Injury
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Outcomes from patients suffering hip fracture remain poor, with 9% mortality at 30 days and 35% at 1 year. Despite robust guidelines these mortality rates have undergone little change. Admission serum lactate in patients with sepsis or suffering general trauma has been shown to be an indicator of adverse clinical outcomes. ⋯ The difference was statistically significant (p<0.0001). Elevated admission venous lactate following hip fracture is a predictor of early death. Venous lactate may be useful as a prognostic indicator or risk stratifier in patients with proximal femoral fractures.
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The role of simulation in orthopaedic surgical training is becoming increasingly evident, as simulation allows repeated sustained practice in an environment that does not harm the patient. Previous studies have shown that the cognitive aspects of surgery are of equal if not greater importance in developing decision making than the practical aspects. ⋯ IFN on the Touch Surgery app demonstrated construct, face and content validity. Users can demonstrate cognitive competencies prior to performing surgical procedures in the operating room. The application is an effective adjunct to traditional learning methods and has potential for curricular implementation.
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Comparative Study
Influence of obesity on surgical outcomes in type III paediatric supracondylar humeral fractures.
Obesity was associated with poor treatment outcome in paediatric supracondylar humeral fractures. It is controversial about the association is related to more severe fractures in obese children or obesity directly affects treatment. The purpose of this study was to evaluate the influence of obesity on surgical outcomes after control of fracture severity. ⋯ Obesity was associated with more postoperative varus deformation and pin-related complications after surgical fixation for type III supracondylar fracture. These findings underline the importance of stable fixation and close post-operative monitoring in obese children.
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Hyperextension instability of the metacarpophalangeal (MCP) joint of the thumb may result in pain, malfunction, and accelerated osteoarthritis in the carpometacarpal (CMC) joint. One method of treatment is sesamoid arthrodesis. The aim of this study is to investigate if a sesamoid transfer as a treatment of hyperextension instability of the thumb MCP joint leads to an altered distribution of the subchondral mineralisation and a negative clinical outcome. ⋯ If it is assumed that the nonoperated thumb represents the normal condition for each individual, then it may be deduced that the operation achieves good clinical results, and the distribution of the subchondral mineralisation does not change.
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Comparative Study
Histological analysis of cross-sectional area of quadruple hamstring tendons and patellar ligament samples in relation to age and gender.
The middle of the patellar ligament and the quadruple hamstring tendons (gracilis and semitendinosus) are two types of graft predominantly used in anterior cruciate ligament (ACL) reconstruction. The aim of this study was to determine the morphometric characteristics of patellar ligament grafts and hamstring tendon grafts and to compare the results according to subject age and gender. ⋯ All samples obtained from male subjects had larger cross-sectional areas compared with the samples taken from females. Furthermore, samples obtained from subjects aged 60 years or under had larger cross-sectional areas than samples obtained from subjects aged at least 61 years for all types of graft.