Plain X-ray is insufficient for correct diagnosis of tibial shaft spiral fractures: a prospective trial.

Purpose: Tibial shaft spiral fractures and fractures of the distal third of the tibia (AO:42A/B/C and 43A) frequently occur with non-displaced posterior malleolus fractures (PM). This study investigated the hypothesis that plain X-ray is not sufficient for a reliable diagnosis of associated non-displaced PM fractures in tibial shaft spiral fractures.

Methods: 50 X-rays showing 42A/B/C and 43A fractures were evaluated by two groups of physicians, each group was comprised of a resident and a fellowship-trained traumatologist or radiologist.

The grade of instability in fragility fractures of the pelvis correlates with impaired early mobilization.

Purpose: This study aimed to investigate whether gait patterns of patients with fragility fractures of the pelvis (FFP) comply with the grade of fracture instability, defined by radiological patterns.

Patients And Methods: This prospective, single-center, observational study included 39 patients with an FFP. Gait analysis was performed with a wearable insole force sensor (Loadsol® by Novel, Munich, Germany) 4-7 days after admission.

Mobility improvement in the first 6 postoperative weeks in orthogeriatric fracture patients.

Background: Physical activity is a relevant outcome parameter in orthopedic surgery, that can be objectively assessed. Until now, there is little information regarding objective gait parameters in the orthogeriatric population. This study focuses on the first 6 weeks of postoperative rehabilitation, and delivers objective data about gait speed and step length in typical orthogeriatric fracture patterns.

Outcomes of Rotating-hinge Total Knee Arthroplasty Following Complex Primary and Revision Total Knee Arthroplasty.

In complex primary and revision total knee arthroplasty (TKA), rotating-hinge TKA (RH-TKA) prostheses play an important role. Compared to early fixed-hinge knee designs, new implants that include rotating platforms and improved hinge constructs may offer improvements in both survival and clinical outcomes. We sought to evaluate early survival following complex primary and revision TKA with a rotating-hinge knee prosthesis.

Cement augmentation of the Proximal Femur Nail Antirotation (PFNA) is associated with enhanced weight-bearing in older adults.

Background: An early postoperative mobilisation shows beneficial effects in terms of complications and mobilisation scores in older adult proximal femur fracture patients. An adequate load-bearing capacity of the operated extremity is essential for early mobilisation. We hypothesize that cement augmentation of the Proximal Femoral Nail antirotation (PFNA) leads to a higher load capacity during postoperative mobilisation compared to a non-cemented PFNA.

Identification of hip fracture patients at risk for postoperative mobilisation complications via handgrip strength assessment.

Introduction: Treatment of older adult hip fracture patients can be challenging and requires early postoperative mobilisation to prevent complications. Simple clinical tools to predict mobilisation/weight-bearing difficulties after hip fracture surgery are scarcely available and analysis of handgrip strength could be a feasible approach. In the present study, we hypothesised that patients with reduced handgrip strength show incapability to follow postoperative weight-bearing instructions.

Inferior Outcome after Unstable Trochanteric Fracture Patterns Compared to Stable Fractures in the Elderly.

Background: Various risk factors affecting outcome of elderly patients after proximal femur fracture have been identified. The present study aims to evaluate the impact of the fracture pattern in trochanteric fractures on postoperative mobility and complications.

Methods: Ninety-two patients with a mean age of 84 years were included.

Immediate Postoperative Improvement in Gait Parameters following Primary Total Knee Arthroplasty Can Be Measured with an Insole Sensor Device.

Total knee arthroplasty (TKA) improves the quality of life in those suffering from debilitating arthritis of the knee. However, little is known about the influence of TKA on restoring physical function. Prior studies have used artificial means, such as instrumented treadmills, to assess physical function after TKA.

Load-Bearing Detection with Insole-Force Sensors Provides New Treatment Insights in Fragility Fractures of the Pelvis.

Background: Due to an aging society, more and more surgeons are confronted with fragility fractures of the pelvis (FFPs). The aim of treatment of such patients should be the quickest possible mobilization with full weight-bearing. Up to now however, there are no data on loading of the lower extremities in patients suffering FFPs.

