Injury
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There were few reports in the literature about the hidden blood loss (HBL) after intramedullary nail (IMN) fixation for extra-articular tibial fractures. Our purpose was to evaluate the amount of hidden blood loss after intramedullary nail fixation for extra-articular tibial fractures, meanwhile, identified the influential factors causing HBL. ⋯ A significant amount of postoperative HBL has occurred after IMN fixation of extra-articular tibial fractures. Surgeons should be aware that more HBL can be developed in patients who have male sex, small medullary cavity, and long-time surgical duration. HBL deserves attention to ensure patients' safety in the perioperative period of IMN fixation for extra-articular tibial fractures.
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We describe a novel technique for removing broken intra-medullary femoral nails METHODS: This technique involves the initial removal of the blade, screw at proximal femur, and proximal part of the broken nail. A hole is then drilled in the remnant nail and a cerclage wire passed into the hole. The distal interlocking screw is then removed, before removing the nail. ⋯ The method described is easy, replicable, and requires only a steel drill, cerclage wires, nail extraction hook and slotted hammer.
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Observational Study
A Comparison in Outcomes of Preoperative Single-shot versus Continuous Catheter Fascia Iliaca Regional Anesthesia in Geriatric Hip Fracture Patients.
Fascia iliaca nerve blocks relieve pain in geriatric hip fracture patients and can be administered via a single-shot or continuous catheter. We compared perioperative opioid consumption and pain scores between these two blocks. ⋯ We report no differences in opioid use and pain scores between single-shot and continuous catheter fascia iliaca nerve blocks. Both blocks similarly reduce preoperative opioid consumption.
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This study was to retrospectively evaluate clinical outcomes of geriatric patients with patella fracture treated by percutaneous cerclage wiring and to introduce the surgical technique. ⋯ Percutaneous cerclage wiring fixation is a viable option for type 34-C patella fracture in geriatric patients.
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Comparative Study
Internal fixation versus hemiarthroplasty for displaced femoral neck fractures in the elderly: A cost-effectiveness analysis.
There is little information on the cost and outcome of different treatments for femoral neck fractures. This study aimed to evaluate the cost-effectiveness of internal fixation compared with hemiarthroplasty (HA) for elderly patients with displaced femoral neck fractures. ⋯ HA is associated with better outcome than internal fixation in the treatment of displaced femoral neck fractures in elderly patients. However, internal fixation may be more cost-effective because of less total cost.