Injury
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Lateral locked plating is a standard treatment option for distal femur fractures. However, the unstable conditions after lateral locked plating are increasing. The objective of this study was to investigate the biomechanical strength of additional medial plate fixation over the unstable lateral locked plating of distal femur fractures. ⋯ Additional fixation of medial plate significantly increased the fracture stability in distal femur fractures fixed with the lateral locked plating. Especially in the clinical situations where sufficient stability cannot be provided at the distal segment, the medial plate may be considered as a useful biomechanical solution to obtain adequate stability for fracture healing.
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Venous thromboembolism (VTE) is a serious complication that contributes to morbidity, mortality, and healthcare costs during the surgical care of patient with lower extremity fractures. Despite this, few recommendations on the topic exist and the literature on VTE incidence is incomplete. Therefore, this study will attempt to estimate annual incidence and trends in 30-day thrombotic events and mortality for the following fractures: (1) hip, (2) femur, (3) patella, (4) tibia and/or fibula, and (5) ankle. ⋯ III.
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Open comminuted intraarticular distal femur fracture represents a formidable challenge for the orthopaedic surgeon for the inherent fracture complexity, soft tissue damage, and contamination. The purpose of this study was to evaluate the mid-term outcome results and safety of using the Ilizarov fixator to treat these fractures. ⋯ Ilizarov fixator was an effective treatment modality of open comminuted distal femur fractures with high union rate, adequate alignment and satisfactory functional outcomes.
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Intramedullary nailing is the treatment of choice for shaft of femur fractures in adults. Antegrade nails involve entry through either piriformis fossa (PE) or greater trochanteric (GT) tip. The superiority of one entry point over the other is a matter of debate, and the present review was done to determine the same. ⋯ GT entry nails are superior to PE nails for treating shaft of femur fractures in adults. They have a shorter learning curve and better functional outcomes, however the rates of union are comparable in both.
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The psychological distress and risk of mental health problems for parents of children with critical injury is well-established. There has been little exploration, however, of parent experiences and psychosocial trajectories over time following child critical injury. To address this knowledge gap, a longitudinal qualitative study was conducted to explore parent experiences and support needs and identify parent psychosocial trajectories in the 12 months following child critical injury. ⋯ This is the first qualitative study to report the psychosocial trajectories of parents of critically injured children. Clinical application of insights provided by these trajectories can assist clinicians to use targeted strategies to help strengthen parental adaptation and prevent adverse mental health outcomes, and address families' psychosocial support needs following child injury. Screening for parent psychological distress and post-traumatic stress disorder is needed from the time of the child's admission, and a dedicated trauma support role can facilitate an integrated care approach for children and families with complex needs across the care continuum.