To employ a simple and fast method to evaluate those patients with neurological deficits and misplaced screws in relatively safe lumbosacral spine, and to determine if it is necessary to undertake revision surgery. A total of 316 patients were treated by fixation of lumbar and lumbosacral transpedicle screws at our institution from January 2011 to December 2012. We designed the criteria for post-operative revision scores of pedicle screw malpositioning (PRSPSM) in the lumbosacral canal. We recommend the revision of the misplaced pedicle screw in patients with PRSPSM = 5′ as early as possible. However, patients with PRSPSM < 5′ need to follow the next consecutive assessment procedures. A total of 15 patients were included according to at least three-stage follow-up.Objectives
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Fundaments: The surgical management of proximal femoral extra-capsular fractures in the elderly remains controversial. Bone quality and purchase of the cephalic screw are the main limitations of the currently available therapeutic options, dynamic hip screws-blade and proximal femoral nailing systems being the standard fixation Methods: which however report a revision rate of 7% due to mechanical failures. Main complications include implant-related fractures and cut out of the head-neck device with subsequent penetration into the acetabulum. The new PFNATM helical blade appears to improve the stability of the whole construct by providing better compaction of the cephalic cancellous bone around the blade. Hypothesis, Type of Study: We conducted a retrospective radiographic-clinical study of a series of PFNATM osteosyntheses. Assessment of the mid-term results was based on the hypothesis that the PFNATM would reduce the occurrence of secondary deviations. Materials and Methods: Between 2006 and 2008, 108 osteosyntheses were performed. Only traumatic fractures were included in this study. Parker’s quality of life scoring system (0 to 9) and Harris hip score (0 to 100) were used for functional evaluation. The PFNA blade position was assessed using intraoperative radiographs while a postoperative radiographic control was performed during follow-up to evaluate the occurrence of complications. Results: 98 patients (98 hips) were reviewed at a mean follow-up of 5.3 months +/− 1.5. At last follow-up, the mean Parker score had decreased by 2.3 points and the Harris hip score by 24 points. All fractures united at an average time of 10.4 weeks (+/− 2.1). Six complications were reported (6.1%). They included 3 infections of the operative site and 3 cut-out of the femoral head. Three patients required reoperation for removal of the helical blade (3%): Two for significant migration and one for intra-acetabular penetration. No statistically significant risk factors could be observed. However, the three cut-out of the femoral head occurred in unstable fractures (type 31-A.2 and 31-A.3 according to the AO classification) with
Shoulder injury related to vaccine administration (SIRVA) is a prolonged episode of shoulder dysfunction that commences within 24 to 48 hours of a vaccination. Symptoms include a combination of shoulder pain, stiffness, and weakness. There has been a recent rapid increase in reported cases of SIRVA within the literature, particularly in adults, and is likely related to the mass vaccination programmes associated with COVID-19 and influenza. The pathophysiology is not certain, but placement of the vaccination in the subdeltoid bursa or other pericapsular tissue has been suggested to result in an inflammatory capsular process. It has been hypothesized that this is associated with a vaccine injection site that is “too high” and predisposes to the development of SIRVA. Nerve conduction studies are routinely normal, but further imaging can reveal deep-deltoid collections, rotator cuff tendinopathy and tears, or subacromial subdeltoid bursitis. However, all of these are common findings within a general asymptomatic population. Medicolegal claims in the UK, based on an incorrect injection site, are unlikely to meet the legal threshold to determine liability. Cite this article:
Post-traumatic periprosthetic acetabular fractures are rare but serious. Few studies carried out on small cohorts have reported them in the literature. The aim of this work is to describe the specific characteristics of post-traumatic periprosthetic acetabular fractures, and the outcome of their surgical treatment in terms of function and complications. Patients with this type of fracture were identified retrospectively over a period of six years (January 2016 to December 2021). The following data were collected: demographic characteristics, date of insertion of the prosthesis, details of the intervention, date of the trauma, characteristics of the fracture, and type of treatment. Functional results were assessed with the Harris Hip Score (HHS). Data concerning complications of treatment were collected.Aims
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Our objective was describing an algorithm to identify and prevent vascular injury in patients with intrapelvic components. Patients were defined as at risk to vascular injuries when components or cement migrated 5 mm or more beyond the ilioischial line in any of the pelvic incidences (anteroposterior and Judet view). In those patients, a serial investigation was initiated by a CT angiography, followed by a vascular surgeon evaluation. The investigation proceeded if necessary. The main goal was to assure a safe tissue plane between the hardware and the vessels.Aims
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