Aims. The aims of this study were to determine the cumulative ten-year
survivorship of hips treated for acetabular fractures using surgical
hip dislocation and to identify factors predictive of an unfavourable
outcome. Patients and Methods. We followed up 60 consecutive patients (61 hips; mean age 36.3
years, standard deviation (. sd. ) 15) who underwent open reduction
and
1. Seventy patients with impacted fractures of the femoral neck treated from 1953 to 1965 have been reviewed. Forty-seven were treated conservatively and twenty-three by primary
Despite worldwide clinical use of bio-absorbable devices for
1. The results of treatment of fractures of the shaft of the femur in fifty patients aged sixty-five years and over seen over a twelve-year period are presented. 2. Half of the patients were treated by
The February 2015 Hip &
Pelvis Roundup. 360 . looks at: Hip arthroplasty in Down syndrome; Bulk femoral autograft successful in acetabular reconstruction; Arthroplasty follow-up: is the internet the solution?; Total hip arthroplasty following acetabular fracture; Salvage arthroplasty following failed hip
Aims. The aim of this study was to assess the feasibility of conducting a full-scale, appropriately powered, randomized controlled trial (RCT) comparing
One hundred and sixteen patients with 129 ununited fractures were treated either by rigid
We reviewed the records of 431 patients who had open reduction and
The August 2014 Trauma Roundup. 360 . looks at: On-table CT for calcaneal fractures; timing of femoral fracture surgery and outcomes; salvage arthroplasty for failed
Aims. Although infrequent, a fracture of the cuboid can lead to significant
disruption of the integrity of the midfoot and its function. The
purpose of this study was to classify the pattern of fractures of
the cuboid, relate them to the mechanism of injury and suggest methods
of managing them. Patients and Methods. We performed a retrospective review of patients with radiologically
reported cuboid fractures. Fractures were grouped according to commonly
occurring patterns of injury. A total of 192 fractures in 188 patients
were included. They were classified into five patterns of injury. Results. Type 1 fractures (93 fractures, 48.4%) are simple avulsion injuries
involving the capsule of the calcaneo-cuboid joint. Type 2 fractures
(25 fractures, 13%) are isolated extra-articular injuries involving
the body of the cuboid. Type 3 injuries (13 factures, 6.8%) are
intra-articular fractures solely within the body of the cuboid.
Type 4 fractures (35 fractures, 18.2%) are associated with disruption
of the midfoot and tarsometatarsal injuries. Type 5 fractures (26 fractures,
13.5%) occur in conjunction with disruption of the mid-tarsal joint
and either crushing of the lateral column alone or of both medial
and lateral columns. Fractures with significant articular disruption or with loss
of length of the lateral column underwent fixation. This involved
either
This study aims to determine the rate of and risk factors for total knee arthroplasty (TKA) after operative management of tibial plateau fractures (TPFs) in older adults. This is a retrospective cohort study of 182 displaced TPFs in 180 patients aged ≥ 60 years, over a 12-year period with a minimum follow-up of one year. The mean age was 70.7 years (SD 7.7; 60 to 89), and 139/180 patients (77.2%) were female. Radiological assessment consisted of fracture classification; pre-existing knee osteoarthritis (OA); reduction quality; loss of reduction; and post-traumatic OA. Fracture depression was measured on CT, and the volume of defect estimated as half an oblate spheroid. Operative management, complications, reoperations, and mortality were recorded.Aims
Methods
We performed a prospective, randomised trial comparing three treatments for displaced intracapsular fractures of the hip in 280 patients aged 65 to 79 years. The mean patient survival was significantly higher in the group undergoing reduction and
Aims. Surgical site infection can be a devastating complication of
hemiarthroplasty of the hip, when performed in elderly patients
with a displaced fracture of the femoral neck. It results in a prolonged
stay in hospital, a poor outcome and increased costs. Many studies
have identified risk and prognostic factors for deep infection.
