Experience of abdominoplasty and analysis of the risk factors.

BACKGROUND: We performed a retrospective study of patients who underwent abdominoplasty to determine the predisposing factors for complications. METHODS: Between 2013 and 2016, 235 patients underwent abdominoplasty at the Brugmann University Hospital. The risk factors for the complications studied were: sex, body mass index (BMI)≥30, active smoking, diabetes, high blood pressure, previous abdominal surgery, weight loss, other associated surgical procedures, liposuction, muscle diastasis correction and the duration of presence of the suction drains. The complications were divided into three groups: major complications requiring a second intervention within the first 15 days, minor complications only requiring local treatment and aesthetic complications corrected at a later stage. RESULTS: Complications were observed in 46.5% of the patients: 19% were major complications, 69% minor complications and 12% aesthetic complications. The significant risk factors for complications were: BMI ≥30, weight loss, associated surgical procedures and suction drains left in place for more than 3 days. We also analysed combinations of risk factors and we found, for example, that certain combinations such as active smoking and previous abdominal surgery increased the risk significantly. CONCLUSIONS: Abdominoplasty is a common plastic surgery procedure associated with an increased risk for complications in certain patients. In our study, a high complication rate was observed, probably because our population was mostly obese and many cases needed an additional procedure. There are no clear guidelines for the surgeon to choose the best surgical candidate. However, risk factors should be taken into consideration and explained to the patient before the surgical decision.

Volar Locking Plating Compared to Conservative Treatment in Distal Radius Fractures in Elderly Patients (>60 years old): A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Purpose: We performed a systematic review and meta-analysis to compare the efficacy of volar locking plating (VLP) to conservative treatment in distal radius fractures in patients aged >60 years old. Methods: English articles were searched in electronic databases including MEDLINE, CENTRAL, Embase, Web of science, and ClinicalTrial.gov from inception to October 2020. Relevant article reference lists also were reviewed. Two reviewers independently screened and extracted data from trials comparing VLP to nonsurgical treatment in distal radial fractures in the elderly. Starting with 3052 citations, 5 trials (539 patients) met the inclusion criteria. The primary outcomes were disabilities of the arm, shoulder, and hand, and patient-rated wrist evaluation scores, grip strength, and range of motion. Results: All trials of this random effect meta-analysis were at a moderate risk of bias due to the lack of blinding. Differences in the disabilities of the arm, shoulder, and hand score (mean difference [MD] -5,91; 95% confidence interval [CI], -8,83; -3,00), patient-rated wrist evaluation score (MD -9.07; 95% CI, -14.57, -3.57), and grip strength (MD 5,12; 95% CI, 0,59-9,65) were statistically significant and favored VLPs, however without reaching clinical significance. No effect was observed in terms of the range of motion and reoperation rates. Conclusion: This review was not able to demonstrate any clinical benefit to the surgical treatment of distal radius fractures with VLP in patients aged >60 years old compared to nonsurgical treatment. Type of study/level of evidence: Therapeutic I.

A low dislocation rate after revision total hip arthroplasty performed through the anterior approach.

BACKGROUND: Dislocation is a major complication in revision total hip arthroplasties. This study aimed to evaluate the dislocation rate, complications, and functional scores of revision total hip arthroplasty performed through the direct anterior approach. METHODS: Between January 2014 and March 2020, 84 patients undergoing revision total hip arthroplasty were retrospectively reviewed. All operations were performed through the direct anterior approach. At the final follow-up, incidences of dislocation, reoperation, acute deep infections, periprosthetic fractures and psoas impingement were assessed. The median postoperative Oxford Hip Score was also calculated. RESULTS: At revision surgery, the mean age was 66 ± 12 years (range, 28-91). During an average follow-up of 4.2 ± 1.2 years, reoperation rate for major complications in the non-infected revisions was 15% (n = 11), including five acute deep infections (7%), four periprosthetic fractures (5%), one dislocation and one psoas impingement (1%). The median postoperative Oxford Hip Score was 39 (interquartile range = 14). CONCLUSION: In our series, revision total hip arthroplasty through direct anterior approach was associated with a very low dislocation rate, acceptable complication rates and good functional results. Our results suggest that this procedure is safe and reliable. TRIAL REGISTRATION: Ethical approval for this study was obtained, before enrollment of the first participant, by CUB Erasme's research ethics committee (P2020/323) and C.H.U Ambroise Paré's research ethics committee.

Arthroscopic Repair of the "Tibial Avulsion Triad"-ACL Posterolateral Bundle, PCL, and Lateral Meniscus Posterior Root: The Triple Tunnel Technique.

Tibial avulsion fractures of the posterior cruciate ligament (PCL) are rare injuries that can be fixed either via and open or arthroscopic approach to restore native knee biomechanics. The advantage of arthroscopic fixation is the ability to treat concomitant intra-articular pathologies that are otherwise difficult to identify and manage via an open approach, such as medial meniscal root tears and avulsions. This technical note describes an all-arthroscopic technique of treating a rare and previously undescribed injury pattern consisting of PCL tibial and lateral meniscus posterior root bony avulsions and ACL posterolateral bundle tibial peel-off, termed the "tibial avulsion triad".