Injury
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Randomized Controlled Trial
A prospective randomized trial of 100 patients using trochanteric support plates; worth their mettle?
To compare the radiological and clinical results of sliding hip screw (SHS) fixation with or without a Trochanteric Support Plate (TSP) on unstable three-or-more-part trochanteric fractures. ⋯ This study cannot confirm that TSP has any beneficial effects on unstable three-or-more-part trochanteric fractures. If any effect at all, the difference is most likely slight and clinically irrelevant.
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The aim of this study was to investigate the postoperative outcomes of cementless Total hip arthroplasty (THA) following failed internal fixation for femoral neck and intertrochanteric fractures. ⋯ Outcomes of cementless THA following failed internal fixation for femoral neck and intertrochanteric fractures were satisfactory; increased intraoperative blood loss, operating time, and requirement of long femoral stem should be considered in the latter type of fracture.
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Comparative Study
The use of regional anaesthesia for surgical intervention has minimal effect on functional outcomes following fracture nonunion repair.
The purpose of this study was to determine the effect of regional anaesthesia as compared to general anaesthesia on clinical, functional, and radiographic outcomes following long bone fracture nonunion repair. ⋯ In this cohort, the use of regional anaesthesia during operative repair of long bone fracture nonunion was associated with no significant difference in functional outcome scores or pain levels at all post-operative time points. Furthermore, the use of regional anaesthesia had no effect on the rate of post-operative complications. Either type of anaesthetic appears to be safe and effective in performing these surgeries.
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Comparative Study
Treatment of femoral neck fractures in patients 45-64 years of age.
Young patients with femoral neck fractures are optimally treated with reduction and stable fixation, while patients over the age of sixty-five are often treated with arthroplasty. This study analyzes in-hospital outcomes associated with total hip arthroplasty, hip hemiarthroplasty and internal fixation for treatment of femoral neck fractures in patients aged 45-64. ⋯ This study demonstrates that the use of total hip arthroplasty in treatment of femoral neck fractures in patients from the age of 45-64 increased 4.2-fold over the study period. This treatment is associated with increased hospital cost, length of stay and complications. Additionally, as age increased in our study population, there was a stepwise increase in the use of arthroplasty, and it appears that hemiarthroplasty is being used with a different patient population.
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Fractures of the proximal humerus are often associated with lesions of the long head of the biceps (LHB) tendon. This often leads to prolonged shoulder pain. Hence, many surgeons decide to perform a tenodesis of the LHB tendon simultaneous to ORIF. The purpose of this study was to evaluate the postoperative outcome after interlocking plate fixation and biceps tenodesis for treating proximal humerus fractures. ⋯ Our results show evidence of an improved shoulder function when a simultaneous tenodesis of the LHB tendon is performed during treatment of proximal humerus fractures using interlocking plate fixation.