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Orthopaedic Trauma Surgery - State of the Art and Future Perspectives

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: closed (20 April 2022) | Viewed by 8293

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Prof. Dr. Hans Christoph Pape

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Guest Editor

Department of Trauma, University of Zurich, 100 Raemi Street, 8091 Zurich, Switzerland
Interests: multiple trauma; orthopaedic trauma surgery; major fracture; soft tissue trauma; critical care medicine; intensive care medicine; mechanical ventilation; biomechanics

Special Issue Information

Dear Colleagues,

This issue deals with special considerations for the assessment and treatment of patients with severe isolated injuries and a polytrauma situation. It is a combination of original work and reviews which summarize the state of the art of trauma care. The subject deals with the management of various severe injuries, which by themselves or in combination can cause posttraumatic complications. These injuries can be generated in the chest, abdomen, pelvis, spine, or the extremities. Complications that have to be dealt with are fat embolism syndrome, adult respiratory distress syndrome, multiple organ dysfunction, or systemic inflammatory response syndrome. Manuscripts are invited which deal with isolated injuries of the body regions mentioned above, or injuries affecting multiple ones. Initial management in the emergency room and subsequent care and planning of fracture fixations are of interest.

Prof. Dr. Hans-Christoph Pape
Guest Editor

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Keywords

Polytrauma
Major fracture
Soft tissue trauma
Soft tissue injury
Fat embolism syndrome
Pelvic ring injury
Femur fracture
Patient assessment

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Published Papers (3 papers)

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Research

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10 pages, 13334 KiB

Open AccessArticle

Arthroscopy-Assisted Reduction and Internal Fixation versus Open Reduction and Internal Fixation for Glenoid Fracture with Scapular Involvement: A Retrospective Cohort Study

by I-Hao Lin, Tsung-Li Lin, Hao-Wei Chang, Chia-Yu Lin, Chun-Hao Tsai, Chien-Sheng Lo, Hui-Yi Chen, Yi-Wen Chen and Chin-Jung Hsu

J. Clin. Med. 2022, 11(4), 1131; https://doi.org/10.3390/jcm11041131 - 21 Feb 2022

Cited by 6 | Viewed by 2690

Abstract

Background: We investigated the superiority of arthroscopy-assisted reduction and internal fixation (ARIF) to open reduction and internal fixation (ORIF) for treating glenoid fracture with scapular involvement. Methods: We retrospectively enrolled patients with glenoid fracture who underwent ARIF or ORIF from 2010–2020. Radiographic outcomes were assessed, and clinical outcomes (active range of motion [ROM], visual analog scale [VAS], Constant, and Disabilities of the Arm, Shoulder and Hand [DASH]) were evaluated 12 months postoperatively. Results: Forty-four patients with Ideberg type II–VI glenoid fractures (ARIF: 20; ORIF: 24; follow-up 12–22 months) were included. Union was achieved in all patients. Active ROM values were comparable between the approaches. Constant and DASH scores were non-significantly better with ARIF (90.9 ± 9.2 vs. 86.6 ± 18.1 [p = 0.341] and 6.8 ± 9.4 vs. 9.3 ± 21.3 [p = 0.626], respectively). However, VAS scores were significantly lower with ARIF (1.5 ± 0.6 vs. 2.7 ± 1.4, p = 0.001). Associated intra-articular lesions (articular depressions [80%], superior labral anterior-posterior tear [20%], labral tears [30%]) were found in most ARIF cases and were repaired during ARIF. Conclusions: For glenoid fracture with scapular involvement, ARIF allows accurate diagnosis of fracture pattern and the management of associated intra-articular lesions, with better pain control outcomes than ORIF. Thus, arthroscopy-assistant surgery should be considered in patient with glenoid fracture. Full article

(This article belongs to the Special Issue Orthopaedic Trauma Surgery - State of the Art and Future Perspectives)

