Injury
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Multicenter Study
Clinical outcomes and predictors of patient satisfaction in displaced midshaft clavicle fractures in adults: Results from a retrospective multicentre study.
The optimal treatment of displaced midshaft clavicle fractures (Robinson Type 2B1 & 2B2) in adults remains controversial. Little is known about patient satisfaction with treatment for this type of injury. The purpose of this study was to compare clinical outcomes and explore predictors of patient satisfaction after nonoperative and direct-operative treatment of displaced midshaft clavicle fractures in adults. ⋯ Direct-operative management led to higher patient satisfaction, despite similar long-term patient reported outcomes with nonoperative treatment. Patients' rating for the level of shared decision-making was the main predictor of overall satisfaction. This study highlights the need to enhance communication to facilitate shared decision-making.
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The neuroprotective mechanisms of therapeutic hypothermia against trauma-related injury have not been fully understood yet. In this study, we aimed to investigate the effects of therapeutic hypothermia on biochemical and histopathological markers of apoptosis using Traumatic brain injury (TBI) and hemorrhagic shock (HS) model. ⋯ Our study results suggest that hypothermia may exert its neuroprotective effects by reducing markers of apoptotic pathway, particularly Caspase-3 on TBI and HS.
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Indications for removing orthopedic hardware on an elective basis varies widely. Although viewed as a relatively benign procedure, there is a lack of data regarding overall complication rates after fracture fixation. The purpose of this study is to determine the overall short-term complication rate for elective removal of orthopedic hardware after fracture fixation and to identify associated risk factors. ⋯ Removal of hardware following fracture fixation is not a risk-free procedure. Patients with liver disease are at increased risk for complications, including increased risk for needing revision surgery following hardware removal. Patients having hardware removed following fixation for pilon fractures also are at increased risk for complication, although they may not require a return trip to the operating room. Finally, removal of pelvic hardware is associated with a higher return to the operating room.
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Comparative Study
Are factor Xa inhibitors effective thromboprophylaxis following hip fracture surgery?: A large national database study.
The purpose of this study was to evaluate the effectiveness of Factor Xa inhibitors (XaI) for thromboprophylaxis following hip fracture surgery in a large cohort of patients, and compare XaI against warfarin and enoxaparin. ⋯ This study compares the effectiveness of Factor Xa inhibitors to warfarin and enoxaparin for hip fracture patients, using a large national database. In this study, Factor Xa inhibitors had similar effectiveness for DVT prophylaxis compared to these agents.