Browse

You are looking at 61 - 70 of 768 items

Elisa Pala Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

Search for other papers by Elisa Pala in
Google Scholar
PubMed
Close
,
Giulia Trovarelli Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

Search for other papers by Giulia Trovarelli in
Google Scholar
PubMed
Close
,
Andrea Angelini Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

Search for other papers by Andrea Angelini in
Google Scholar
PubMed
Close
,
Maria Chiara Cerchiaro Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

Search for other papers by Maria Chiara Cerchiaro in
Google Scholar
PubMed
Close
, and
Pietro Ruggieri Department of Orthopedics and Orthopedic Oncology, University of Padova, Padova, Italy

Search for other papers by Pietro Ruggieri in
Google Scholar
PubMed
Close

  • The best treatment of unicameral bone cyst and aneurismatic bone cyst (ABC) is debated in the literature.

  • For simple bone cysts, multiple treatments were proposed from observation only to open curettage. The historical treatment with intraosseous injection of methylprednisolone acetate into the bone cysts nowadays is reduced due to the morbidity of multiple injections and the risk of multiple pathologic fractures until the healing.

  • Different types of treatments for ABC are reported, including surgery, percutaneous treatments, and medical treatments; however, there is currently no consensus on the best approach. The association of curettage, bone graft, and elastic stable intramedullary nail (ESIN) had a success rate of over 85%. Decompressing the cyst wall is more critical for increasing the healing rate than the type of graft used to fill the cavity.

  • In ABC, sclerotherapy offers the advantages of lower invasiveness and morbidity, associated with better functional scores and faster return to full weight-bearing. Moreover, they can be used in challenging locations.

  • Selective arterial embolization is a complex procedure and often requires association with other treatments. Further studies are needed to confirm the effectiveness of denosumab and its side effects on skeletally immature patients. Curettage with adjuvants and autogenous bone grafting still shows promising results and can be used in larger, aggressive defects or superficial lesions.

  • For simple bone cysts, the combination of curettage, bone graft, and ESIN showed the best results. Sclerotherapy for ABC also shows promising results.

Open access
Ilse Degreef Department of Orthopaedic, Hand Unit, Leuven University Hospitals, Gasthuisberg, Herestraat, Leuven, Belgium

Search for other papers by Ilse Degreef in
Google Scholar
PubMed
Close
and
Donald H Lalonde Division of Plastic Surgery, Dalhousie University, Saint John, New Brunswick, Canada

Search for other papers by Donald H Lalonde in
Google Scholar
PubMed
Close

  • Wide-awake local anesthesia no tourniquet is named the WALANT technique.

  • WALANT has had a major positive impact on cost, convenience, ecology, patient satisfaction, access to surgical care, and outcomes in hand surgery in the last 20 years.

  • Safe and efficient application of the technique is based on two principles.

  • The first principle is the tumescent injection of a large volume low concentration 0.25–1% lidocaine, with 1:100 000–1:400 000 epinephrine.

  • The second principle of WALANT is that the proper injection should be almost painless, with the patient only feeling the first needle poke of a tiny 30G needle.

  • This wide awake patient approach reduces pain, neuropraxia, and systemic side effects of sedation with preservation of motor control, thereby aiding balanced reconstruction in hand surgery.

Open access
Anna E van der Windt Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands

Search for other papers by Anna E van der Windt in
Google Scholar
PubMed
Close
,
Lisette C Langenberg Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands

Search for other papers by Lisette C Langenberg in
Google Scholar
PubMed
Close
,
Joost W Colaris Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands

Search for other papers by Joost W Colaris in
Google Scholar
PubMed
Close
, and
Denise Eygendaal Department of Orthopaedics and Sports Medicine, Erasmus Medical Center, University Medical Center Rotterdam, The Netherlands

Search for other papers by Denise Eygendaal in
Google Scholar
PubMed
Close

  • Despite the common occurrence of radial head fractures, there is still a lack of consensus on which radial head fractures should be treated surgically.

  • The radial head is an important secondary stabilizer in almost all directions. An insufficient radial head can lead to increased instability in varus–valgus and posterolateral rotatory directions, especially in a ligament-deficient elbow.

