3D model-assisted instrumentation of the pediatric spine: a technical note.

Background: Instrumentation of the pediatric spine is challenging due to anatomical constraints and the absence of specific instrumentation, which may result in iatrogenic injury and implant failure, especially in occipito-cervical constructs. Therefore, preoperative planning and in vitro testing of instrumentation may be necessary.

Methods: In this paper, we present a technical note on the use of 1:1 scale patient-specific 3D printed spinal models for preoperative assessment of feasibility of spinal instrumentation with conventional spinal implants in pediatric spinal pathologies.

Cemented stems in healthy elderly patients result in higher hypoxia despite a paradoxical lower femoral increase of intramedullary pressure.

Purpose: Hypoxia is a well-known complication in cemented arthroplasty; however, it is not known whether the level of hypoxia is related to the intramedullary pressure or to the age of the patient; therefore, we studied the intramedullary pressure and level of hypoxia in patients undergoing cemented arthroplasty.

Methods: A prospective study was performed during cemented arthroplasties in 25 patients with an average age of 66.2 ± 12.

When does hip fracture surgery delay affects the length of hospital stay?

Purpose: To define factors influencing length of hospital stay (LOS) besides surgery delay.

Methods: We retrospectively analyzed 634 patients operated for hip fractures in 1-year period. Investigated characteristics were age, gender, American Society of Anesthesiologists score (ASA), time to surgery (first 48 h was considered early), type of surgery, anticoagulant therapy and non-routine pre-operative tests.

Fractures of the acetabulum: from yesterday to tomorrow.

Purpose: The aim of this article is to present history, state of the art, and future trends in the treatment of acetabular fractures.

Methods: Review of recent and historical literature.

Results: Acetabular fractures are difficult to treat.

Window of opportunity for surgical decompression in patients with acute traumatic cervical spinal cord injury.

Objective: The objective of this prospective study was to determine the optimal timing for surgical decompression (SD) in patients with acute traumatic cervical spinal cord injury (tSCI) within the first 24 hours of injury.

Methods: In successive patients with fracture and/or dislocation of the subaxial cervical spine and American Spinal Injury Association Impairment Scale (AIS) grades A-C, receiver operating characteristic curve analysis was used to determine the optimal timing for SD within the first 24 hours of cervical tSCI to obtain a neurological recovery of at least two AIS grades. Multivariate logistic regression was used to model significant neurological recovery with time to SD, degree of spinal canal compromise (SCC), and severity of injury.

Hip stress distribution - Predictor of dislocation in hip arthroplasties. A retrospective study of 149 arthroplasties.

Dislocation after hip arthroplasty is still a major concern. Recent study of the volumetric wear of the cup has suggested that stresses studied in a one-legged stance model could predispose arthroplasty dislocation. The aim of this work was to study whether biomechanical parameters of contact stress distribution in total hip arthroplasty during a neutral hip position can predict a higher possibility of the arthroplasty dislocating.

3D printing of implants for patient-specific acetabular fracture fixation: an experimental study.

Purpose: To test the effect of 3D printed implants, designed according to surgeon's individual plan, on the accuracy of reduction of an acetabular fracture model.

Methods: Seven identical standardized plastic bone models of an anterior column/posterior hemi-transverse acetabular fracture were used. A CT of one plastic fracture model was made.

Threatening Fracture of Intraosseous Lipoma Treated by Internal Fixation .

Intraosseous lipomas are rare benign bone neoplasms with an incidence of less than 0.1%; origin in the calcaneus has been reported in only a few patients. First-line treatment remains conservative, but several surgical techniques have also been described.

Increased perioperative C-reactive protein and decreased postoperative albumin is associated with acute posttraumatic osteomyelitis in patients with high-energy tibial fractures.

Background: Early diagnosis of acute posttraumatic osteomyelitis (POM) is of vital importance for avoiding devastating complications. Diagnosing POM is difficult due to the lack of a highly specific and sensitive test, such as in myocardial infarct, stroke and intracranial bleeding. Serum inflammatory markers, C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBC) can support clinical findings but they are not able to differentiate between inflammatory response to infection and the host response to non-infection insult with high specificity and sensitivity.

Guided tissue regeneration with heterologous materials in primary subtalar arthrodesis: a case report.

Background: Calcaneal fractures are relatively rare and difficult to treat. Treatment options vary based on the type of fracture and the surgeon's experiences. In recent years, surgical procedures have increasingly been used due to the better long-term results.

Scapula fractures: interobserver reliability of classification and treatment.

Objectives: There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment.

Acetabular loading in active abduction.

Operative fixation of fragments in acetabular fracture treatment is not strong enough to allow weight bearing before the bone is healed. In some patients, even passive or active nonweight-bearing exercises could lead to dislocation of fragments and posttraumatic osteoarthritis. Therefore, early rehabilitation should avoid loading the acetabulum in the regions of fracture lines.

Preoperative planning in pelvic and acetabular surgery: the value of advanced computerised planning modules.

An experimental computer program for virtual operation of fractured pelvis and acetabulum based on real data of the fracture is presented. The program consists of two closely integrated tools, the 3D viewing tools and the surgeon simulation tools. Using 3D viewing tools the virtual model of a fractured pelvis is built.