Injury
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The aim of this study was to investigate morbidity and mortality following hip fractures in middle aged patients. In addition, we aimed to identify risk factors which could be used to predict postoperative complications. All patients aged 40-55 who sustained a hip fracture in Lothian from 2007 to 2008 were identified from a prospective trauma database. ⋯ No patient with a FRAX score of less than 10 suffered a complication, whereas 50% of patients who had a FRAX score of more than 10 suffered a complication. The results of our study suggest that low energy hip fractures in middle age are due to underlying morbidity and are associated with a high incidence of postoperative complications and mortality. The FRAX score could be used as a simple method of identifying patients in this age group who are at risk of a poor outcome.
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A number of studies have investigated the effect of presentation time on the outcome of patients presenting following trauma. However, it is uncertain whether there is a difference in the incidence of missed injuries between patients presenting during 'office hours' to those presenting in the 'after-hours' period. ⋯ Injuries in patients sustaining trauma are more likely to be missed 'after-hours' than during 'office hours'. T-spine and abdominal injuries are more likely to be missed when compared to other anatomical regions of the body.
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We hypothesized that resident participation in a hands-on fracture fixation course leads to significant improvement in their performance as assessed in a simulated fracture fixation model. ⋯ Participation in a formal surgical skills course significantly improved practical operative skills as assessed by the simulation. The benefits of the course were maintained to 6 months with residents who completed the training earlier continuing to demonstrate an advantage in skills. Such courses are a valuable training resource which directly impact resident performance.
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The literature lacks recent population-based epidemiology studies of the incidence, trauma mechanism and fracture classification of tibial shaft fractures. The purpose of this study was to provide up-to-date information on the incidence of tibial shaft fractures in a large and complete population and report the distribution of fracture classification, trauma mechanism and patient baseline demographics. ⋯ This study shows an incidence of 16.9/100,000/year for tibial shaft fractures. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures.
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Impact of comorbidity on risk of readmission and death after hip fracture surgery has not been sufficiently explored. We planned to investigate the role of common diseases in predicting adverse events during recovery after hip surgery. ⋯ Common comorbidities are associated with higher risk of rehospitalisation and mortality following hip fracture surgery in the elderly. This information may be useful in postoperative risk assessment and prevention of negative outcomes.