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Derotational osteotomy and internal fixation of a 180°malrotated humerus:A case report

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World Journal of Orthopedics 2022年第10期13卷 940-948页

作者： Katharina Elisabeth Wenning Thomas Armin Schildhauer Clifford Barry Jones Martin Franz Hoffmann Department of General and trauma surgery BG University Hospital Bergmannsheil BochumBochum 44789Germany Department of orthopaedic surgery Creighton Medical School PhoenixPhoenix85012United States

BACKGROUND Humeral shaft fractures are relatively common in *** malalignment is reported as one complication but severe rotational deformity of the humerus is extremely *** our knowledge,only three cases of symptomatic humeral malrotation have been *** are sparse literature reports of humeral reconstruction *** SUMMARY We present a case of extreme rotational deformity of the humerus(180°)after humeral shaft *** patient complained of pain and difficulties with activities of daily *** addition,she found the deformity cosmetically ***,she was searching for surgical *** of the radial nerve followed by derotational osteotomy of the humerus and internal fixation were ***,the patient demonstrated transient iatrogenic radial nerve palsy which recovered completely during postoperative *** Disabilities of the Arm,Shoulder,and Hand score improved from 55 preoperatively to 16 at the final 2-year *** Single-stage radial neurolysis,derotational osteotomy and stable fixation is a feasible option to improve anatomic and functional problems of severely malrotated humeral shaft fractures.

关键词： Humerus Malrotation Corrective osteotomy Plate osteosynthesis Radial nerve palsy Case report

Periprosthetic joint infections in femoral neck fracture patients treated with hemiarthroplasty–should we use antibiotic-loaded bone cement?

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World Journal of Orthopedics 2022年第2期13卷 150-159页

作者： Diana Crego-Vita Daniel Aedo-Martín Rafael Garcia-Cañas Andrea Espigares-Correa Coral Sánchez-Pérez Christof Ernst Berberich Department of orthopaedic and trauma surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of orthopaedic and trauma surgery Hospital Universitario del HenaresUniversidad Francisco de VitoriaCoslada 28822MadridSpain Department of Orthopeadic and trauma surgery Hospital Central de la Defensa Gómez UllaMadrid 28047Spain Department of Orthopeadic and trauma surgery General University Hospital Gregorio MaranonMadrid 28007Spain Department of Medical Training Heraeus Medical GmbHWehrheim 612173HessenGermany

BACKGROUND Hemiarthroplasty is the most common treatment in elderly patients with displaced intra-capsular femoral neck fracture(FNF).Prosthetic joint infection(PJI)is one of the most feared and frequent complications post-surgery because of the frail health status of these patients and the need for fast track ***,priorities should lie in effective preventive strategies to mitigate this *** To determine how much the implementation of the routine use of antibioticloaded bone cement(ALBC)as a relatively easy-to-apply amendment to the surgical practice reduces the infection rate in our hemiarthroplasty *** We retrospectively assessed all demographic,health status and treatment-related data of our FNF patients undergoing cemented hemiarthroplasty in the period from 2011 to 2017;241 patients were further analyzed after exclusion of patients with cancer-related sequelae and those who died before the end of the 1-year observation *** PJI rate as diagnosed on basis of the Musculoskeletal Infection Society(MSIS)criteria 2011 was determined for each included patient and compared in function of the bone cement used for hip stem *** were split into a group receiving a plain bone cement in the period from January 2011 to June 2013(non-ALBC group)and into a group receiving an ALBC in the period July 2013 to December 2017(ALBC group).Data analysis was performed with statistical *** further calculated the cost-efficacy of the implementation of routine use of ALBC in the second group balancing the inhospital infection related treatment costs with the extra costs of use of *** In total 241 FNF patients who received cemented hemiarthroplasty in the period from January 2011 to January 2017 were eligible for inclusion in this retrospective *** were 8 PJI cases identified in the ALBC group among n=94 patients,whereas 28 PJI cases were observed in the non-ALBC group among n=147 *** statistical analysis

关键词： prosthetic joint infection Femoral neck fracture patients Hemiarthroplasty Antibiotic-loaded bone cement Prophylaxis Cost-efficacy

Fragility of statistically significant findings from randomized clinical trials of surgical treatment of humeral shaft fractures:A systematic review

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World Journal of Orthopedics 2022年第9期13卷 825-836页

作者： Stephen Craig Morris Anirudh K Gowd Avinesh Agarwalla Wesley P Phipatanakul Nirav H Amin Joseph N Liu Department of orthopaedic surgery Loma Linda UniversityLoma LindaCA 92354United States Department of orthopaedic surgery Wake Forest University Baptist Medical CenterWinston-SalemNC 27157United States Department of orthopaedic surgery Westchester Medical CenterValhallaNY 10595United States Department of orthopaedic surgery Premier Orthopaedic and Trauma SpecialistsPomonaCA 91767United States Department of Orthopedic surgery USC Epstein Family Center for Sports MedicineLos AngelesCA 90089United States

