ABSTRACT
Introduction: Sternoclavicular joint dislocations are infrequent among all joint injuries. Conservative management is often described and recommended as a means of closed reduction and immobilization of the affected limb. This study aims to review results of patients affected by this injury who were treated surgically using locking plates. Materials and methods: A descriptive case series study was carried out. Cases of patients affected with sternoclavicular joint dislocation treated with open reduction and fixation with locking plates between 2009 and 2019 were included. The Constant score was applied to each patient to assess functional outcome. Results: According to inclusion criteria, 15 patients were included, 12 males and 3 females. Post-operative assessment showed very positive results since the range of Constant scores was consistently over 90 in all cases. Discussion: Fixation of sternoclavicular joint dislocations using locking plates had a low complication rate and provided good functional results.Level of evidenceIV.
ABSTRACT
BACKGROUND: Acetabular fractures often require surgical intervention for fracture fixation and can result in premature osteoarthritis of the hip joint. This study hypothesized that total hip arthroplasty (THA) in patients with a prior acetabular fracture who had undergone open reduction and internal fixation (ORIF) is associated with a higher rate of subsequent periprosthetic joint infection (PJI). METHODS: About 72 patients with a history of acetabular fracture that required ORIF, undergoing conversion THA between 2000 and 2017 at our institution, were matched based on age, gender, body mass index, Charlson comorbidity index, and date of surgery in a 1:3 ratio with 215 patients receiving primary THA. The mean follow-up for the conversion THA cohort was 2.9 years (range, 1-12.15) and 3.06 years (range, 1-12.96) for the primary THA. RESULTS: Patients with a previous acetabular fracture, compared with the primary THA patients, had longer operative times, greater operative blood loss, and an increased need for allogeneic blood transfusion (26.4% vs 4.7%). Most notably, PJI rate was significantly higher in acetabular fracture group at 6.9% compared with 0.5% in the control group. Complications, such as aseptic revision, venous thromboembolism, and mortality, were similar between both groups. CONCLUSION: The present study demonstrates that conversion THA in patients with prior ORIF of acetabular fractures is associated with higher complication rate, in particular PJI, and less optimal outcome compared with patients undergoing primary THA. The latter findings compel us to seek and implement specific strategies that aim to reduce the risk of subsequent PJI in these patients.