International orthopaedics
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Comparative Study
Regional anaesthesia for hip fracture surgery is associated with significantly more peri-operative complications compared with general anaesthesia.
Although several studies have advocated the use of regional versus general anaesthesia as a means of reducing peri-operative complications from hip fracture surgery, the ideal method of anaesthesia remains controversial. Our purpose was to investigate the association between anaesthesia type and peri-operative complications in hip fracture surgery. ⋯ Using a large multi-centre database, we demonstrate that regional anaesthesia was associated with significantly greater odds of minor and total peri-operative complications compared with general anaesthesia. Our results challenge the notion that regional anaesthesia is the preferred method of anaesthesia for hip fractures in the elderly.
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Since 2003, we have been performing rotational open-wedge osteotomy (ROWO) for older children with severe Legg-Calve-Perthes disease (LCPD). We compared the treatment outcomes before and after the introduction of ROWO for patients aged ≥ eight years, classified in the modified lateral pillar B/C border or C group. ⋯ The application of ROWO combined with NWB in the treatment of older children with severe LCPD improved their outcomes, compared to those obtained by NWB treatment alone.
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The efficacy of immediate full weight bearing in accelerating bone regeneration after medial opening wedge high tibial osteotomy (HTO) was evaluated in patients operated with the Limmed system (locked plate fixation) that allows dynamisation of the site of the osteotomy. ⋯ The Limmed medial opening wedge HTO system with immediate full weight bearing accelerates bone graft substitute osseointegration and bone healing as compared with controls without full weight bearing.
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Osteonecrosis of the femoral head (ONFH) is a very common complication after femoral neck fracture. The purpose of this study was to assess the femoral head vascularity after femoral neck fracture using single photon emission computerized tomography and computerized tomography (SPECT/CT), and to evaluate its value in predicting ONFH. ⋯ SPECT-CT proved to be reliable and valid for predicting ONFH after femoral neck fracture.
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Accurate evaluation of femoral offset is difficult with conventional anteroposterior (AP) X-rays. The EOS imaging system is a system that makes the acquisition of simultaneous and orthogonal AP and lateral images of the patient in the standing position possible. These two-dimensional (2D) images are equivalent to standard plane X-rays. Three-dimensional (3D) reconstructions are obtained from these paired images according to a validated protocol. This prospective study explores the value of the EOS imaging system for comparing measurements of femoral offset from these 2D images and the 3D reconstructions. ⋯ This study points out the limitations of 2D measurements of femoral offset on standard plane X-rays. The reliability of the EOS 3D models has been previously demonstrated with CT scan reconstructions as a reference. The EOS imaging system could be an option for obtaining accurate and reliable offset measurements while significantly limiting the patient's exposure to radiation.