BACKGROUND Despite recent meta-analyses of randomized controlled trials(RCTs),there remains no consensus regarding the preferred surgical treatment for humeral shaft *** fragility index(FI)is an emerging tool used to evaluate the robustness of RCTs by quantifying the number of participants in a study group that would need to switch outcomes in order to reverse the study *** To investigate the fragility index of randomized control trials assessing outcomes of operative fixation in proximal humerus *** We completed a systematic review of RCTs evaluating the surgical treatment of humeral shaft *** criteria included:articles published in English;patients randomized and allotted in 1:1 ratio to 2 parallel arms;and dichotomous outcome *** FI was calculated for total complications,each complication individually,and secondary surgeries using the Fisher exact test,as previously *** Fifteen RCTs were included in the analysis comparing open reduction plate osteosynthesis with dynamic compression plate or locking compression plate,intramedullary nail,and minimally invasive plate *** median FI was 0 for all parameters *** individual outcomes,the FI was 0 for 81/91(89%)of *** FI exceeded the number lost to follow up in only 2/91(2%)*** The FI shows that data from RCTs regarding operative treatment of humeral shaft fractures are fragile and does not demonstrate superiority of any particular surgical technique.

关键词： Humerus fracture Open reduction internal fixation Intramedullary nail Fragility index Complications Fragility index

Digital templating in total hip arthroplasty:Additional anteroposterior hip view increases the accuracy

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World Journal of Orthopedics 2017年第1期8卷 30-35页

作者： Sophia K Stigler Franz J Müller Sebastian Pfaud Michael Zellner Bernd Füchtmeier Clinic for trauma Orthopaedic and Sports MedicineHospital Barmherzige Brüder

AIM To analyze planning total hip arthroplasty(THA) with an additional anteroposterior hip view may increases the accuracy of preoperative planning in *** We conducted prospective digital planning in 100 consecutive patients: 50 of these procedures were planned using pelvic overview only(first group), and the other 50 procedures were planned using pelvic overview plus antero-posterior(a.p.) hip view(second group). The planning and the procedure of each patient were performed exclusively by the senior surgeon. Fifty procedures with retrospective analogues planning were used as the control group(group zero). After the procedure, the planning was compared with the eventually implanted components(cup and stem). For statistic analysis the x^2 test was used for nominal variables and the t test was used for a comparison of continuous *** Preoperative planning with an additional a.p. hip view(second group) significantly increased the exact component correlation when compared to pelvic overview only(first group) for both the acetabular cup and the femoral stem(76% cup and 66% stem vs 54% cup and 32% stem). When considering planning ± 1 size, the accuracy in the second group was 96%(48 of 50 patients) for the cup and 94% for the stem(47 of 50patients). In the analogue control group(group zero), an exact correlation was observed in only 1/3 of the *** Digital THA planning performed by the operating surgeon and based on additional a.p. hip view significantly increases the correlation between preoperative planning and eventual implant sizes.

关键词： Digital Templating Preoperative planning Hip view Total hip arthroplasty

Lumbar and cervical viscoelastic disc replacement:Concepts and current experience

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World Journal of Orthopedics 2020年第8期11卷 345-356页

作者： Jean Yves Lazennec Department of orthopaedic and trauma surgery Pitié-Salpêtrière HospitalAssistance Publique-Hôpitaux de ParisParis F-75013France

The ideal lumbar and cervical discs should provide six degrees of freedom andtri-planar (three-dimensional) motion. Although all artificial discs are intended toachieve the same goals, there is considerable heterogeneity in the design oflumbar and cervical implants. The “second generation total disc replacements”are non-articulating viscoelastic implants aiming at the reconstruction ofphysiologic levels of shock absorption and flexural stiffness. This review aims togive an overview of the available implants detailing the concepts and thefunctional results experimentally and clinically. These monobloc prostheses raisenew challenges concerning the choice of materials for the constitution of theviscoelastic cushion, the connection between the components of the internalstructure and the metal endplates and even the bone anchoring mode. Newobjectives concerning the quality of movement and mobility control must bedefined.

关键词： Lumbar disc replacement Cervical disc replacement Viscoelastic Total disc replacement Lumbar spine Cervical spine Disc arthroplasty

Treatment options for irreparable postero-superior cuff tears in young patients

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World Journal of Orthopedics 2015年第10期6卷 770-775页

作者： Olimpio Galasso Filippo Familiari Giorgio Gasparini Department of orthopaedic and trauma surgery "Magna Graecia" University of Catanzaro

Rotator cuff tears(RCTs) occur more commonly with advanced age,with most rotator cuff abnormalities in patients less than 30 years old being painful tendinoses or partial-thickness *** postero-superior cuff tears has been reported as frequent as 7% to 10% in the general population,and the incidence of irreparable RCTs in young patients is still *** surgical procedures have been proposed for young patients with irreparable postero-superior RCTs,such as rotator cuff debridement,partial rotator cuff repair,biceps tenotomy/tenodesis,rotator cuff grafting,latissimus dorsi tendon transfer,and reverse shoulder *** being thoroughly investigated in open surgery,arthroscopic techniques for latissimus dorsi tendon transfer have been recently *** have been shown to be an adequate option to open surgery for managing irreparable postero-superior RCTs refractory to conservative management.

