Injury
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Review Meta Analysis
Efficacy and safety of tranexamic acid in hip fracture surgery. How does dosage affect outcomes: A meta-analysis of randomized controlled trials.
The objective of this study was to assess the efficacy and safety of intravenous TXA administration in elderly patients undergoing hip fracture surgery focusing on the effect of various dosages. ⋯ This meta-analysis provides strong evidence that TXA is a safe and effective agent to reduce perioperative blood loss in hip fracture surgery. When compared with higher dosages, a single dose of 15 mg/kg is associated with a non-significant reduction in adverse events, while achieving comparable outcomes.
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Background Road Safety has become a worldwide concern due to the alarming repercussions road accidents may bear. This study examined the relationship between different geometric design elements and the accident rates on Rashid Bin Saeed Street, Arabian Gulf Street, and Sultan Bin Zayed Street in Abu Dhabi, United Arab Emirates. Methods The geometric design was collected from the satellite images of google earth in compliance with the standard geometric design manual of Abu Dhabi roads. ⋯ Regarding the road's geometric design, which is the focus of this study, a sensitivity analysis was made to determine the most influential geometric design element on accident frequency. Interpretation The number of lanes had the highest sensitivity index followed by the median width, and then came the lane width. Thus, modifying the number of lanes on a highway is anticipated to have the highest impact on accident frequency and road safety than any other geometric parameter.
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The aim of this study is to identify if there is any association between neuromuscular disorders and prosthetic dislocation in patients treated with hip hemiarthroplasty for neck of femur fractures. ⋯ Our study demonstrates an increased risk of dislocation after hemiarthroplasty for patients with Parkinson's disease in comparison to other groups. No increase was apparent for those with mental impairment or weakness from a previous stroke.
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A triangular configuration with three parallel cannulated screws is an established treatment for fixing transverse patellar fractures; however, the stability achieved with this approach is slightly lower than that attained with cannulated screws combined with anterior wiring. In the present study, triangular configurations were modified by partially or totally replacing the cannulated screws with headless compression screws (HCSs). Through finite element simulation involving a model of distal femoral, patellar, and proximal tibial fractures, the mechanical stability levels of the modified triangular configurations were compared with that of two cannulated screws combined with anterior wiring. ⋯ The highest stability was obtained with the three HCSs in a backward triangular configuration, as indicated by the least fragment displacement and the smallest fracture gap size. In extension and flexion, this size was smaller than that observed under the use of two deeply placed parallel cannulated screws with anterior wiring by 50.3% (1.53 vs. 0.76 mm) and 43.2% (1.48 vs. 0.84 mm), respectively. Thus, the use of three HCSs in a backward triangular configuration is recommended for the fixation of transverse patellar fractures, especially without the use of anterior wiring.