Radiographic outcome of children older than twenty-four months with developmental dysplasia of the hip treated by closed reduction and spica cast immobilization in human position: a review of fifty-one hips
ConclusionsOur study showed that stable CR could be achieved in 76.5% of patients aged 24 to 36  months with DDH at the time of index procedure. Satisfactory outcomes can be expected in 56.4% of the cases (5.0% AVN rate), although late acetabular dysplasia may develop in 43.6% of the hips. (Source: International Orthopaedics)
Source: International Orthopaedics - April 12, 2019 Category: Orthopaedics Source Type: research

Risk factors and failures in the management of limb injuries in combat casualties
ConclusionsTwo main risk factors of treatment failure are highlighted: those in relation to traumatic mechanisms and general lesional assessment and those in relation to surgical site conditions. There is no over risk of failure in relation to surgical procedure and treatment. (Source: International Orthopaedics)
Source: International Orthopaedics - April 11, 2019 Category: Orthopaedics Source Type: research

Computer-assisted virtual surgical technology in pre-operative design for the reconstruction of calcaneal fracture malunion
AbstractPurposeNo computer-assisted pre-operative design for calcaneal fracture malunions has been presented. The aim of the study is to evaluate the intra-operative realization of computer-assisted pre-operative planning (CAPP) and the clinical outcomes based on computer-assisted virtual surgical technology for calcaneal malunions.MethodsBetween 2010 and 2016, 20 patients with 21 calcaneal fracture malunions were retrospectively reviewed with the average follow-up time of 22.3  months (range, 12 to 43 months), which were operatively treated with the help of CAPP. The CAPP steps included the image segmentation, e...
Source: International Orthopaedics - April 10, 2019 Category: Orthopaedics Source Type: research

General and specialized Orthopaedics
(Source: International Orthopaedics)
Source: International Orthopaedics - April 10, 2019 Category: Orthopaedics Source Type: research

Outcomes of cerclage wiring to manage intra-operative femoral fracture occurring during cementless hemiarthroplasty in older patients with femoral neck fractures
ConclusionOur results revealed a low mean distance of distal stem migration and a low subsidence rate. Functional outcomes and quality of life were similar between the two groups. Cerclage wiring technique is safe, and it should be routinely performed when intra-operative femoral fracture occurs during cementless hemiarthroplasty. (Source: International Orthopaedics)
Source: International Orthopaedics - April 9, 2019 Category: Orthopaedics Source Type: research

Age and “general health”—beside fracture classification—affect the therapeutic decision for geriatric pelvic ring fractures: a German pelvic injury register study
ConclusionThe results of the present study underline the importance of the factors age and general health besides fracture classification for therapeutic decision-making in the treatment of pelvic ring fractures in the elderly. (Source: International Orthopaedics)
Source: International Orthopaedics - April 4, 2019 Category: Orthopaedics Source Type: research

Risk factors for recurrent lumbar disc herniation after discectomy
ConclusionsLumbosacral transitional vertebrae and a hypermobile disc in flexion-extension radiography were found to be risk factors for recurrent lumbar disc herniation. (Source: International Orthopaedics)
Source: International Orthopaedics - March 30, 2019 Category: Orthopaedics Source Type: research

Outcomes of percutaneous endoscopic trans-articular discectomy for huge central or paracentral lumbar disc herniation
ConclusionPETAD could be a good alternative for treatment of huge central/paracentral LDH. (Source: International Orthopaedics)
Source: International Orthopaedics - March 30, 2019 Category: Orthopaedics Source Type: research

Contemporary cemented versus uncemented hemiarthroplasty for the treatment of displaced intracapsular hip fractures: a meta-analysis of forty-two thousand forty-six hips
ConclusionsThis meta-analysis shows that contemporary cemented prostheses have less intra-operative and post-operative fractures, but longer operative time, more intra-operative blood loss, and heterotopic ossifications. Otherwise, there were no significant differences between both groups. (Source: International Orthopaedics)
Source: International Orthopaedics - March 27, 2019 Category: Orthopaedics Source Type: research

