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American Journal of Orthopedic Research and Reviews

American Journal of Orthopedic Research and Reviews, Recent Articles

COMPUTATIONAL ANALYSIS OF FEMORAL STRENGTH AND FRACTURE LOCATION OF NORMAL, OSTEOARTHRITIS AND AVASCULAR NECROSIS FEMURS USING CT-IMAGE BASED FINITE ELEMENT METHOD

Research Article of American Journal of Orthopedic Research and Reviews Computational Analysis of Femoral Strength and Fracture Location of Normal, Osteoarthritis and Avascular Necrosis Femurs using CT-Image based Finite Element Method Zaw Linn Htun1, 3, Mitsugu Todo1, 2, Manabu Tsukamoto4, Takuaki Yamamoto5 , Masaaki Mawatari6,  Yasuharu Nakashima7 1Interdisciplinary Graduate School of Engineering Sciences, Kyushu University 6-1 Kasuga-koen, Kasuga 816-8580, Japan; 2. Research Institute for Applied Mechanics, Kyushu University 6-1 Kasuga-koen, Kasuga 816-8580, Japan; 3. Department of Physics, University of Yangon, 11041 Kamayut, Yangon, Myanmar; 4. Department of Orthopaedic Surgery, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka 807-8555, Japan; 5. Department of Orthopedic Surgery, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180; 6. Department of Orthopedic Surgery, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan; 7. Department of Orthopaedic Surgery, Kyushu University 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8580, Japan Recent years, the risk of hip fractures in elderly people has exponentially increased due to a progressive loss of bone mass and bone structure deterioration due to osteoporosis and increased incidental falls. It is, therefore, expected that the prediction of femoral strength and fracture location of specific patient will be clinically very useful. It is also considered that some typical femoral diseases such as osteoarthritis (OA) and avascular necrosis (AVN) could affect the strength and fracture behaviour of the femurs. In this study, 130 computational femoral models were constructed using CT images of 73 patients. Then, CT image based finite element method (CT-FEM) combined with a damage mechanics analysis was applied to predict the fracture load as the femoral strength and the fracture location of the femoral models. The computational results exhibited that the fracture load tended to increase with increase of the volumetric bone mineral density (vBMD) estimated in the femoral head and neck region in all the three types ...
American Journal of Orthopedic Research and Reviews, Recent Articles

TIBIAL PLATEAU FRACTURES IN A LIMITED-RESOURCE SETTING: A PROSPECTIVE STUDY OF SURGICAL TECHNIQUES AND OUTCOME OVER THREE YEARS

Research Article of American Journal of Orthopedic Research and Reviews Tibial plateau fractures in a limited-resource setting: A prospective study of surgical techniques and outcome over three years Daniel Handy Eone1*, Itambi Maxwell Asoh1, Ernest Kikah Ndifor1, Mbaga Ntjam Andre Claude1, Fonkoue Loic2, Muluem Olivier Kennedy1, Guifo Marc Leroy3, Kaldadak Martin4, Ibrahima Farikou5 1Orthopaedic and Trauma Surgery Unit, Yaounde Central Hospital. 2Orthopaedic and Trauma Surgery Unit, Yaounde Emergency Centre. 3Orthopaedic and Trauma Surgery Unit, Yaounde University Teaching Hospital. 4Orthopaedic and Trauma Surgery Unit, Yaounde Military Hospital. 5Department of Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, The University of Yaounde I. Introduction: Tibial plateau fractures form a wide spectrum of injuries accounting for 1.2% of all fractures and a prevalence of 10 cases per 100,000 inhabitants. Methodology: A prospective consecutive multicentre study from May 2018 to May 2021 was carried out in Yaounde. All consenting cases of tibial plateau fracture underwent surgical treatment while patients with pathologic fractures, previous knee osteoarthritis, medically unfit for surgery, and discharging against medical advice were excluded. Data was analysed with SPSS 26.0 and the level of significance set at p<0.05. Results:Eighty-four (84) cases of tibial plateau fractures were sampled and 68 consented to surgery. The mean age was 42 ±13.6 years and sex ratio 2.4. Estimated prevalence was 2.2 cases per 100,000 inhabitants. Schatzker type II fractures were most represented (33.3%). The left leg was affected in 57.1%. Motorbike accidents were the main cause of injury (66.7%). Of the 68 operated, 63.3% by plating osteosynthesis, 32.4% by external fixation, and 4.4% by screws fixation. Tricortical iliac bone graft was realised in 4 cases. The minimum follow-up was 6 months, with a median of 18 months (5 to 37 months). Plating osteosynthesis (p<0.001), operative time between 60 to 120 minutes (p<0.02) and a good ...
American Journal of Orthopedic Research and Reviews, Recent Articles

