The number of operatively treated clavicle fractures has increased over the past decades. Consequently, this has led to an increase in secondary procedures required to treat complications such as fracture-related infection (FRI). The primary objective of this study was to assess the clinical and functional outcome of patients treated for FRI of the clavicle. The secondary objectives were to evaluate the healthcare costs and propose a standardized protocol for the surgical management of this complication. All patients with a clavicle fracture who underwent open reduction and internal fixation (ORIF) between 1 January 2015 and 1 March 2022 were retrospectively evaluated. This study included patients with an FRI who were diagnosed and treated according to the recommendations of a multidisciplinary team at the University Hospitals Leuven, Belgium.Aim
Method
Negative-pressure wound therapy (NPWT) is often propagated as treatment option for fracture-related infection (FRI). After surgical debridement and repeated NPWT dressing changes, the wounds are often closed by free flaps. Sometimes even healing by secondary intention seems an alternative. Recently, concerns have been raised on the long-term use of NPWT as it could be related to bacterial overgrowth and possible re-infection. The purpose of this study was to conduct a retrospective evaluation of the influence of long-term NPWT on tissue culture results and outcome in FRI patients Between January 1st, 2015 and December 31st, 2018, a total of 852 patients were treated with NPWT for different indications on the Department of Trauma Surgery. Inclusion criteria for this study were patients with a closed fracture, stabilized with osteosynthetic fixation and complicated with a confirmed FRI according to the Aim
Method
Addressing posterior tibial plateau fractures is increasingly recognized as an important prognostic factor for functional outcome. The treatment of posterior tibial plateau fractures is rather demanding and the implants are still standard, off-the-shelf implants. This emphasizes the need for a more thorough morphological study of the posterior tibial plateau, in order to treat these posterior fractures more adequately. We aimed to demonstrate anatomical variations of the tibia in order to develop better implants. After approval of the ethical committee 22 historically available CT scans of intact left tibia”s were segmented using Mimics (Materialise, Belgium). In order to perform principal component analysis, corresponding meshes are necessary. Mesh correspondence was achieved by deforming one selected source tibia to every other target tibia, through non rigid registration. The non-rigid registration algorithm was based on the algorithm described by Amberg et al (ref). After performing the non-rigid registration, principal component analysis was performed in Matlab (Mathworks, USA).Purpose
Method
The objective of this study was to define hospital-related healthcare costs associated with infection after fracture fixation (IFF) of the tibia and identify the subset of clinical variables relevant in driving these costs within the Belgium's healthcare system. Between January 1st 2009 and January 1st 2014, a total of 358 patients treated operatively for AO type 41, 42 and 43 tibial fractures, were included in this study. The calculated costs were related to the Belgium's healthcare financing context and limited to costs induced by hospital related care. Five main hospital-related cost categories were studied: honoraria, materials, hospitalization, day care admission, and pharmaceuticals. In addition, a total of 19 clinical and process variables were defined.Aim
Method
Hip resurfacing arthroplasty (HRA) has seen a recent revival with third generation Metal-on-Metal prostheses and is now widely in use. However, safety and effectiveness of hip resurfacing are still questioned. We systematically reviewed peer-reviewed literature on hip resurfacing arthroplasty to evaluate implant survival and functional outcomes of hybrid Metal-on-Metal hip resurfacing Arthroplasty. Electronic databases and reference lists were searched from 1988 to September 2009. Identified abstracts were checked for inclusion or exclusion by two independent reviewers. Data were extracted and summarized by one reviewer and verified by a second reviewer. Main study endpoint was implant survival, which we compared with the National Institute of Clinical Excellence (NICE) benchmark. We also evaluated radiological and functional outcomes, failure modes and other adverse events.Introduction
Method
Hip resurfacing arthroplasty (HRA) has seen a recent revival with third generation Metal-on-Metal prostheses and is now widely in use. However, safety and effectiveness of hip resurfacing are still questioned. We systematically reviewed peer-reviewed literature on hip resurfacing arthroplasty to address these issues. To evaluate implant survival and functional outcomes of hybrid Metal-on-Metal hip resurfacing arthroplasty (HRA).Background
Objective
Cementless Total Hip Replacement surgery is a well established procedure for relative young patients with severe hip disease. Excellent long term clinical results have been published on the performance of the femoral component. With growing clinical experience, our concern focused on excessive wear of the Ultra High Molecular Weight Polyethylene (UHMWPE) ringloc liner of the Mallory Head cementless Total Hip Prosthesis. After its introduction in our clinic in 1997, this implant is still in use without any modification. We were concerned that due to premature liner wear, the performance of this implant would not be compliant with the international guideline on implant survival (NICE guidelines: at 10 year follow up, 90% of all implants should still be in situ). Our objective was to establish the amount of liner wear in our first 200 MH implants. Our first 200 patients consecutively treated with Mallory Head prostheses were followed up to obtain a recent digital image. Follow up was complete for 181 (90.5%) of our 200 patients. Ten had died and nine were not able or willing to come for follow up. The mean duration of follow up was 8.3 years (range: 8–13). The 181 recent digital images were classified as either excessive wear or no excessive wear by two independent orthopedic surgeons. Next, liner wear was measured in the 2D frontal plane using PolyWare Pro/3D Digital Version Rev 5.1 software (Draftware Developers, Conway, USA). A threshold for excessive liner wear was set at 0.2mm/year, according to literature.INTRODUCTION
METHODS