External fixation for primary and definitive management of open long bone fractures: the Syrian war experience
ConclusionThe use of external fixation for definitive treatment of open long bone shaft fractures caused by high energy trauma during times of wars or conflicts is reliable and should be used in early frontline intervention and in areas with limited access to resources. (Source: International Orthopaedics)
Source: International Orthopaedics - March 23, 2019 Category: Orthopaedics Source Type: research

Comorbidity and mortality after hip fracture in nineteen thousand six hundred and eighty two patients aged eighteen to sixty five  years in Denmark from 1996 to 2012
ConclusionHeart disease and diabetes were associated with high mortality in the young patients while having cancer was associated with high mortality in the middle-aged patients. (Source: International Orthopaedics)
Source: International Orthopaedics - March 23, 2019 Category: Orthopaedics Source Type: research

Significant improvement in patient self-assessed comfort and function at six weeks after the smooth and move procedure for shoulders with irreparable rotator cuff tears and retained active elevation
This study sought to demonstrate that clinically significant g ains in comfort, function, and active motion can be realized as early as 6 weeks after this procedure.MethodsWe conducted a prospective cohort study of the 6-week clinical outcomes for 48 patients enrolled prior to a smooth and move procedure for irreparable rotator cuff tears. Prior rotator cuff repair had been attempted in 28 (70%).ResultsIn 40 patients with preoperative and 6-week postoperative measurements, the Simple Shoulder Test scores improved from an average of 3.4  ± 2.8 preoperatively to 5.7 ± 3.5 at 6 weeks (p 
Source: International Orthopaedics - March 22, 2019 Category: Orthopaedics Source Type: research

Comparison of sinus tarsi approach versus extensile lateral approach for displaced intra-articular calcaneal fractures Sanders type IV
ConclusionSimilar clinical and radiographic outcomes are achieved between STA and ELA. And STA has a lower incidence of wound healing complication and sural nerve injury. Therefore, ORIF via STA can be a considerable management for DIACFS IV. (Source: International Orthopaedics)
Source: International Orthopaedics - March 22, 2019 Category: Orthopaedics Source Type: research

Disc herniation and disc disease: the present and the future of management
(Source: International Orthopaedics)
Source: International Orthopaedics - March 20, 2019 Category: Orthopaedics Source Type: research

Joint replacement surgery in Ghana (West Africa)
(Source: International Orthopaedics)
Source: International Orthopaedics - March 20, 2019 Category: Orthopaedics Source Type: research

Is ceramics an appropriate bone morphogenetic protein delivery system for clinical use?
(Source: International Orthopaedics)
Source: International Orthopaedics - March 15, 2019 Category: Orthopaedics Source Type: research

Lumbar disc  herniation: long-term outcomes after mini-open discectomy
ConclusionsNearly 2/3 of our patient series keep satisfactory outcomes after about 15-year follow-up. The mini open discectomy remains a reliable surgical technique provided we respect the indications and surgical requirements. This procedure also avoids excessive instrumentation and its possible iatrogenic complications. Powerful randomized and controlled trials are needed to strengthen these deductions. (Source: International Orthopaedics)
Source: International Orthopaedics - March 8, 2019 Category: Orthopaedics Source Type: research

Cup alignment in total hip arthroplasty using the muscle-sparing modified Watson-Jones approach —comparison between lateral and supine positions
AbstractPurposeThe present study aimed to compare the cup alignment outliers in total hip arthroplasty (THA) using the same surgical approach with the patient in the supine position versus the lateral position.MethodsTHA using the muscle-sparing modified Watson-Jones approach was performed in 142 consecutive hips. THA was performed with the patient in the lateral position in 84 hips (lateral group) and in the supine position in 58 hips (supine group). The cup alignment was aimed at 40 ° inclination and 20° anteversion by referring to the mechanical alignment guide. Cup alignment and outliers (10° > &t...
Source: International Orthopaedics - March 6, 2019 Category: Orthopaedics Source Type: research

