The treatment of fracture-related infections (FRI) focuses on obtaining fracture healing and eradicating infection to prevent osteomyelitis. Treatment guidelines include removal, exchange, or retention of the implants used according to the stability of the fracture and the time from the infection. Infection of a fracture in the process of healing with a stable fixation may be treated with implant retention, debridement, and antibiotics. Nonetheless, the retention of an intramedullary nail is a potential risk factor for failure, and it is recommended to exchange or remove the nail. This surgical approach implies additional life-threatening risks in elderly fragile hip fracture patients. Our study aimed to analyze the results of implant retention for the treatment of infected nails in elderly hip fracture patients. Our retrospective analysis included patients 65 years of age or older with an acute fracture-related infection treated with implant retention from 2012 to 2020 in 6 Spanish hospitals with a minimum 1-year follow-up. Patients that required open reduction during the initial fracture surgery were excluded. Variables included in our analysis were patient demographics, type of fracture, date of FRI diagnosis, causative microorganism, and outcome. Treatment success was defined as fracture healing with infection eradication without the need for further hospitalization.Aim
Methods
Restoration of the joint line of the knee during primary and revision total knee arthroplasty is one of many critical steps that directly influence patient outcomes. Fifty MRI scans of normal atraumatic knees were analyzed to determine a quantitative relationship between the joint line of the knee and the bony landmarks of the knee joint: femoral epicondyles, metaphyseal flare of the femur, tibial tubercle, and proximal tibio-femoral joint. We describe the relationship of these six anatomic landmarks about the knee in a gender and size independent manner. This description supports a simple three-step algorithm allowing orthopaedic surgeons to calculate, instead of estimate, the location of the joint line of the knee.
