Injury
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Randomized Controlled Trial
No role for antiseptics in routine pin site care in Ilizarov fixators: A randomised prospective single blinded control study.
Pin site infection is the commonest complication of Ilizarov external fixation. The aim of the study was to examine if use of antiseptics was superior over control and further if daily dressing was superior to weekly dressing in regular pin site care in reducing the burden of pin site infection in Ilizarov fixators. ⋯ Use of antiseptics does not offer any advantage in regular pin site care in Ilizarov external fixation and daily pin site care is not superior to weekly pin site care. Empirical therapy in early and low grade pin site infections must be targeted against Staphylococcus.
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This is a retrospective study that evaluate the outcome of patients with extremity sarcoma between extramedullary plate and intramedullary nailing for the biological reconstruction after tumor resection. ⋯ The findings of the present study showed that intramedullary nailing does not improve the union rate or decrease the incidence of mechanical complications for patients with extremity sarcoma after biological reconstruction. However, intramedullary nailing may have potential advantages on the service life for the biological reconstruction after extremity sarcoma resection.
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Patellar dislocation and rupture of the medial patellofemoral ligament (MPFL) are frequently seen in daily orthopedic practice. Besides initial non-surgical treatment, surgery and subsequent rehabilitation are crucial for restoring stability in the femoropatellar joint. This study investigated current rehabilitation strategies after patellar dislocation because knowledge on this topic has been severely limited so far. ⋯ Both conservative and surgical treatment after patellar dislocation showed restrictions in the early phase of the rehabilitation. Earlier functional therapy was more common after MPFL reconstruction than after conservative treatment. Further clinical and biomechanical studies on rehabilitation strategies after patellar dislocation are needed to improve patient care und individualized therapy.
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Optimal timing of pharmacological thromboprophylaxis (VTEp) in patients with severe pelvic fractures remains unclear. The high risk of venous thromboembolic (VTE) complications after severe pelvic fractures supports early VTEp however concern for fracture-associated hemorrhage can delay initiation. Patients with pelvic fractures also frequently have additional injuries that complicate the interpretation of the VTEp safety profiles. To minimize this problem, the study included only patients with isolated severe pelvic fractures. ⋯ In isolated severe pelvic fractures, early VTEp is independently associated with improved survival and fewer VTE. LMWH may be preferred over UH for this purpose.
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Surgical treatment of the posterior cruciate ligament (PCL) tibial avulsion fracture is challenging due to the deep-seated location of the lesion with complex adjacent anatomy and usually with small-sized bone fragment. We introduce a novel arthroscopic reduction technique using two cross-linked pull-out sutures (2XLPOS) through triple bone tunnels in posterior cruciate ligament (PCL) tibial avulsion fracture. Posterior trans-septal portal was established following the four standard arthroscopic portals. ⋯ Posterior instability decreased from mean 12.6 mm preoperatively to 3.2 mm at 1-year postoperative follow up. Radiographic union of the fracture site was confirmed in 11 cases. Our new surgical technique yielded good clinical and radiological outcome, and we consider it is unique in utilizing two cross-linked sling type pull-out suture constructs and triple bone tunnels for their passage.