Injury
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Observational Study
A retrospective observational cohort study: Epidemiology and outcomes of pediatric unintentional falls in US emergency departments.
The objective is to determine how outcomes from unintentional falls differ for children with and without developmental disabilities, with a sensitivity analysis specifically examining those with ADHD. ⋯ Children with developmental disabilities, in particular those with ADHD, who experience falls are often older and male. They had greater odds of poor outcomes. These children need additional anticipatory guidance and attention to adequate treatment to prevent injuries from unintentional falls.
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The prognosis of patients with chronic kidney disease (CKD) and intertrochanteric fractures is unclear. This study was aimed to analyze the mortality and complication rates among CKD patients with intertrochanteric femoral fractures and the risk factors of one-year mortality after surgery. ⋯ The mortality and complication rates were high among the CKD patients with intertrochanteric fractures. Grades of CKD significantly correlated with one-year mortality after surgery; therefore, they and an important factor that must be considered when developing a strategy to improve the postoperative survival rate of patients with CKD.
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Numerous classifications have been developed to assess tibial plateau fractures (TPF). Of these, the Schatzker system is the most widely reported in the literature yet this system is limited in its characterisation of morphological fracture features underlying the fracture location. The purpose of this study was to compare 3D morphological features of TPFs across different Schatzker types. ⋯ Assessment of underlying fracture characteristics in addition to fracture location can serve to provide greater detail relating to fracture morphology, which has the potential to assist with both surgical decision making and assessment of postoperative outcomes. Incorporating this information as part of a hierarchical or multifactorial framework for classifying fractures may help distinguish subtle differences between fracture types that are classifiable using the most current systems.
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Proximal femoral plating serves as a good alternative for the fixation of femoral neck fractures, but fixation loss still occurs. This study aimed to evaluate the effect of a hybrid configuration of short- and long-threaded cannulated screws in proximal femoral plating in terms of decreasing varus collapse of femoral neck fractures. ⋯ The hybrid configuration of short- and long-threaded screws in proximal femoral plating offers better resistance against varus collapse and yields better functional outcomes in femoral neck fractures.
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Evidence regarding recommendations for treatment of ballistic fractures remains limited. This paucity of literature has largely been attributed to gunshot wound victims being a difficult population to study secondary to loss to follow-up. The purpose of this study was to examine the epidemiology of operatively treated ballistic femur fractures at our institution, the frequency of outpatient follow-up and risk factors for loss to follow-up. ⋯ This study reinforces the difficulty of studying ballistic fractures secondary to loss to follow-up. Younger age, shorter hospital stays and intramedullary fixation increased the risk for loss to follow-up at 3 months.