Injury
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Randomized Controlled Trial Multicenter Study Comparative Study
A multicentre, prospective, randomised comparison of the sliding hip screw with the Medoff sliding screw and side plate for unstable intertrochanteric hip fractures.
This study aimed to compare the dynamic hip screw (DHS) and Medoff sliding plate (MSP) for unstable intertrochanteric hip fractures. ⋯ The two techniques produced similar results for the clinically important outcomes of the need for further surgery and functional status of the patients at 6 months' follow-up.
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Percutaneous iliosacral screw placement following pelvic trauma is a very demanding technique involving a high rate of screw malpositions possibly associated with the risk of neurological damage or inadequate stability. In the conventional technique, the screw's correct entry point and the small target corridor for the iliosacral screw may be difficult to visualise using an image intensifier. 2D and 3D navigation techniques may therefore be helpful tools. The aim of this multicentre study was to evaluate the intra- and postoperative complications after percutaneous screw implantation by classifying the fractures using data from a prospective pelvic trauma registry. The a priori hypothesis was that the navigation techniques have lower rates of intraoperative and postoperative complications. ⋯ In this prospective multicentre study, the 2D/3D navigation techniques revealed similar results for the rate of intraoperative and postoperative complications compared to the conventional technique. The rate of neurological complications was significantly higher in the navigated group.
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Randomized Controlled Trial Comparative Study
Randomised trial of blood transfusion versus a restrictive transfusion policy after hip fracture surgery.
Debate exists as to what should be the transfusion threshold for patients with anaemia after hip fracture surgery. ⋯ This study confirms other recent research studies which found that reducing the transfusion threshold to 8.0gdl(-1) appears to be a safe practice for this group of patients.
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Angiographic embolisation (AE) is a successful treatment for haemodynamically unstable pelvic ring injuries. However, recent evidence has shown a significant complication rate following AE together with a lower success rate than previously reported. The aim of the current study was to review and indentify the factors predicting success or failure of AE. ⋯ Angiographic embolisation provides a reasonable option for haemodynamically unstable pelvic ring injured patients with an acceptable outcome, supporting previously reported literature. Patients with unstable APC type pelvic fracture may benefit the most from early angiographic embolisation. Patients requiring multiple vessel embolisation have a guarded outcome.
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Road traffic injuries pose a significant threat to the Egyptian population. Recent estimates revealed that Egypt experiences 42 road traffic deaths per 100,000 population (1.8% of all deaths in the country), which is the highest death rate in the region. More than half of the road traffic crashes that resulted in injuries occurred on the country's highways. Despite the significance of this public health problem, very little risk factor information currently exists. The overall goal of this paper is to understand the burden of speeding and the level of seatbelt and child restraint use on a highway (Cairo Ring Road) and two urban roads crossing Alexandria city (Kornish and Gamal Abd-Elnaser roads). ⋯ Future interventions need to focus on enhancing enforcement of speed and seatbelt wearing, closing gaps in legislation, and standardizing existing data systems to help inform good road safety policies.