Multidisciplinary inpatient rehabilitation improves the long-term functional status of geriatric hip-fracture patients.

Background: As the world population ages, the number of hip-related fractures in the elderly is steadily increasing. These fractures generate a major worldwide healthcare problem and frequently lead to deterioration of life quality, mobility and independence in activity of daily life of geriatric patients. At present, many studies have investigated and proved benefits of multidisciplinary orthogeriatric care for elderly hip-fracture patients.

Postoperative physical activity in orthogeriatric patients - new insights with continuous monitoring.

Background: An early postoperative mobilization shows beneficial effects in terms of complications and long-term mobilization scores in elderly adult fracture patients. The primary objective of this study was to evaluate the overall mobilization of orthogeriatric patients during the postoperative hospital stay based on a continuous accelerometry measurement. Secondly, the collected data was analyzed to detect fracture related differences.

Biomechanical stability of sacroiliac screw osteosynthesis with and without cement augmentation.

Background: Percutaneous sacroiliac (SI) screw fixation is the standard operative treatment of traumatic disruptions to the posterior pelvic ring. The technique offers good outcomes and early postoperative mobilization, which is vital in elderly patients with fragility fractures of the pelvis. While a double-screw technique has been shown to provide optimal biomechanical stability compared to a single-screw construct, anatomic variations and patient-specific characteristics may prevent the safe insertion of two SI screws.

Weight bearing in patients with femoral neck fractures compared to pertrochanteric fractures: A postoperative gait analysis.

Early mobilization following hip fracture surgery is of superior importance especially in elderly hip fracture patients. Reduced mobilization can result in complications and increased mortality. In this study a gait analysis was performed using force-measuring insoles.

Weight-bearing restrictions reduce postoperative mobility in elderly hip fracture patients.

Background And Purpose: Reduced mobility is a severe threat to the clinical outcomes and survival of elderly hip fracture patients. These patients generally struggle to comply with partial weight bearing, yet postoperative weight-bearing restrictions are still recommended by nearly 25% of surgeons. Therefore, we hypothesized that weight-bearing restrictions in elderly hip fracture patients merely leads to reduced mobility, while transposing full weight to the fractured extremity remains unaffected disregarding the prescribed aftercare.

Orthogeriatric treatment reduces potential inappropriate medication in older trauma patients: a retrospective, dual-center study comparing conventional trauma care and co-managed treatment.

Background: Multimorbidity and polypharmacy are common challenges in the treatment of older trauma patients. Therefore, various integrated care models were developed over the last few years, merging the expertise of geriatricians and trauma surgeons. The aim of this study was to evaluate, if the number of prescriptions of potentially inappropriate medication (PIM) could be reduced in these patients by an interdisciplinary co-managed concept compared to conventional trauma care.

Training with biofeedback devices improves clinical outcome compared to usual care in patients with unilateral TKA: a systematic review.

Purpose: Biofeedback following total knee arthroplasty (TKA) seems to be a feasible approach to improve rehabilitation, outcomes, mobility and reduce pain. This systematic review gives the practicing orthopedic surgeon a summary of what is available and how biofeedback affects clinical outcomes.

Methods: We reviewed the current literature regarding methods, devices and effects of biofeedback in patients who underwent total knee arthroplasty.

Inability of Older Adult Patients with Hip Fracture to Maintain Postoperative Weight-Bearing Restrictions.

Background: For elderly trauma patients, a basic goal is early mobilization, as immobilization can trigger various complications, such as venous thromboembolism, pneumonia, urinary tract infections, and pressure ulcers. Although partial weight-bearing has been shown to significantly increase mortality compared with unrestricted weight-bearing, it remains a frequent recommendation of aftercare following lower-extremity fracture fixation.

Methods: An insole force sensor was used to measure true postoperative weight-bearing by patients ≥75 years of age treated for hip fracture compared with patients 18 to 40 years of age treated for ankle fracture.