Current practices in haemophilic patients undergoing orthopedic surgery ‑ a systematic review

Bădulescu, Oana Viola; Filip, Nina; Sîrbu, Paul Dan; Bararu-Bojan, Iris; Vladeanu, Maria; Bojan, Andrei; Ciocoiu, Manuela

doi:10.3892/etm.2020.9337

Cited by 12 publications

(8 citation statements)

References 30 publications

(12 reference statements)

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“…The limitation of the approach is that it offers a limited view to the quadrilateral plate, lack of direct visualization of the acetabular surface and control in severely displaced posterior column fractures. In addition, a high rate of postoperative infection and iatrogenic injury to the ilio-femoral vessels and femoral nerve is common (6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Omega plate for the treatment of acetabular fractures involving the quadrilateral plate

et al. 2021

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This retrospective study aimed to assess the outcome of a modified Stoppa approach using an anatomically precontoured plate for the treatment of acetabular fractures. In total, 30 patients (mean age 50.3 years; 25 men and 5 women) with acetabular fractures were treated between January 1, 2018 and December 31, 2019. In all 30 cases, fracture reduction was performed through a modified Stoppa approach and fixed with the omega plate. In specific fracture patterns, additional approaches were needed (lateral window in 4 cases and posterior Kocher-Langenbeck approach in 7 cases). Patients were assessed for restoration of the hip joint congruency, complications, and overall fracture reduction. Quality of reduction was categorized based on Matta's radiological principles and to assess functional outcome the Merle d' Aubigné-Postel and Harris hip score was used. The average anesthesia time was 253.6 min, the mean intraoperative blood lost was 266.6 ml and the mean intraoperative fluoroscopy dose was 3.21 mGy. According to Matta criteria for reduction quality, anatomical reduction was recorded in 22 cases, imperfect reduction in 6 cases and 2 cases had poor reduction. The average follow-up was 22.5 months. Malunion, loss of reduction or implant loosening were not recorded. Late complications included one case of avascular necrosis of the femoral head and post-traumatic arthritis changes in 5 cases. At the final follow-up, a mean Merle d'Aubigné-Postel score of 13.26±4.46 and a mean Harris score of 86.03±13.37 were recorded. The possibility of an anatomically precontoured plate with subsequent lower operative time combined with stable fixation of the primary acetabular fracture fragments and the quadrilateral plate makes the omega plate a viable option for treating acetabular fractures with a very low complication rate and good to excellent results in 89% of the cases.

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Section: Introductionmentioning

confidence: 99%

Omega plate for the treatment of acetabular fractures involving the quadrilateral plate

et al. 2021

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“…Many of these goals focus on maintaining a proper level of platelets and blood clotting factors throughout the procedure. Badulescu et al 2 specifically focused on management of patients with hemophilia A and B undergoing total arthroplasty and state that recombinant coagulation factor VIII and/or an antifibrinolytic should be used during surgery. To maximize use of intraoperative hemolytic management, patients undergoing ORIF who need additional joint surgery could be candidates to address all operative treatments under 1 anesthetic.…”

Section: Discussionmentioning

confidence: 99%

Association of Bleeding Disorders and Risk of Complications Following Open Reduction and Internal Fixation of the Ankle

et al. 2021

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Background: Open reduction and internal fixation (ORIF) of the ankle is a common procedure performed to correct ankle fractures in many different patient populations. Diabetes, peripheral vascular disease, and osteoporosis have been identified as risk factors for postoperative complications following surgery for ankle fractures. To date, there have not been any studies evaluating postoperative outcomes in patients with bleeding disorders undergoing operative treatment for ankle fractures. The aim of this study was to determine the postoperative complication rate following ORIF of the ankle in patients with a bleeding disorder vs those without a bleeding disorder. Methods: From 2006 to 2018, patients undergoing operative treatment for ankle fracture were identified in the National Surgical Quality Improvement Program database. Two patient cohorts were defined: patients with a bleeding disorder and patients without a bleeding disorder. Patients who underwent either inpatient or outpatient ORIF of the ankle were included in this study. In this analysis, demographics, medical comorbidities, and postoperative complications variables were assessed between the 2 cohorts. Bivariate and multivariate analyses were performed. Results: Of 10 306 patients undergoing operative treatment for ankle fracture, 9909 patients (96.1%) had no bleeding disorder whereas 397 patients (3.9%) had a bleeding disorder. Following adjustment on multivariate analysis, compared to patients who did not have a bleeding disorder, those with a bleeding disorder had an increased risk of any postoperative complications (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.05-2.08, P = .024), requirement for postoperative blood transfusion (OR 2.86, 95% CI 1.53-5.36, P = .001), and extended length of hospital stay greater than 5 days (OR 1.46, 95% CI 1.10-1.93, P = .010). Conclusion: Patients with bleeding disorders are associated with increased risk of postoperative complications following ORIF for ankle fractures. Determining patient risk factors and creating optimal preoperative and perioperative management plans in patients with bleeding disorders undergoing ORIF can be beneficial in reducing postoperative complications, improving patient outcomes, and reducing overall morbidity. Level of Evidence: Level III, retrospective cohort study.

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“…HHC is characterized by increased concentration of homocysteine (HC) in plasma, and is associated with both venous and arterial thrombosis [23][24][25][26]. It is generally accepted that HHC dis-rupts normal endothelial functions, which are the relaxation of blood vessels and the state of anticoagulation of the blood, thus disturbing coagulation-fibrinolysis balance [27,28]. Hyperhomocysteinemia is caused by an inherited or acquired deficiency of the enzymes involved in its metabolism (methylenetetrahydrofolate reductase or cystathionine beta synthetase) or a deficiency of vitamins belonging to the group of B vitamins.…”

Section: Laboratory Assessment Of Dvtmentioning

confidence: 99%

Serological Parameters and Vascular Investigation for a Better Assessment in DVT during Pregnancy—A Systematic Review

et al. 2021

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Pregnancy and the postpartum period represent a condition characterized by a thrombotic predisposition. The majority of pregnant women do not face acute or severe thrombotic events. In general, mild inconveniences such as leg swelling or moderately painful thrombotic events (phlebitis) are encountered. However, when pregnancy is associated with inherited or acquired deficits that affect homeostasis, the risk of acute or even life-threatening events can increase significantly. The major consequence is the loss of the fetus or the venous thromboembolism that endangers the mother’s life. Venous thromboembolism is caused by deep vein thrombosis, therefore timely detection and especially the assessment of the extent of the thrombotic event are crucial. In this paper we have summarized the most important paraclinical investigations. The study emphasizes the importance of selecting the methods of investigation. The right choice allows establishing a correct diagnosis and individualizing the treatment.

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Current practices in haemophilic patients undergoing orthopedic surgery ‑ a systematic review

Cited by 12 publications

References 30 publications

Omega plate for the treatment of acetabular fractures involving the quadrilateral plate

Omega plate for the treatment of acetabular fractures involving the quadrilateral plate

Association of Bleeding Disorders and Risk of Complications Following Open Reduction and Internal Fixation of the Ankle

Serological Parameters and Vascular Investigation for a Better Assessment in DVT during Pregnancy—A Systematic Review

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