Injury
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According to the classification of Judet and Letournel, all double column acetabular fractures will certainly involve the disruption of the quadrilateral plate (QLP). Accurate reduction and reliable fixation of QLP is the key to obtain a normal congruent hip joint and avoid postoperative arthritis. The aims of this study were to assess the biomechanical properties of a novel dynamic anterior plate-screw system (named DAPSQ) and to compare its biomechanical stability with buttress-plate construct. ⋯ In this in vitro biomechanical study, DAPSQ plate and quadrilateral screws fixation of a double column acetabular fracture involving the QLP resulted in a better fixation construct than the traditional suprapectineal pelvic reconstruction plate and 1/3 tube buttress plate fixation.
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Time-to-surgery in geriatric hip fractures remains of interest. The majority of the literature reports a significantly decreased mortality rate after early surgery. Nevertheless, there are some studies presenting no effect of time-to-surgery on mortality. The body of literature addressing the effect of an orthogeriatric co-management is growing. Here we investigate the effect of time-to-surgery on in-house mortality in a group of patients treated under the best possible conditions in certified orthogeriatric treatment units. ⋯ Our results suggest that for those patients, who were treated in an orthogeriatric co-management under the best possible conditions, there are no significant differences regarding in-house mortality rate between the time-to-surgery intervals of 24 and 48 h or slightly above. This and the comparatively small number of patients who underwent surgery after 24 h show that an extension of the pre-surgery interval, justified by an orthogeriatric treatment team, will not be detrimental to the affected patients.
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The aim of this study was to evaluate changes in both mechanism and diagnoses of injuries presenting to the orthopaedic department during this lockdown period, as well as to observe any changes in operative case-mix during this time. ⋯ In conclusion, the nationwide lockdown has led to a decrease in emergency orthopaedic referrals and procedure numbers. There has been a change in mechanism of injuries, with fewer sporting injuries, conversely, there has been an increase in the number of pushbike or scooter related injuries during the lockdown period. NOF fractures remained at similar levels to the previous year. There was a change in strategy for managing distal radius fractures with more fractures being treated non-operatively.
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Bisphosphonates use is a recognised cause of atypical femur fractures. Intramedullary nailing is the first line of treatment for these fractures, but failure is a common problem due to altered biology, resulting in a non-union and a challenging problem. ⋯ Fracture healing can be achieved with bone grafting and compression plating in all patients. However, a prolonged time to achieve union and a long follow-up duration should be expected.
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Case Reports Multicenter Study
Pediatric tracheal injuries: Report on 5 cases with special view on the role of bronchoscopy and management.
The purpose of these case reports is to draw the attention to the difficulties of diagnosing trachea injuries in children, who are often part of a polytrauma scenario. ⋯ Pneumomediastinum and persistent ventilation difficulties should raise suspicion of a tracheal injury in a typical clinical scenario. Bronchoscopy is recommended for early diagnosis, despite the possibility of misdiagnosis. In certain cases CT scan only and close observation may be considered.