Comment on Medina et al.: orthopaedic surgery patients who use recreational marijuana have less pre-operative pain
(Source: International Orthopaedics)
Source: International Orthopaedics - March 5, 2019 Category: Orthopaedics Source Type: research

Strength of suture-button fixation versus ligament reconstruction in syndesmotic injury: a biomechanical study
ConclusionThe stability of the suture-button fixation was equivalent to ligament reconstruction using semitendinosus tendon autograft in treatment of syndesmotic injury as determined with biomechanical testing. However, this study does not prove that one is advantageous over the other. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials
AbstractPurposeOsteoarthritis (OA) is one of the most common causes of disability and a prevalent chronic disease. The use of collagen is growing due to the satisfactory results in the treatment of OA. However, the possible beneficial effects of collagen for the treatment of OA are currently controversial. The aim of the present meta-analysis was to evaluate the effect of collagen-based supplements on OA symptoms.MethodsPubMed-Medline, Scopus, and Google Scholar databases were searched for randomized placebo-controlled trials evaluating the effect of orally administered collagen on OA symptoms using the Western Ontario and...
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Osteonecrosis of the femoral head: genetic basis
ConclusionTaken together, these associations may lead to new pathways of bone repair and remodeling while opening new avenues for therapeutic targets. Knowledge of genetic variations could help identify individuals considered to be at higher risk of developing ONFH and prevent the multiple hit effect. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Clinical application of a minimally invasive cement-augmentable Schanz screw rod system to treat pelvic ring fractures
ConclusionThe investigated Schanz screw rod system is a suitable implant to broaden the established procedures to stabilize dorsal pelvic ring fractures.Trial registrationThe study is registered at the Clinical Trial Registry University of Regensburg (Number Z-2017-0878-3). (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

The correlation of sagittal osteotomy inclination and the anteroposterior translation in medial open-wedge high tibial osteotomy —one of the causes affecting the patellofemoral joint?
ConclusionHigh rates of anterior-inclined osteotomy have been described previously as well as in this study. Anterior-inclined osteotomy tends to result in the anterior translation of the proximal fragment. This may result in increased vertical vector force onto the patellofemoral joint, which further accelerates patellofemoral joint degeneration. Therefore, surgeons should attempt to perform parallel osteotomy or avoid anterior displacement of the proximal fragment if there is concern of anterior-inclined osteotomy. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Socioeconomic factors and individual lifestyles influencing the incidence of patella fractures: a national population-based survey in China
ConclusionsSpecific public health policies focusing on decreasing alcohol consumption should be implemented. Individuals aged 45 –64 and 65–74 should pay more attention to bone mass density and prevention of falls, especially those with previous history of fracture. (Source: International Orthopaedics)
Source: International Orthopaedics - March 1, 2019 Category: Orthopaedics Source Type: research

Decision-making algorithm for sequential treatment of diaphyseal bone gaps in war-wounded patients in the Middle East
ConclusionsLess invasive procedures may lead to better patient outcomes, although unfortunately may not always be possible given the nature of the injury and/or injury site. (Source: International Orthopaedics)
Source: International Orthopaedics - February 23, 2019 Category: Orthopaedics Source Type: research

Reply to “Letter to the Editor on: The impact of the third fragment features on the healing of femoral shaft fractures managed with intramedullary nailing: a radiological study”
(Source: International Orthopaedics)
Source: International Orthopaedics - February 23, 2019 Category: Orthopaedics Source Type: research

Perceived skills for sports performance after primary hip arthroplasty: a cross-sectional study
ConclusionsA significant number of patients return to sports after hip arthroplasty and most of them perceive a good athletic performance after surgery. These findings should enrich the pre-operative assessment of patient ’s expectations, particularly for those who wish to resume physical activity. (Source: International Orthopaedics)
Source: International Orthopaedics - February 19, 2019 Category: Orthopaedics Source Type: research

