Injury
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The study was to introduce a new and reliable behavioral model of upper trunk of brachial plexus avulsion for the study of persistent neuropathic pain. 60 rats were divided into three groups randomly: upper trunk of brachial plexus avulsion (UTBPA) group (20), global brachial plexus avulsion (GBPA) group (20), and sham- operated group (20). The animals were tested for behavioral responsiveness before surgeries and 3, 7, 14, 21, 28, 56, 84days after surgeries. The injured level of spinal cord was resected and the sections were processed for GFAP (astrocyte) and Iba1 (microglia) immunohistochemistry 3 weeks after surgeries. The UTBPA group developed significant signs both of mechanical and cold hypersensitivity, which matched the immunohistochemistry result, as well as the nature of avulsion was close to the clinical type of injury, the UTBPA group could be used as a suitable and effective persistent neuropathic pain model following brachial plexus injury.
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Post-operative follow-up after internal fixation of fractures is a common practice. The goal of this study was to evaluate the necessity of a routine follow-up visit after internal fixation of a proximal femoral fracture. Our hypothesis is that these follow-up visits do not result in a change in the treatment plan, but add an extra cost to the health care system and lead to the purposeless utilisation of limited resources. ⋯ The first scheduled visit within ten weeks after internal fixation of a proximal femoral fracture leads to no changes in treatment. We recommend considering the need of these follow-up visits.
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Trauma-related amputations are a common cause of limb loss in the United States. Despite the military and public health impact of trauma-related amputations, distributions of various lower limb amputations and the relative frequency of complications and revision amputations have not been well described. We used the National Trauma Data Bank (NTDB) in order to investigate the epidemiology of trauma-related lower extremity amputations among civilians in U.S. trauma centers. ⋯ We report a high rate of complications and revision amputations among trauma-related lower limb amputees, and identify predictors of surgical outcomes that have not been described in the literature including African American race. Compartment syndrome is a significant predictor of major post-surgical complications, revision amputation, and length of hospitalization.
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Our aim was to determine the effect of hypoalbuminaemia as a marker of malnutrition on the 30-day postoperative complication rate and mortality in patients receiving surgical treatment for hip fractures using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. ⋯ Hypoalbuminaemia alone can predict postoperative outcomes in patients with hip fractures. Furthermore, patients with hypoalbuminaemia had a longer hospital length of stay. Further studies are needed to assess whether nutritional support can improve postoperative complications in patients with hypoalbuminaemia.
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Implant breakage is a serious complication after cephalomedullary nailing for unstable intertrochanteric fracture. Failure usually occurs at the lag screw hole in the nail body. On the other hand, lag screw failure is extremely rare and occurs around the nail-lag screw junction. We experienced rare mechanical failure of the Intertan nail, which showed breakage at the lag screw hole and failure of the integrated compression screw underneath the main lag screw.