Injury
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Postoperative cardiac events in orthopaedic trauma patients constitute severe morbidity and mortality. It is therefore increasingly important to determine patient risk factors that are predictive of postoperative myocardial infarctions and cardiac arrests. This study sought to assess if there is an association between anatomic area and cardiac complications in the orthopaedic trauma patient. ⋯ There is a significant difference in adverse cardiac events following orthopaedic trauma based on anatomic region. Hip/Pelvis surgery appeared to be a significant risk factor in developing an adverse cardiac event. Further studies should investigate why hip/pelvic patients are at a higher risk of adverse cardiac events.
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Multicenter Study
Incidence and risk factors for removal of an internal fixation following surgery for ankle fracture: A retrospective cohort study of 997 patients.
Implant removal in ankle fractures treated by open reduction and fixation is often based on diffuse complaints. This study determined the incidence of implant removal and identified risk factors for two principal causes for removal: complaints and surgical site infection (SSI). ⋯ In total 17% of patients had implant removal after open reduction and fixation; the majority because of subjective complaints. The risk factors for implant removal were different for removal due to complaints than for those removed due to infection. This information may be used to inform patients about the risk and risk factors for future implant removal.
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In this article, a mini-invasive technique is described, which consists of arthroscopic adhesiolysis and quadriceps pie-crusting lengthening basing on pre-operative sonographic examination. Sonographic diagnostic value of quadriceps tendon fibrosis is also evaluated. ⋯ This technique is a simple, effective and mini-invasive method, allowing an immediate, aggressive rehabilitation postoperatively. Pre-operative sonographic location of quadriceps tendon fibrosis could potentially improve the efficacy and accuracy of percutaneous pie-crusting procedures.
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Variable angle (VA) locking plates in fracture fixation surgery allow screws to be fastened to the plate within a conical "locus of vectors" in order to avoid existing prostheses, joint surfaces, or poor quality bone. Clinical failures of VA constructs in which screws have rotated at the plate/screw interface have been reported raising the concern that there may be a biomechanical cost for the increased flexibility that VA provides. The objective of this study was to test the mechanical properties of one commonly used VA locking mechanism with screws placed in both nominal and off-axis trajectories and compare these against the standard locking mechanism. ⋯ Surgeons should weigh the risks and benefits of VA systems and attempt to minimize the off-axis angle magnitude when VA systems are selected.
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Metal debris can produce a foreign body inflammatory reaction or as third body wear in the situation of joint arthroplasty. We evaluate a simple method for reducing this debris using a sterile water-based lubricating gel. ⋯ We show that using a safe, inexpensive and easily available water-based lubricating gel reduces the amount of embedded debris when burring metal implants using a high-speed burr.