Injury
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Comparative Study
Managing B2 periprosthetic femoral fractures: ORIF vs stem-revision.
The gold-standard treatment for Vancouver type B2 and B3 fractures is revision arthroplasty. This procedure can be prolonged and complex, posing challenges for patients with severe medical comorbidities and reduced physical status. Recently, osteosynthesis has been proposed as an alternative treatment for B2 periprosthetic femoral fractures (PFF) in frail patients, though its efficacy compared to revision arthroplasty has not been studied in detail. ⋯ IV.
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Although hook plate fixation is popularly used, concerns exist regarding periprosthetic fractures and the necessity to remove the plate to prevent subacromial erosion and subsequent acromion fracture, due to its non-anatomical design. We hypothesized that a low profile 2.7 mm distal locking hook plate would provide comparable stability to a properly used 3.5 mm distal locking hook plate MATERIALS AND METHODS: A 3.5 mm distal locking plate (type 1) and a low profile 2.7 mm plate (type 2) were assessed by finite element analysis. Peak von Mises stress (PVMS) was calculated on the acromion's undersurface, clavicle shaft, and hook, focusing on how these stresses varied with the number and placement of distal locking screws. ⋯ The low profile 2.7 mm distal locking hook plate showed comparable biomechanical results to the 3.5 mm distal locking hook plate. Increasing the number of distal locking screws showed less stress concentration on the bone and hook in both models. The most posterior distal locking screw showed an essential role in stress distribution.
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Femoral neck fractures (FNF) in young and middle-aged adults are primarily caused by high-energy injuries in traffic accidents. Surgical delays often occur due to transportation issues, preoperative evaluations, and economic burdens. ⋯ Early surgical intervention, within a 2-days period after injury, seems to be crucial for young adults with FNF. If CRIF is challenging in some cases, ORIF can be another choice.
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Survivors of burn injuries may be at risk of early death. This study describes the mortality of burn survivors in comparison with two matched cohorts. ⋯ Survivors of burn injury are at increased risk of mortality compared to individuals matched on sex, age and socioeconomic deprivation in both the general population and with a hospital admission due to acute pancreatitis.
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To identify the determinants that influence the outcome of the return to work (RTW) after occupational injuries. ⋯ Biomechanical exposure and social support are main influencers of the return-to-work process.