Review
Orthopedics
Dominique Saragaglia, Ramsay Refaie
Summary: Clavicle fractures are common injuries, with sports being a major cause. For displaced mid-shaft fractures in athletes and young active individuals, surgical treatment is often considered the best option.
INTERNATIONAL ORTHOPAEDICS
(2021)
Article
Orthopedics
Tzu-Hao Wang, Hao-Chun Chuang, Fa-Chuan Kuan, Chih-Kai Hong, Ming-Long Yeh, Wei-Ren Su, Kai-Lan Hsu
Summary: The study showed that open cerclage wiring significantly improved the reduction of femoral shaft fractures, without affecting the union rate.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2021)
Article
Orthopedics
Seung-Min Youn, Jong Dae Kim, Ho Yeon Jeong, Kyunghan Ro, Myung Seo Kim, Yong Girl Rhee, Sung-Min Rhee
Summary: The standard technique for treating simple mid shaft clavicular fractures, which involves open reduction and internal fixation with a plate and screws, often results in large incisions and keloid scar formation. Other minimally invasive techniques, such as retrograde intramedullary fixation with a posterolateral entry point on the shoulder, also have their own complications. This article presents a surgical technique of antegrade intramedullary fixation for mid shaft clavicular fractures, along with a case series.
JOURNAL OF ORTHOPAEDIC TRAUMA
(2022)
Article
Orthopedics
Willem-Jan Metsemakers, Kirsten Kortram, Nando Ferreira, Mario Morgenstern, Alexander Joeris, Hans-Christoph Pape, Christian Kammerlander, Sanjit Konda, Jong-Keon Oh, Peter V. Giannoudis, Kenneth A. Egol, William T. Obremskey, Michael H. J. Verhofstad, Michael Raschke
Summary: The management of tibial shaft fractures remains a challenge despite advances in modern fracture care. The F.R.O.S.T. registry aims to create a global database to support future clinical decisions by evaluating the association between different treatment strategies and patient outcomes. This prospective, international, multicenter registry seeks to address knowledge gaps and optimize strategies to prevent severe musculoskeletal complications.
BMC MUSCULOSKELETAL DISORDERS
(2021)
Article
Orthopedics
Jou-Hua Wang, Hao-Chun Chuang, Wei-Ren Su, Wei-Lun Chang, Fa-Chuan Kuan, Chih-Kai Hong, Kai-Lan Hsu
Summary: Iatrogenic comminution is not rare in antegrade interlocking nailing of simple femoral shaft fractures and is associated with a higher nonunion rate. Age older than 35 shows a trend toward an increased risk of iatrogenic comminution. In multivariate analysis, open reduction technique, IC occurrence, and higher BMI are significantly correlated with fracture nonunion.
BMC MUSCULOSKELETAL DISORDERS
(2022)
Article
Orthopedics
Liang Ren, Zhiqiang Yang, Yongqing Wang, Sapkota Basanta, Bosong Du, Zhuo Gao, Baoxi Hao, Renhui Chen
Summary: Comparing the effectiveness of threaded elastic intramedullary nail and elastic locking intramedullary nail (ELIN) for mid-shaft clavicular fractures, the study found that ELIN can prevent shortening and malunion of the clavicle, reduce secondary damage to related tissues, and lead to restoration of clavicle length and faster osseous healing.
