Injury
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Posterior wall fractures are the commonest type of acetabular fracture. Nonoperative management is associated with significant complications and poor outcome. Consequently, open reduction and internal fixation has become increasingly common. In this article, inaugurating the new section of "how do I do it", we present our current approach to the treatment of posterior wall fractures of the acetabulum, including the preoperative planning, the details of the operative procedure in terms of patient's positioning and draping, surgical approach, osteosynthesis and wound closure.
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Current methods of fracture care use various adjuncts aimed at decreasing time to fracture union and improving fracture union rates. Among the most commonly used modalities, low-intensity pulsed ultrasound is emerging as a safe, cost-effective and reliable treatment for both fresh fractures and fracture nonunions. Both in vivo and in vitro basic science studies have helped to elucidate potential mechanisms of ultrasound action and a number of prospective, randomised, double-blind, placebo-controlled trials exist demonstrating the clinical efficacy of low-intensity pulsed ultrasound. This article will review the evidence for the use of low-intensity pulsed ultrasound in fracture care.
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Multicenter Study
Epidemiology and outcome after hip fracture in the under 65s-evidence from the Scottish Hip Fracture Audit.
To report the epidemiology and outcomes after hip fractures in the patients under 65 years of age. ⋯ Patients aged 50-64 years have significantly better outcome measures after surgery for hip fracture in terms of survival and function. Such differences exist even after controlling for differences in patient case-mix variables.
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Hip fractures are an ever increasing cause of morbidity and mortality. Treatment of this condition requires an all-encompassing approach from prevention to post-operative care. It is important in such a situation to gather data on the incidence and trends of hip fractures to aid in the future treatment planning of this important condition. ⋯ Mortality after a hip fracture remains significant, being 11-23% at 6 months and 22-29% at 1 year from injury. Geographical variations exist in the mortality after hip fracture. More detailed international comparisons are required to determine if these differences in outcome are accounted for by the variations in the demographics of patients or due to diversities in treatment methods.
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This study investigated the sport-related ankle injuries attending an accident and emergency (A&E) department during a 1-year period. ⋯ The results of this study together with the previous study on ankle sprain epidemiology suggested the following sports ankle injury pattern in Hong Kong-major and serious ankle ligamentous sprains and fractures were sustained from basketball, soccer and hiking, leading to A&E attendance, while minor sprains were sustained in running and jogging and racquet sports. We suggested that the Sports medicine specialists in Hong Kong should emphasise the ankle injury prevention strategies in these sports.