  • The decision to perform surgery is often not dictated by the fracture pattern alone but also by the presence of associated injury. Comminution of the radial head and complete loss of cortical contact of at least one fracture fragment are associated with a high occurrence of associated injuries.

  • Nondisplaced and minimally displaced radial head fractures can be treated non-operatively with early mobilization. Displacement (>2 mm) of fragments in radial head fractures without a mechanical block to pronation/supination is not a clear indication for surgery.

  • Mechanical block to pronation/supination and comminution of the fracture are indications for surgery.

  • The following paper reviews the current literature and provides state-of-the-art guidance on which radial head fractures should be treated surgically.

Open access
Guillermo Droppelmann Research Center on Medicine, Exercise, Sport and Health, MEDS Clinic, Santiago, RM, Chile
Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Murcia, Spain
Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA

Search for other papers by Guillermo Droppelmann in
Google Scholar
PubMed
Close
,
Constanza Rodríguez Facultad de Medicina, Universidad Finis Terrae, Santiago, RM, Chile

Search for other papers by Constanza Rodríguez in
Google Scholar
PubMed
Close
,
Carlos Jorquera Facultad de Ciencias, Escuela de Nutrición y Dietética, Universidad Mayor, Santiago, RM, Chile

Search for other papers by Carlos Jorquera in
Google Scholar
PubMed
Close
, and
Felipe Feijoo School of Industrial Engineering, Pontificia Universidad Católica de Valparaíso, Valparaíso, Chile

Search for other papers by Felipe Feijoo in
Google Scholar
PubMed
Close

Purpose

  • The integration of artificial intelligence (AI) in radiology has revolutionized diagnostics, optimizing precision and decision-making. Specifically in musculoskeletal imaging, AI tools can improve accuracy for upper extremity pathologies. This study aimed to assess the diagnostic performance of AI models in detecting musculoskeletal pathologies of the upper extremity using different imaging modalities.

Methods

  • A meta-analysis was conducted, involving searches on MEDLINE/PubMed, SCOPUS, Cochrane Library, Lilacs, and SciELO. The quality of the studies was assessed using the QUADAS-2 tool. Diagnostic accuracy measures including sensitivity, specificity, diagnostic odds ratio (DOR), positive and negative likelihood ratios (PLR, NLR), area under the curve (AUC), and summary receiver operating characteristic were pooled using a random-effects model. Heterogeneity and subgroup analyses were also included. All statistical analyses and plots were performed using the R software package.

Results

  • Thirteen models from ten articles were analyzed. The sensitivity and specificity of the AI models to detect musculoskeletal conditions in the upper extremity were 0.926 (95% CI: 0.900; 0.945) and 0.908 (95% CI: 0.810; 0.958). The PLR, NLR, lnDOR, and the AUC estimates were found to be 19.18 (95% CI: 8.90; 29.34), 0.11 (95% CI: 0.18; 0.46), 4.62 (95% CI: 4.02; 5.22) with a (P < 0.001), and 95%, respectively.

Conclusion

  • The AI models exhibited strong univariate and bivariate performance in detecting both positive and negative cases within the analyzed dataset of musculoskeletal pathologies in the upper extremity.

Open access
Matías Sepulveda Universidad Austral de Chile, Valdivia, Chile
Hospital Base de Valdivia, Valdivia, Chile
AO Foundation, LEGEC Expert Group, Davos, Switzerland

Search for other papers by Matías Sepulveda in
Google Scholar
PubMed
Close
,
Gabriel Orellana Universidad Austral de Chile, Valdivia, Chile
Hospital Base de Valdivia, Valdivia, Chile

Search for other papers by Gabriel Orellana in
Google Scholar
PubMed
Close
,
Francisco Sanchez Clínica Puerto Varas, Puerto Varas, Chile
Clínica Puerto Montt, Puerto Montt, Chile

Search for other papers by Francisco Sanchez in
Google Scholar
PubMed
Close
, and
Estefania Birrer Universidad Austral de Chile, Valdivia, Chile
Hospital Base de Valdivia, Valdivia, Chile

Search for other papers by Estefania Birrer in
Google Scholar
PubMed
Close

  • Brachymetatarsia involves a reduction in length of one or more metatarsals.

