Classification of inertial sensor-based gait patterns of orthopaedic conditions using machine learning: A pilot study.

Elderly patients often have more than one disease that affects walking behavior. An objective tool to identify which disease is the main cause of functional limitations may aid clinical decision making. Therefore, we investigated whether gait patterns could be used to identify degenerative diseases using machine learning.

Extraction force, energy and nail deformation for 1.5 m versus 1.0 m intramedullary femoral nail bow design: A biomechanical investigation.

Background: The impact of the nail radius of curvature, as one of the most important design features in modern femoral nails on the ease of nail removal, remains unknown. Therefore, the aim of this study was to investigate force, energy, and nail deformation of different nail designs.

Methods: Nail insertion and extraction was performed on six pairs of fresh-frozen human cadaveric femora on a material testing machine with two different nail systems - Trochanter femoral nail ADVANCED™ Nailing System with a radius of curvature of 1.

Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing.

Background: With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing.

Methods: Eight pairs of fresh-frozen human cadaveric femora aged 72.

Biomechanical evaluation of the docking nail concept in periprosthetic fracture fixation around a stemmed total knee arthroplasty.

Intramedullary femoral nails provide an ideal mechanical axis for periprosthetic fracture fixation. Slotted nails allow a connection to a total knee arthroplasty (TKA) stem. This study aims to compare implant and construct stiffness, interfragmentary movement and cycles to failure between an antegrade slotted femoral nail construct docked to a TKA stem and a distal femoral locking plate in a human periprosthetic femoral fracture model.

Surgical Skills Training Using Simulation for Basic and Complex Hip and Knee Arthroplasty.

Skills training is important in an arthroplasty curriculum and can focus either on "part tasks" or on full procedures. The most commonly used simulations in orthopedics including arthroplasty are anatomic specimens, dry bone models, and virtual or other technology-enhanced systems. A course curriculum planning committee must identify the gaps to address, define what learners need to be able to do, and select the most appropriate simulation modality and assessment for delivery.

Screw-in-screw fixation of fragility sacrum fractures provides high stability without loosening-biomechanical evaluation of a new concept.

Surgical treatment of fragility sacrum fractures with percutaneous sacroiliac (SI) screw fixation is associated with high failure rates. Turn-out is detected in up to 20% of the patients. The aim of this study was to evaluate a new screw-in-screw implant prototype for fragility sacrum fracture fixation.

Bio-Derived Apatite As a Bone Graft for Vertebral Trauma.

Introduction: Traumatic spinal injury presents the potential for significant morbidity and mortality, and posterior fixation and fusion with bone grafts is a primary treatment for many vertebral fractures. While iliac crest autograft (ICBG) is considered the gold standard in bone grafting, this carries risks of morbidity at the donor site as well as prolonging surgery time. Bone graft substitutes (BGS) may provide a viable alternative to autograft but there is little published data concerning its use in trauma.

Is suture comparable to wire for cerclage fixation? A biomechanical analysis.

Background: Cerclage wire is the current standard for circumferential bone fixation. Advances in technology have improved modern sutures, allowing for expanded utility and broader application. The present study compared the strength and durability of cerclage fixation between modern suture materials and monofilament wire.

An excellent 5-year survival rate despite a high incidence of distal femoral cortical hypertrophy in a short hip stem.

Background: Although reported results on short stems sound very promising, the occurrence of distal femoral cortical hypertrophy is often observed. The aim of the present study was to report 5-year survival data of a commercially available trochanter sparing short stem and investigate the clinical impact of distal femoral cortical hypertrophy on the outcome.

Methods: 123 total hip arthroplasties were performed on 120 patients from April 2008 to May 2010 (mean age 62, range 29-89 years; 71 hips from male patients, 58%).

Decrease surgery time by using an alternative lateral parapatellar approach for tibia shaft fracture nailing.

Introduction: Medial parapatellar or transpatellar ligament approaches are commonly used for nail osteosynthesis in tibia shaft fractures. The lower leg is normally in a hanging position to allow guide wire insertion and reaming of the tibia. However, this position complicates fracture reduction and retention, as well as image intensification throughout the procedure.

Long-term follow-up after MIPO Philos plating for proximal humerus fractures.

Introduction: Minimally invasive plate osteosynthesis (MIPO) has been described as a suitable technique for the treatment of proximal humerus fractures, but long-term functional results have never been reported. The aim of this study was to describe the long-term functional outcome and implant-related irritation after MIPO for proximal humerus fractures.

Methods: A long-term prospective cohort analysis was performed on all patients treated for a proximal humerus fracture using MIPO with a Philos plate (Synthes, Switzerland) between December 2007 and October 2010.

Biomechanical evaluation of a new gliding screw concept for the fixation of proximal humeral fractures.

