Injury
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Interprosthetic femoral fractures following ipsilateral hip and knee arthroplasty are a rare but serious complication in clinical practice. In most cases, adequate management of these injuries might constitute a challenging problem. However, the literature provides only few data regarding the treatment and outcome of interprosthetic femoral fractures, and there are only few classifications available, which might assist in finding an appropriate treatment concept. The purpose of this study was to analyse our experience in the management of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. ⋯ We had a satisfactory outcome following individualised treatment of interprosthetic femoral fractures following ipsilateral hip and knee joint replacement. Compared to the rare data in current literature, we had promising functional result and high rate of bony fusion. Regarding the complexity and challenges in many of these cases, interprosthetic fractures require an adequate analysis of the fracture aetiology and a suitable transfer into the best possible treatment concept.
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The study estimated the hospital costs associated with the surgical fixation of ankle fractures by either open reduction internal fixation (ORIF) or external fixation. ⋯ The results highlight the considerable hospital costs associated with the surgical fixation of an ankle fracture, thus providing valuable information for resource planners. Future research should broaden the perspective of the economic analysis to include rehabilitation costs and assess the cost-effectiveness of potential cost-saving strategies.
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Bone bruising of the scaphoid is a term reported when magnetic resonance imaging (MRI) is carried out for scaphoid injury. The aim of our study was twofold: to see if bone bruising alone without fracture of the scaphoid bone seen on initial MRI, in a clinically symptomatic (tender) patient at 10-14 days, progressed to fracture, and to define how this entity of bone bruising should be managed. ⋯ Bone bruising detected on MRI without fracture is an important entity, and can lead to occult fracture (2%). It can take anywhere up to 8 weeks to declare. Treatment for bone bruising should be with a scaphoid cast and follow-up X-ray.
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Editorial
Enhancement of fracture healing with the diamond concept: the role of the biological chamber.
Bone regeneration presents a unique challenge to both clinicians and scientists. Recently, a vast amount of knowledge has been attained with regard to the molecular mediators, cell populations and the overall cascade of events participating in the bone repair processes. ⋯ At the end of the surgical procedure the non-union bed should have been transformed to a 'biological chamber' active enough to support efficiently all the necessary physiological processes for a successful outcome. The notion of creating the optimum 'biological chamber' represents the centre of the highest biological activity and in a sense the heart of the diamond concept.
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There is an increase in the number of anabolic-steroid (AS)-abusing trainees, who suffer from sports injuries, needing reconstruction surgery. Rupture of the distal biceps brachii tendon is a common injury in this group. ⋯ The results of our study suggest that there is a correlation between the effect of AS and the quicker and better recuperation and rehabilitation observed in group A. Nonetheless, these results must be interpreted with caution, and further in vivo research is needed to confirm these findings.