Abstract:
INTRODUCTION:Nonunion is a common complication after intramedullary nailing of subtrochanteric femoral fractures. A more detailed knowledge, particularly of avoidable risk factors for subtrochanteric fracture nonunion, is thus desired to develop strategies for reducing nonunion rates. The aim of the present study therefore was to analyse a wide range of parameters as potential risk factors for nonunion after intramedullary nailing of subtrochanteric fractures. MATERIALS AND METHODS:Seventy-four patients who sustained a subtrochanteric fracture and were treated by femoral intramedullary nailing at a single level 1 trauma centre within a 6-year period were included in this study. A total of 15 patient-related, fracture-related, surgery-related, mechanical and biological parameters were analysed as potential risk factors for nonunion. Furthermore, the accuracy of each of these parameters to predict nonunion was calculated. RESULTS:Nonunion occurred in 17 of 74 patients (23.0%). Of the 15 potential risk factors analysed, only 3 were found to have a significant effect on the nonunion rate (p < 0.05): postoperative varus malalignment, postoperative lack of medial cortical support and autodynamisation of the nail within the first 12 weeks post-surgery. Accuracy of each of these 3 parameters to predict nonunion was > 0.70. Furthermore, the nonunion rate significantly increased with the number of risk factors (no risk factor: 2.9%, one risk factor: 23.8%, two risk factors: 52.9%, and three risk factors: 100% [Chi-square test, p = 0.001)]. CONCLUSIONS:Our study indicates that intraoperative correction of varus malalignment and restoration of the medial cortical support are the most critical factors to prevent nonunion after intramedullary nailing of subtrochanteric femoral fractures. In addition, autodynamisation of the nail within the first 3 months post-surgery is a strong predictor for failure and should result in revision surgery.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Krappinger D,Wolf B,Dammerer D,Thaler M,Schwendinger P,Lindtner RAdoi
10.1007/s00402-019-03131-9subject
Has Abstractpub_date
2019-06-01 00:00:00pages
769-777issue
6eissn
0936-8051issn
1434-3916pii
10.1007/s00402-019-03131-9journal_volume
139pub_type
杂志文章abstract:INTRODUCTION:Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromiocl...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-019-03258-9
更新日期:2020-04-01 00:00:00
abstract:PURPOSE:The physical examination of the shoulder is usually not reliable for the true diagnosis of superior glenoid labrum anterior to posterior (SLAP) lesions. Magnetic resonance imaging (MRI) has been routinely used for the diagnosis. This prospective study investigates the radiological diagnosis of the SLAP lesions ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2605-7
更新日期:2017-02-01 00:00:00
abstract:INTRODUCTION:Commonly used headless design screws such as Acutrak and Herbert screws have limited compressive effect on short fragment fixation. Therefore, we investigated whether preloaded compression techniques could be helpful in improving the compression effect. METHOD:A prototype of interfragmentary compression s...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0971-0
更新日期:2009-12-01 00:00:00
abstract:INTRODUCTION:This study was undertaken to compare the clinical outcomes between the conservative treatment and pull-out repair of the medial meniscus root tear (MMRT), and to analyze the prognostic factors of the MMRT repair for the determination of repair indication. MATERIALS AND METHODS:38 patients, diagnosed with ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2269-8
更新日期:2015-09-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to evaluate outcomes after reverse shoulder arthroplasty for the treatment of complex three- and four-fragment proximal humeral fractures after mean follow-up time of 45 months and to compare our results with the results published by other authors. MATERIALS AND METHODS:Retro...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2751-6
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Pelvic ring injuries are serious injuries, often associated with substantial morbidity and mortality rates. The long-term consequences of these injuries might affect the patients' personal life. Our aim was to assess the long-term effects of pelvic ring injuries on physical functioning and quality of life (Q...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03170-2
更新日期:2019-09-01 00:00:00
abstract::The cortical bone mineral density (BMD), bone volume, bone mass and muscle volume of the thigh, and the BMD of the distal femur and proximal tibia were measured quantified by quantitative computed tomography (QCT) after an operation for a displaced femoral neck fracture. Twenty patients were randomized to osteosynthes...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00387579
更新日期:1997-01-01 00:00:00
abstract:PURPOSE:To evaluate changes in hospital length-of-stay and time-to-operation of older hip fracture patients before and after the foundation of a co-managed Geriatric Fracture Center (GFC). METHODS:A co-managed GFC was established in a German level-1 trauma center. In a retrospective cohort study, we analyzed femoral n...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1845-z
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:Although long bone defects may be treated by callus distraction, frequent complications arise from the long duration of external fixation. To reduce such complications, bone transport over an intramedullary nail (BTON) has been done for tibial bone defect. METHODS:In 12 patients (mean age, 46.1 years) of ch...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0491-8
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Total hip arthroplasty (THA) is a challenging option for the treatment of posttraumatic arthritis due to acetabular fractures. METHODS:The study aimed to determine the short- and mid-term clinical and radiographic results of THA following acetabular fracture. The fracture pattern, the extent of injury and t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03272-x
更新日期:2020-03-01 00:00:00
abstract:INTRODUCTION:The direct anterior approach (DAA) is an increasingly popular technique for performing total hip arthroplasty (THA). This muscle-sparing approach may yield functional benefits. However, DAA has been associated with an increased risk incidence (RI) of intra- and postoperative complications. MATERIALS AND M...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00402-015-2258-y
更新日期:2015-08-01 00:00:00
abstract:INTRODUCTION:We present a single-surgeon series of 14 acute ruptured distal biceps tendons repaired using a biotenodesis screw through a single anterior incision. PATIENTS:The demographics of this population reveal a typical injury pattern and reflect the preponderance of distal biceps ruptures in the middle aged, act...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-009-0974-x
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:Proximal ulna fractures are common in orthopaedic surgery. Comminuted fractures require a high primary stability by the osteosynthesis, to allow an early functional rehabilitation as fast as possible, to reduce long-term limitations of range of motion. Classical dorsal plating is related to wound healing p...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03473-9
