Injury
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Randomized Controlled Trial Multicenter Study Comparative Study
Posterior versus lateral approach for hemiarthroplasty after femoral neck fracture: Early complications in a prospective cohort of 583 patients.
To compare early complications after the posterior and the direct lateral (transgluteal) approach, when using hemiarthroplasty in the treatment of displaced femoral neck fractures in the elderly. ⋯ There was an 8-fold increased risk for prosthetic dislocations after the posterior approach compared to lateral approach. There was a high risk for recurrent prosthetic dislocations and a subsequent risk for further surgeries and a poor end result. The potential advantages of the posterior approach have not been demonstrated after femoral neck fractures and we advise against its continued use.
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Review Multicenter Study
Injury factors associated with discharge status from emergency room at two major trauma hospitals in The Gambia, Africa.
Injuries are the leading cause of disability across all ages and gender. In this study, we identified predictors of discharge status and disability at discharge among patients who seek emergency room treatment. ⋯ Epidemiology of injuries in The Gambia is similar to other low-income countries. However, the magnitude of cases and issues uncovered highlights the need for a formal registry.
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Multicenter Study Comparative Study
Patterns of health care use of injured adults: A population-based matched cohort study.
Healthcare use by traumatically injured individuals prior to and subsequent to their injury are not often explored for different types of injuries. This study aims to describe health care use 12 months preceding and 12 months following a traumatic injury by injury type and injury severity. ⋯ After sustaining a traumatic injury, many individuals are readmitted to hospital and require ongoing care up to 12 months post-injury. That injured individuals post-injury largely return to their pre-index injury hospital use by 6 to 7 months could imply a return to pre-injury function and/or that other measures of health service use should be explored. Trauma services should consider long-term follow-up and support services for seriously injured patients post-hospital discharge.
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The Cephalomedullary Nail (CMN) (Zimmer, Warsaw) was introduced in 2010 as part of a multicenter trial to evaluate its performance. At one year the CMN had results in keeping with other intramedullary devices with good union rates and low complication rates. In the second and third years of use an increased rate of implant failure was observed, towards the higher end of the 1-5% nail breakage rate seen in other studies. This study aims to evaluate if there any common features in this cohort of patients. ⋯ Implant failure is a recognised complication of intramedullary nailing in cases of non-union. The increased rate of implant failure in our department required a change to a 130° CMN implant and a 3.2mm diameter guide wire for placement of the lag screw. We continue to monitor this difficult group of patients very closely.
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Multicenter Study
The correlation between stabbing-related upper extremity wounds and survival of stabbing victims with abdominal and thoracic injuries.
When treating patients with stab injuries of the torso, clinicians often lack timely information about the degree and nature of internal organ damage. An externally observable sign significantly associated with characteristics of torso injuries may therefore be useful for practitioners. One such potential sign is the presence of wounds to the hands, sometimes sustained during victims' attempt to defend themselves during the violent altercation. Thus, the primary aim of this study was to evaluate the association between presence of upper extremity wounds and the severity of the thoracic and intra-abdominal injuries due to stabbing. ⋯ Patients with stabbing-related upper extremity wounds had a significant survival advantage over patients without such injuries. However, a greater number of sustained upper extremity wounds may be an external sign of greater severity of thoracic and intraabdominal stabbing injuries.