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There are many published cup anteversion measurements for postoperative total hip arthroplasty (THA), including Liaw's, Lewinnek's, and Murray's methods. However, most measurements ignore the potential pelvic rotation on radiographs except in Liaw's method. Without considering pelvic rotation, clinicians can miscalculate cup anteversion. Therefore, we aimed to quantify the mean degree of pelvic rotation. Herein, we collected 388 radiographs of 98 postoperative THA hips of 77 patients and measured pelvic rotation by measuring h, the horizontal displacement of the sacrococcygeal junction associated with the upper pole of the symphysis pubis, and ssd, the distance between the sacrococcygeal junction and pubic symphysis. The angle θ of pelvic rotation was defined as θ = arc sin (h/ssd) × (180°/π). The mean degree of pelvic rotation was then calculated. The standard deviation of h was 7.84 mm, and the mean ssd was 158 mm. The potential pelvic rotation was 2.50°. The p-values from the paired t-test were all >0.05 when interobserver and intraobserver errors were assessed. This is the first study to quantify the potential pelvic rotation in the coronal plane on postoperative plain radiographs. The potential pelvic rotation was too large to be neglected during the measurement of cup anteversion. [ABSTRACT FROM AUTHOR]

Background and objectives: Treatment of a displaced or comminuted periprosthetic distal femur fracture is challenging, especially in patients with osteoporosis. In this case report, we shared our successful surgical experience of using a long intramedullary fibula bone graft in a plate fixation surgery for a periprosthetic distal femur fracture in an extremely elderly patient with osteoporosis. Case report: A 95-year-old woman with severe osteoporosis (bone mineral density level: −3.0) presented with right knee pain and deformity after a fall, and a right periprosthetic distal femur fracture was identified. The patient underwent an open reduction and an internal plate fixation surgery with the application of a long intramedullary fibular bone graft. Due to a solid fixation, immediate weight-bearing was allowed after the surgery. She could walk independently without any valgus or varus malalignment or shortening 3 months after the surgery. A solid union was achieved 4 months postoperatively. Conclusions: We present a case wherein a long intramedullary allogenous fibula strut bone graft was used successfully to treat a right periprosthetic femur fracture in an extremely elderly patient. A long allogenous fibula bone graft can act not only as a firm structure for bridging the bone defect but also as a guide for precise component alignment. We believe this treatment option for periprosthetic fractures is beneficial for achieving biological and mechanical stability and facilitates early mobilization and weight-bearing for the patient. [ABSTRACT FROM AUTHOR]

The aim of this study is to develop an AI model that accurately identifies referable blepharoptosis automatically and to compare the AI model's performance to a group of non-ophthalmic physicians. In total, 1000 retrospective single-eye images from tertiary oculoplastic clinics were labeled by three oculoplastic surgeons as having either ptosis, including true and pseudoptosis, or a healthy eyelid. A convolutional neural network (CNN) was trained for binary classification. The same dataset was used in testing three non-ophthalmic physicians. The CNN model achieved a sensitivity of 92% and a specificity of 88%, compared with the non-ophthalmic physician group, which achieved a mean sensitivity of 72% and a mean specificity of 82.67%. The AI model showed better performance than the non-ophthalmic physician group in identifying referable blepharoptosis, including true and pseudoptosis, correctly. Therefore, artificial intelligence-aided tools have the potential to assist in the diagnosis and referral of blepharoptosis for general practitioners. [ABSTRACT FROM AUTHOR]

Background: Mismatch of intramedullary nails with the bowing of femur is a frequent clinical finding. Previous studies showed inconsistent results. Methods: We present an algorithm of region growing territory method to get the radii of the anterior bowing of femur. We also tested it on ten radiographs. Plain radiographs of the lateral view of femur from five men and five women taken between January and August 2014 in Taipei Hospital were chosen randomly. The curvature of femur outline and medullary canal were measured for three times each. Radii of curvature of whole femur, proximal, middle and distal parts were calculated and analyzed. Results: The coefficient of variation of the 240 measurements ranged from 0.007 to 0.295 and averaged 0.088. The average radii of curvature of the whole, proximal, middle, and distal femur were 1318 mm, 752 mm, 1379 mm, and 599 mm, respectively. At the distal part of the femur, the radius of curvature of the femur outline (452 mm) was smaller than the medullary canal (746 mm) (p < 0.05). Women's femur was straighter than men's when we compared the whole length (1435 mm vs. 1201 mm, p < 0.05). The radii we calculated were smaller than the current intramedullary nails. Conclusion: The results showed that the inter-observer and intra-observer differences are acceptable, support the impression that different bowing conditions existed for Asians as compared to Caucasians, and also indicate the mismatch of current instruments to the curvature of femur. [ABSTRACT FROM AUTHOR]