Injury
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Current methods of fracture care use various adjuncts aimed at decreasing time to fracture union and improving fracture union rates. Among the most commonly used modalities, low-intensity pulsed ultrasound is emerging as a safe, cost-effective and reliable treatment for both fresh fractures and fracture nonunions. Both in vivo and in vitro basic science studies have helped to elucidate potential mechanisms of ultrasound action and a number of prospective, randomised, double-blind, placebo-controlled trials exist demonstrating the clinical efficacy of low-intensity pulsed ultrasound. This article will review the evidence for the use of low-intensity pulsed ultrasound in fracture care.
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Multicenter Study
Epidemiology and outcome after hip fracture in the under 65s-evidence from the Scottish Hip Fracture Audit.
To report the epidemiology and outcomes after hip fractures in the patients under 65 years of age. ⋯ Patients aged 50-64 years have significantly better outcome measures after surgery for hip fracture in terms of survival and function. Such differences exist even after controlling for differences in patient case-mix variables.
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Comparative Study Controlled Clinical Trial
Continuous compartment pressure monitoring vs. clinical monitoring in tibial diaphyseal fractures.
A cohort of 109 consecutive patients with a tibial fracture who underwent continuous compartment pressure monitoring of the anterior compartment of the leg were reviewed and compared to a historical control group of the immediate previous 109 patients who were clinically monitored. Of these patients 33 underwent fasciotomies for acute compartment syndrome in association with tibial diaphyseal fractures. Seventeen patients had continuous compartment pressure monitoring and 16 clinical assessments alone. ⋯ The mean time delay from injury to fasciotomy was 22 h in the monitored group and 23 h in the non-monitored group. Continuous compartment pressure monitoring did not increase the rate of unnecessary fasciotomies. We could not demonstrate a significant difference in terms of clinical outcome and time delay from injury to fasciotomy.
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This study investigated the sport-related ankle injuries attending an accident and emergency (A&E) department during a 1-year period. ⋯ The results of this study together with the previous study on ankle sprain epidemiology suggested the following sports ankle injury pattern in Hong Kong-major and serious ankle ligamentous sprains and fractures were sustained from basketball, soccer and hiking, leading to A&E attendance, while minor sprains were sustained in running and jogging and racquet sports. We suggested that the Sports medicine specialists in Hong Kong should emphasise the ankle injury prevention strategies in these sports.
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Randomized Controlled Trial Comparative Study
Outcome after femoral neck fractures: a comparison of Harris Hip Score, Eq-5d and Barthel Index.
The objective of this study was to evaluate the discriminatory ability and responsiveness of the Harris Hips Score, the Barthel Index and the Eq-5d (Euroqol) in an unselected population of patients with displaced femoral neck fracture. ⋯ All the scales may be used for this patient group, but Harris Hip Score performed better than the other scales.