Injury
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Antibiotic-impregnated cement nails are used to treat postoperative deep infections after primary intramedullary nail insertion for the treatment of tibial fractures. Few data exist regarding the efficacy of this treatment strategy. We hypothesized that such treatment with antibiotic nails results in a high rate of infection clearance at intermediate follow-up. ⋯ The use of antibiotic nails for treatment of tibial infections seems to be a reasonable option, clearing 76% of infections at the 6-month time frame. Further investigation is needed to compare this treatment algorithm with other strategies, such as antibiotic treatment without nail removal and massive débridement with ring fixator placement.
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Despite the importance of rehabilitation in the treatment of patients with severe trauma or even of severely injured patients, the cooperation between acute and rehabilitation hospitals is often inadequate. The present study aims to identify factors that make it probable that a severely injured patient requires inpatient rehabilitation following the acute treatment. ⋯ Knowing independent factors for a required inpatient rehabilitation helps the treating physicians to identify the patients at an early stage in acute hospitals. So the transfer to a rehabilitation clinic can be organized faster and more selective in future.
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Review Meta Analysis
Masquelet technique: myth or reality? A systematic review and meta-analysis.
The induced membrane technique (IMT) or Masquelet technique, is a two-step surgical procedure used to treat pseudoarthroses and bony defects. Many authors have introduced variants to the technique. This study aims to compare the surgical variants of IMT and to evaluate its efficacy in achieving infection eradication and bone union. ⋯ Further studies are needed to demonstrate the role the patients' clinical features and IMT variants have upon achieving bone union and infection eradication.
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There is a risk of iatrogenic injury to the soft tissues of the calcaneus and this study assesses the risk of injury to these structures in circular frame calcaneal fracture fixation. ⋯ This study highlights the relevant anatomical relations in circular frame fixation for calcaneal fractures to minimise damage to these structures.
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Non-displaced hip fractures can be difficult to diagnose on plain film radiographs. When there is ongoing clinical suspicion of an occult fracture, further imaging is obtained. We investigated the sensitivity of computed tomography (CT) scans in detecting these fractures and the delays to surgery that three-dimensional imaging causes. ⋯ Our results demonstrate that CT scan does not bear sufficient sensitivity to detect all OHFs. We therefore recommend that MRI should be offered when a fracture is suspected. CT scans should be reserved for when MRI is not available, but a negative scan should be confirmed with subsequent MRI.