Injury
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Observational Study
Comparison of outcomes after different methods of fixation for extracapsular hip fractures: An observational study.
Optimal management of intertrochanteric fractures using either sliding hip screws (SHS) or Intramedullary nail (IMN) fixation has long been disputed and the optimal length of a 'short nail' has yet to be clarified. Our aim was to investigate functional outcomes in patients who have undergone either sliding hip screw fixation or intramedullary fixation using varied lengths of nails to assess potential superiority. ⋯ We advise caution in interpreting the results of studies between different nails and SHS, as not all nails appear to be the same. Design features of modern nails such as length, proximal diameter, the use of a compression screw, lag screw interface within the nail and valgus inclination may all play a role in functional outcomes.
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Open pelvic fractures remain challenging in terms of their management. The purpose of this narrative review was to evaluate the latest advances made in the management of these injuries and report on their clinical outcome. ⋯ Mortality following open pelvic fracture remains high despite the evolution of trauma management the last 2 decades. Sufficient blood transfusion, bleeding control, treatments of associated injuries, fracture fixation and soft tissue management remain essential for the reduction of mortality and improved outcomes.
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To investigate the clinical effects and complications that may arise as a result of ipsilateral clavicle turnover during tumorous bone defect repair of the proximal humerus, and to explore the feasibility of performing combined free fibula transplantation and internal fixation in reducing complications METHODS: We treated 13 patients with clavicle turnover or free fibular transplantation from September 1998 to February 2020. There were 7 males and 6 females with the average age of 26.2 years (7-50 years). The histological diagnoses were osteosarcoma in 6 patients (Enneking IIB), giant cell tumors in 3 patients (Campanacci III) and one patient each with Ewing's sarcoma (Enneking IIB), chondrosarcoma (Canceration of multiple osteochondromatosis), fibrosarcoma and metastatic cancer of bone (Bone metastasis of lung cancer). Pathological fractures were found in 7 of the 13 patients. ⋯ Clavicle turnover is a feasible method for the treatment of tumorous bone defect of the proximal humerus. Flipping clavicle fracture is the most common complication. The application of total clavicle fixation and free fibular transplantation strengthens the flipping clavicle and reduces the risk of clavicle fracture.