Injury
-
Editorial Case Reports
Is it true that most intra-articular glenoid fractures should have surgery?
-
Review Meta Analysis
Arthroplasty treatment options for femoral neck fractures in the elderly: A network meta-analysis of randomized control trials.
Treatment options for displaced intracapsular femoral neck fractures in elderly patients include unipolar hemiarthroplasty (UHA), bipolar hemiarthroplasty (BHA), unipolar total hip arthroplasty (UTHA), and dual-mobility total hip arthroplasty (DMTHA). This network meta-analysis (NMA) of randomized controlled trials (RCTs) quantitatively compares these treatments to identify the optimal surgical technique. ⋯ A variety of arthroplasty procedures can be used to treat displaced intracapsular femoral neck fractures. Our results indicate that while BHA resulted in the best post-operative ranking amongst the compared treatment strategies in terms of dislocation rates, blood loss and mortality, the differences between the treatment options does not clearly favor a specific treatment option.
-
Assessment of wounds based on visual appearance has poor inter- and intra-rater reliability and it is difficult to differentiate between inflammation and infection. Thermography is a user-friendly quantitative image technique that collects the skin surface temperature pattern of the wound area and immediately visualizes the temperatures as a rainbow coloured diagram. The aim of this scoping review is to map and summarize the existing evidence on how thermography has been used to assess signs of inflammation in humans and animals with surgical or traumatic wounds. ⋯ If a secondary temperature peak happens during the healing phase of a surgical wound, it is likely that infection has occurred. Modern handheld thermographic cameras might be a promising tool for the clinician to quickly quantify the temperature pattern of surgical wounds to distinguish between inflammation and infection. However, firm evidence supporting infection thermography surveillance of surgical wounds as a technique is missing.
-
Phage therapy (PT) continues to attract interest in the fight against fracture-related infection (FRI), particularly for recurring infections that have not been resolved using conventional therapeutic approaches. The journey PT has taken from early clinical application in the pre-antibiotic era to its recent reintroduction to western clinical practice has been accelerated by the increased prevalence of multi-drug resistant (MDR) pathogens in the clinic. ⋯ The challenges for PT, for example the most optimal application technique and dosing, are also discussed and underscore the importance of personalized approaches and the urgent need for more robust clinical evidence. Future perspectives, including phage engineering and innovative delivery systems will be discussed, as they may broaden the applicability of PT to a point where it may become a standard rather than an option of last resort for orthopedic infection management.