Injury
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The extended deltoid-splitting approach was developed as an alternative to the deltopectoral approach in the treatment of three- and four-part proximal humeral fractures. The aim of our prospective study was to determine whether this approach was associated with evidence of nerve injury, functional deficits or other complications in these cases, during the first year following reconstruction. ⋯ This technique is a useful alternative in the treatment of complex proximal humeral fractures, providing good access for reduction and implant placement without adverse effects.
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To illustrate the correlations and effects of age, gender and cause of accident on the type of vertebral fracture and fracture distribution, as well as on the likelihood to sustain an associated injury or neurological deficit. ⋯ This study demonstrates correlations between the cause of accident, the type of spinal fracture and the fracture distribution. Using the AO classification, the likelihood to sustain either associated and/or spinal cord injuries, is predictable.
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To compare the prevalence and characteristics of hip fractures sustained after inpatient falls (hospital subgroup) to those presenting with a fall in the community (control group). ⋯ Patients suffering hip fractures after falls in hospital are frailer with impaired cognitive function and have more co-morbidities than those suffering a fracture in the community. These patients have increased mortality, with almost 50% dead within 1 year of the fall. The majority of hip fractures after falls occur in medical or geriatric wards, but the highest risk group appears to be elderly patients on psychiatric wards. Therefore, falls risk assessment and falls prevention schemes in hospital elderly patients are of paramount importance.
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To measure long-term functional outcome and health-related quality of life following tibial fracture in association with the full spectrum of soft tissue injury. ⋯ These results show that patients with these injuries still report long-term problems with their health-related quality of life, though to varying degrees. This information is useful when determining the treatment options for these patients and it is important that it is shared with the patient prior to surgery where possible.
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Neglected femoral diaphyseal fractures are not uncommon in developing nations however there is a paucity of literature in this regard. Due to lack of effective traction, reduction or immobilisation these fractures are invariably associated with shortening and adjacent joint stiffness, presenting a challenging problem to the treating surgeon. The socioeconomic constraints in our society which result in patients seeking non-medical forms of treatment in the first place also warrant the need for an economically viable, simple effective form of treatment which can be carried out in a less advanced setup, gives reliable outcomes and allows early return to work. ⋯ We conclude that the treatment of neglected femoral diaphyseal fractures with open intramedullary nailing and bone grafting followed by manipulation of the knee with preoperative traction in selected cases is a satisfactory method of treatment showing reliable bony union however knee mobilisation should be undertaken with caution.