关键词： Postero-superior rotator cuff tears Young patients Irreparable Latissimus dorsi Tendon transfer

Damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma

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Chinese Journal of traumatology 2008年第5期11卷 283-287页

作者：王爱民殷翔孙红振杜全印王子明 Department of orthopaedic and traumatic surgery Daping Hospital/Research Institute of Surgery Third Mili-tary Medical University Chongqing 400042 China

Objective： To discuss damage control orthopaedics in 53 cases of severe polytrauma who have mainly sustained orthopaedic trauma. Methods： The data of 53 cases of severe polytrauma who had mainly sustained orthopaedic trauma were retrospectively analyzed. And the methods and timing of damage control orthopaedics were discussed in this study. Results： We succeeded in rescuing the lives of all the 53 patients, and 38 patients returned to their former work. Conclusions： Injury Severity Score （ISS90） should be 17 in severe polytrauma patients, but in severe polytrauma patients who have mainly sustained orthopaedic trauma, the ISS90 of bone and joint injuries should be 16. We recommend that primary minimallyinvasive external fracture stabilization should be made for extremities and pelvis in these patients to avoid additional surgical trauma and that definitive secondary fracture care should be performed after medical stabilization for these patients in intensive care unit （ICU）.

关键词： orthopaedics Wounds and injuries Damage control

Locking compression plate+T-type steel plate for postoperative weight bearing and functional recovery in complex tibial plateau fractures

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World Journal of Clinical Cases 2022年第2期10卷 502-510页

作者： Hai-Feng Li Tao Yu Xing-Fei Zhu Hua Wang Ying-Qi Zhang Department of orthopaedic surgery Tongji HospitalSchool of MedicineTongji UniversityShanghai 200065China Department of orthopaedic surgery Zhabei Central HospitalShanghaiShanghai 200070China

Complex tibial plateau fractures can seriously affect quality of life and physical and mental health of *** anatomical relationship between the proximal tibial bone and soft tissue is complex,resulting in different types of tibial plateau *** trauma can lead to displaced fracture,serious soft tissue injury,and potentially,dislocation of the knee ***,tibial plateau fractures are extremely *** To assess the use of locking compression plate(LCP)+T-type steel plate for postoperative weight bearing and functional recovery of complex tibial plateau *** Ninety-seven patients with complex tibial plateau fractures who underwent surgery at our hospital were selected for retrospective ***-nine patients had been treated with LCP+T-type steel plate limited internal fixation(study group),and 48 patients with bilateral ordinary steel plate support(control group).The operation process index,postoperative rehabilitation related index,Rasmussen score of the knee joint,tibial plateau varus angle(TPA),tibial plateau retroversion angle(PA),and surgical complications of the two groups were *** The operation time and intraoperative bone graft volume in the study group were lower than those in the control group(P0.05).There was no significant difference in the TPA and PA angle between the groups immediately and 18 mo after surgery(P>0.05).At 12 mo after surgery,the Rasmussen scale score was higher in the study group than in the control group(Psurgery,and the radiology score at 12 and 18 mo after surgery,between the two groups(P>0.05).The postoperative complication rate in the study group(3.77%)was lower than that in the control group(15.

关键词： Locking compression plate T-type steel plate Complexity Tibial plateau fracture Functional recovery Complications

Two-stage revision arthroplasty for coagulase-negative staphylococcal periprosthetic joint infection of the hip and knee

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World Journal of Orthopedics 2019年第10期10卷 348-355页

作者： Ewout S Veltman Dirk Jan F Moojen Marc L van Ogtrop Rudolf W Poolman Department of orthopaedic and trauma surgery OLVGJoint Research OLVGAmsterdam 1091ACNetherlands Department of orthopaedic surgery Leiden University Medical CentreLeiden 2333ZANetherlands Department of Medical Microbiology OLVGAmsterdam 1091ACNetherlands

BACKGROUND Periprosthetic joint infections(PJIs)are frequently caused by coagulase-negative Staphylococci(CoNS),which is known to be a hard-to-treat *** resistance among causative pathogens of PJI is ***-stage revision is the favoured treatment for chronic CoNS infection of a hip or knee *** hypothesised that the infection eradication rate of our treatment protocol for two-stage revision surgery for CoNS PJI of the hip and knee would be comparable to eradication rates described in the *** To evaluate the infection eradication rate of two-stage revision arthroplasty for PJI caused by *** All patients treated with two-stage revision of a hip or knee prosthesis were retrospectively *** with CoNS infection were included in the study,including polymicrobial *** outcome was infection eradication at final *** Forty-four patients were included in the ***-nine patients were treated for PJI of the hip and fifteen for PJI of the *** final follow-up after a mean of 37 mo,recurrent or persistent infection was present in eleven *** PJI with CoNS can be a difficult to treat infection due to increasing antibiotic *** eradication rate of 70%-80%may be achieved.

关键词： Periprosthetic joint infection Two-stage revision Knee arthroplasty Hip arthroplasty Coagulase-negative Staphylococcus