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Harm Hoekstra, Jasper Vanhees, Juriaan van den Berg, Stefaan Nijs
No abstract text is available yet for this article.
November 3, 2018: Injury
Miquel Videla-Cés, José-Miguel Sales-Pérez, Rubén Sánchez-Navés, Eudald Romero-Pijoan, Sebastián Videla
Background Peri-implant fractures occur in association with an implant used to treat a previous injury and that is still attached to the bone. Peri-implant fractures are considered to be relatively "new" fractures and they lack any classification system that is accepted in practice. Generally, the fracture classification systems currently used in our clinical practice were not developed or validated using rigorous scientific evaluation methods. Aim To provide data for a proposed classification of peri-implant femoral fractures...
November 1, 2018: Injury
Michael M Hadeed, Cody L Evans, Brian C Werner, Wendy M Novicoff, David B Weiss
INTRODUCTION: Tibial pilon fractures are often treated with initial external fixation followed by delayed definitive fixation. It has been postulated that the external fixator pin site may correlate with infection risk. The purpose of this study was to determine whether external fixator pin-site distance from definitive implants impacts the risk of deep infection in pilon fractures. MATERIALS AND METHODS: A retrospective cohort study was completed at a single level 1 trauma center...
November 1, 2018: Injury
Daniel Wenger, Sanet Andersson
INTRODUCTION: The reported rate of nonunion of distal femoral fractures varies in the literature. Several risk factors for nonunion following lateral locked plating (LLP) have been described. We aimed to study the rate of nonunion, and risk factors thereof, in a Swedish population where fragility fractures are common. A secondary aim was to study risk factors for reoperation for any cause. PATIENTS AND METHODS: We retrospectively reviewed the hospital files and radiographs of all adult patients admitted to our institution with a distal femoral fracture, from 2004 through 2013...
October 30, 2018: Injury
Xin Zhang, Da-Ke Tong, Fang Ji, Xu-Zhou Duan, Pei-Zhao Liu, Sheng Qin, Kai-Hang Xu, Xia-Ti Di-Li
To evaluate the risk factors for the development of postoperative delirium and design a predictive nomogram for the prevention of delirium in elderly patients with a hip fracture, we retrospectively studied 825 patients who sustained a femoral neck fracture from January 2005 to December 2015. Independent risk factors for developing delirium within 6 months of surgery were identified using multivariable logistic regression analyses. A predictive nomogram model was built based on the results, and the discrimination and calibration were determined by C-index and calibration plot...
October 30, 2018: Injury
David J Ciufo, Caroline P Thirukumaran, Russel Marchese, Irvin Oh
BACKGROUND: Many patients undergoing below knee amputations (BKA) return for subsequent unplanned operations, hospital readmission, or postoperative complications. This unplanned medical management negatively impacts both patient outcomes and our healthcare system. This study primarily investigates the risk factors for unplanned reoperation following BKA. METHODS: Below knee amputations from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database from the years 2012-2014 were identified by CPT code 27880 for amputation through the tibia and fibula...
October 30, 2018: Injury
Zi-Chen Hao, Yan Xia, Jiang-Hong Wu, Yun-Tong Zhang, Shuo-Gui Xu
PURPOSE: To compare the outcomes of the arched shape-memory connector (ASC) only fixation and the lateral one-third tubular plate fixation in managing unstable Type A or B lateral malleolus fractures according to the Weber (AO) classification, and to evaluate the feasibility and reliability of ASC only fixation in treating these fractures. METHODS: From January 2010 to January 2015, 148 patients with Type A or B (Weber (AO) classification) lateral malleolus fractures treated with the arched shape-memory connector (ASC) only fixation or lateral plate fixation were included...