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11 pages, 3099 KiB

Open AccessArticle

Is Anterior Plating Superior to the Bilateral Use of Retrograde Transpubic Screws for Treatment of Straddle Pelvic Ring Fractures? A Biomechanical Investigation

by Moritz F. Lodde, J. Christoph Katthagen, Clemens O. Schopper, Ivan Zderic, R. Geoff Richards, Boyko Gueorguiev, Michael J. Raschke and René Hartensuer

J. Clin. Med. 2021, 10(21), 5049; https://doi.org/10.3390/jcm10215049 - 28 Oct 2021

Cited by 7 | Viewed by 2639

Abstract

Background: Fractures of the four anterior pubic rami are described as “straddle fractures”. The aim of this study was to compare biomechanical anterior plating (group 1) versus the bilateral use of retrograde transpubic screws (group 2). Methods: A straddle fracture was simulated in 16 artificial pelvises. All specimens were tested under progressively increasing cyclic loading, with monitoring by means of motion tracking. Results: Axial stiffness did not differ significantly between the groups, p = 0.88. Fracture displacement after 1000–4000 cycles was not significantly different between the groups, p ≥ 0.38; however, after 5000 cycles it was significantly less in the retrograde transpubic screw group compared to the anterior plating group, p = 0.04. No significantly different flexural rotations were detected between the groups, p ≥ 0.32. Moreover, no significant differences were detected between the groups with respect to their cycles to failure and failure loads, p = 0.14. Conclusion: The results of this biomechanical study reveal less fracture displacement in the retrograde transpubic screw group after long-term testing with no further significant difference between anterior plating and bilateral use of retrograde transpubic screws. While the open approach using anterior plating allows for better visualization of the fracture site and open reduction, the use of bilateral retrograde transpubic screws, splinting the fracture, presents a minimally invasive and biomechanically stable technique. Full article

(This article belongs to the Special Issue Orthopaedic Trauma Surgery - State of the Art and Future Perspectives)

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Review

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15 pages, 679 KiB

Open AccessReview

Incidence of Fat Embolism Syndrome in Femur Fractures and Its Associated Risk Factors over Time—A Systematic Review

by Maximilian Lempert, Sascha Halvachizadeh, Prasad Ellanti, Roman Pfeifer, Jakob Hax, Kai O. Jensen and Hans-Christoph Pape

J. Clin. Med. 2021, 10(12), 2733; https://doi.org/10.3390/jcm10122733 - 21 Jun 2021

Cited by 17 | Viewed by 6682

Abstract

Background: Fat embolism (FE) continues to be mentioned as a substantial complication following acute femur fractures. The aim of this systematic review was to test the hypotheses that the incidence of fat embolism syndrome (FES) has decreased since its description and that specific injury patterns predispose to its development. Materials and Methods: Data Sources: MEDLINE, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases were searched for articles from 1 January 1960 to 31 December 2019. Study Selection: Original articles that provide information on the rate of FES, associated femoral injury patterns, and therapeutic and diagnostic recommendations were included. Data Extraction: Two authors independently extracted data using a predesigned form. Statistics: Three different periods were separated based on the diagnostic and treatment changes: Group 1: 1 January 1960–12 December 1979, Group 2: 1 January 1980–1 December 1999, and Group 3: 1 January 2000–31 December 2019, chi-square test, χ² test for group comparisons of categorical variables, p-value < 0.05. Results: Fifteen articles were included (n = 3095 patients). The incidence of FES decreased over time (Group 1: 7.9%, Group 2: 4.8%, and Group 3: 1.7% (p < 0.001)). FES rate according to injury pattern: unilateral high-energy fractures (2.9%) had a significantly lower FES rate than pathological fractures (3.3%) and bilateral high-energy fractures (4.6%) (p < 0.001). Conclusions: There has been a significant decrease in the incidence of FES over time. The injury pattern impacts the frequency of FES. The diagnostic and therapeutic approach to FES remains highly heterogenic to this day. Full article

(This article belongs to the Special Issue Orthopaedic Trauma Surgery - State of the Art and Future Perspectives)

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