  • The affected metatarsal is shortened by 5 mm or more, altering the normal metatarsal parabola.

  • In addition to being an aesthetic deformity, it can present with pain due to transfer metatarsalgia.

  • A possible association with genetic disorders needs to be investigated during clinical evaluation.

  • Surgical treatment may involve a one-stage lengthening procedure or progressive distraction, each having its advantages and limitations.

Open access
Andrew Kailin Zhou Department of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom
West Hertfordshire Hospitals NHS Trust, London, United Kingdom

Search for other papers by Andrew Kailin Zhou in
Google Scholar
PubMed
Close
,
Eric Jou Kellogg College, University of Oxford, Oxford, United Kingdom

Search for other papers by Eric Jou in
Google Scholar
PubMed
Close
,
Victor Lu Department of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom
James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, Norfolk, United Kingdom

Search for other papers by Victor Lu in
Google Scholar
PubMed
Close
,
James Zhang Department of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom
Basildon and Thurrock University Hospitals NHS Foundation Trust, Basildon, Essex, United Kingdom

Search for other papers by James Zhang in
Google Scholar
PubMed
Close
,
Shirom Chabra Department of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom
School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom

Search for other papers by Shirom Chabra in
Google Scholar
PubMed
Close
, and
Matija Krkovic Department of Trauma and Orthopaedics, Addenbrookes Major Trauma Unit, Cambridge University Hospitals, United Kingdom

Search for other papers by Matija Krkovic in
Google Scholar
PubMed
Close

  • Compared to other techniques, poller screws with intramedullary nailing are technically simple, practical, and reproducible for the fixation of metaphyseal fractures.

  • In addition, poller screws do not require special instruments or hardware and are minimally invasive. This review takes a historical perspective to evaluate poller screws holistically.

  • A non-systematic search on PubMed was performed using ‘Poller screw’ or ‘Blocking screw’ to find early use of poller blocking screws. Relevant references from these primary studies were then followed up.

  • In 1999, Krettek et al. first coined the term poller screws after the small metal bollards that block and direct traffic.

  • Poller screws were introduced as an adjunct to aid the union of metaphyseal long bone fractures during intramedullary nailing.

  • However, as more evidence was published, the true effectiveness of poller screws was not appreciated, leading to split opinions.

  • Through our research, we have built upon our understanding of poller screws, and we present a novel classification of poller screws over the years while exploring our novel technique and what we believe to be the fourth generation of poller screws.

  • Currently, there is a paucity of research focussing on poller screws.

  • However, studying the original evidence regarding poller screws through the most recent articles has demonstrated a confusion of research in this field. Therefore, we suggest a more organised approach to classify the use of poller screws.

Open access
Hongfu Jin Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Hongfu Jin in
Google Scholar
PubMed
Close
,
Shide Jiang Department of Orthopaedics, The Central Hospital of Yongzhou, Yongzhou, Hunan, China

Search for other papers by Shide Jiang in
Google Scholar
PubMed
Close
,
Volotovski Pavel Republican Scientific and Practical Center of Traumatology and Orthopedics, Minsk, Belarus

Search for other papers by Volotovski Pavel in
Google Scholar
PubMed
Close
,
Djandan Tadum Arthur Vithran Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Djandan Tadum Arthur Vithran in
Google Scholar
PubMed
Close
,
Wenfeng Xiao Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Wenfeng Xiao in
Google Scholar
PubMed
Close
, and
Yusheng Li Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, Hunan, China
National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China

Search for other papers by Yusheng Li in
Google Scholar
PubMed
Close

  • Reverse total shoulder arthroplasty (rTSA) has been demonstrated to be an effective intervention for various shoulder disorders. The number of rTSA-related studies performed has increased annually over the past three decades.

  • The Journal of Shoulder and Elbow Surgery had the highest number of publications and citations in the rTSA-related research domain and is therefore considered to be the most influential journal in this field.

  • The USA published the most publications and established a high degree of cooperation with many countries worldwide. The University of Florida, the Hospital for Special Surgery, and Rush University, Mayo Clinic were representative and active institutions in this field.

