Journal of orthopaedic trauma
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Comparative Study
Outcome after hip fracture in individuals ninety years of age and older.
To assess outcome after hip fracture in patients ninety years of age and older, as compared with a population of the same age and sex in the United States and younger patients with hip fractures. ⋯ The mean patient age was 79.7 years (range 65 to 105 years). Seventy-six (8.9 percent) patients were ninety years of age and older. Patients who were ninety years of age and older had significantly longer mean hospital lengths of stay than younger individuals (p = 0.01). People ninety years of age and older were more likely to die during the hospital stay (p = 0.001) and within one year of surgery (p = 0.001). Patients who were ninety years of age and older were more likely to have a decrease in their basic activities of daily living status (p = 0.03) and ambulation level (p = 0.01). Younger individuals had a higher standard mortality ratio (1.48) than did patients who were ninety years of age and older (1.24). Being ninety years of age and older was not predictive of having a postoperative complication, of being placed in a skilled nursing facility at discharge or at one-year follow-up, or recovering of prefracture independence in instrumental activities of daily living.
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Randomized Controlled Trial Comparative Study Clinical Trial
Prospective, randomized, double-blind study comparing single-agent antibiotic therapy, ciprofloxacin, to combination antibiotic therapy in open fracture wounds.
The purpose of this study was to compare the efficacy of a single agent, ciprofloxacin, with that of combination antibiotic therapy consisting of cefamandole and gentamicin in all types of open fracture wounds. ⋯ Single-agent antibiotic therapy with ciprofloxacin is effective in treatment of Type I and Type II open fracture wounds. However, on the basis of our results, we cannot recommend ciprofloxacin alone for Type III wounds. Possibly one can use fluoroquinolones in combination therapy, specifically as an alternate to an aminoglycoside.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of acute reamed versus unreamed intramedullary nailing on compartment pressure when treating closed tibial shaft fractures: a randomized prospective study.
To compare anterior and deep posterior compartment pressures during reamed and unreamed intramedullary nailing of displaced, closed tibial shaft fractures. ⋯ These data support acute (within three days of injury) reamed intramedullary nailing of closed, displaced tibial shaft fractures without the use of a fracture table.
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Case Reports
Bilateral epiphyseal fractures of the proximal tibia within a six-month interval: a case report.
An epiphyseal fracture commonly results from avulsion of the epiphysis by traction through the attached ligaments. A fracture of the proximal tibial epiphysis is, therefore, a rare injury because of the absence of collateral ligament attachments. Most proximal tibial epiphyseal injuries occur as avulsion fractures of the tibial tubercle; Salter-Harris Types I or II injuries involving pressure epiphyses are rare. In the current case of a thirteen-year-old boy, the proximal tibial epiphyseal injuries in both knees occurred during quadriceps contraction in the absence of violent trauma, and there was a six-month interval between the two injuries.
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Comparative Study Clinical Trial Controlled Clinical Trial
Prospective comparison of retrograde and antegrade femoral intramedullary nailing.
To prospectively compare the results, function, and complications of antegrade and retrograde femoral nailing for femoral shaft fractures. ⋯ Both antegrade and retrograde nailing yielded high union rates. Each insertion technique has its own advantages and disadvantages. The two insertion modes appear to be relatively equal for the treatment of femoral shaft fractures.