However, most have combined the rates of infection following total
hip arthroplasty and
The June 2024 Trauma Roundup360 looks at: Skin antisepsis before surgical fixation of limb fractures; Comparative analysis of intramedullary nail versus plate fixation for fibula fracture in supination external rotation type IV ankle injury; Early weightbearing versus late weightbearing after intramedullary nailing for distal femoral fracture (AO/OTA 33) in elderly patients: a multicentre propensity-matched study; Long-term outcomes with spinal versus general anaesthesia for hip fracture surgery; Operative versus nonoperative management of unstable medial malleolus fractures: a randomized clinical trial; Impact of smoking status on fracture-related infection characteristics and outcomes; Reassessing empirical antimicrobial choices in fracture-related infections; Development and validation of the Nottingham Trauma Frailty Index (NTFI) for older trauma patients.
1. A simple method of
Objectives. The treatment of osteoporotic fractures is a major challenge, and the enhancement of healing is critical as a major goal in modern fracture management. Most osteoporotic fractures occur at the metaphyseal bone region but few models exist and the healing is still poorly understood. A systematic review was conducted to identify and analyse the appropriateness of current osteoporotic metaphyseal fracture animal models. Materials and Methods. A literature search was performed on the Pubmed, Embase, and Web of Science databases, and relevant articles were selected. A total of 19 studies were included. Information on the animal, induction of osteoporosis, fracture technique, site and fixation, healing results, and utility of the model were extracted. Results. Fracture techniques included drill hole defects (3 of 19), bone defects (3 of 19), partial osteotomy (1 of 19), and complete osteotomies (12 of 19). Drill hole models and incomplete osteotomy models are easy to perform and allow the study of therapeutic agents but do not represent the usual clinical setting. Additionally, biomaterials can be filled into drill hole defects for analysis. Complete osteotomy models are most commonly used and are best suited for the investigation of therapeutic drugs or noninvasive interventions. The metaphyseal defect models allow the study of biomaterials, which are associated with complex and comminuted osteoporotic fractures. Conclusion. For a clinically relevant model, we propose that an animal model should satisfy the following criteria to study osteoporotic fracture healing: 1) induction of osteoporosis, 2) complete osteotomy or defect at the metaphysis unilaterally, and 3)
Fractures of the hip in children have been associated with a very high rate of serious complications including avascular necrosis (up to 47%) and coxa vara (up to 32%). Over a period of 20 years, we have treated displaced fractures by early anatomical reduction,
This study aimed to investigate the risk of postoperative complications in COVID-19-positive patients undergoing common orthopaedic procedures. Using the National Surgical Quality Improvement Programme (NSQIP) database, patients who underwent common orthopaedic surgery procedures from 1 January to 31 December 2021 were extracted. Patient preoperative COVID-19 status, demographics, comorbidities, type of surgery, and postoperative complications were analyzed. Propensity score matching was conducted between COVID-19-positive and -negative patients. Multivariable regression was then performed to identify both patient and provider risk factors independently associated with the occurrence of 30-day postoperative adverse events.Aims
Methods
To assess the feasibility of a randomized controlled trial (RCT) that compares three treatments for acetabular fractures in older patients: surgical fixation, surgical fixation and hip arthroplasty (fix-and-replace), and non-surgical treatment. Patients were recruited from seven UK NHS centres and randomized to a three-arm pilot trial if aged older than 60 years and had a displaced acetabular fracture. Feasibility outcomes included patients’ willingness to participate, clinicians’ capability to recruit, and dropout rates. The primary clinical outcome measure was the EuroQol five-dimension questionnaire (EQ-5D) at six months. Secondary outcomes were Oxford Hip Score, Disability Rating Index, blood loss, and radiological and mobility assessments.Aims
Methods
Infected nonunion of a long bone continues to
present difficulties in management. In addition to treating the infection,
it is necessary to establish bony stability, encourage fracture
union and reconstruct the soft-tissue envelope. We present a series of 67 infected nonunions of a long bone in
66 patients treated in a multidisciplinary unit. The operative treatment
of patients suitable for limb salvage was performed as a single
procedure. Antibiotic regimes were determined by the results of
microbiological culture. At a mean follow-up of 52 months (22 to 97), 59 patients (88%)
had an infection-free united fracture in a functioning limb. Seven
others required amputation (three as primary treatment, three after
late failure of limb salvage and one for recalcitrant pain after
union). The initial operation achieved union in 54 (84%) of the salvaged
limbs at a mean of nine months (three to 26), with recurrence of
infection in 9%. Further surgery in those limbs that remained ununited
increased the union rate to 62 (97%) of the 64 limbs treated by
limb salvage at final follow-up. The use of