This study aimed to answer the following questions: do 3D-printed models lead to a more accurate recognition of the pattern of complex fractures of the elbow?; do 3D-printed models lead to a more reliable recognition of the pattern of these injuries?; and do junior surgeons benefit more from 3D-printed models than senior surgeons? A total of 15 orthopaedic trauma surgeons (seven juniors, eight seniors) evaluated 20 complex elbow fractures for their overall pattern (i.e. varus posterior medial rotational injury, terrible triad injury, radial head fracture with posterolateral dislocation, anterior (trans-)olecranon fracture-dislocation, posterior (trans-)olecranon fracture-dislocation) and their specific characteristics. First, fractures were assessed based on radiographs and 2D and 3D CT scans; and in a subsequent round, one month later, with additional 3D-printed models. Diagnostic accuracy (acc) and inter-surgeon reliability (κ) were determined for each assessment.Aims
Methods
The impact of tobacco use on readmission and medical and surgical complications has been documented in hip and knee arthroplasty. However, there remains little information about the effect of smoking on the outcome after total shoulder arthroplasty (TSA). We hypothesized that active smokers are at an increased risk of poor medical and surgial outcomes after TSA. Data for patients who underwent arthroplasty of the shoulder in the USA between January 2011 and December 2015 were obtained from the National Readmission Database, and 90-day readmissions and complications were documented using validated coding methods. Multivariate regression analysis was performed to quantify the risk of smoking on the outcome after TSA, while controlling for patient demographics, comorbidities, and hospital-level confounding factors.Aims
Methods
Dislocation of the acromioclavicular joint is
a relatively common injury and a number of surgical interventions
have been described for its treatment. Recently, a synthetic ligament
device has become available and been successfully used, however,
like other non-native solutions, a compromise must be reached when
choosing non-anatomical locations for their placement. This cadaveric
study aimed to assess the effect of different clavicular anchorage points
for the Lockdown device on the reduction of acromioclavicular joint
dislocations, and suggest an optimal location. We also assessed
whether further stability is provided using a coracoacromial ligament
transfer (a modified Neviaser technique). The acromioclavicular
joint was exposed on seven fresh-frozen cadaveric shoulders. The
joint was reconstructed using the Lockdown implant using four different
clavicular anchorage points and reduction was measured. The coracoacromial
ligament was then transferred to the lateral end of the clavicle,
and the joint re-assessed. If the Lockdown ligament was secured
at the level of the conoid tubercle, the acromioclavicular joint
could be reduced anatomically in all cases. If placed medial or
2 cm lateral, the joint was irreducible. If the Lockdown was placed
1 cm lateral to the conoid tubercle, the joint could be reduced
with difficulty in four cases. Correct placement of the Lockdown
device is crucial to allow anatomical joint reduction. Even when the
Lockdown was placed over the conoid tubercle, anterior clavicle
displacement remained but this could be controlled using a coracoacromial
ligament transfer. Cite this article:
