Injury
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T-condylar fractures of the humerus are very rare in children. The treatment options vary from simple reduction and percutaneous stabilisation to open reduction and fixation with plates, screws and Kirchner wires. We evaluated 19 patients who underwent different types of treatment aiming to compare two different approaches of reduction, postoperative results and complications. ⋯ The present study concludes that any type of T-condylar fracture of the humerus can be solved to a satisfactory degree, either closed or open reduction and with proper stabilisation.
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Acute compartment syndrome (ACS) is a clinical condition with potentially dramatic consequences, therefore, it is important to recognise and treat it early. Good management of ACS minimises or avoids the sequelae associated with a late diagnosis, and may also reduce the risk of malpractice claims. The aim of this article was to evaluate different errors ascribed to the surgeon and to identify how the damage was evaluated. ⋯ ACS is a clinical emergency that requires continuous clinical surveillance from both medical and nursing staff. The related damage should be evaluated in two parts: damage deriving from the trauma, so that it is considered inevitable and independent from the surgeon's conduct, and damage deriving from a surgeon's error, which is eligible for an indemnity payment.
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Case Reports
Management of infected non-union of the proximal femur: A combination of therapeutic techniques.
A challenging case of a nonunion of the proximal femur complicated by infection attributed to microbial and fungal pathogens requiring a combination of novel surgical techniques to achieve eradication of infection, preservation of the native hip joint, and restoration of function.
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Admission body temperature is a critical parameter in all trauma patients. Low admission temperature is strongly associated with adverse outcomes. We have previously shown, in a prospective study that low admission body temperature is common and associated with high mortality in hip fracture patients (Uzoigwe et al., 2014). However, no previous studies have evaluated whether admission temperature is an independent predictor of mortality in hip fracture patients after adjustment for the 7 recognised independent prognostic indicators (Maxwell et al., 2008). ⋯ Low body temperature is strongly and independently associated with 30-day mortality in hip fracture patients.
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Surgical treatment options for distal femur fractures include intramedullary nailing or plating using a lateral or lateral parapatellar approach. However, medial plating is required for additional stability in some fractures such as severely comminuted fractures and periprosthetic fractures, and in those for which use of a lateral plate or nail is not appropriate. This study aimed to explore the safe zone for medial minimally invasive plate osteosynthesis of the distal femur with computed tomography angiography. ⋯ The anteromedial aspect of the distal half of the femur is the safe zone, and a long plate can be positioned safely in this zone at the anterior aspect up to the level of 8 cm below the LT.