Injury
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Surgical treatment of extra-articular distal-third diaphyseal humeral fractures is controversial in terms of surgical approach and position of implant. The aim of this study is to evaluate the clinical and radiological outcomes of a modified application of the proximal humeral internal locking system (PHILOS) plate in extra-articular distal-third diaphyseal humeral fractures. ⋯ Therapeutic level IV, case series.
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By linking health and census data, the objective of this study was to determine the effect of a femoral neck fracture on the household income of non-elderly patients. ⋯ Over a quarter of the femoral neck fracture patients in this study sustained a decline of ≥2 deciles in their household income following their injury. The income decline was disproportionately absorbed by patients with baseline incomes in the 6th decile or higher. This suggests that the available incapacity programs are limited in providing income protection to patients with higher incomes.
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BOAST (British Orthopaedic Association Standards for Trauma) and NICE (National Institute of Clinical Excellence) guidelines recommend clinical photography of all open fractures on admission and at key stages of patient care for objective wound documentation and to avoid repeated examination. Recording and handling photographs in a compliant and confidential manner in the setting of acute trauma management can prove challenging. To facilitate clinical photography at our Major Trauma Centre (MTC) institution, a smartphone-based Secure Clinical Image Transfer (SCIT) app was introduced and integrated with the existing clinical photography database to allow clinicians to take photographs, which are saved directly to patient records. ⋯ Integrating commonplace smartphone technology with a secure platform for taking and storing photographs can improve rates of IG-compliant clinical photography of open fractures. This may improve documentation, communication and patient care.
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Metabolic syndrome has been known as a risk factor for morbidity following orthopedic procedures, yet its impact on surgical treatment of ankle fractures remains unclear. The aim of this study was to compare the patient outcomes of surgical treatment of supination-external rotation ankle fractures in patients with and without metabolic syndrome. This study was designed as a retrospective matched case-control study. ⋯ The K&L scale and complications did not differ significantly between the two groups. Patients with metabolic syndrome are at risk for higher pain scores and lower functional outcomes after surgical treatment for supination-external rotation ankle fracture. These results suggest that metabolic syndrome should be treated together with ankle fractures.