.5117). CONCLUSION The findings support the use of THA in patients with Paget's disease hip arthropathy. The post-operative functional outcome is largely similar to other patients; however, the revision rate is higher with aseptic loosening being the most common reason for revision. Uncemented implants appear to be associated with a lower failure rate, however, there were no modern stem designs fixed using current generation cementing techniques used in the reported studies, and as such, caution is advised when drawing any conclusions.

关键词： Total hip arthroplasty Paget’s disease Revision Loosening Heterotopic ossification

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Management of syndesmotic injuries:What is the evidence?

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World Journal of Orthopedics 2016年第11期7卷 718-725页

作者： Marc Schnetzke Sven Y Vetter Nils Beisemann Benedict Swartman Paul A Grützner Jochen Franke department for trauma and orthopaedic surgery MINTOS-Medical Imaging and Navigation in Trauma and Orthopaedic SurgeryBG Trauma Center Ludwigshafen at Heidelberg University Hospital

Ankle fractures are accompanied by a syndesmotic injury in about 10% of operatively treated ankle fractures. Usually, the total rupture of the syndesmotic ligaments with an external rotation force is associated with a Weber type B or C fracture or a Maisonneuve fracture. The clinical assessment should consist of a comprehensive history including mechanism of injury followed by a specific physical examination. Radiographs, and if in doubt magnetic resonance imaging, are needed to ascertain the syndesmotic injury. In the case of operative treatment the method of fixation, the height and number of screws and the need for hardware removal are still under discussion. Furthermore, intraoperative assessment of the accuracy of reduction of the fibula in the incisura using fluoroscopy is difficult. A possible solution might be the assessment with intraoperative three-dimensional imaging. The aim of this article is to provide a current concepts review of the clinical presentation, diagnosis and treatment of syndesmotic injuries.

关键词： Ankle sprain Syndesmotic injury Syndesmotic screw Ankle TightRope Three-dimensional

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Surgical Fixation of Fourth and Fifth Metacarpal Shaft Fractures with Flexible Intramedullary Absorbable Rods： Early Clinical Outcomes and Implications

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Chinese Medical Journal 2015年第21期128卷 2851-2855页

作者： Ge Xiong Zi-Run Xiao Shi-Gong GUO Wei Zheng Lu-Fei Dai department of Hand surgery Beijing Jishuitan Hospital Beijing 100035 China department of trauma and orthopaedic surgery Lister Hospital Stevenage UK

Background： To avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures. Methods： Five patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively. Results： At final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion （ROM） of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. hand was 94.0 ± 9.6%. X-rays showed that the arch of the second Compared with the contralateral hand, the grip strength of the injured to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings. Conclusion： The intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and filth metacarpal fractures with good early clinical outcomes and no significant complications.

关键词： Absorbable Implant Follow-up： Intramedullary Fixation Metacarpal Fracture

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