BACKGROUND Adult distal humeral fractures(DHF)comprise 2%-5%of all fractures and 30%of all elbow fractures.Treatment of DHF may be technically demanding due to fracture complexity and proximity of neurovascular struct...BACKGROUND Adult distal humeral fractures(DHF)comprise 2%-5%of all fractures and 30%of all elbow fractures.Treatment of DHF may be technically demanding due to fracture complexity and proximity of neurovascular structures.Open reduction and internal fixation(ORIF)are often the treatment of choice,but arthroplasty is considered in case of severe comminution or in elderly patients with poor bone quality.Ulnar nerve affection following surgical treatment of distal humerus fractures is a well-recognized complication.AIM To report the risk of ulnar nerve affection after surgery for acute DHFs.METHODS We retrospectively identified 239 consecutive adult patients with acute DHFs who underwent surgery with ORIF,elbow hemiarthroplasty(EHA)or total elbow arthroplasty(TEA)between January 2011 and December 2019.In all cases,the ulnar nerve was released in situ without anterior transposition.We used our institutional database to review patients’medical records for demographics,fracture morphology,type of surgery and ulnar nerve affection immediately;records were reviewed after surgery and at 2 wk and 12 wk of routine clinical outpatient follow-up.Twenty-nine percent patients were excluded due to pre-or postoperative conditions.Final follow-up examination was a telephone interview in which ulnar nerve affection was reported according to the McGowen Classification Score.A total of 210 patients were eligible for interview,but 13 patients declined participation and 17 patients failed to respond.Thus,180 patients were included.RESULTS Mean age at surgery was 64 years(range 18-88 years);121(67.3%)patients were women;59(32.7%)were men.According to the AO/OTA classification system,we recorded 47 patients with type A3,55 patients with type B and 78 patients with type C fractures.According to the McGowen Classification Score,mild ulnar nerve affection was reported in nine patients;severe affection,in two.A total of 69 patients were treated with ORIF of whom three had mild temporary ulnar nerve affection and one had severe ulnar nerve 展开更多
AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and...AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 stud展开更多
文摘BACKGROUND Adult distal humeral fractures(DHF)comprise 2%-5%of all fractures and 30%of all elbow fractures.Treatment of DHF may be technically demanding due to fracture complexity and proximity of neurovascular structures.Open reduction and internal fixation(ORIF)are often the treatment of choice,but arthroplasty is considered in case of severe comminution or in elderly patients with poor bone quality.Ulnar nerve affection following surgical treatment of distal humerus fractures is a well-recognized complication.AIM To report the risk of ulnar nerve affection after surgery for acute DHFs.METHODS We retrospectively identified 239 consecutive adult patients with acute DHFs who underwent surgery with ORIF,elbow hemiarthroplasty(EHA)or total elbow arthroplasty(TEA)between January 2011 and December 2019.In all cases,the ulnar nerve was released in situ without anterior transposition.We used our institutional database to review patients’medical records for demographics,fracture morphology,type of surgery and ulnar nerve affection immediately;records were reviewed after surgery and at 2 wk and 12 wk of routine clinical outpatient follow-up.Twenty-nine percent patients were excluded due to pre-or postoperative conditions.Final follow-up examination was a telephone interview in which ulnar nerve affection was reported according to the McGowen Classification Score.A total of 210 patients were eligible for interview,but 13 patients declined participation and 17 patients failed to respond.Thus,180 patients were included.RESULTS Mean age at surgery was 64 years(range 18-88 years);121(67.3%)patients were women;59(32.7%)were men.According to the AO/OTA classification system,we recorded 47 patients with type A3,55 patients with type B and 78 patients with type C fractures.According to the McGowen Classification Score,mild ulnar nerve affection was reported in nine patients;severe affection,in two.A total of 69 patients were treated with ORIF of whom three had mild temporary ulnar nerve affection and one had severe ulnar nerve
基金the University of Toledo College of Medicine and Life Sciences’ Medical Student Summer Research Program
文摘AIM To compare infection rates in primary and revision total knee arthroplasty(TKA) procedures using antibiotic impregnated bone cement(AIBC) to those rates in procedures not using AIBC.METHODS A systematic review and meta-analysis was conducted in search for randomized controlled trials/studies(RCTs) pertaining to the field of antibiotic AIBC vs non-AIBC groups in both primary and revision TKA procedures. The primary literature search performed was to identify all RCTs that assessed AIBC in primary and revision TKA procedures. This search was done strictly through the Pub Med database using the article "filters" setting that identified and separated all RCTs from the overall search. The original search was "Primary/revision total knee arthroplasty using AIBC". Other key terms and phrases were included in the search as well. Eligible articles that were used in the "results" of this review met the following criteria:(1) Involved primary or revision TKA procedures(for any reason);(2) included TKA outcome infection rate information;(3) analyzed an AIBC group vs a non-AIBC control group;(4) were found through the RCT filter or hand search in Pub Med; and(5) published 1985-2017. Exclusion criteria was as follows:(1) Patients that were not undergoing primary or revision TKA procedures;(2) articles that did not separate total hip arthroplasity(THA) vs TKA results if both hip and knee revisions were evaluated;(3) papers that did not follow up on clinical outcomes of the procedure;(4) extrapolation of data was not possible given published results;(5) knee revisions not done on human patients;(6) studies that were strictly done on THAs;(7) articles that were not found through the RCT filter or through hand search in Pub Med;(8) articles that did not evaluate AIBC used in a prosthesis or a spacer during revision;(9) articles that did not compare an AIBC group vs a non-AIBC control group; and(10) articles that were published before 1985.RESULTS In total, 11 articles were deemed eligible for this analysis. Nine of the 11 stud