Recent UK national guidelines advocate using a combination of mechanical and pharmacological VTE prophylaxis in patients undergoing lower limb arthroplasty. We compared the results from our two series of patients: one treated with clexane and the other treated with rivaroxaban. Both groups received mechanical prophylaxis. In the first group 89 patients were given 40 mg subcutaneous clexane once daily from the day prior to surgery until they were independently mobile. The second group comprised 99 patients who were given 10 mg of oral rivaroxaban.Introduction
Methods
Recent UK national guidelines advocate using a combination of mechanical and pharmacological VTE prophylaxis in patients undergoing lower limb arthroplasty but do not recommend one particular pharmacotherapy over another. We compared the results from our two series of patients: one treated with clexane and the other treated with rivaroxaban, with respect to average length of stay, postoperative wound leakage, readmission within 30 days of surgery and re-do surgeryIntroduction
Objectives
Clavicle fractures accounting for 3–5% of all adult fractures are usually treated non-operatively. There is an increasing trend towards their surgical fixation. The aim of our study was to investigate the outcome following titanium elastic stable intramedullary nailing (ESIN) for midshaft non-comminuted clavicle fractures with >20mm shortening/displacement.Introduction
Objective
The treatment of undisplaced femoral neck fracture in the elderly population is still controversial. We analysed the outcome of cancellous screw fixation for undisplaced femoral neck fracture in patients over 70 years. From 1998 to 2003, ninety-seven patients with undisplaced femoral neck fracture, aged over 70 and treated with cancellous screw fixation were retrospectively identified. Full clinical data was available for 79 of the 97 patients identified. All patients had in situ fracture fixation. Of the 79 patients, M:F was 22:57, average age was 81.3 years. The average inpatient stay was 13.2 days. The mean follow-up was 12 months. 24 patients had Garden type I and 55 type II fractures. 26 (32.9%) patients did not return to their pre-morbid mobility status, 5 (6.3%) did not return to their preadmission dwelling (2 went to residential homes and 3 to nursing homes). We had documented radiographic details in 46 patients: 41 patients had a healed fracture on radiographs (89.1%), 5 patients had AVN, 4 patients had non-union and 1 patient had AVN with non-union. The radiographic failure rate was 22%. 15 patients had evidence of screw back out with healed fracture. 12 of the 46 complained of pain post-operatively of which 9 (19.6%) patients had re-operation; 6 (13%) underwent revision surgery and 3 (6.5%) required screw removal. 30-day mortality was 3.7%. 1-year mortality was 23.2% of which 16 died within the first 6 months (19.5%).Materials and methods
Results
