Injury
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The results of treatment for 83 patients treated with a new implant designed specifically for the internal fixation of intracapsular hip fractures are reported. Nonunion occurred in one out of the 37 undisplaced fractures (3%) and seven out of the 46 displaced fractures (15%). ⋯ The functional recovery at patients at 1 year was excellent. The results to date for this new implant suggest that it may lead to reduced fracture-healing complications in comparison to the currently used methods of internal fixation.
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A retrospective analysis of 150 adolescents who underwent spinal fusion for idiopathic scoliosis. ⋯ There is a high incidence of postoperative proximal junctional kyphosis after posterior fusion to the upper thoracic vertebra within 1.5 years after surgery in adolescents with idiopathic scoliosis. In order to reduce its incidence, the risk factors for PJK should be carefully evaluated before surgery.
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Pelvic ring fractures caused by high-energy trauma are severe injuries with well described radiological and clinical outcomes, whereas description from the patient's perspective is less well documented. The purpose of this study was to investigate patient-reported outcome following surgical treatment of pelvic fractures using quality of life instruments. ⋯ Two years after surgical treatment of pelvic ring fractures, patients reported substantially lower quality of life for both physical and mental domains, when compared with a reference population, even when radiological and clinical outcomes were considered favourable.
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Postoperative surgical site infection (SSI) in orthopaedic trauma surgery is uncommon, but can present serious complications. This study was designed to assess the prevalence of, and to identify the risk factors for, SSI following acetabular fracture open reduction and internal fixation. A total of 326 consecutive patients who underwent acetabular fracture surgery were retrospectively reviewed. ⋯ Univariate analysis demonstrated that the SSI group had statistically significant higher Injury Severity Score, longer intensive care unit (ICU) stays, larger amount of packed red blood cells transfused, longer operative time, larger estimated operative blood loss, higher body mass index (BMI), more frequent performance of combined approach, embolisation of internal iliac arteries, association of urinary tract injury, and Morel-Lavallée lesion compared to the no SSI group. Multivariate analysis using these 10 parameters showed that BMI, ICU stay, and Morel-Lavallée lesion were independently significant risk factors for SSI. To reduce the incidence of SSI following acetabular fracture surgery, special attention should be directed at the care of obese patients, patients requiring ICU care, and patients with associated Morel-Lavallée lesions.