Abstract:
INTRODUCTION:The incidence of periprosthetic femoral fracture is constantly increasing, with high associated morbidity and mortality. Surgical treatment is guided by the Vancouver classification, but the influence of type of treatment on morbidity and mortality has been little analyzed. The theoretical advantage of implant revision over internal fixation is that it should allow earlier weight-bearing, although the impact of this on morbidity and mortality and autonomy has not been demonstrated. We conducted a case-control study, to assess the influence of type of treatment (implant revision or internal fixation) (1) on mobility and autonomy and (2) on morbidity and mortality. HYPOTHESIS:The study hypothesis was that clinical results and morbidity and mortality do not differ between these two types of treatment. METHODS:A retrospective study included 70 patients with a total of 71 femoral periprosthetic fractures treated between 2007 and 2014. Two treatment groups, comparable for mean age, gender and ASA and Parker scores, were studied. Mean age was 78±13.5years (range, 23-95years). Thirty-six fractures (50.7%) were treated by implant revision via a posterolateral approach, using a revision stem with (n=11) or without cement (n=25) (REVISION group); immediate postoperative weight-bearing was authorized. Thirty-five fractures (49.3%) were treated by open reduction and internal fixation, using a locking plate (ORIF group); weight-bearing was authorized only in the third month. Mean follow-up was 43±27months (range, 0.75-107months). RESULTS:Autonomy on Parker score was reduced by 2 points at 1year's follow-up. Mean preoperative scores were 7.32±1.79 (range, 3-9) and 7.43±1.79 (range, 4-9) in the REVISION and ORIF group, respectively, (p=0.8), falling to 5.06±2.6 (range, 0-9) and 4.5±2.01 (range, 0-9) respectively at follow-up (p=0.349). Sixteen patients in the REVISION group versus 13 in the ORIF group had made adaptations in their home or changed place of residence (p=0.2). At last follow-up, 18 patients (28.6%) had died: 12 (37.5%) in the ORIF and 6 (19.3%) in the REVISION group (p<0.05). Survival with death as endpoint at a mean 3.5years was 88±11% in the REVISION group versus 51±11% in the ORIF group (p=0.02). Three implant replacements were performed in each group (p=0.83). Twelve medical or surgical complications occurred in the ORIF group (37.5%) and 11 in the REVISION group (34%) (p=0.9). CONCLUSION:Implant revision for periprosthetic femoral fracture showed significantly lower overall mortality than internal fixation, without difference in terms of treatment failure or complications requiring revision surgery. LEVEL OF EVIDENCE:Level III, case-control study.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Cohen S,Flecher X,Parratte S,Ollivier M,Argenson JNdoi
10.1016/j.otsr.2017.12.018subject
Has Abstractpub_date
2018-05-01 00:00:00pages
363-367issue
3issn
1877-0568pii
S1877-0568(18)30043-4journal_volume
104pub_type
杂志文章abstract:PURPOSE:Advances in small arthroscopy have enabled a minimally invasive surgery for thumb carpometacarpal joints. However, surgery is often difficult using standard CM-radial (CM-R) and CM-ulnar portals (CM-U). Here, we describe the clinical applications and complications associated with using thenar portal (TP) and st...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.04.009
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Acute Achilles tendon rupture can be treated conservatively or surgically. Open surgery restores tendon continuity but carries a risk of skin complications. Tenolig(®) is a device designed for the percutaneous biological treatment of acute Achilles tendon rupture. Earlier studies found high rates of recurren...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.09.018
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Valgus high tibial osteotomy is considered to be an effective treatment for unicompartmental medial osteoarthritis. It is generally admitted that tibial slope increases after open-wedge high tibial osteotomy and decreases after closing-wedge high tibial osteotomy. However, the effects on posterior tibial s...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2011.08.013
更新日期:2012-02-01 00:00:00
abstract:INTRODUCTION:There is concern regarding potential non-union of the fibula following distraction osteogenesis and if non-union of the fibula leads to poor outcome. HYPOTHESIS:Assess the incidence of fibula non-union in patients undergoing distraction osteogenesis of the tibia and to report the effects on patient outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.09.012
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Cemented versions of dual-mobility cups (DMCs), helpful in cases of bone stock alteration, are usually used in association with a reinforcement device. To simplify the intervention in elderly subjects or those with a poor bone stock, the cups can be cemented directly into the bone, but the long-term result...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.09.027
更新日期:2015-12-01 00:00:00