Aims: Plating displaced proximal humeral fractures is associated with a high rate of screw perforation. Dynamization of the proximal screws might prevent these complications. The aim of this study was to develop and evaluate a new gliding screw concept for plating proximal humeral fractures biomechanically.

Operative Stabilization of Chest Wall Trauma: Single-Center Report of Initial Management and Long-Term Outcome.

Background: Conservative treatment of even severe thoracic trauma including flail chest was traditionally the standard of care. Recently, we reported possible benefits of surgical chest wall stabilization in accordance with other groups. The aim of this study was to critically review our indications and results of internal fixation of rib fractures in the long-term course.

Benefits of hardware removal after plating.

Routine implant removal is frequently performed although evidence-based guidelines are lacking. But routinely planned implant removal has significant economic implications and shows considerable complication rates. In general, clinical outcome seems to improve but pain relief after operation is often unpredictable.

Diagnostic challenges and future perspectives in fracture-related infection.

Fracture-related infection (FRI) is one of the most challenging complications in orthopaedic trauma surgery. It has severe consequences for patients and an important socio-economic impact. FRI has distinct properties and needs to be addressed interdisciplinary.

Clinical application of a minimally invasive cement-augmentable Schanz screw rod system to treat pelvic ring fractures.

Purpose: The purpose of this study is to analyze the results using the USS fracture MIS system (DePuy Synthes) to treat instable pelvic ring fractures. As its outstanding feature, it is the only Schanz screw and rod system at present that combines angular stability, perforation/fenestration of the screws for cement-augmentation, a variable screw length, and a large screw diameter.

Materials And Methods: Retrospective investigation of 134 pelvic ring fractures treated in 2012-2013.

Healthcare-resource utilization associated with radiation to bone across eight European countries: Results from a retrospective study.

Background: Bone metastases and lytic lesions due to multiple myeloma are common in advanced cancer and can lead to debilitating complications (skeletal-related events [SREs]), including requirement for radiation to bone. Despite the high frequency of radiation to bone in patients with metastatic bone disease, our knowledge of associated healthcare resource utilization (HRU) is limited.

Methods: This retrospective study estimated HRU following radiation to bone in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland.

Biomechanical investigation of four different fixation techniques in sacrum Denis type II fracture with low bone mineral density.

With increasing life expectancy, fragility fractures of the pelvic ring are seen more frequently. Although their osteosynthesis can be very challenging, specific biomechanical studies for investigation of the fixation stability are still lacking. The aim of this study was to biomechanically evaluate four different fixation methods for sacrum Denis type II fractures in osteoporotic bone.

A cadaveric biomechanical study comparing the ease of femoral nail insertion: 1.0- vs 1.5-m bow designs.

Introduction: Anatomic fit of intramedullary nails was suggested by previous studies to improve significantly when the nail radius of curvature (ROC) is closer to the average femoral anatomy. However, no attempt has been made to investigate the impact of different ROC designs on the nail insertion process. Therefore, this biomechanical study quantitatively compared the ease of insertion between femoral intramedullary nails with a 1.

Are two retrograde 3.5 mm screws superior to one 7.3 mm screw for anterior pelvic ring fixation in bones with low bone mineral density?

Objectives: Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible.The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws.

Pathologic fracture and healthcare resource utilisation: A retrospective study in eight European countries.

Background: Skeletal-related events (SREs; pathologic fracture [PF], spinal cord compression and radiation or surgery to bone) are common complications of bone metastases or bone lesions and can impose a considerable burden on patients and healthcare systems. In this study, the healthcare resource utilisation (HRU) associated with PFs in patients with bone metastases or lesions secondary to solid tumours or multiple myeloma was estimated in eight European countries.

Methods: Eligible patients were identified in Austria, the Czech Republic, Finland, Greece, Poland, Portugal, Sweden and Switzerland.

Knee joint kinematics with dynamic augmentation of primary anterior cruciate ligament repair - a biomechanical study.

Background: Dynamic augmentation of anterior cruciate ligament tears seems to reduce anteroposterior knee translation close to the pre-injury level. The aim of the present study is to biomechanically investigate the course of translation during a simulated early post-operative phase. It is hypothesized that anteroposterior translation is maintained at the immediate post-operative level over a simulated rehabilitation period of 50'000 gait cycles.

Biomechanical comparison of plate and screw fixation in anterior pelvic ring fractures with low bone mineral density.

Introduction: Osteosynthesis of anterior pubic ramus fractures can be challenging, especially in poor bone quality. The aim of the present study was to compare plate and retrograde endomedullary screw fixation of the superior pubic ramus with low bone mineral density (BMD).

Materials And Methods: Twelve human cadaveric hemi-pelvises were analyzed in a matched pair study design.