Injury
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Case Reports
Isolated locked compression plating for Vancouver Type B1 periprosthetic femoral fractures.
Report treatment results of periprosthetic femoral fractures adjacent or at the tip of a stable femoral stem (Vancouver Type B1) using a locked compression plate as the sole method of fracture stabilisation. ⋯ Open reduction internal fixation of Vancouver Type B1 periprosthetic femoral fractures using a lateral locked-plate that spans the full extent of the femur as the sole method of stabilisation is a successful treatment method that minimises soft-tissue dissection and provides adequate fixation strength to maintain fracture alignment to fracture union.
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Case Reports
The role of LISS (less invasive stabilisation system) in the treatment of peri-knee fractures.
The purpose of present study was to evaluate the role of LISS after a large series of patients in whom a fracture around the knee had been treated with this uniform technique. Between April 2004 and September 2006, 210 patients with a total of 216 fractures around the knee were treated with LISS, all at the Affiliated Hospital to Nantong University. Patients were followed for a mean of 27 months (range 12-42 months). 26 patients were excluded from the study. ⋯ The results indicate the LISS system is perfect but by no means unique in the treatment of the fractures around the knee. The fixation is adequate enough to maintain alignment and obtain union with a low incidence of complications even in patients with osteoporotic bone. We firmly believe favourable results can be achieved when this device is combined with correct indications as well as skillful techniques.
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Improved training and expertise has enabled emergency medical personnel to provide advanced levels of care at the scene of trauma. While this could be expected to improve the outcome from major injury, current data does not support this. ⋯ Current data relates to the urban environment where transport times to trauma centres are short and where it appears better to simply rapidly transport the patient to hospital than attempt major interventions at the scene. There may be more need for advanced techniques in the rural environment or where transport times are prolonged and certainly a need for more studies into subsets of patients who may benefit from interventions in the field.
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We performed a retrospective study of 28 patients who underwent bolt fixation for a syndesmotic injury to the ankle. The mean follow-up period was 66 months (range: 24-139 months). The results of surgery were assessed clinically and radiographically. ⋯ It is a simple and quick operative procedure providing reliable syndesmotic reduction. The material should not be removed prior to walking. The only drawback is the greater need for removal in the event of local symptoms.
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The management of polytraumatised patients remains challenging in spite of advances and improvements in trauma care in recent decades. Trauma systems require enormous staff resources as well as technical equipment. Internal and external quality management processes are necessary to identify weak points and improve treatment quality. ⋯ Standard operating procedures such as prehospital trauma algorithms and clinical management protocols (ie, ATLS) can help to standardise and compare treatment of patients suffering from major trauma. In this overview, we describe the development and current state of our trauma department. Differences in our cohort of polytraumatised patients compared to other facilities and current strategies for initial treatment of these patients are also discussed.