Injury
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Comparative Study
Investigation of perioperative hidden blood loss of unstable intertrochanteric fracture in the elderly treated with different intramedullary fixations.
Our aim was to investigate perioperative hidden blood loss (PHBL) of unstable intertrochanteric fracture (UIF) in the elderly treated with different intramedullary fixations. ⋯ Elderly patients with UIF treated by intramedullary fixations always have a significant amount of PHBL, which is much greater than that observed intra-operatively. Regular perioperative measurements of full blood count are necessary to avoid anaemia. InterTan nail is associated with a significantly higher PHBL than that of TGN and PFNA, which needs to be monitored carefully in usual clinical practice.
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Comparative Study
Effectiveness of sonography assisted minimal invasive plate osteosynthesis (MIPO) compare with fluoroscope assisted in femoral shaft fracture: A cadaveric study.
A minimal invasive plate osteosynthesis (MIPO) has an advantage of biological soft tissue preservation that consists of preserving bony blood supply, fracture hematoma and less soft tissue damage which leads to decreasing of infection rate and rapid bone healing. However, the radiation exposure is still a disadvantage of this technique. A sonography that provides dynamic real time imaging may be used as an alternative technique for assisting MIPO. The aim of this study was to compare the effectiveness of MIPO in femoral shaft fracture between the sonography assisted and the fluoroscopy assisted. ⋯ Images from the sonography could provide visualization of the fracture during reduction and MIPO as accurately as the radiography. Thus, the sonography assisted MIPO in femoral shaft fracture can be done effectively comparing with radiographic assisted.
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Young femoral neck fracture patients require surgical fixation to preserve the native hip joint and accommodate increased functional demands. Recent reports have identified a high incidence of fracture shortening and this may have negative functional consequences. We sought to determine if fracture shortening is associated with poor functional outcome in young femoral neck fracture patients. ⋯ Severe shortening is associated with clinically important decreases in functional outcome as measured by HHS following fixation of young femoral neck fractures, occurring in 13% of patients in this population. The principle of fracture site compression utilized by modern constructs may promote healing; however, excessive shortening is associated with worse patient-reported outcomes and objective functional measures.
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Non-union of neck femur is a common but difficult situation to manage especially in young adults. There are two main options of arthroplasty or osteotomy. The aim of this study was to assess the results of intertrochanteric valgus osteotomy in non-union femoral neck fractures. ⋯ Valgus intertrochanteric osteotomy achieved good union rates and good functional outcome with minimal complications.
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Quadrilateral plate fractures constitute one of the most challenging components of acetabular fractures. The objective of this study is to describe and evaluate the novel technique of buttress screw fixation of the quadrilateral plate component of the acetabular fractures. ⋯ Buttress screw fixation of the quadrilateral plate fracture component in associated acetabular fractures is a safe and effective technique for reduction and fixation of these challenging fractures with no major complications related to this novel technique.