Injury
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A case of a comminuted trochanteric fracture where the lesser trochanteric fragment had displaced significantly injuring and becoming lodged within the common femoral vein.
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Trauma patients exhibit a complex coagulopathy which is not fully understood and deep venous thrombosis (DVT) rates remain high. The effects of alcohol (EtOH) consumption on coagulopathy in trauma patients have not been studied. We hypothesized that acute EtOH intoxication would produce a relative hypocoagulable state as measured by thrombelastography (TEG) and would be associated with reduced DVT rates. ⋯ Alcohol consumption is associated with a relative hypocoagulable state on TEG that is associated with a decreased DVT incidence. This difference is not detected by conventional assays.
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The goal of this study was to evaluate the performance of haemothorax quantification to predict an abundant transfusion in blunt thoracic trauma patients. ⋯ Retrospective review, level III.
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One-year mortality after hip fracture may exceed 30% with a very large number of reported risk factors. Determinants of mortality beyond 1 year are rarely described. This study employs multiple data linkages to examine mortality rates, risk factor profiles and age-specific excess mortality at intervals from 30 days to 4 years. ⋯ Pre-fracture RAC residence was the strongest determinant factor for mortality. Patients selected for rehabilitation had lower mortality rates. The profiles of explanatory variables for death altered with increasing time from the index fracture event.
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Minimally invasive plate osteosynthesis (MIPO) using a locking plate has been widely used for distal femur fractures in the elderly with osteoporosis and yielded favourable results. However, implant failure and subsequent periplate fracture have still occurred owing to the controversy of concepts regarding locked plating. The treatment after failed MIPO in elderly patients is very challenging and has been not yet addressed definitely in the literature, although several options can be considered. We report the successful outcomes of two cases treated with overlapping intramedullary (IM) nailing for implant failure and periplate fracture after MIPO for osteoporotic distal femur fracture, along with simple tips of distal interlocking of IM nail.