更新日期:2020-05-16 00:00:00
abstract::A case of painful junctura tendinum of the hand extensors is presented. This rare condition may have developed because of anatomical factors, including the type of connection and location of the junctura, and because of the unique position that the fingers assume during bowling. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050275
更新日期:1998-01-01 00:00:00
abstract::We report on a patient with a 3-week-old acetabular fracture and pelvic ring disruption, in whom supra-acetabular osteotomy was performed for reduction and internal fixation of the fracture. Fourteen months after surgery, the results are satisfactory and the patient is walking without aids. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00441840
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Metal-on-metal (MoM) bearings are known to release metal ions secondary to wear and corrosion. This may cause local reactions (adverse soft tissue reactions and osteolysis) and systemic effects. Little is known about the exact pattern and the differences between large head MoM total hip replacements (THA) ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2439-3
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:To date, reports of surgical treatment of spontaneous osteonecrosis of the knee (SPONK) refractory to non-operative treatment have primarily focused on knee arthroplasty. This report presents an overview of the characteristics of SPONK and reports our experience with joint-preserving surgical treatment of th...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-009-0872-2
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:The airbag is an established car safety device. However, recent studies pointed out that even the airbag might cause injuries. Nevertheless, most physicians do consider a lower risk in accident victims sustaining severe injury of the chest, when a deployed frontal airbag has been reported. We set out to ve...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-006-0181-y
更新日期:2006-10-01 00:00:00
abstract:INTRODUCTION:Fractures of the radial head and associated elbow instability can be treated with operation with radial head prosthesis. In this study, we evaluate function 1-7 years after implantation and also function after removal of five prostheses. MATERIAL AND METHODS:Eighteen patients with radial head fracture and...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0032-2
更新日期:2006-04-01 00:00:00
abstract:PURPOSE:Purpose of this study was to establish and validate an MRI-associated classification to graduate postoperative results of MPFL reconstructions. METHODS:30 autologous MPFL reconstructions of 28 patients were evaluated by two independent raters using MRI. All grafts were assigned to a novel graduation system res...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2349-9
更新日期:2016-02-01 00:00:00
abstract:INTRODUCTION:The main purpose of our study was to evaluate intra-articular lesions in glenohumeral-instability with arthroscopy and correlate them with clinical findings as well as history of instability. MATERIAL AND METHODS:In this prospective multi-centre study, we evaluated arthroscopic findings in 303 patients wi...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00402-005-0006-4
更新日期:2006-05-01 00:00:00
abstract::Using a model of meniscal injury in rabbit, the effects of hyaluronic acid (HA) injection into the joint on the rate of filling area and the cell shape in the defects were studied. After a cylindrical defect was made in the anterior horn of the lateral meniscus, HA was injected into the joint once a week. At 1 and 6 w...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050255
更新日期:1998-01-01 00:00:00
abstract::Total knee arthroplasty (TKA) has been shown to have good long-term outcomes and survivorship. Nonetheless, dissatisfied patients are frequently reported in the literature. Bi-cruciate retaining total knee prostheses (BCR TKA) were designed to address the demand for more kinematically functional implants that better r...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-020-03622-0
更新日期:2020-10-13 00:00:00
abstract:INTRODUCTION:There are very few reports on the use of a free composite flap from the toe to repair small tissue defects in the hand. Here, we describe our experience using a free composite flap from the great toe and second toe. METHOD:Fifteen patients sought surgical treatment for tissue defects of the hand at our me...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-012-1626-0
更新日期:2013-01-01 00:00:00
abstract::The most common fracture of the proximal fifth metatarsal is the tuberosity avulsion fracture. Most of the time, the fracture is relatively undisplaced and it can be treated conservatively with a hard-soled shoe or walking cast. For painful intra-articular nonunion, internal fixation with or without bone graft is the ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0556-8
更新日期:2008-11-01 00:00:00
abstract:INTRODUCTION:Osteopetrosis is caused by general increase in bone density and obliteration of the medullary canal. Fractures are a frequent complication and their management is considered a challenge due to increased resistance to reaming and screw positioning; reduction maneuvers have to be done more carefully to avoid...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-2144-z
更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:The biological response of the muscles around the knee in chronic ligamentous instability was investigated in an animal study. MATERIALS AND METHODS:There were four groups of 6- to 9-month-old adult New Zealand albino rabbits (2500-3300 g). The animals were divided into groups according to the ligament th...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-003-0633-6
更新日期:2004-11-01 00:00:00
abstract::There is little information available regarding the sagittal mechanical axis of the lower extremity of normal subjects under weight-bearing conditions. The purpose of this study was to determine the sagittal alignment of the lower extremity under such conditions. Anteroposterior and lateral radiographs were taken of t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0528-z
更新日期:2008-04-01 00:00:00
abstract:BACKGROUND:Either one- or two-stage revision arthroplasties can be used for the treatment of chronic periprosthetic joint infection (PJI) after total hip arthroplasty (THA). We report our results following two-stage revision surgery performed through the direct anterior approach (DAA) interval using a custom-made artic...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03317-1
更新日期:2020-02-01 00:00:00
abstract:PURPOSE:Polyethylene (PE) wear remains a common reason for revision surgery following total hip arthroplasty (THA). An established treatment method is isolated liner exchange in a well-fixed acetabular cup and entails a known high risk of hip dislocation after revision surgery. The purpose of this retrospective study w...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-020-03603-3
更新日期:2020-11-01 00:00:00