Injury
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Glenohumeral dislocations occurring during snowboarding and skiing are severe and often leave after effects. However, little is known about their aetiology and injury pattern. The purpose of this study was to elucidate the feature of glenohumeral dislocations in these winter sports. ⋯ Snowboarding and skiing are sports with increased risk of glenohumeral dislocation compared with the general population, and the injury pattern differs between them. In snowboarding, injury patterns seem to be influenced by performance style.
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Polyaxial angle-stable plating is thought to be particularly beneficial in the management of complex intra-articular fractures of the distal radius. The purpose of the present study was to investigate whether the technique provides stability to match that of conventional (fixed-angle) angle-stable constructs. ⋯ The polyaxial two-column plate tested in this study provides a biomechanically sound construct for the management of intra-articular fractures of the distal radius.
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Comparative Study
Comparison of depressive symptoms during the early recovery period in patients with a distal radius fracture treated by volar plating and cast immobilisation.
Patients with orthopaedic trauma experience substantial psychological and physical morbidities. The purpose of this study was to assess depressive symptoms in patients with a distal radius fracture, and to determine whether early use of the wrist after volar plating reduces depressive symptoms as compared with cast immobilisation during the early recovery period. ⋯ Early use of the wrist after volar plating was not found to reduce depressive symptoms as compared with cast immobilisation in the early treatment period following a distal radius fracture. Pain was found to be an important predictor of depression, suggesting that caution is needed to address pain during the early rehabilitation period.
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The aim of the study was to investigate the possible outcomes of intracapsular femoral neck fractures managed non-operatively or with a simple form of internal fixation. ⋯ Appreciation of these appearances and an understanding of how these fractures may progress are important in the current diagnosis and management of delayed presentations, neglected or inadequately fixed subcapital fractures of the femoral neck.
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We present our experience in the management of hip fracture patients after the application of a value-stream approach, the Lean framework, in our trust. This system uses available resources in an efficient manner whilst eliminating waste. ⋯ To our knowledge, this is the largest study in the literature where the Lean framework has been successfully employed for the management of a very challenging health-care issue faced by the National Health Service. Future prospective studies are, however, needed to reconfirm these results and to evaluate the components that are most critical to the success of the implemented framework.