Injury
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Multicenter Study
Early efficacy evaluation of mesenchymal stromal cells (MSC) combined to biomaterials to treat long bone non-unions.
Advanced therapy medicinal products (ATMP) frequently lack of clinical data on efficacy to substantiate a future clinical use. This study aims to evaluate the efficacy to heal long bone delayed unions and non-unions, as secondary objective of the EudraCT 2011-005441-13 clinical trial, through clinical and radiological bone consolidation at 3, 6 and 12 months of follow-up, with subgroup analysis of affected bone, gender, tobacco use, and time since the original fracture. ⋯ Bone consolidation was efficaciously obtained with the studied expanded hBM-MSCs combined to biomaterials, by clinical and radiological evaluation, and confirmed by bone biopsies, with lower consolidation scores in smokers.
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The necessity for reduction and fixation of posterior malleolus fractures remains under debate. Therefore, we assessed the functional outcome and quality after plate osteosynthesis of the posterior malleolus, identified the main drivers of outcome and aimed to determine which patient and fracture type are eligible for plate osteosynthesis of the posterior malleolus. ⋯ There is no indication for routine plate osteosynthesis of all posterior malleolus fractures. Careful patient selection, less invasive surgery and modified postoperative rehabilitation seem mandatory to improve the outcome and prevent adverse effects.
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Review Case Reports
The diagnostic and management challenge for concomitant fragility fractures of pelvis and hip - a Case series with literature review.
Fragility fractures of hip and pelvis in the elderly population are common. They do co-exist but are frequently missed and undertreated. ⋯ Surgical treatment of fragility hip and pelvic fractures improves fracture stability, achieves better pain relief and allows earlier mobilization. Anti-osteoporotic treatment is essential as secondary prevention in fragility fractures.
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Comparative Study
Length of stay and 30-day readmissions after isolated humeral shaft fracture open reduction and internal fixation compared to intramedullary nailing.
Open reduction with internal fixation (ORIF) and intramedullary nailing (IMN) have similar union rates for treating humerus shaft fractures, but IMN leads to increased incidence of shoulder impingement and reoperation. The difference in 30-day readmission rate and length of stay (LOS) between these procedures is unknown. The objective of the study was to compare 30-day unplanned readmissions and length of stay between humeral shaft fractures fixed with either ORIF or IMN. ⋯ Comorbid conditions are risk factors for 30-day readmission and increased LOS. Comorbidity, discharge disposition, and open fractures are risk factors for increased LOS. Treating humeral shaft fractures with either ORIF or IMN did not affect readmission or length of stay.
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This study aimed to determine changes in functional status, pain, and return to work/study (RTW/study) over 12 months post-injury in motorcyclists admitted to a large hospital in Ho Chi Minh City (HCMC), Vietnam. ⋯ The study found improvements in outcomes over the study period, although there was ongoing disability at 12 months post-injury (18% had not RTW/study). This study provides further evidence on the burden of motorcycle injuries in Vietnam and priorities for research, and further informs treatment and rehabilitation service planning.