abstract:INTRODUCTION:The coracoacromial ligament is a complex anatomical structure involved in the development of subacromial impingement; treatment is founded on sectioning the ligament, with or without associated arthroscopic acromioplasty and debridement. HYPOTHESIS:Complete coracoacromial ligament section can be performed...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2013.09.018
更新日期:2014-04-01 00:00:00
abstract::A 56-year-old patient presented with neurological disorders resulting from an extrinsic medullary compression extending from T3 to T5 associated with a T4 corporeal invasion by a high-grade non-Hodgkin's malignant lymphoma. Treatment consisted in a laminectomy without spinal stabilization followed immediately by chemo...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.03.007
更新日期:2009-06-01 00:00:00
abstract:INTRODUCTION:Glenohumeral arthrodesis is a rare salvage procedure for selected patients with different shoulder pathologies. Among a variety of surgical techniques, compression screws or plate fixation are most widely used. Minimally invasive screw fixation has become more popular, although it has been shown to be biom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2017.05.021
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:The intrawound application of vancomycin powder in addition to intravenous administration of antibiotics has been reported to be an easy and cost-efficient technique for reducing the deep infection, which is a serious complication of spinal surgeries. The aim of the present meta-analysis was to derive a prel...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.otsr.2014.05.022
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:There is no consensus about the necessity of exchanging a stable femoral component during revision total hip arthroplasty (RTHA) when only the acetabular component requires replacement. Sparing the femoral component reduces morbidity, but can make acetabular replacement technically more difficult. Moreover...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.08.014
更新日期:2012-02-01 00:00:00
abstract:UNLABELLED:Extensor digitorum tendon (EDT) tear in the wrist is frequently associated with inflammation (rheumatoid arthritis, chondrocalcinosis) or distal radio-ulnar osteoarthritis. EDT protection and repair is often hampered by poor tissue trophicity and associated procedures. We describe an extensor retinaculum (ER...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.03.005
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Heterotopic ossification (HO) is a common complication of elbow fracture surgery that can significantly impair function and range of motion (ROM). Whereas numerous studies have assessed HO after hip trauma or replacement surgery, few data have been reported on the prevalence and risk factors of HO after elbo...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.10.021
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope® reduction with results after acromioclavicular transfixation via K-wires only and additional...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.11.009
更新日期:2017-04-01 00:00:00
abstract:INTRODUCTION:During tibial lengthening procedures, it is recommended to prevent fibular malleolus proximal migration using a distal tibiofibular syndesmotic screw, which is removed at 6 months. We have observed proximal migrations of the fibular malleolus despite placement of this syndesmotic screw. OBJECTIVE:The obje...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.06.011
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The initial treatment of congenital idiopathic clubfoot (CIC) is nonoperative. Either the French physiotherapy method or the Ponseti casting method may be used. Whether either method is superior over the other remains unclear. However, the method used initially is not the only determinant of the final outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2016.07.012
更新日期:2016-12-01 00:00:00
abstract:INTRODUCTION:Shoulder arthroscopy is particularly suited to outpatient surgery, thanks to advances in anesthetic and analgesic techniques. The main goal of this study was to compare postoperative recovery after shoulder arthroscopy between outpatient and inpatient management. HYPOTHESIS:There is no difference in funct...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.10.010
更新日期:2018-02-01 00:00:00
abstract::Extra- and intra-articular proximal tibia malunion is not uncommon. Functional impact is variable but may lead to almost total impotence. The present study aimed to provide a review on malunion, answering 5 questions: (1) How should malunion be classified, and with what pathogenicity? Malunion results from reduction d...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2019.03.018
更新日期:2020-02-01 00:00:00
abstract:INTRODUCTION:Lumbar fusion is now a currently accepted treatment for degenerative lumbar spondylolisthesis (DLSP), but may induce adjacent segment degeneration (ASD). The present study hypothesis was that there are radiological parameters associated with ASD. The study objective was to determine predictive factors of A...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.03.012
