Injury
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We reviewed the functional outcome of 68 patients with open ankle fractures managed in an orthoplastic specialist centre. ⋯ Patients from groups S and R underwent more procedures. However, a similar outcome can be achieved, highlighting the importance of managing such injuries in an orthoplastic specialist centre.
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Hospital admission rates for a number of conditions have been linked to variations in the weather. It is well established that trauma workload displays significant seasonal variation. A reliable predictive model might enable targeting of high-risk groups for intervention and planning of hospital staff levels. To our knowledge there have been no systematic reviews of the literature on the relationship between weather and trauma workload, and predictive models have thus far been informed by the results of single studies. ⋯ Weather conditions may have a substantial effect on trauma workload independent of the effects of seasonal variation; the population studied and timecourse of weather events appear critical in determining this relationship. Methodological differences between studies limit the validity of conclusions drawn from analysis of the literature, and we identify a number of areas that future research might address.
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Venous thromboembolism (VTE) is a significant cause of morbidity and mortality following tibial fractures. The risk is as high as 77% without prophylaxis and around 10% with prophylaxis. Within the current literature there are no figures reported specifically for those individuals treated with circular frames. Our aim was to evaluate the VTE incidence within a single surgeon series and to evaluate potential risk factors. ⋯ This study suggests that increased BMI is a statistically significant risk factor for VTE, as reported in current literature. In addition, we calculated the true risk of VTE following circular frame treatment for tibial fracture in our series is from 1.13% to 6.87%, which is at least comparable to other forms of treatment.
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Comparative Study
Biomechanical evaluation of two innovative locking implants for comminuted olecranon fractures under high-cycle loading conditions.
The relatively high complication rate after fixation of olecranon fractures has led to an increasing application of anatomically pre-contoured locking plate systems. The purpose of the present study was to conduct a biomechanical comparison of olecranon osteosyntheses by applying the Olecranon VA-LCP and the 3.5mm LCP Hook Plate (LCP, locking compression plate) to an unstable fracture model under high-cycle loading conditions. ⋯ A significantly higher biomechanical stability can be achieved in the fixation of unstable olecranon fractures by application of the Olecranon VA-LCP rather than the 3.5mm LCP Hook Plate.
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The aim of this study was to report the epidemiological characteristics and the experience of 5 departments of trauma, in France, in the management of fractures of the proximal ulna. 163 patients with fractures of the proximal ulna with a mean age of 49.9 years (range 16-97) were managed. The most common mode of injury was a motor vehicle collision (48%). 18% sustained associated injuries to the ipsilateral limb. Open fractures were present in 42 patients (25%). ⋯ The radiocapitellar joint has to be restored appropriately, preserving the radial head when possible and replacing it with a prosthesis otherwise. The lateral collateral ligament complex is commonly disrupted and usually can be reattached to its origin from the lateral epicondyle. In addition, a brief period of hinged external fixation should be considered.