European Journal of Orthopaedic Surgery & Traumatology
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Published By Springer-Verlag

1432-1068, 1633-8065
Updated Sunday, 17 October 2021

Erel Ben-Ari ◽  
Yaniv Pines ◽  
Dan Gordon ◽  
Joseph D. Zuckerman ◽  
Catherine Petchprapa ◽  

Omer M. Farhan-Alanie ◽  
Taegyeong Tina Ha ◽  
James Doonan ◽  
Ashish Mahendra ◽  
Sanjay Gupta

Abstract Introduction Limb-sparing surgery with negative margins is possible in most soft tissue sarcoma (STS) resections and focuses on maximising function and minimising morbidity. Various risk factors for surgical site infections (SSIs) have been reported in the literature specific to sarcoma surgery. The aim of this study is to determine whether systemic inflammatory response prognostic scoring systems can predict post-operative SSI in patients undergoing potentially curative resection of STS. Methods Patients who had a planned curative resection of a primary STS at a single centre between January 2010 and December 2019 with a minimum follow-up of 6 months were included. Data were extracted on patient and tumour characteristics, and pre-operative blood results were used to calculate inflammatory prognostic scores based on published thresholds and correlated with risk of developing SSI or debridement procedures. Results A total of 187 cases were included. There were 60 SSIs. On univariate analysis, there was a statistically significant increased risk of SSI in patients who are diabetic, increasing specimen diameter, American Society of Anaesthesiology (ASA) grade 3, use of endoprosthetic replacement, blood loss greater than 1 L, and junctional tumour location. Modified Glasgow prognostic score, C-reactive protein/albumin ratio and neutrophil–platelet score (NPS) were statistically associated with the risk of SSI. On multivariate analysis, ASA grade 3, junctional tumour location and NPS were independently associated with the risk of developing a SSI. Conclusion This study supports the routine use of simple inflammation-based prognostic scores in identifying patients at increased risk of developing infectious complications in patients undergoing potentially curative resection of STS.

Samantha Nino ◽  
Joshua A. Parry ◽  
Frank R. Avilucea ◽  
George J. Haidukewych ◽  
Joshua R. Langford

Pierre-Alban Bouche ◽  
Nicolas Gaujac ◽  
Simon Corsia ◽  
Philippe Leclerc ◽  
Philippe Anract ◽  
Ct Scan ◽  
X Rays ◽  

Michael-Alexander Malahias ◽  
Qian-Li Ma ◽  
Seong J. Jang ◽  
Marios Loucas ◽  
Alex Gu ◽  

Selina Summers ◽  
Natasha Faye Daniels ◽  
Azeem Thahir ◽  
Matija Krkovic

Abstract Purpose Infected orthopaedic metalwork is challenging to treat. Negative pressure wound therapy (NPWT) with irrigation is an emerging therapy for infected wounds as an adjunct to antibiotic therapy. The senior author had devised a modified technique to augment its efficacy, utilising high-flow rate irrigation and skin closure over the standard NPWT dressing. This novel technique was originally evaluated in a different centre and produced 100% success in metalwork retention. The present study is a reproducibility test of the same technique. Methods A retrospective review was performed on 24 patients with infected orthopaedic metalwork, including 3 upper limb and 21 lower limb cases, for outcomes relating to implant retention and infection resolution. Patients underwent a modified NPWT technique as an adjunct to antibiotic therapy and surgical debridement. Detailed medical and microbiology information were obtained from the patient records. Results 23 of 24 (96%) patients had successful metalwork retainment with healed wounds and resolution of infection, allowing fracture union. 27 infective organisms were identified in this cohort, and the antibiotic regimens for each patient are provided. The average follow-up was 663 days. No adverse effects were observed. Conclusion This series supports the modified NPWT technique as a safe, reliable and effective adjunct therapy to resolve metalwork infection. The same results have been reproduced as the previous cohort in a different centre.

Marco Di Stefano ◽  
Lorenzo Sensi ◽  
Leonardo di Bella ◽  
Raffaele Tucci ◽  
Efisio Bazzucchi ◽  

Abstract Purpose The aim of our study is to compare the modified double incision (DI) with bone tunnel reinsertion with the single-incision (SI) double tension slide technique in terms of clinical and functional outcomes and complication rates. Methods A retrospective comparative analysis was performed on 65 patients treated for total distal biceps tendon rupture. The surgical technique adopted for each patient was based on the preference of two experienced elbow surgeons. The DASH and MAYO questionnaires, functional outcome and ROM were recorded in all subjects. Results Of 65 patients, we collected data of a cohort of 54 distal biceps tendon ruptures that satisfied inclusion criteria. Twenty-five were treated by modified DI and 29 SI techniques. The recovery of the complete ROM in terms of flexion/extension and prono-supination occurred in the 79.6% of the patients, without statistical significant difference between the adopted technique. We reported a complication rate of 12% and 20.7% for DI and SI techniques, respectively, without statistical correlation (P = 0.84). The average DASH score was similar for DI and SI techniques without significant differences (P = 0,848). The Mayo score results were excellent in the majority of the patients. No significant difference in MAYO results was reported comparing the surgical techniques (P = 1). Conclusion Both techniques provide a reliable and strong repair with an optimal recovery of ROM returning to preinjury activity with substantially overlapping timelines.

Pravesh Panchoo ◽  
Maritz Laubscher ◽  
Michael Held ◽  
Sithombo Maqungo ◽  
Nando Ferreira ◽  

Amir Abdelmalek ◽  
John McFarlane

Tuna Pehlivanoglu ◽  
Ali Erşen ◽  
Serkan Bayram ◽  
Ata Can Atalar ◽  
Mehmet Demirhan

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