Injury
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Limited studies have been conducted to determine the minimum amount and sensitivity of the saline load test of the ankle. Prior studies, only performed in arthroscopic models, have suggested a wide range of volumes necessary to confirm arthrotomy. The purpose of this study was to investigate the amount of fluid required and the sensitivity of the saline load test to identify an intra-articular arthrotomy of the ankle. Using cadavers without prior ankle trauma or surgeries we aim to assess volume needed to detect ankle arthrotomies at varying arthrotomy locations. We hypothesized that the volume needed would vary based on site of arthrotomy. ⋯ V.
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The Talon™ DistalFix™ Proximal Femoral Nail (Talon-PFN) is a new proximal femoral intramedullary nail designed for the treatment of intertrochanteric femoral fractures. This study aimed to report the clinical and radiological outcomes of patients treated using a proximal femoral intramedullary nail with a novel design. ⋯ According to the results obtained in this study, the Talon-PFN, which has similar clinical and radiological outcomes compared to other proximal femoral intramedullary nail designs according to the reported studies, can be a suitable alternative in the treatment of intertrochanteric fractures.
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Contemporary uncemented hemiarthroplasties are being used after displaced femoral neck fractures, however, their functional and radiological results remain controversial. The aim of this study was to evaluate the clinical and radiological results of a tapered uncemented stem combined with a uni- or bipolar hemiarthroplasty after a minimum follow-up of ten years. ⋯ Bone fixation can be obtained with a contemporary uncemented stem in hemiarthroplasty for patients over 70 years old with a femoral neck fracture. Acetabular erosion was frequent after ten years, however, the rate of revision surgery was low.
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The increase in life expectancy has led to the appearance of a subgroup of hip fracture (HF) patients with special characteristics known as centenarians. The aim of the present study is to analyse the demographic characteristics, complications and mortality rate of this subgroup in order to identify the specific risk factors for mortality in these patients. ⋯ FAC score, number of comorbidities, dementia and the Charlson Comorbidity Index have been shown to be risk factors of mortality in centenarians with HF.
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The medial sural artery perforator (MSAP) flap: A versatile flap for lower extremity reconstruction.
The medial sural artery perforator (MSAP) flap provides a thin, pliable and durable soft tissue reconstruction with adequate pedicle length and low donor morbidity. It is an ideal choice for small-to-moderate defects of the lower extremity, although it does have limitations. We report our experience of the flap in a three-pronged anatomical, clinical and patient reported outcome-based study. ⋯ The MSAP provides robust foot-and-ankle reconstruction, whilst permitting glide when over the knee. Patient satisfaction and functional outcomes are excellent with careful patient selection. Care should be taken to avoid compression or kinking of the large, thin walled veins as the most commonly observed complication was venous congestion. We advocate MSAP as a first choice flap for small-to-moderate foot, ankle or knee defects.