Injury
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Interprosthetic femoral fractures (IFF) are rare but increasing with an ageing population. Operative management is challenging and there is currently a paucity of outcome data in literature. The purpose of this study was to evaluate outcomes of IFFs managed with modern distal femoral locking plates, in a larger sample size than previously published. ⋯ IFFs are occurring with increasing frequency in a frail elderly population. In patients with IFFs, MIPO and biological fixation techniques using modern distal femoral locking plates can achieve high rate of union when combined with immediate unrestricted weight bearing postoperatively.
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To identify the value of the evoked potential as an adjuvant predictive tool in pelvic ring and acetabulum fractures focusing on the neurological deficit. ⋯ Evoked potential tests can quickly and accurately detect imminent neurological impairment during surgery of acetabular and pelvic ring injuries. This results in significantly better surgical outcomes, although in some cases the irreversible nature of the injury cannot be prevented.
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Observational Study
Hip fractures in cyclist - a six-year cohort study at a single large volume trauma centre.
Cycling has gained in popularity as a recreational activity and method or travel, in part due to its recognised health benefits in maintenance of good cardiovascular strength and also for environmental issues. As a consequence of this, there is unfortunately an increased number of cycling related injuries. One particular injury incurred is a proximal femoral fracture, but there is little information in the literature with regarding this and its management. ⋯ One patient continued to complain of pain and subsequently underwent a total hip arthroplasty. The mean follow up for these patients was 1033 days (range 1 year to 7 years). 47 (94%) had full return back to pre-injury levels. Given that cycling is likely to increase in the future, we recommend that early surgical fixation is a viable and functionally positive treatment management in these particular group of patients.
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To compare the clinical effects of an inverted L-shaped postero-medial approach with a homemade hook plate and arthroscopic fixation with Endobutton for tibial avulsion fractures of the posterior cruciate ligament. ⋯ The fixation of PCL tibial avulsion fractures with a homemade hook plate through an inverted L-shaped postero-medial approach is safe and effective. It showed almost the same satisfactory outcomes as arthroscopic Endobutton fixation.
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Operative fixation of pelvic ring injuries is associated with a high risk of hardware failure and loss of reduction. The purpose of this study was to determine whether preoperative radiographs can predict failure after operative treatment of pelvic ring injuries and if the method of fixation effects their risk. ⋯ Our study demonstrates that both gender and the method of posterior fixation are associated with hardware failure or displacement.