Injury
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Positron emission tomography (PET) combined with Computerised Tomography (CT) is gaining ground in clinical settings due to its added value of combined metabolic and anatomical imaging. PET/CT has shown promising results in diagnosing both acute and chronic infection of the axial and appendicular skeleton. PET imaging has an advantage in patients with metallic implants because FDG uptake, in contrast to magnetic resonance imaging (MRI) and standard computed tomography (CT), is not hampered by metallic artifacts. The role of PET/CT in the evaluation of implant-related infections involving the tibia in particular has not been thoroughly studied. ⋯ PET/CT is a promising imaging modality that can aid in the work up of patients with suspected implant-related infections of the tibia following osteosynthesis, and may be used as a supportive measure in clinical decision making.
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Adult isolated ulnar shaft fractures (IUSFs) are uncommon, and treatment remains controversial. The purpose of this study was to compare results of operative (reduction internal fixation (RIF)) and nonoperative treatment (NOT) in patients with IUSF. ⋯ Level III.
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Randomized Controlled Trial
Intertrochanteric femur fractures in the elderly treated with either proximal femur nailing or hemiarthroplasty: A prospective randomised clinical study.
The purpose of this prospective randomised study is to compare in the elderly the functional results of intertrochanteric femur fractures treated either with closed reduction and internal fixation with proximal femoral nailing or cemented hemiarthroplasty. ⋯ Although cases with hemiarthroplasty achieved a better level of activity in the beginning, cases with proximal femoral nailing reached a comparable level of activity within a short period of time, faster than those treated with hemiarthroplasty, displaying a better level of activity in the end.
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Multicenter Study Comparative Study
Clinical and functional outcomes and treatment options for paediatric elbow dislocations: Experiences of three trauma centres.
Although elbow dislocations are seen rarely in children, their management remains controversial. In this study, over a 7 years period, we evaluated retrospectively the clinical and functional results of paediatric elbow dislocations managed in three different trauma centres. Pure dislocations and dislocations with associated injuries were evaluated separately. ⋯ From the thirty-four patients that had associated injuries, two (6%) had an excellent, 6 (18%) a good, 10 (29%) a fair and 16 (47%) a poor result. Overall, patients with pure dislocation were found to have a better range of motion compared to patients with dislocation and associated injuries. Prolonged follow ups, and effective rehabilitation programs are required in order to expect good outcomes.
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Tip-apex distance is a well described method for assessment of screw placement in dynamic hip screw fixation of proximal femoral fracture. A distance of <25mm is associated with a significantly lower rate of cut out of the fixation device. Measurement is frequently performed retrospectively, although there has been no demonstration as to what accuracy the surgeon has of estimating tip-apex distance from image intensifier images, whilst scrubbed in theatre. ⋯ Level of seniority, awareness of the concept of tip-apex distance and use of the concept in clinical practice were each assessed. The accuracy in identifying the correct TAD was 82.5% in consultants, 83.8% in registrars and 71.1% in Senior house officers (SHO). The method was used in clinical practice by 50% of consultants, 89% of registrars and none of the SHOs.