International orthopaedics
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Cardiovascular complications constitute morbidity and mortality for hip fracture patients. Relatively little data exist exploring risk factors for post-operative complications. Using the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database, we identified significant risk factors associated with adverse cardiac events in hip fracture patients and provide recommendations for practising orthopaedists. ⋯ Orthopaedic trauma surgeons should be aware of cardiac disease history and atherosclerotic conditions (PVD, stroke) in risk stratifying patients to prevent cardiac complications. Our recommendations to reduce cardiac events include simple pre-operative lab-work to full-fledged cardiac work-up and referrals to specific medicine disciplines based on the specific risk factors present.
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The main purpose of the present study was to evaluate the clinical results and prognosis of pure elbow dislocations in the paediatric age group following non-surgical treatment. ⋯ Acute traumatic pure elbow dislocation in childhood is a very rarely seen emergency that can be treated safely with closed reduction combined long-arm plaster splinting and physical rehabilitation.
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Randomized Controlled Trial
Peri-articular injections of local anaesthesia can replace patient-controlled analgesia after total knee arthroplasty: a randomised controlled study.
In recent years, there has been an increasing interest in peri-articular injections (PAI) to control post-operative pain after total knee arthroplasty (TKA). Previous studies have evaluated the effect of PAI using multimodal analgaesic protocols, but the concomitant use of patient-controlled analgesia (PCA) may has masked the genuine effects of PAI. We investigated the efficacy of PAI compared with PCA and determined whether conventional PCA can be effectively replaced with PAI after TKA. ⋯ PAI offered improved pain control and minimal side effects compared with PCA. Thus, PAI can replace conventional PCA for controlling post-operative pain after TKA.
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Acetabular coverage deficiency displays individual difference among patients with developmental dysplasia of the hip (DDH). Therefore, the correct direction and degree of the acetabular fragment is patient-specific during Bernese periacetabular osteotomy (PAO). This paper introduces a feasible method using 3D computed tomography (CT) and computer image processing technology for customised surgical planning. ⋯ The geometric feature of the pelvis for patients with DDH can be assessed comprehensively by using 3D-CT reconstruction and image processing technology. Based on this method, surgeons can design individualised treatment scheme and improve the effect of PAO.
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Comparative Study
Arthroplasty for unstable pertrochanteric hip fractures may offer a lower re-operation rate as compared to cephalomedullary nailing.
Cephalomedullary (CM) nailing is widely used for the treatment of pertrochanteric hip fractures. Fixation failures with CM nailing tend to occur in unstable fracture patterns often necessitating revision surgery. The purpose of this study was to compare the complications and clinical outcomes of primary arthroplasty to CM nailing for the treatment of unstable pertrochanteric hip fractures. ⋯ Arthroplasty is a viable option for treatment of unstable pertrochanteric fractures in an elderly population. Arthroplasty may offer a lower re-operation rate in the treatment of unstable pertrochanteric hip fractures as compared to CM nailing.