ORTHOPAEDIC SURGERY
(2021)
Article
Orthopedics
Yuan Quan, Hao Lu, Peng Qi, Songyao Tian, Jiantao Liu, Chunlong Zhang, Boyu Zhang, Hailin Xu
Summary: This study aimed to assess the mid-term prognosis of posterior malleolar fractures based on different morphological types and provides evidence for the treatment of these fractures. The study found that surgical fixation of the posterior malleolar fragment led to a better prognosis in fractures with a single fragment. All single fragments should be fixed regardless of size. Fixation of the posterior region in all single and multifragments in posterior malleolar fractures led to satisfactory outcomes.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2023)
Article
Orthopedics
Nicket Dedhia, Rachel A. Ranson, Samantha A. Rettig, Sanjit R. Konda, Kenneth A. Egol
Summary: Humeral shaft fractures account for 1-3% of all fractures and are mostly treated nonoperatively with a union rate of over 85%. There is conflicting evidence regarding whether proximal third fractures are more prone to nonunion. This study aimed to investigate the association between fracture location, fracture pattern, and development of nonunion in nonoperatively treated humeral shaft fractures. The results showed no significant association between fracture pattern or location and nonunion.
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
(2023)
Article
Biotechnology & Applied Microbiology
Li-Wei Hung, Hsuan-Yu Lu, Chung-Hsun Chang, Tsan-Yang Chen, Ting-Ming Wang, Tung-Wu Lu
Summary: Mid-shaft clavicle fractures account for 35-44% of shoulder injuries, with evidence supporting surgical repair but with reports of poor functional outcomes. Patients treated with surgery showed altered scapular protraction and retraction during arm elevations, with reduced clavicle retraction. Monitoring of shoulder kinematics following surgical treatment is important, with bilateral rehabilitative training potentially needed for improved movement control.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2021)
Article
Orthopedics
Mathieu Severyns, Dalila Belaid, Kevin Aubert, Ali Bouchoucha, Arnaud Germaneau, Tanguy Vendeuvre
Summary: This biomechanical study using finite element modelling aimed to evaluate the impact of variations in the mechanical axis of the lower limb on femoral diaphysis fracture. The results showed that varus axial deformation poses a higher risk for atypical femoral fractures (AFF). Therefore, variations in the mechanical axis of the lower limb can increase the risk of AFF.
JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
(2022)
Article
Orthopedics
Francois Egrise, Gilles Clowez, Nicolas Recanatesi, Jacques Tabutin, Paul Emile Borge, Olivier Gastaud
Summary: This study aimed to confirm the success of humeral shaft fracture treatment without distal locking and compare the outcomes with and without distal locking. The results showed that there were no significant differences in union rate, functional recovery, and range of motion between the two groups. However, the procedure without distal locking reduced operative time, fluoroscopy time, and the risk of neurological damage.
ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH
(2023)
Article
Orthopedics
Nicole M. Stevens, Blake J. Schultz, Dylan T. Lowe, Kenneth A. Egol
Summary: This article presents a treatment process and technique for nonunion of humeral shaft fracture in a 58-year-old female patient, including preparation of the nonunion site, direct compression of the fracture site using plate osteosynthesis, and iliac crest bone graft harvest and utilization.
JOURNAL OF ORTHOPAEDIC TRAUMA
(2021)
Article
Orthopedics
Kenneth A. Egol, Connor P. Littlefield, Timothy Walden, Philipp Leucht, Jaime Levine, Sanjit Konda
Summary: The study evaluated the outcomes of patients with nonunion tibia fractures who underwent soft tissue flap coverage, finding a high union rate and better functional scores in the flap coverage group.
JOURNAL OF ORTHOPAEDIC TRAUMA
(2021)
Article
Critical Care Medicine
Christopher M. Gibbs, Richard A. Wawrose, Blake R. Turvey, Gele B. Moloney, Peter A. Siska, Ivan S. Tarkin
Summary: This study found that using a lateral paratricipital approach for nonunion reconstruction of the humerus can decrease the risk of radial nerve injury. This surgical approach allows for exploration, decompression, neurolysis, and protection of the radial nerve before fracture manipulation and instrumentation. Similar to previous studies, conventional surgical approaches may predispose patients to a high rate of postoperative radial nerve palsy.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2022)
Article
Orthopedics
Briggs M. Ahearn, Ellen Shanley, Charles A. Thigpen, Stephan G. Pill, Michael J. Kissenberth
Summary: The study found that adolescent athletes with clavicular fractures predictably return to athletics, including collision sports. Athletes managed conservatively returned 40% faster than those with surgery, but this difference may be related to the severity and complexity of surgically treated fractures. This study offers evidence to guide adolescent athletes with clavicular fractures on expectations for returning to sports.