Congenital orthopaedic limp deformities in Corpus Hippocraticum
AbstractDuring the fifth century BC in ancient Greece during the eve of orthopaedics, the Hippocratic School of Medicine diagnosed a series of congenital limb deformities. Congenital dislocation of the arm, elbow, wrist, hip, knee, tarsotibial joint, apex leg, as well as talipes valgus (clubfoot), congenital clavicle fractures, and thumb malfunction were all discussed by Hippocrates and his followers. Ancient Greek medico-philosophers, fond of a “perfect” human body, proposed an immediate non-interventional approach, while archaic orthotics and specialized footwear were suggested. The Hippocratic methodology wa...
Source: International Orthopaedics - February 15, 2019 Category: Orthopaedics Source Type: research

Lumbar disc herniation: what has the Spine Patient Outcomes Research Trial taught us?
ConclusionsThis report reviewed the current state of SPORT publications related to IDH to identify and summarize what we have learned about diagnosis, patient characteristics, treatments, outcomes, and cost-effectiveness in patients with lumbar disc herniations. Many important findings are now published from this robust trial ’s data. Clinicians should incorporate these results into their clinical decision-making and during counseling patients presenting with lumbar disc herniations. (Source: International Orthopaedics)
Source: International Orthopaedics - February 15, 2019 Category: Orthopaedics Source Type: research

Autologous mesenchymal stem cell implantation, hydroxyapatite, bone morphogenetic protein-2, and internal fixation for treating critical-sized defects: a translational study
ConclusionsThe combination of autologous BM-MSCs, HA granules, and BMP-2 is safe and remains to be a good option for the definitive treatment for CSD with previous failed surgical attempts. Further studies with a larger sample size are required to be done. (Source: International Orthopaedics)
Source: International Orthopaedics - February 12, 2019 Category: Orthopaedics Source Type: research

Haematology panel biomarkers for humeral, femoral, and tibial diaphyseal fractures
AbstractPurposeThe neutrophil to lymphocyte ratio (NLR) is a simple predictor used in oncology and cardiology. We aimed to analyze the NLR profile of patients with diaphyseal fractures of the humerus, femur, and tibia.MethodsWe performed a cross-sectional, consecutive-case population-based study including 148 patients (41.9% men respectively 58.1% women) with humeral (23.0%), femoral (30.4%), and tibial (46.6%) diaphyseal fractures, admitted for surgical treatment in our level 1 trauma centre over two  years.ResultsThe differences in NLR between the studied subgroups were not significant (p = 0.067), the h...
Source: International Orthopaedics - February 6, 2019 Category: Orthopaedics Source Type: research

Single-stage treatment of infected tibial non-unions and osteomyelitis with bone marrow granulocytes precursors protecting bone graft
(Source: International Orthopaedics)
Source: International Orthopaedics - February 2, 2019 Category: Orthopaedics Source Type: research

A “thank you” editorial concerning the evolution and growth of “International Orthopaedics”, the journal team, outstanding authors and acknowledged expert reviewers
(Source: International Orthopaedics)
Source: International Orthopaedics - February 2, 2019 Category: Orthopaedics Source Type: research

Correction to: A biomechanical comparison of different fixation techniques for fractures of the acetabular posterior wall
In the original publication, the following authors have been omitted due to a technical error in the original article: (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

