Injury
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Uncertainty remains regarding the optimum method of anaesthesia for hip fracture surgery. We randomised 322 patients with a hip fracture to receive either general anaesthesia or regional (spinal) anaesthesia. ⋯ There was no notable difference in the outcomes of hospital stay, need for blood transfusion or post-operative complications between groups. 30-day mortality was marginally reduced for spinal anaesthesia 7/164(4.3%) versus 5/158(3.2%) (p=0.57), whilst at 1 year it was less for general anaesthesia 20/163(12.1%) versus 32/158(20.2%) (p=0.05). Within the confines of the limited patient numbers studied we conclude that there are no marked differences in outcome between the two techniques.
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Despite decline in U.S. traffic fatalities, non-fatal injuries remain a main cause of reduced self-reported health. The authors used a nationally representative survey to examine the long-term (≥1 year) implications of traffic injuries on self-care, depression, mobility, pain and activity domains of a widely used measure assessing Health-Related Quality of Life (HRQOL). ⋯ Traffic injuries are significantly associated with long-term reduced HRQOL. Injured individuals may benefit from early intervention programs to prevent the development of secondary complications and reduced HRQOL.
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Intramedullary nailing (IMN) is the preferred treatment for femoral shaft fractures in adults. Although previous studies published good outcomes, some controversies remain. The purpose of this retrospective study was to identify factors that influence outcome after IMN for femoral shaft fractures. ⋯ Fracture stabilisation with IMN is a good treatment option for femoral shaft fractures in adults. The purpose of this study was to evaluate risk factors of poor outcome after IMN of femoral shaft fractures. The present analysis revealed that there was no difference in the outcome whether the fracture was reamed or not. Univariate and multivariate analysis could only correlate AO/OTA fracture type with the occurrence of nonunion. Therefore, in this study, unreamed nailing and damage control EF were not associated with a negative outcome.
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Navicular fractures (NF) are uncommon. The purpose of this study was to compare results of operative (ORIF) and non-operative (NOT) treatment in NF. ⋯ Level III.
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The presence of a L5 transverse process fracture is reported in many texts to be a marker of pelvis fracture instability. There is paucity of literature to support this view. Only two previous studies have been performed on this subject with statistical analysis. ⋯ The presence of an L5 transverse process fracture on an abdominopelvic CT scan is strongly associated with an underlying pelvis fracture (P<0.001). Statistically, its presence however does not strongly predict instability (P=0.724). The latter finding differs from the previously published studies.