October 30, 2018: Injury
K Young, A Aquilina, T J S Chesser, M L Costa, S Hettiaratchy, M B Kelly, C G Moran, I Pallister, M Woodford
AIMS: To assess current national practice in the management of severe open tibial fractures against national standards, using data collected by the Trauma and Audit Research Network. MATERIALS AND METHODS: Demographic, injury-specific, and outcome data were obtained for all grade IIIB/C fractures admitted to Major Trauma Centres in England from October 2014 to January 2016. RESULTS: Data was available for 646 patients with recorded grade IIIB/C fractures...
October 29, 2018: Injury
Rik J Molenaars, Lucian B Solomon, Job N Doornberg
OBJECTIVES: The purpose of this study is to analyze posteromedial fragment morphology using two-dimensional computed tomography fracture mapping and to compare posteromedial fragment morphology in various Schatzker type tibial plateau fractures. MATERIALS & METHODS: One hundred twenty-seven consecutive AO/OTA B- and C-type tibial plateau fractures were retrospectively analyzed using 2DCT fracture mapping. The posteromedial articular fracture angle and articular surface areas of all fractures with posteromedial fragments were calculated...
October 29, 2018: Injury
Haggai Schermann, Ron Gurel, Aviram Gold, Eran Maman, Oleg Dolkart, Ely L Steinberg, Ofir Chechik
INTRODUCTION: Direct oral anticoagulation agents (DOACs) are increasingly prescribed to older adults. Concerns for perioperative blood loss dictate cessation of anticoagulation treatment and postponement of surgery until the coagulation system returns to normal state. The goal of this study is to compare the estimates of perioperative blood loss and mortality between patients using DOACs and patients receiving no anticoagultaion, in order to challenge the existing policy and question the need for surgery deferral...
October 29, 2018: Injury
M C Liebensteiner, B Henninger, C Kittl, R Attal, J M Giesinger, C Kranewitter
PURPOSE: To assess the visibility of both the anterolateral ligament (ALL) and the deep structures of the iliotibial tract (ITT) by means of MRI in paediatric patients. To determine reproducibility for such measurements. METHODS: Knee MRI data from patients aged <18a without lesions of the capsule or ligaments, fractures, bone edemas, foreign material or motion artifacts were analyzed by two musculoskeletal radiologists separately and twice. The visibility of the different parts of the ALL was determined (femoral, meniscal, tibial parts)...
October 29, 2018: Injury
Gamal Ahmed Hosny, Abdel-Salam Abdel-Aleem Ahmed
Nonunion is a devastating complication of tibial fractures with a debilitating effect. Several studies reporting tibial nonunions in adults are available; however, the reports on infected nonunions in children are scarce. The purpose of this study was to evaluate the results of treating paediatric infected tibial nonunion using Ilizarov fixator without radical resection. MATERIALS AND METHODS: The study included 36 cases with infected nonunion of the tibia with 31 males and 5 females, and an average age of 11...
October 29, 2018: Injury
Won Chul Shin, Nam Hoon Moon, Jae Hoon Jang, Jae Yoon Jeong, Kuen Tak Suh
BACKGROUND: The main purpose of this study is to introduce our surgical technique and report surgical outcomes for percutaneous cable fixation in the treatment of subtrochanteric femoral fractures. METHODS: Between May 2013 and April 2017, 51 patients with subtrochanteric femoral fractures treated with closed intramedullary nailing and percutaneous cable fixation were enrolled in this study. Postoperative angulation, union rate, time from injury to union, and femoral shortening were also evaluated to assess radiologic outcomes...
October 29, 2018: Injury
R Stroop, Ch Schöne, Th Grau
BACKGROUND: Vehicle extrication of crash victims is a highly-demanding challenge, due to the frequently life-threatening injuries of entrapped occupants. In this phase, crash victims are often exposed to the outdoor-temperature, with the risk of sustained hypothermia. Hypothermia can significantly raise the morbidity and mortality rates of crash victims. Therefore, we have correlated the incidence of severe car accidents with entrapped patients, the outdoor conditions, and expenditure of time for extrication...