  • It is anticipated that advancements in prosthesis design, specifically with regards to lateralized design concepts, expanding indications for rTSA, a trend toward younger patient populations, and the management of postoperative complications will emerge as research hotspots in the following years.

  • The most valuable publications, influential journals, major researchers, and leading countries were analyzed. The findings of our study will help researchers gain insights into current research hotspots and frontiers and shape their research focus in the field of rTSA.

Open access
Laura Walthert Department of Orthopaedic and Traumatology, CHUV, Lausanne, Switzerland

Search for other papers by Laura Walthert in
Google Scholar
PubMed
Close
,
Michael Ris Department of Orthopaedic and Traumatology, CHUV, Lausanne, Switzerland

Search for other papers by Michael Ris in
Google Scholar
PubMed
Close
,
Kevin Moerenhout Department of Orthopaedic and Traumatology, CHUV, Lausanne, Switzerland

Search for other papers by Kevin Moerenhout in
Google Scholar
PubMed
Close
,
Sébastien Déglise Department of Vascular Surgery, CHUV, Lausanne, Switzerland

Search for other papers by Sébastien Déglise in
Google Scholar
PubMed
Close
,
Pietro Giovanni Di Summa Department of Plastic and Hand Surgery, CHUV, Lausanne, Switzerland

Search for other papers by Pietro Giovanni Di Summa in
Google Scholar
PubMed
Close
, and
Sylvain Steinmetz Department of Orthopaedic and Traumatology, CHUV, Lausanne, Switzerland

Search for other papers by Sylvain Steinmetz in
Google Scholar
PubMed
Close

  • Major amputations of the lower extremity may be required after trauma and a variety of underlying diseases such as peripheral vascular disease, diabetes, and malignancies.

  • The goal of any major amputation is an optimal functional result with a maximum limb length in combination with optimal wound healing. The preservation of the knee joint is essential for successful rehabilitation, and this is best achieved by the Burgess below-knee amputation (BKA).

  • Whenever a BKA is not possible, the Gritti–Stokes amputation is our first choice.

  • This technique mainly consists of a through-knee amputation with the creation of a pedicled patella flap consisting of the patella, patellar ligament, and overlying soft tissue. After osteotomy of the distal femur and resection of the articular surface of the patella, the anterior flap is rotated in order to cover the femur defect while performing a patellofemoral arthrodesis.

  • The aim of this paper is to describe our surgical technique and experience with GSA and to point out the important steps of this procedure.

  • In conclusion, GSA is an excellent surgical option for patients requiring major lower limb amputations where BKA cannot be considered. Particular attention must be paid to careful preoperative evaluation and optimization of comorbidities. A meticulous surgical technique is warranted, including atraumatic tissue handling and an optimal patellofemoral arthrodesis technique.

Open access
Victor Housset Clinique de l'épaule, Clinique Maussins-Nollet, Paris, France

Search for other papers by Victor Housset in
Google Scholar
PubMed
Close
,
Sean Wei Loong Ho Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore

Search for other papers by Sean Wei Loong Ho in
Google Scholar
PubMed
Close
,
Alexandre Lädermann Division of Orthopaedics and Trauma Surgery, Hôpital de La Tour, Meyrin, Switzerland
FORE (Foundation for Research and Teaching in Orthopedics, Sports Medicine, Trauma, and Imaging in the Musculoskeletal System), Meyrin, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland

Search for other papers by Alexandre Lädermann in
Google Scholar
PubMed
Close
,
Sean Kean Ann Phua Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore

Search for other papers by Sean Kean Ann Phua in
Google Scholar
PubMed
Close
,
Si Jian Hui Department of Orthopaedic Surgery, National University Health System, Singapore

Search for other papers by Si Jian Hui in
Google Scholar
PubMed
Close
, and
Geoffroy Nourissat Clinique de l'épaule, Clinique Maussins-Nollet, Paris, France

Search for other papers by Geoffroy Nourissat in
Google Scholar
PubMed
Close

Purpose

  • A variety of instabilities are grouped under multidirectional instability (MDI) of the shoulder. This makes understanding its diagnostic process, presentation and treatment difficult due to lack of evidence-based consensus. This review aims to propose a novel classification for subtypes of MDI.