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Burnout syndrome is one of the manifestations of distress in healthcare workers and is characterised by emotional exhaustion (EE), depersonalisation (DP), and a sense of low personal accomplishment (PA). The surgical residency is a period of intense training that imposes major challenges on future surgeons, ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.08.016
更新日期:2018-12-01 00:00:00
abstract:INTRODUCTION:Chronic scapholunate instability can lead to functional deficits and radiocarpal osteoarthritis. A number of procedures, namely scapho-trapezio-trapezoid (STT) fusion, scaphocapitate (SC) fusion or soft tissue reconstruction procedures, aim to improve function while protecting the wrist from osteoarthritis...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2010.11.006
更新日期:2011-04-01 00:00:00
abstract:BACKGROUND:The limits of the glenoid track have been defined through methods that do not take properly into account the physiological articular forces involved in the articular contact, which may interfere with its size. Finite elements numerical models can simulate joint forces more realistically. OBJECTIVE:To evalua...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.03.004
更新日期:2020-06-01 00:00:00
abstract:INTRODUCTION:Freiberg's disease is osteonecrosis of the dorsal side of a metatarsal head. The gold-standard surgical treatment is the osteotomy procedure first described by Gauthier. HYPOTHESIS:Gauthier osteotomy for Freiberg's disease will restore the joint space and lead to long-term clinical improvement. A retrospe...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.07.010
更新日期:2015-10-01 00:00:00
abstract:INTRODUCTION:Elastic stable intramedullary nailing (ESIN) has transformed children's femoral shaft fracture treatment, but this technique requires an image intensifier. Without it, open reduction is used to check fracture reduction and pin passage. The aim of this study was to describe our techniques and to evaluate ou...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.05.006
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Hip dislocation is one of the most frequent complications of total hip replacement. The direction of dislocation matters. Most dislocations are posterior; anterior dislocation remains rare and its treatment is controversial. STUDY OBJECTIVES:To clinically and radiologically evaluate the outcomes of the cons...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2009.08.003
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:The potential value of proximal femoral locking compression plate (PFLCP) for extracapsular femoral fractures has been discussed in several case reports; however, clinical control studies are lacking. Therefore, we performed a case control study to assess: (1) If PFLCP offers better functional results and ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.06.012
更新日期:2014-10-01 00:00:00
abstract:INTRODUCTION:Occupational infection of clinical health care workers with blood-borne viruses (BBVs) like human immunodeficiency virus (HIV), hepatitis B virus (HBV) or hepatitis C virus (HCV) is a current and often emotionally discussed issue. HCV and especially HIV are still stigmatized. The consequence is a broad and...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.02.012
更新日期:2016-06-01 00:00:00
abstract::Management of knee bone loss after gunshot trauma requires a multidisciplinary approach. Two cases of knee arthroplasty after devastating ballistic trauma are reported. Treatment comprised several steps: sampling, bone resection, reinforced cement spacer, latent sepsis control, and prosthetic reconstruction. The patie...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.08.014
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:The treatment of total hip arthroplasty (THA) infections is long and costly. However,the number of studies in the literature analysing the real cost of THA revision in relation to their etiology, including infection, is limited. The aim of this retrospective study was to determine the cost of revision of i...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.rcot.2010.02.005
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Tibial plateau fractures are notoriously difficult to manage, particularly when there is a medial or posteromedial component. We report a retrospective analysis of our experience with consecutive tibial plateau fractures including a medial component that were managed using a single lateral locking plate. HY...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.10.009
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Proprioception makes a critical contribution to body balance. The objective of this study was to evaluate static postural control after anterior cruciate ligament (ACL) reconstruction combined with medial meniscus (MM) suture, comparatively to healthy controls. HYPOTHESIS:Body balance is adversely affecte...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.07.015
更新日期:2015-11-01 00:00:00