Injury
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Temporary external fixation is a viable option for numerous conditions and fixations in orthopaedic and trauma surgery. If the external fixator is left in place it is necessary to disinfect it prior to surgery, yet the subsequent risk for bacterial contamination of the surgical site originating from the external fixator remains unknown. ⋯ We conclude that the presented perioperative management to decontaminate external fixators allows for a safe definitive osteosynthesis in a staged protocol without increasing bacterial contamination of the surgical site. It is safe to leave the external fixator in place for definitive osteosynthesis.
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Acute kidney injury (AKI) is a common and serious complication after hip fracture surgery in older adults. Hypoalbuminemia is a known independent risk factor for AKI. However, few studies have investigated the relationship between early postoperative hypoalbuminemia and AKI after hip fracture surgery. Therefore, we sought to determine the incidence of and risk factors for AKI and the effects of early postoperative hypoalbuminemia on AKI incidence after surgery for hip fractures, especially intertrochanteric fractures of the proximal femur. ⋯ The incidence of postoperative AKI was 11.8%. Our findings demonstrate that early postoperative hypoalbuminemia is an independent risk factor for AKI in patients undergoing surgery for intertrochanteric fracture of the proximal femur.
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Morel-Lavallée lesions are rare, closed degloving soft tissue injuries in which the skin and subcutaneous tissues are traumatic separated from the underlying fascia. There is lack of consensus regarding optimal management of these lesions. After failure of conservative management, operative intervention is imperative. The purpose of this manuscript is to describe a minimally invasive endoscopic method for treatment of Morel-Lavallée Lesions, which achieves the goal of an open surgical debridement.
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The ageing of society is driving an enormous increase in fragility fracture incidence and imposing a massive burden on patients, their families, health systems and societies globally. Disrupting the status quo has therefore become an obligation and a necessity. ⋯ We call for implementation of a systematic approach to fragility fracture care with the goal of restoring function and preventing subsequent fractures without further delay. There is an urgent need to improve: To address this fragility fracture crisis, the undersigned organisations pledge to intensify their efforts to improve the current management of all fragility fractures, prevent subsequent fractures, and strive to restore functional abilities and quality of life.
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Traumatic spinal cord injury (SCI) is a devastating injury, frequently resulting in paralysis and a lifetime of medical and social problems. Reducing time to surgery may improve patient outcomes. A vital first step to reduce times is to map current pathways of care from injury to surgery, identify rapid care pathways and factors associated with rapid care pathway times. ⋯ Notwithstanding that the vast majority of SCI patients presented with other traumatic injuries, half of all SCI cases reached surgery within 18 h of injury, with 25% within 9 h. SCI was independently associated with direct transfer to surgery from the trauma unit. SCI patients achieve rapid times to surgery within a complex trauma service. Furthermore, the trauma system is well positioned to implement further time reductions to surgery for SCI patients.