Injury
-
Every year more than 300,000 proximal femur fractures are diagnosed. Their number will double within 30 years. In femoral neck fractures treated with hip hemiarthroplasty 90-days mortality is 29.5-51.6%. Haemorrhage is one amongst other complications that is associated with increasing postoperative mortality. Transfusion rate in these patients ranges from 25.7% to 39%. Blood transfusions expose to complications. Fibrin sealants are useful in reducing perioperative need for transfusions, total blood loss, blood loss from drainage. The aim of this study is to assess whether the use of a fibrin sealant during hip hemiarthroplasty implant reduces the need for transfusion. ⋯ EVICEL reduces need for transfusion in patients undergoing hip hemiarthroplasty for a femoral neck fracture. It must be held among the options when a stricter control on transfusional requirement is needed.
-
Soft tissue swelling after acute fracture surgery is a challenge which may increase wound dehiscence, delay early range of motion, and increase infection rate postoperatively. This study investigates closed incision negative pressure therapy (ciNPT) using wide-range cover over the incision site and the peripheral swelling trauma zone to promote early active motion and to mitigate joint stiffness, bulla formation, and tendon adhesion. ⋯ The prophylactic ciNPT use in the trauma area after surgery reduced postoperative distension pain and improved early range of motion of the tendon and joint in these patients.
-
Injuries exert an enormous impact on athletes and teams. This is seen especially in professional soccer, with a marked negative impact on team performance and considerable costs of rehabilitation for players. Existing studies provide some preliminary understanding of which factors are mostly associated with injury risk, but scientific systematic evaluation of the potential of statistical models in forecasting injuries is still missing. ⋯ Organisms, participants or traits within a dynamic system adapt and change when factors within that system change. Scientists routinely predict risk in a variety of dynamic systems, including weather, political forecasting and projecting traffic fatalities and the last years have started the use of predictive models in the human health industry. We propose that the use of artificial intelligence may well help in assessing risk and help to predict the occurrence of sport injuries.
-
Surgical management of thoracolumbar burst fractures is controversial. While the goals of surgical treatment are well accepted (i.e., fracture reduction and stabilization, neural elements decompression, and segmental angular deformity correction), the choice of the best surgical approach (i.e., posterior vs. anterior vs. combined approach) remains controversial. Several studies have debated the advantages of each surgical approach but there is no definitive evidence available to date, particularly in young adult patients. The aim of this study was to assess whether posterior approach alone can be a valid surgical treatment for patient under the age of 40 affected by thoracolumbar burst fractures and incomplete neurological deficits. ⋯ A single posterior surgical approach is an acceptable option in terms of clinical, radiological and functional outcomes at 2 years follow-up in patients under the age of 40 presenting with a thoracolumbar burst fracture and neurological deficit.