Injury
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Patellar fractures constitute almost 1% of total skeletal injuries. Existing common operative methods include the use of different types of Tension band wiring techniques like cannulated screws and K-wires. The Patellar plating construct is a relatively newer operative method for patellar fracture fixation with promising outcomes with fewer complications. ⋯ Patients with low profile patellar plate constructs have favorable clinical and radiological outcomes with minimal non-specific complications.
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The aim of this study is to identify if there is any association between neuromuscular disorders and prosthetic dislocation in patients treated with hip hemiarthroplasty for neck of femur fractures. ⋯ Our study demonstrates an increased risk of dislocation after hemiarthroplasty for patients with Parkinson's disease in comparison to other groups. No increase was apparent for those with mental impairment or weakness from a previous stroke.
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Observational Study
Predicting mortality for critically ill burns patients, using the Abbreviated Burn Severity Index and Simplified Acute Physiology Score 3.
Reviewing the profile of patients admitted at the Burns Intensive Care Unit at São Paulo Hospital - UNIFESP, as well as the available literature, it becomes evident the need for tools able to predict those patients' outcomes. Distinct score models are used in different health centers, not only as prognostic models, but also as research and quality control tools. Amongst these prognostic scores, there are two strands, the burns specific scores - which consider the injury's characteristics - and the general critical patient's scores. ⋯ The study evidences that SAPS 3 score, frequently used at general Intensive Care Units, has a similar performance to ABSI score, which is specific for burns populations. ABSI score is easier to implement, as it is simpler and able to show instant results.
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Compartment syndrome generates an oxidative condition causing the death of skeletal muscle cells. Hirudin has antioxidant and anti-inflammatory properties. However, its correlation with the pathway of Nrf2/HO-1 for the protection of the skeletal muscle is unknown. ⋯ Nuclear translocation Nrf2 and HO-1 staining in cytoplasm were increased, and the levels of HO-1 mRNA were also increased. In conclusion, double-doses of H8 alleviate the death of muscle cells induced by oxidative stress 72 h after compartment syndrome in rabbits. This protective effect is associated with the nuclear translocation of Nrf2 and an elevated expression of HO-1.
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Distal femoral fractures occur in patients with osteoporotic bone and also as a consequence of high energy trauma. The recognised treatment options include closed or open reduction of the fracture and fixation using a locking plate or a femoral nail. Both these fixation modalities have some drawbacks. There is a risk of metalwork failure with single lateral locking plates and limited distal fixation with intramedullary nails. Since January 2018, we started using augmented fixation of distal femoral fractures using a combination of a retrograde femoral nail and a lateral locking plate. This study compares the outcomes of single lateral femoral plating (SLP) and combined nail-plate fixation (NPF). ⋯ Augmented fixation of distal femoral fractures using a nail plate fixation provided significantly higher union and enabled early weightbearing compared to single plate fixation. We recommend nail plate fixation for the treatment of distal femoral fractures, particularly in osteoporotic fractures.