Injury
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Avascular necrosis (AVN) of the femoral head is a progressive disease that generally affects patients in the second through fifth decades of life; if left untreated, it leads to complete deterioration of the hip joint. Treatments range from simple decompression of the femoral head, to muscle pedicle bone grafting of the involved area, or by using a vascularized fibular graft with varying degree of success. ⋯ We present a study of management of 60 young patients aged less than 50 years having either early stage AVN (stage I and II A/B of Ficat & Arlet classification) or Neck of the femur fractures, treated with quadratus femoris muscle pedicle bone grafting & cancellous screws. With aim To evaluate the results of the above modality in the management of AVN of the hip & neck femur fractures and to study the radiological & functional outcome of the procedure in young patients.
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This study evaluates the associations between post injury depressive symptomology and opioid use from the initial time of injury in orthopedic trauma patients without pre-existing psychiatric conditions. ⋯ This study suggests that depressive symptomology immediately following musculoskeletal trauma is predictive for persistent depressive symptomology in a subset of our patient population. Inpatient BDI-II depressive symptom severity levels in the hospital were significantly related to BDI-II at 2-weeks, 6-weeks, and 3-months, and persistent opioid use, past 6-weeks, was independently associated with prolonged depressive symptomology as well. Further study into effective treatment and monitoring of mental health disturbances following trauma is needed, particularly in patients with continued need for and use of opioids after discharge.
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Trauma is a leading cause of morbidity and mortality globally, with a disproportionate burden affecting low- and middle-income countries (LMIC). Rapid urbanization and differences in transportation patterns result in unique injury patterns in LMIC. Trauma registries are essential to determine the impact of trauma and the nature of injuries in LMIC to enable hospitals and healthcare systems to optimize care and to allocate resources. ⋯ Trauma registries are necessary for the assessment of the local trauma burden and injury pattern, but require significant financial commitment and time. To fully capture the local burden of trauma in resource-limited settings, acquiring, validating, and analyzing accurate data is crucial. Anticipating the financial burden of a trauma surveillance registry ahead of time is imperative.
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Clinically, treatment of Mayo IIA olecranon fractures (MIOF) using pins is associated with a high rate of failure. The purpose of our study was to compare the biomechanical stability and strength of four different fracture fixation configurations and to recommend the best method for the clinical treatment of MIOFs. ⋯ Our biomechanical analysis indicated that using a double cortical pin configuration provided the best stability and strength and, thus, may lower the risk of fracture fixation failure. The use of either K-wires or pins in the double cortical configuration did not influence fixation stability. A loose double cortical configuration might decrease fracture stability, although there differences were not significant.