JOURNAL OF SHOULDER AND ELBOW SURGERY
(2021)
Article
Critical Care Medicine
J. A. Nicholson, L. Z. Yapp, J. F. Keating, A. H. R. W. Simpson
Summary: Fracture nonunion poses significant challenges to patients and society, with traditional radiographic monitoring having limitations. CT scanning is increasingly popular for evaluating bridging callus, while MRI and nuclear imaging advances show promise in assessing infected nonunion.
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
(2021)
Article
Orthopedics
Liam Z. Yapp, Leo Baxendale-Smith, Jamie A. Nicholson, Mark S. Gaston, Christopher M. Robinson
Summary: Recurrent instability following shoulder dislocation in patients aged 14 years or younger is relatively high, with a portion of patients requiring surgical intervention. Shoulder dislocation is not a benign event and requires close attention.
JOURNAL OF PEDIATRIC ORTHOPAEDICS
(2021)
Article
Orthopedics
Patrick G. Robinson, Thomas R. Williamson, Liam Z. Yapp, Christopher M. Robinson
Summary: The study demonstrated that the combined locking plate and open reduction-tunneled suspensory device fixation can effectively manage nonunion of lateral-end clavicle fractures, with excellent union rates and functional outcomes, as well as low complication rates. The most significant complication of this technique is subsequent metalwork removal.
JOURNAL OF SHOULDER AND ELBOW SURGERY
(2021)
Article
Orthopedics
L. Z. Yapp, N. D. Clement, M. Moran, J. Clarke, A. H. R. W. Simpson, C. E. H. Scott
Summary: This study aimed to determine the long-term mortality rate and associated factors following primary and revision knee arthroplasty. Retrospective analysis of data from the Scottish Arthroplasty Project revealed that the mortality rates for both primary and revision cohorts were lower than the general population. However, certain patient and surgical factors, such as periprosthetic joint infection (PJI), were associated with an increased risk of mortality within ten years post-surgery.
BONE & JOINT JOURNAL
(2022)
Article
Orthopedics
K. L. Elcock, T. H. Carter, L. Z. Yapp, D. J. MacDonald, C. R. Howie, A. Stoddart, G. Berg, N. D. Clement, C. E. H. Scott
Summary: This study compared the cost-effectiveness of total knee arthroplasty (TKA) in patients with a BMI above and below 40 kg/m(2). The results showed that although patients with a BMI of 40 kg/m(2) or higher had higher complication rates, TKA remained a cost-effective treatment compared to patients with a BMI below 40 kg/m(2).
BONE & JOINT JOURNAL
(2022)
Article
Cell & Tissue Engineering
L. Z. Yapp, C. E. H. Scott, C. R. Howie, D. J. MacDonald, A. H. R. W. Simpson, N. D. Clement
Summary: This study aimed to report the meaningful values of EQ-5D-3L questionnaire and EQ-VAS in patients undergoing primary knee arthroplasty. The study found that EQ-5D-3L questionnaire demonstrated good internal consistency and determined the minimum clinically important difference for evaluating clinically relevant changes. The findings of this study are of significance for assessing postoperative changes in patients' quality of life.
BONE & JOINT RESEARCH
(2022)
Article
Orthopedics
L. Z. Yapp, N. D. Clement, M. Moran, J. Clarke, A. H. R. W. Simpson, C. E. H. Scott
Summary: This study aimed to assess factors associated with the estimated lifetime risk of revision surgery after primary knee arthroplasty (KA). The results showed that patient sex, age, and underlying diagnosis were related to the risk of revision surgery.
