Injury
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the frequency of distal femur fractures in the elderly is rapidly increasing. A study of these fractures was conducted in our center in order to evaluate the comorbidities and the mortality associated with this entity. ⋯ low-energy distal femur fractures comprise a severe injury in the elderly and are associated with high mortality. Surgical treatment showed better outcomes in terms of survival, with no significant differences depending on the type of fracture, the type of implant or the median time to surgery.
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Randomized Controlled Trial
Intramedullary nail versus bridge plate in open tibial fractures - randomized clinical trial.
Open tibial shaft fractures present a challenge to the orthopedic surgeon, because they are common, have a high rate of complications and still have a controversial treatment. As a result of the high incidence of these fractures, the need of a definitive treatment and the unavailability of the intramedullary nail or a well-trained team, we developed this study to compare the effectiveness of the bridge-plating (BP) with the unreamed intramedullary nail (UIMN) in the treatment of open tibial shaft fractures. ⋯ We concluded that both methods were effective for the treatment of open tibia shaft fractures, however, the implant failure rate was higher in the bridge plate group.
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Trans-olecranon fracture dislocations are the least frequent complex elbow instability. Proper surgical treatment should be performed to avoid postoperative complications. ⋯ Trans-olecranon fracture dislocations could obtain functional range of movement, pain relief and good functional outcomes with a standardized protocol of surgical fixation. It is important to achieve proper ulnar fixation, focusing in reestablishing dorsal angulation, and also to treat radial head and coronoid injuries properly, if present.
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The U.S. military conflicts in Iraq and Afghanistan yielded the most combat casualties since Vietnam. With more service members than ever surviving their wounds, prospective research on factors related to long-term, patient-reported outcomes, including self-rated health (SRH), has increased importance. This study's objective was to use preinjury and postinjury SRH measures to identify trajectories and predictors of SRH after combat-related injury. ⋯ This is the first study to examine long-term SRH trajectory following combat-related injury, finding that a majority of military personnel remain at their preinjury health levels of good or better. Decreases in postinjury SRH were associated with physical and psychological factors, which reinforces the need for a multidisciplinary approach to care.
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The comparison of mortality and morbidity between distal femur (DF) and hip fracture in the old age is rarely reported in the literature. We aim to analyze a nationwide database among the elderly to compare the outcomes between hip fractures and distal femur fractures in the United States. ⋯ III.