Injury
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Comparative Study
Achilles tendon rupture repair: Biomechanical comparison of the locking block modified Krackow technique and the Giftbox technique.
Open Giftbox repair of the Achilles tendon has good biomechanical advantages, but it is not minimally invasive. We designed a peritendon fixation technique, the "Locking Block Modified Krackow" (LBMK) technique, to meet minimally invasive needs. This study used a simulated protocol of early rehabilitation to compare the biomechanics of LBMK with those of the Giftbox technique. ⋯ Both the LBMK and Giftbox techniques meet the requirements of early rehabilitation, but the suture strength in the LBMK group was significantly higher than that in the Giftbox group.
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Acetabular fractures in the elderly are associated with high levels of morbidity and mortality. Despite advances in operative techniques, there remains a cohort of elderly, extremely frail patients with comminuted fractures who are considered unfit for surgery and are treated conservatively. We aim to assess mortality, mobility and radiological outcomes one-year post injury in this challenging cohort. ⋯ Conservative management of this cohort is associated with poor outcomes and current operative solutions are unsuitable for this frail cohort of patients. Future developments should focus on minimising surgical insult and allowing weight bearing mobilisation to maximise the rehabilitation potential in this frail cohort.
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This study investigated which patient and injury characteristics are associated with 12-month mortality rates and living independently after isolated hip fracture. ⋯ Characteristics that are associated with social disadvantage, frailty, poor health and reduced independence before injury were associated with increased rates of death and reduced odds of living independently 12 months after isolated hip fracture.
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Acute physiologic compartment syndrome (ACS) is a disorder of increased intra-compartmental pressure leading to decreased tissue perfusion and muscle necrosis. Tissue ischemia can result in irreversible muscle and nerve injury and requires urgent fasciotomy. The aim of this study was to determine the factors associated with the presence of necrotic muscle in patients undergoing leg fasciotomy. ⋯ ACS is a potentially limb threatening condition often associated with poor outcomes, particularly when the diagnosis is delayed. Patients with open fracture have a three-fold increase in odds of necrotic muscle at the time of fasciotomy.
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To evaluate functional and radiological outcomes in distal femoral fracture patients (distal femoral shaft fractures or metaphyseal fractures) receiving indirect reduction and internal fixation with the minimally invasive percutaneous plate osteosynthesis (MIPPO) assisted by 3D printing navigation templates. ⋯ MIPPO assisted by 3D printing navigation templates could practically improve surgical accuracy and eliminate postoperative rotational deformity in patients with distal femoral fractures.