RESUMO
Background: High cost of eight-plate makes it unavailable in many countries; therefore, developing an alternative device for temporary hemiepiphysiodesis of knee deformities in pediatrics is valuable. In this study, we compared the outcome of the eight-plate with the reconstruction-plate in this setting. Methods: In this retrospective study, 109 skeletally immature patients (212 physes) who underwent temporary hemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate were used in 47 patients (90 physes) and 62 patients (122 physes), respectively. Outcome measures were the valgus angle, medial proximal tibial angle (MPTA), the lateral distal femoral angle (LDFA), the joint-line convergence angle (JLCA), and lower limb mechanical axis (LLMA). Results: The baseline characteristics of the patients were comparable between the two plate groups. The mean follow-up of the patients was 32.9 ± 15.1 months. The mean MPTA change was 2.7 ± 3.7º in the eight-plate group and 2.1 ± 3.4º in the reconstruction-plate group (P=0.2). The mean LDFA improvement was 8 ± 3.7º in the eight-plate group and 7.9 ± 3.5º in the reconstruction-plate group (P=0.61). The mean valgus correction was 10.7 ± 4.4º in the eight-plate group and 10.4 ± 4.6º in the reconstruction-plate group (P=0.74). Moreover, the mean change of JLCA was 0.7 ± 1.3º in the eight-plate group and 0.8 ± 1.3º in the reconstruction-plate group (P=0.58). The postoperative LLMA was comparable between the two study groups as well. In total, five postoperative complications were recorded in this series, which included one case of screw loosening in each group, two cases of overcorrection, and one screw breakage in the reconstruction-plate group. Conclusion: The radiologic results and complications of the reconstruction-plate are comparable with the eight-plate. Therefore, it can be safely and efficiently used in hemiepiphysiodesis to correct idiopathic genu valgum.
RESUMO
Coronavirus disease 2019 (COVID-19) patients who undergo hip fracture surgery are expected to have worse outcomes because they are vulnerable to developing COVID-19-associated complications. The present review attempted to assess the in-hospital and 30-day mortality rates as well as the length of hospital stay in patients with COVID-19 infection who had hip fracture surgery. METHODS: Two authors independently searched Google Scholar, PubMed, Web of Knowledge, SCOPUS, and Embase, based on the MeSH-matched scientific keywords. The nine-star Newcastle-Ottawa Scale (NOS) scoring system was employed to assess the methodological quality of all eligible studies. RESULTS: Eleven cohort studies that included 336 patients comprised the study. Three studies reported in-hospital mortality. Eight studies reported 30-day postoperative mortality. The pooled in-hospital mortality rate was 29.8% (95% CI: 26.6%-35.6%). The pooled 30-day postoperative mortality rate was 35.0% (95% CI: 29.9%-40.5%). The mean hospital stay was 11.29 days (95% CI: 10.65 days-11.94 days). CONCLUSIONS: The rates of in-hospital and 30-day mortality in COVID-19 patients who undergo hip fracture surgery is high. These data suggest delaying hip fracture surgery until COVID-19 infection of the patients is controlled. LEVEL OF EVIDENCE: Level II.