INDICATIONS AND OUTCOMES OF THE KOCHER-LANGENBECK SURGICAL APPROACH IN THE MANAGEMENT OF ACETABULAR FRACTURES IN A RESOURCE LIMITED SETTING

Research Article of American Journal of Orthopedic Research and Reviews Indications and Outcomes of the Kocher-Langenbeck Surgical Approach in the Management of Acetabular Fractures in a Resource Limited Setting Handy ED1*, EK Ndifor¹, AM Itambi¹, Mbaga AC¹, Ndikum BN², Fonkoue L³, Muluem K⁴, Guifo ML⁵, MA Sosso⁶ 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 1Orthopeadics and Trauma Unit, Yaounde Central Hospital. 2Public Health Expert, Elig-Essono Sub-Divisional Medical Centre. 3Orthopeadics and trauma unit, Yaounde Emergency Centre. 4Orthopeadics and Trauma Unit, Yaounde General Hospital. 5Orthopeadics and Trauma Unit, Yaounde University Teaching Hospital. 6Head of Department, Surgery and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I. The Kocher-Langenbeck (K-L) approach is the ‘workhorse’ of surgery for acetabular fractures needing posterior fixation. It is indicated for most of these fractures for proper surgical technique and optimal outcome. We therefore evaluated the outcome of surgically treated acetabular fractures through the K-L approach in our setting with limited resources. 57 patients were operated by the K-L approach during the 3-year study period. The most common indications of this approach were: posterior wall (38.6%) and transverse + posterior wall fractures (36.8%). Based on Matta’s criteria of fracture reduction, 81 % were judged anatomic, 16% imperfect and 3 % poor. A surgery waiting time of 8 to 14 days after injury, significantly favoured anatomic fracture reduction. The MAP score was excellent in 72 % and unacceptable in 10.6 %. Factors associated with poor outcomes were poor fracture reduction and the development of early post-operative complications. Iatrogenic sciatic nerve palsy (ISNP) was the most significant post-operative complication (19.3%). The levering of Hohmann retractors in the sciatic notches was the major risk factor for developing ISNP, compared to the use of sciatic nerve ...
American Journal of Orthopedic Research and Reviews, Recent Articles

FOOT AND ANKLE CHARACTERISTICS IN GOUT: A SYSTEMATIC REVIEW

Review Article of American Journal of Orthopedic Research and Reviews Foot and Ankle Characteristics in Gout: A Systematic Review Kerry Bendell1 MSc, Brunilda Agalliu2 BSc(Hons), Simon Otter2,3* PhD 1Podiatry Department Sussex Community NHS Foundation Trust, Durrington Health Center, BN13 2RX 2School of Sport & Health Science, University of Brighton, 49 Darley Rd, Eastbourne, BN20 7UR, UK 3Centre for Regenerative Medicine and Devices, University of Brighton, Lewes Rd, Brighton, BN2 4AT Objectives: Gout has a predilection for the foot and ankle, but the impact of gout has limited presence in the literature. The aim of this systematic review was to synthesise existing literature which has investigated the characteristics of foot and ankle involvement in gout; identifying consensus and highlighting areas for further study. Methods: Studies were included if they were published in English and involved participants over 18 years of age with gout, and presented original findings relating to outcome measures associated with the foot and ankle. Methodological quality was assessed using a modified version of the Quality Index Tool. Results. Of 707 studies identified, 16 met the inclusion criteria and were included in this review. The mean (range) quality score was 68.1% (38.9%-88.9%). Compared to controls, participants with gout reported higher levels of activity limitation, foot-related pain and disability and walked more slowly. Plain radiography, dual-energy Computer Tomography and diagnostic ultrasound consistently demonstrated pathological features of gout in the first metatarsophalangeal joint and Achilles tendon. However, studies offered limited quality, particularly around recruitment strategies, validity and potential impact of confounding factors, making definitive statements difficult. Conclusions: This systematic review highlights the negative impact of gout on the structure and function of the foot and ankle causing significant impairment and disability. To effectively guide management, improvements in methodological quality are recommended. Keywords: Gout, Foot, Ankle ...

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American Journal of Orthopedic Research and Reviews

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