The impact of obesity on resource utilization among patients undergoing total joint arthroplasty
AbstractPurposeThe presence of obesity poses a challenge for clinical and administrative staff in the peri-operative setting. Evidence indicates that obesity may increase peri-operative complications. However, data on resource utilization in patients undergoing total knee and hip arthroplasty remain rare. Using national data, we sought to determine whether increasing levels of patient obesity is associated with greater resource utilization. We hypothesized that patient care in individuals with a body mass index (BMI) greater than 40 is associated with longer operative and anaesthetic times, longer hospital stays, and great...
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Parallel versus orthogonal plate osteosynthesis of adult distal humerus fractures: a meta-analysis of biomechanical studies
ConclusionsThis meta-analysis shows that parallel constructs provide greater axial stiffness, axial strength, and torsional stiffness than orthogonal plate for DHF fixation. A subgroup analysis revealed that parallel constructs had better torsional stiffness in supracondylar fracture fixation.Level of evidenceIA (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Correction to: Denosumab does not decrease the risk of lung metastases from bone giant cell tumour
Last and second name of an author have been mixed up. It shows Piergiuseppe as the last name, but his second name is Tanzi and the first name is Piergiuseppe. (Source: International Orthopaedics)
Source: International Orthopaedics - February 1, 2019 Category: Orthopaedics Source Type: research

Randomised clinical trial assessing migration of uncemented primary total hip replacement stems, with and without autologous impaction bone grafting
ConclusionsAutologous impaction bone grafting in uncemented primary THR has shown its short-term post-operative outcomes to be equivalent to standard uncemented technique, whilst offering a better fit in patients who are between femoral stem sizes.Australian clinical trial registration numberACTRN12618000652279. (Source: International Orthopaedics)
Source: International Orthopaedics - January 31, 2019 Category: Orthopaedics Source Type: research

Lateral column lengthening versus subtalar arthroereisis for paediatric flatfeet: a systematic review
ConclusionsThe LCL group has achieved more radiographic corrections and more improvements in the AOFAS score than the AR group. Complications were more common in the LCL group than in the AR group, and the re-operation rates were similar between the two groups. (Source: International Orthopaedics)
Source: International Orthopaedics - January 30, 2019 Category: Orthopaedics Source Type: research

Comparison of the modified Heuter approach and the Kocher-Langenbeck approach in the treatment of Pipkin type I and type II femoral head fractures
AbstractPurposeTo evaluate and compare the effectiveness of the modified Heuter approach and the Kocher-Langenbeck approach in the treatment of Pipkin type I and II femoral head fractures.MethodsThe study cohort consisted of 39 patients with Pipkin type I or type II femoral head fractures who were treated by open reduction and internal fixation through the modified Heuter approach (the Heuter group) or the Kocher-Langenbeck approach (the K-L group) between June 2013 and January 2016. Standard radiographs and computed tomography (CT) scans were obtained before surgery and during the follow-up. The two approaches were compar...
Source: International Orthopaedics - January 25, 2019 Category: Orthopaedics Source Type: research

Can surgical site infections be controlled through microbiological surveillance? A three-year laboratory-based surveillance at an orthopaedic unit, retrospective observatory study
ConclusionsThe infection control was a significant problem at the studied orthopaedic unit, as evidenced by the SSI incidence rate significantly higher than expected. We suggest implementing the infection control and prevention based on evidence-based medicine, and a unit-based surveillance. A cumulative unit-based antibiogram reflects the drug-susceptibility pattern for the strains from the infections acquired at the unit. (Source: International Orthopaedics)
Source: International Orthopaedics - January 24, 2019 Category: Orthopaedics Source Type: research

Joint replacement surgery in Ghana (West Africa) —an observational study
ConclusionThis observational study could serve as a springboard for establishment of arthroplasty registries for countries in the sub-region as a whole. (Source: International Orthopaedics)
Source: International Orthopaedics - January 24, 2019 Category: Orthopaedics Source Type: research

Tibiofemoral dislocation after primary total knee arthroplasty: a systematic review
ConclusionsImproved implant design has reduced the rate of tibiofemoral dislocation, although this complication remains serious in both the short and the long term. The present review identified patient- and surgeon-related risk factors. Awareness of the former, which are identifiable pre-operatively, and of the most frequent technical errors is critical. (Source: International Orthopaedics)
Source: International Orthopaedics - January 23, 2019 Category: Orthopaedics Source Type: research