BONE & JOINT JOURNAL
(2022)
Article
Orthopedics
L. Farrow, J. W. Kennedy, L. Yapp, T. Harding, P. Walmsley
Summary: This study retrospectively reviewed the cases of Revision Knee Arthroplasty (rTKA) in Scotland in 2019. The results showed that most centers could increase their surgical volumes by reorganizing services or providing rTKA within a region, which would improve access to Multidisciplinary Team (MDT) involvement. Additionally, a significant number of surgeons had very low surgical volumes, contradicting current evidence-based practice.
Article
Orthopedics
S. Gupta, L. Z. Yapp, D. Sadczuk, D. J. MacDonald, N. D. Clement, T. O. White, J. F. Keating, C. E. H. Scott
Summary: This study aimed to investigate the impact of tibial plateau fracture (TPF) on the health-related quality of life (HRQoL) of older adults (aged >= 60 years) compared to preinjury and population matched values. The results showed a significant decline in HRQoL after TPF and identified the importance of certain aspects of treatment to patients, such as returning to their own home, having a stable knee, and returning to normal function.
Article
Orthopedics
L. C. Walker, N. D. Clement, L. Z. Yapp, D. J. Deehan
Summary: The change in microorganism between the first and second stage of knee revision surgery is associated with treatment failure. Identifying this change prior to the second stage may improve the success of surgery.
Article
Orthopedics
C. E. H. Scott, G. T. Snowden, W. Cawley, K. R. Bell, D. J. MacDonald, G. J. Macpherson, L. Z. Yapp, N. D. Clement
Summary: This study examines the long-term patient-reported outcome measures (PROMs) following cemented single radius total knee arthroplasty (TKA). The results show significant and sustained improvements in PROMs, with the highest scores for Oxford Knee Score (OKS) observed at five years and for physical health at one year. Patient satisfaction remained high at 15 years.
Article
Orthopedics
Nick D. Clement, Liam Z. Yapp, Leo D. Baxendale-Smith, Deborah Macdonald, Colin R. Howie, Paul Gaston
Summary: The study aimed to compare the survival rates of cemented standard and short Exeter(R) V40 femoral stems in primary total hip arthroplasty (THA). The short stems had similar survival rates to the standard stems at 5- to 10-year follow-up, regardless of the design. The results suggest that the short stems offer comparable outcomes to the standard stems in terms of survival.
Article
Orthopedics
N. S. Makaram, J. A. Nicholson, L. Z. Yapp, M. Gillespie, C. P. Shah, C. M. Robinson
Summary: This study aimed to evaluate the effect of demographic factors and measures of instability severity on patient-reported outcome measures in patients who underwent an open Latarjet procedure. The results suggest that pre-existing demographic factors have a significant predictive role on surgical outcomes.
BONE & JOINT JOURNAL
(2023)
Article
Orthopedics
L. Z. Yapp, C. E. H. Scott, D. J. MacDonald, C. R. Howie, A. H. R. W. Simpson, N. D. Clement
Summary: This study aimed to investigate whether primary knee arthroplasty (KA) restores health-related quality of life (HRQoL) to levels expected in the general population. Using retrospective case-control design, HRQoL data from patients undergoing KA were compared with data from the Health Survey for England. The results showed that patients awaiting KA had poorer HRQoL compared to the general population, but one year after surgery, their HRQoL improved significantly and reached levels similar to their matched peers.
BONE & JOINT JOURNAL
(2023)
Article
Orthopedics
C. E. H. Scott, L. Z. Yapp, T. Howard, J. T. Patton, M. Moran
Summary: Periprosthetic femoral fractures, which are similar to pathological fractures, are increasing in frail elderly patients. The aim of treatment is to achieve immediate, unrestricted weightbearing with low complication rates and without stress risers that may lead to further fractures. The surgical approach, soft-tissue handling, and fracture exposure are crucial in minimizing complications.
BONE & JOINT JOURNAL
(2023)