Injury
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The unique configuration of periprosthetic femoral fractures (PFFs) is a major determinant of the subsequent management. The aim of this preliminary study was to investigate potential relationships between fracture angle (FA), fracture level (FL) and bone quality of Vancouver type B PFF. The FA, FL and the canal thickness ratio (CTR) were quantified for 27 patient X-rays. ⋯ This preliminary study suggests that the effect of FA on the optimal management of Vancouver type B1 fractures could be considered, independent of the quality of the bone or fracture position. Furthermore, fractures around or below the tip of the stem may suggest a poor bone quality. Larger number of patients is required to confirm these initial findings.
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The incidence of pudendal nerve palsy following routine trauma and elective orthopaedic surgery procedures ranges from 1.9% to 27.6%. Excessive and/or prolonged traction against the perineal post of a traction table, leading to direct compression and localised ischaemia to the nerve are suggested mechanisms of injury. Misuse of traction and the inappropriate placement of the perineal post, leading to crushing and stretching of the pudendal nerve, are two main contributing factors leading to its postoperative palsy. ⋯ Adequate muscle relaxation during anaesthesia is particularly important in young men who have strong muscles and thus require larger traction forces when compared to elderly patients. Orthopaedic surgeons should be aware of the pathophysiology behind the development of this palsy and the measures that can be employed to reduce its occurrence. In procedures where a traction table is employed, consenting for pudendal nerve palsy should be considered by the surgical team.
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Multicenter Study
Attitude change in youths after being exposed to different road safety interventions in two Mexican cities.
To assess the reach of three different types of road safety interventions (social marketing, education and law enforcement) implemented as part of the Iniciativa Mexicana de Seguridad Vial y Prevención de Lesiones en el Tránsito (Mexican Initiative for Road Safety and the Prevention of Road Traffic Injuries) among youth in two Mexican cities (Guadalajara-Zapopan, Jalisco and León, Guanajuato), and to examine students' self-reported attitude change after being exposed to these interventions. ⋯ Our results show a potential moderate impact, measured as self-reported attitude change, resulting from the three intervention approaches under study. Future studies should address the intensity of exposure as well as the translation of attitude change into safer behaviors. Information generated by this study could be useful for local authorities in the intervention areas to inform their activities.