Use of a fibrin sealant within a blood-saving protocol in patients undergoing revision hip arthroplasty: effects on post-operative blood transfusion and healthcare-related cost analysis
AbstractPurposeBlood transfusion and blood management are important aspects in orthopaedic surgery. Strategies include intra-operative and post-operative blood salvage and even the use of fibrin sealant in selected case. Objectives of the study were (1) to compare the total number of transfusions and the length of hospital stay in patients undergoing complete revision hip arthroplasty (RHA) with and without the use of a fibrin sealant (EVICEL ®) and (2) to evaluate the possible role in cost savings of EVICEL® in association with the blood-saving protocol.MethodsRetrospective observational study evaluating patients ...
Source: International Orthopaedics - January 23, 2019 Category: Orthopaedics Source Type: research

Inferior displacement of greater tuberosity fracture suggests  an occult humeral neck fracture: a retrospective single-centre study
AbstractPurposeTo radiographically characterize the relationship between inferior displacement of great tuberosity (GT) fracture and associated occult or minor displaced humeral neck fracture.MethodsThirty patients with inferior displacement of the GT on the initial anterior-posterior (AP) view X-ray were included in this study. Twenty-four patients received further computed tomography (CT) scans. One patient with negative CT scans underwent MRI. Radiographic indexes included the cervico-diaphyseal angle, the distance of the inferior displacement of the GT fracture, the apex-tuberosity distance, and the direction of the GT...
Source: International Orthopaedics - January 21, 2019 Category: Orthopaedics Source Type: research

Thoracic disc herniation, avoidance, and management of the surgical complications
In this study, we aim to describe the most common complications that can occur during or after surgical management of thoracic disc herniations. Furthermore, we describe tips and tricks for avoidance and, if necessary, management of surgical complications. Common complications addressed in this review include vertebral column instability, neurologic injury, cerebrospinal fluid leak/pleural fistula, thoracic viscera injury, wrong level surgery, incomplete disk resection, and intercostal neuralgia. (Source: International Orthopaedics)
Source: International Orthopaedics - January 21, 2019 Category: Orthopaedics Source Type: research

The Ganz acetabular reinforcement ring shows excellent long-term results when used as a primary implant: a retrospective analysis of two hundred and forty primary total hip arthroplasties with a minimum follow-up of twenty  years
AbstractPurposeThe acetabular reinforcement ring with a hook (ARRH) has been designed for acetabular total hip arthroplasty (THA) revision. Additionally, the ARRH offers several advantages when used as a primary implant especially in cases with altered acetabular morphology. The implant facilitates anatomic positioning by placing the hook around the teardrop and provides a homogenous base for cementing the polyethylene cup. Therefore, the implant has been widely used in primary total hip arthroplasty at our institution. The present study reports the long-term outcome of the ARRH after a minimum follow-up of 20  years....
Source: International Orthopaedics - January 20, 2019 Category: Orthopaedics Source Type: research

Two-stage hip revision arthroplasty for periprosthetic joint infection without the use of spacer or cemented implants
ConclusionWe demonstrated a high success rate for two-stage exchange of infected total hip arthroplasty. Spacer-free treatment does not negatively affect success rate or function. Implantation of an uncemented pressfit prosthesis was possible in all patients. (Source: International Orthopaedics)
Source: International Orthopaedics - January 18, 2019 Category: Orthopaedics Source Type: research

Lateral femoral sliding osteotomy in total knee arthroplasty with valgus deformity greater than twenty degrees
This study aims to investigate its utility in TKA with valgus deformity greater than 20 °, for which few studies have examined.MethodsConsecutive TKA patients with valgus deformity treated with the sliding osteotomy at our institution were retrospectively studied. Constraint implants were not used. Radiological and clinical parameters at follow-ups were compared with those pre-operatively. Radiological parameters included the hip-knee-ankle angle (HKA), the anatomical lateral distal femoral angle (aLDFA), the anatomical lateral plateau ankle angle (aLPTA), and the angle between the femoral mechanical axis and transepic...
Source: International Orthopaedics - January 18, 2019 Category: Orthopaedics Source Type: research