Injury
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Randomized Controlled Trial Multicenter Study Comparative Study
Proximal Femoral Nail Antirotation versus Gamma3 nail for intramedullary nailing of unstable trochanteric fractures. A randomised comparative study.
The purpose of this study was to compare the clinical results and the complication rates of a new generation of two intramedullary fixation devices: Proximal Femoral Nail Antirotation® (PFNA) and Gamma3®. We conducted a prospective randomised multicentre trial of 61 patients who underwent a PFNA fixation treatment (31 patients) or a Gamma3 nail (30 patients). ⋯ The risk for experiencing a postoperative complication after Gamma3 nailing was 40% versus 45% after PFNA fixation. At the 6-month and 1-year follow-up evaluations, there were no significant differences in terms of range of motion, clinical scores and radiological outcomes.
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Multicenter Study
Penetrating assaults in children: often non-fatal near-miss events with opportunities for prevention in the UK.
Media reports portray a growing problem of gun and stab assaults amongst UK children. Recent legislative changes aim to increase integration between services and protect children better. Child victims of gun or stab assaults are at increased risk of reinjury and are therefore vital targets for interventions shown to be effective at preventing violent injury. There is currently a paucity of data with which to inform public debate, guide policy and develop prevention strategies. We therefore aimed to provide contemporary data on the epidemiology and clinical outcomes for intentional gun and stab injuries in children, using a large UK city as a model environment and also to ascertain whether interventions to prevent violent injury are currently in routine use in a sample of UK urban paediatric EDs. ⋯ Patient safety literature emphasises the need to identify near miss events. Media reports of tragic child deaths due to gunshot and stabbing are actually accompanied by large numbers of minor wounds that we should see as near miss events. Measures shown to reduce reinjury in these high-risk groups could now be pursued in the UK for patient safety and child protection purposes.
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Multicenter Study
Bicycle accidents - do we only see the tip of the iceberg? A prospective multi-centre study in a large German city combining medical and police data.
Bicycles are becoming increasingly popular. In Münster, a German town with a population of 273,000, bicycles were the main method of transportation in 2009, used more often (37.8%) than cars (36.4%). Each day in Münster, bicycles are used around 450,000 times. In 1982, they were only used around 270,000 times a day. However, the increased use of bicycles has also led to an increased number of bicycle accidents. ⋯ Bicycle accidents occur more frequently than indicated by police records. The results of the Münster Bicycle Study have shown that the actual number of bicycle accidents exceeds the officially reported number by nearly two times. Since bicycle helmets cannot prevent accidents it is recommended not only to focus on helmet use as the only injury prevention method. Other factors, such as weather, pavement and default of traffic, roadworthiness of the bicycles or alcohol/drug abuse also affect the accident rates.
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Review Multicenter Study
Bias towards dementia: are hip fracture trials excluding too many patients? A systematic review.
Patients with hip fractures are older and often present many co-morbidities, including dementia. These patients cannot answer quality of life questionnaires and are generally excluded from trials. We hypothesized that a significant number of patients are being excluded from these studies and this may impact outcomes. ⋯ Only two studies compared demented and non-demented groups. In these studies significant increases in both mortality and complications were found. In summary, when investigating hip fractures, choosing appropriate objective endpoints is essential to ensure results are also applicable to patients with dementia.
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Multicenter Study
Epidemiology of spinal fractures among the elderly in Chongqing, China.
To illustrate the epidemiology of spinal fractures including traumatic spinal fractures and osteoporotic spinal fracture with no specific cause, spinal fracture caused by tumour and tuberculosis among the elderly. ⋯ Spinal fractures usually occur outdoors causing by accidental falls from low heights, most frequently happen on the road. The number of fall-induced injuries and sports injury increased steadily with age, may indicate that there is growing concern for the consequences of falls and sports in the elderly.