Study: General Anesthesia Associated with Higher Complication Rates after TJA
The Journal of the AAOS® published a propensity-matched study that compared the major postoperative complications and pneumonia between spinal anesthesia (SA) versus general anesthesia (GA) in patients undergoing total joint arthroplasty (TJA). Overall, 217,267 patients were identified for both the GA and SA groups. The rates of pneumonia for the GA and SA groups were 0.39 percent and 0.25 percent, respectively. Patients in the GA group experienced slightly higher rates of major complications (3.2 percent versus 2.5 percent), unplanned postoperative intubation (0.18 percent versus 0.10 percent), and mortality (0.14 percent versus 0.09 percent).
Study Finds Risk Factors for Nonunion in Patients with Transcondylar Fracture of the Distal Humerus after ORIF
According to a study in the Journal of Shoulder and Elbow Surgery, tension band wiring (TBW) fixation was a risk factor for nonunion in patients with transcondylar fracture of the distal humerus after ORIF. Preoperative demographics such as smoking and diabetes mellitus (DM) were retrospectively reviewed in 68 patients. Operation characteristics were also reviewed, including the fixation method (dual plate versus single plate versus TBW). The overall rate of nonunion was 11.8 percent. Among demographic data, DM and smoking were significant risk factors for nonunion.
Study: High Rates of Reoperation after Percutaneous Screw Fixation for Femoral Neck Fractures without Sagittal Malalignment
A retrospective case series in the Journal of Orthopaedic Trauma investigated the rate of reoperation in patients aged >50 years without sagittal plane malalignment who underwent percutaneous screw fixation of a valgus-impacted femoral neck fracture. The incidence of reoperation and major complications were reviewed in 207 patients. Overall, 15 percent of patients required reoperation and major complications occurred in 17.3 percent. The risk of reoperation was higher with constructs consisting of all partially threaded screws compared with the use of at least one fully threaded screw (17 percent versus 7.5 percent) when an inverted triangle configuration was used.
Study Assesses the Effect of Time from Injection of Collagenase to Manipulation in Patients with Dupuytren Disease
A review of 309 patients who underwent an injection of collagenase Clostridium histolyticum for Dupuytren disease examined the impact of time from injection to manipulation on outcomes and complications. This study was published in the Journal of Hand Surgery. Manipulation took place at two, five, or seven days after injection. Contracture angles and frequency of skin tears and tendon ruptures were compared pre- and postinjection. The rates of skin tears and ruptures were similar regardless of when manipulation occurred postinjection, and all patients showed improvement in contracture. Risk factors for complication included number of cords injected and history of previous collagenase injection.
Study: Vertebral Bone Quality Scores Are Independently Associated with Proximal Junctional Kyphosis after Thoracic AIS Surgery
Higher vertebral bone quality (VBQ) scores were associated with proximal junctional kyphosis (PJK) occurrence after corrective surgery for thoracic adolescent idiopathic scoliosis (AIS), according to a study in the European Spine Journal. A retrospective design was employed to evaluate the utility of VBQ score in predicting PJK after corrective surgery for thoracic AIS. The study included 206 patients, of which 33 developed PJK. VBQ scores were significantly different between the PJK and non-PJK groups (2.8 versus 2.5). Following multivariable analysis, VBQ scores had a predictive accuracy of PJK of 83 percent.
Study Finds High Local Recurrence Rate after Unplanned Sarcoma Excision
A study, which was presented at the AAOS 2023 Annual Meeting by Ryu Terauchi of the Kyoto Prefectural University of Medicine in Japan, investigated outcomes after unplanned excisions of soft-tissue sarcomas found that the rate of local recurrence was higher in such circumstances than after planned excisions. Based on the results of this study, it is advisable to perform an additional extensive excision when patients with unplanned excision present at the outpatient clinic, Dr. Terauchi said.
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