Injury
-
Review
Pain relief management following proximal femoral fractures: Options, issues and controversies.
The majority of proximal femoral fractures occur in the elderly population. Safe and adequate pain relief is an integral part of the overall management of hip fractures. ⋯ The pain management should start as soon as possible and special emphasis should be paid to contemporary methods of regional anaesthesia whilst a multimodal approach should be adopted in the perioperative period. The present review summarises the contemporary treatment options and controversies pertaining to the management of pain in elderly patients with proximal femoral fractures.
-
Randomized Controlled Trial Comparative Study
Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial.
The aim of this study was to compare the clinical and radiographic outcomes between two different plating methods (superior vs. anteroinferior) in minimally invasive plate osteosynthesis (MIPO) for acute displaced clavicular shaft fractures. ⋯ Level I, a single-centre, prospective, randomized controlled trial.
-
The purpose of this study was to compare imaging modalities in the diagnosis of occult radial head and neck fractures and to assess the diagnostic value of ultrasound in diagnosing occult fractures of the radial head and neck. The study included 193 patients (101 male, 92 female) who were referred by trauma surgeons from January 2011 to July 2014 and presented with history of acute elbow trauma. The mean age of the patients was 37 years (range 15-82 years); 95 right and 98 left elbows were included in the study. ⋯ In conclusion, ultrasound imaging proved to be an effective method for diagnosing occult fractures of the radial head or neck when initial radiograms showed only intraarticular effusion. Ultrasound imaging is a cost-effective, easy-to-use and radiation-free method. For these reasons we recommend it for early detection of occult fracture in the emergency room.
-
Review
Total elbow joint replacement for fractures in the elderly-Functional and radiological outcomes.
The purpose of this paper was to review the literature on the treatment of intra-articular fractures of the distal humerus in the elderly in order to evaluate the place for total elbow replacement (TER) in the light of our experience over the past 15 years. ⋯ TER is now the treatment of choice for unreconstructable fractures of the distal humerus in the elderly. This option should therefore be available at the time of surgery for all distal humeral fractures in this patient population. A surgical approach other than olecranon osteotomy, which would preclude TER is therefore required.
-
Randomized Controlled Trial
Precise placement of lag screws in operative treatment of trochanteric femoral fractures with a new guide system.
We assessed the accuracy of a new guide system that we developed to place lag screws in the proper position with the minimum number of attempts for operative treatment of trochanteric femoral fractures. ⋯ With this new guide system, we are able to insert lag screws successfully in the optimal position even in most unstable fractures. The present study indicated that this new guide system and nail facilitate accurate placement of lag screws in the appropriate position with the minimum number of attempts.