Injury
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The purpose of this study is to determine the efficacy of tibiotalocalcaneal arthrodesis by reamed intramedullary nail in the management of the distal tibia non-unions, associated with end-stage osteoarthritis of ankle and subtalar joints. ⋯ The procedure showed good results at final follow up. Consolidation was achieved in all the treated cases. Considering AOFAS and VAS scores at final follow-up, there was an evident improvement of the conditions of the patients.
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Pelvic fractures (PF) require high force mechanism and their severity have been linked with an increase in the incidence of associated injuries within the abdomen and chest. Our goal is to assess the impact of solid organ injury (SOI) on the outcome of patients with PF and to identify risk factors predictive of morbidity and mortality among these patients. ⋯ The presence of SOI did not affect the outcome of patients with pelvic fracture, although our results may be linked to the limited number of patients with high grade SOI. The degree of pelvic AIS is predictive of associated injuries within the abdomen and chest.
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To date, surgically treated multifragmentary patellar fractures are still associated with high rates of complications, such as i.e. secondary fracture displacement. Osteosynthesis is most frequently performed with screws and cerclages. To increase primary stability, locking plates have been introduced. However, there is still a lack of biomechanical data supporting the superiority of plate fixation compared to screw fixation with cerclages in these cases. The goal of the present study was to conduct biomechanical comparison of these two techniques under dynamic loading conditions. ⋯ Anterior locking plate osteosynthesis of comminuted patellar fractures biomechanically provides better primary stability compared to cannulated screws with anterior tension band wiring.
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To highlight an alternative method of treatment for femoral fractures associated with vascular injury, allowing both fracture fixation and vascular repair from the same surgical approach. ⋯ A midlateral approach is traditionally used for fractures of femur when plates and screws are used for fixation. In association with vascular injury, this procedure requires two separate incisions. The added soft tissue disruption associated with open reduction and internal fixation by lateral incision can be reduced with the use of single medial approach, which allows bony stabilization under direct visualization of the repaired vessels.
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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.