October 24, 2018: Injury
Cedric Carrie, Yassine Guemmar, Vincent Cottenceau, Louis de Molliens, Laurent Petit, Francois Sztark, Matthieu Biais
Introduction The main objective of this prospective study was to assess the incidence of chronic pain and long-term respiratory disability in a single-center cohort of severe blunt chest trauma patients. Methods Over a 10-month period, all consecutive blunt chest trauma patients admitted in Intensive Care Unit (ICU) were screened to participate in a 3-month and 12-month follow-up. The following variables were prospectively assessed: persistence of chronic chest pain requiring regular used of analgesics, neuropathic pain, respiratory disability, physical and mental health status...
October 22, 2018: Injury
James N Bogert, Jeffrey P Salomone, Pamela W Goslar, Jordan A Weinberg
INTRODUCTION: As the population ages, growing numbers of individuals are turning to assisted mobility devices (AMDs) to maintain independence. These devices often place users in a seated position. Like ambulatory pedestrians, pedestrians seated in an AMD are at risk for involvement in an automobile versus pedestrian crash. The purpose of this study is to compare the injury pattern and comorbidities of standing pedestrians struck by an automobile versus those of seated pedestrians. METHODS: The Arizona State Trauma Registry was queried for pedestrians struck by an automobile between 2010 and 2015...
October 22, 2018: Injury
Ingrid Bugge, Tine K Jensen, Lisa Govasli Nilsen, Øivind Ekeberg, Grete Dyb, Trond H Diseth
OBJECTIVE: The objective of the study was to explore hospitalized youths' experiences with psychosocial care in the hospital after the shooting on Utøya Island, Norway, in 2011. METHODS: 17 hospitalized youths were interviewed face-to-face 30-31 months after the attack. The interviews were analysed using interpretative phenomenological analysis (IPA). The initial reading and coding of the interviews was carried out inductively. To explore the emphasis placed on everyday conversation and ordinary interaction detected during the initial reading, the text was re-read while bearing in mind concepts from the research field of sociology concerning the therapeutic potential in commonplace conversations and situations...
October 22, 2018: Injury
Jonne Prins, Johanna C E Donders, David L Helfet, David S Wellman, Craig E Klinger, Mariya Redko, Peter Kloen
INTRODUCTION: Periprosthetic femoral nonunions (PPFN) have a reported incidence of 3-9%. Literature on PPFN management is scarce. The study aim was to review combined results of two academic teaching hospitals using comparable PPFN treatment strategies. MATERIALS AND METHODS: A retrospective review was conducted of all patients treated for a PPFN between February 2005 and December 2016. All patients treated with internal fixation for a PPFN with complete clinical and radiological follow-up until healing were included...
October 18, 2018: Injury
Alvin K Shieh, Motasem Refaat, Nasser Heyrani, Tanya C Garcia-Nolen, Mark A Lee, Jonathan G Eastman
OBJECTIVES: Prophylactic femoral neck fixation may be performed in the setting of geriatric diaphyseal femur fracture, pathologic or impending atypical femur fractures. Fixation constructs often utilize cephalomedullary implants with one or two proximal interlocking screws into the femoral head/neck. Variations in proximal femoral anatomy and implant design can interfere with the placement of two screws in the femoral head and neck. Our objective was to assess the strength of piriformis entry reconstruction implants with one versus two proximal interlock screws for prophylactic femoral neck fixation...
October 17, 2018: Injury
Sean W L Ho, Lynn Thwin, Ernest B K Kwek
BACKGROUND: Occult hip fractures in the elderly are challenging to diagnose and often result in surgical delays which may worsen outcomes. However, the minimally displaced nature of these fractures may conversely lead to better outcomes. The aim of this study was to determine if surgically treated occult hip fractures have better short to mid term functional outcomes when compared to non-occult fractures. The secondary aim was to determine if there are any differences in clinical characteristics of patients who present with occult hip fractures...
October 15, 2018: Injury
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