Injury
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As an emerging proposed type of ankle joint injury, the concept of logsplitter injury is a unified overview of the high-energy ankle fracture and dislocation accompanied by distal tibiofibular syndesmosis separation and displacement. Since the concept of logsplitter injury is still relatively novel, there is no uniform standard for its clinical classification, diagnosis and treatment currently. Thus, we reviewed previous literatures here to provide certain references for its better clinical diagnosis and treatment in future. ⋯ None of the definitive consensuses exists on how logsplitter injury should be diagnosed and surgically managed. In light of the novel concept, short presentation time and numerous postoperative complications, the logsplitter injury has not been well understood by most surgeons currently, and its overall situation still needs to be supported by a larger sample size of multicenter research in the future.
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The purpose of the study was to evaluate the efficacy of hemiarthroplasty with minimally invasive direct anterior approach (DAA) for the treatment of femoral neck fracture in elderly patients. We aimed to compare the DAA and the standard anterolateral approach (ALA), assessing multiple peri‑ and post-operative parameters. ⋯ The bipolar hemiarthroplasty with DAA allows earlier mobilisation, reduced postoperative pain and need for rehabilitation with an overall better functional outcome, compared to ALA. DAA is proven a reliable choice for femoral neck fractures, offering good outcome and faster recovery, similarly to total hip arthroplasties with degenerative arthritis.
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Meta Analysis
Intramedullary tibial nailing using infrapatellar and suprapatellar approaches: A systematic review and meta-analysis.
Intramedullary nailing of diaphyseal tibial fractures has become the gold standard method of fixation with high rates of union and low complication rates reported. The suprapatellar (SP) approach may have many advantages over the traditional infrapatellar (IP) approach. Controversy exists due to potential damage to the patellofemoral joint leading to persistent anterior knee pain. This systematic review and meta-analysis aims to evaluate the clinical and procedural outcomes of the SP approach in comparison to the traditional IP approach. ⋯ Based on the data presented in this review, intramedullary nailing of the tibia using the SP approach demonstrates superior Lysholm knee scores, greater entry point accuracy and reduced fluoroscopy exposure with equivalent risk of developing complications when compared to the IP approach.
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Sacral fractures are often underdiagnosed but are relatively frequent in the setting of pelvic ring injury. Causes include traumatic insults and osteoporosis. Sacral fractures have become more frequent owing to the growth of the elderly population worldwide as osteoporosis is an age-related disease. ⋯ Unfortunately, the wide range of classification systems hinders adequate communication among clinicians. Therefore, a complete understanding of the pathology, and communication within the interdisciplinary team, are necessary to ensure adequate treatment and satisfactory clinical outcomes. The aim of this manuscript is to present the current knowledge available regarding classification systems, clinical assessment, decision-making factors, and current treatment options.