Orthopedic Surgery Research Updates

In a retrospective series of 96 patients (mean age 76, 62% female) undergoing revision total hip arthroplasty (rTHA) for femoral periprosthetic fractures (mostly Vancouver B2), postoperative dislocation occurred in 10% and 29% required reoperation. Higher Charlson Comorbidity Index and postoperative dislocation (OR 4.8) were associated with increased 1-year mortality, while modular tapered fluted stems (used in 83 cases) showed 2- and 5-year re-revision survivorships of ~95% and 94%, respectively.

This cohort study of pediatric patients with medial epicondyle fractures treated at a tertiary academic center compared operative (indications included fragment incarceration, >5 mm displacement, and elbow valgus instability) versus nonoperative management with minimum 2-year follow-up, using QuickDASH and PROMIS Pediatric Upper Extremity patient-reported outcome measures. No significant differences were found in QuickDASH scores, PROMIS scores, or range of motion between groups, though surgically treated patients were older and had greater fracture displacement; the authors conclude operative and nonoperative strategies produced comparable long-term patient-reported outcomes when applied to appropriately selected patients.

In a prospective randomized trial of 32 children (age 5–14) with length-unstable femoral shaft fractures, submuscular biological plating (SBP) was compared with flexible intramedullary nailing augmented with external fixation (FIMN/EF). SBP had shorter operative and fluoroscopy times and greater knee flexion at final follow-up, while time to union, complication rates, limb-length discrepancies, and functional outcomes were similar between groups; FIMN/EF offered easier implant removal.