Methods

  • A systematic search was performed on PubMed Medline and Embase. A combination of the following 'MeSH' and 'non-MesH' search terms were used: (1) Glenohumeral joint[tiab] OR Glenohumeral[tiab] OR Shoulder[tiab] OR Shoulder joint[tiab] OR Shoulder[MeSH] OR Shoulder joint[MeSH], (2) Multidirectional[tiab], (3) Instability[tiab] OR Joint instability[MeSH]. Sixty-eight publications which met our criteria were included.

Results

  • There was a high degree of heterogeneity in the definition of MDI. Thirty-one studies (46%) included a trauma etiology in the definition, while 23 studies (34%) did not. Twenty-five studies (37%) excluded patients with labral or bony injuries. Only 15 (22%) studies defined MDI as a global instability (instability in all directions), while 28 (41%) studies considered MDI to be instability in two directions, of which one had to include the inferior direction. Six (9%) studies included the presence of global ligamentous laxity as part of the definition. To improve scientific accuracy, the authors propose a novel AB classification which considers traumatic etiology and the presence of hyperlaxity when subdividing MDI.

Conclusion

  • MDI is defined as symptomatic instability of the shoulder joint in two or more directions. A comprehensive classification system that considers predisposing trauma and the presence of hyperlaxity can provide a more precise assessment of the various existing subtypes of MDI.

Level of Evidence

  • III

Open access
Tarik Ait-Si-Selmi Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Santé, 55 Avenue Jean Mermoz, Lyon, France
Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Tarik Ait-Si-Selmi in
Google Scholar
PubMed
Close
,
Jean-Pierre Vidalain Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Jean-Pierre Vidalain in
Google Scholar
PubMed
Close
,
Sonia Ramos-Pascual ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Sonia Ramos-Pascual in
Google Scholar
PubMed
Close
,
Thomas Kuratle ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Thomas Kuratle in
Google Scholar
PubMed
Close
,
Mo Saffarini ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Mo Saffarini in
Google Scholar
PubMed
Close
,
Edouard Dejour ReSurg SA, Rue Saint Jean 22, Nyon, Switzerland

Search for other papers by Edouard Dejour in
Google Scholar
PubMed
Close
, and
Michel P Bonnin Centre Orthopédique Santy, Hôpital Privé Jean Mermoz, Ramsay Santé, 55 Avenue Jean Mermoz, Lyon, France
Artro Institute, 8, rue du Pont de Thé, Annecy Le Vieux, France

Search for other papers by Michel P Bonnin in
Google Scholar
PubMed
Close

Purpose

  • to systematically review comparative studies reporting revision rates, clinical outcomes, or radiographic outcomes of total hip arthroplasty (THA) using collared versus collarless conventional-length uncemented hydroxyapatite (HA)-coated stems.

Methods

  • In adherence with PRISMA guidelines, a literature search was performed on Medline, Embase, and Scopus. Comparative clinical studies were eligible if they reported outcomes of collared versus collarless uncemented HA-coated stems for primary THA. Two reviewers screened titles, abstracts, and full-texts to determine eligibility; then performed data extraction; and assessed the quality of studies according to Joanna Briggs Institute (JBI) checklist.

Results

  • The search returned 972 records, 486 were duplicates, and 479 were excluded after title/abstract/full-text screening. Three further studies were included from the references of eligible studies and from discussions with subject matter experts, resulting in 11 included studies. The JBI checklist indicated six studies scored ≥7 points and four studies ≥4 points. Pooled data revealed collared stems had significantly lower revision rates (OR = 0.45; 95% CI = 0.31–0.64) and subsidence (MD = −1 mm; 95% CI = −1.6–-0.3), but no significant difference in intraoperative complication rates (OR = 0.94; 95% CI = 0.67–1.32) in the short term to mid-term. Unpooled data indicated that collared stems provide equivalent survival, equivalent or better outcomes, and equivalent or lower complication rates.

Conclusion

  • In comparative studies, collared stems have lower revision rates than collarless stems, as well as equivalent or better clinical and radiographic outcomes. Differences could be due to a protective effect that the collar offers against subsidence, particularly in undersized or misaligned stems. Further studies are warranted to confirm long-term results and better understand differences between registry data and clinical studies.

Open access