Injury
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This study was conducted to evaluate baseline cerebral tissue regional oxygen saturation (rSO(2)) values and identify risk factors related to severe rSO(2) reductions in elderly patients with hip fractures. ⋯ Low baseline cerebral rSO(2) values are common in elderly hip fracture patients, despite normal haemodynamic and arterial saturation values. Preoperative haematocrit, SpO(2) and age explain a significant portion of cerebral rSO(2) variability. More studies are needed to validate our findings and assess the potential benefit of interventions aimed at improving cerebral rSO(2) in elderly hip fracture patients.
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Radial nerve palsy associated with humeral shaft fractures is the most common nerve lesion complicating fractures of long bones. The purpose of the study was to review the outcome of surgical management in patients with low energy and high energy radial nerve palsy after humeral shaft fractures. ⋯ The outcome of the radial nerve palsy following humeral fractures is associated to the initial trauma. Palsies that are part of a low energy fracture uniformly recover and therefore primary surgical exploration seems unnecessary. In high energy fractures, neurotmesis or severe contusion must be expected. In this case nerve recovery is unfavourable and the patients should be informed of the poor prognosis and the need of tendon transfers.
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Femoral neck fracture is one of the common clinical traumas, especially amongst elder patients. This study aims to test, compare and evaluate the bone-screw interface strengths, the fatigue strengths, and the stabilities of our newly designed expansive cannulated screw (ECS) and the common cannulated compression screw (CCS) in the fixation of femoral neck fracture, which is a summary of recent research. ⋯ The ECS shows better fixation performance than the currently and commonly used CCS; under certain circumstances, fixation with two ECSs can achieve the same effect as that with traditional three CCSs.
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The conflict between the anatomist and biologist surgeons is exemplified by the debate about subtrochanteric hip fractures. Closed intramedullary nailing is biologically friendly but may result in prolonged procedures and malunion. By contrast, accurate anatomical open reduction may disturb the biological composition of the fracture environment. ⋯ The results demonstrate that judicious use of cerclage cables to augment fixation of subtrochanteric femur fractures does not have a deleterious effect on healing. One should endeavour, however, to minimise the number of cables used. The basic science literature underpinning our approach to these unstable fractures is also discussed.
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This study was designed to estimate trends in the number of proximal femoral fractures (PFFs), and consequent bed day requirements and financial implications for England until 2033. ⋯ The evaluation and implementation of cost-effective preventive and therapeutic strategies in the short term may help to ameliorate the future financial burden of PFF, and, more importantly, improve the outcome and quality of life for the elderly after fracture.