Injury
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Terrible triad injuries of the elbow are complex injuries which can result in long term complications and significant disability. They must be identified correctly, and managed appropriately in order to maximise functional outcomes. ⋯ Urgent reduction of the elbow, followed by 3-dimensional imaging and surgical repair or replacement of the injured structures is the mainstay of treatment in the majority of cases. This review presents a summary of the relevant anatomy and the evidence for the management of these complex injuries.
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Randomized Controlled Trial
A long term follow-up for a randomised trial of total hip arthroplasty versus hemiarthroplasty for displaced intracapsular fractures.
104 patients with a displaced intracapsular fracture were randomised to surgical treatment with either a cemented hemiarthroplasty or a cemented total hip arthroplasty. All surviving patients were followed up for five years from injury by a blinded observer. ⋯ There was a tendency to more complications and re-operations for those treated with the total hip arthroplasty. We continue to recommend that caution should be exercised regarding the increased promotion of THR for intracapsular hip fractures until further studies with long term follow up are completed.
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Multicenter Study
Predictors of postoperative complications of tension band wiring techniques for patella fracture: A retrospective multicenter (TRON group) study.
The relationship between postoperative complications and operative techniques of tension band wiring (TBW) is not well studied. We aimed to evaluate the incidence of implant breakage, implant migration, and loss of reduction in patellar fractures treated with TBW and identify radiographic factors associated with these postoperative complications. ⋯ This study highlights the importance of bending both ends of the K-wires and proper placement of the tension band and K-wires in reducing postoperative complications in patellar fractures treated with TBW. Further research is needed to better understand the risk factors associated with loss of reduction.
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Comment Letter Randomized Controlled Trial Multicenter Study
Letter to the editor for "Outcomes of cement augmentation in fragility hip fracture: A Multicenter randomized control trial follow-up".
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Atypical femoral fractures (AFFs) are associated with delayed union and higher reoperation rates. Axial dynamization of intramedullary nails is hypothesized to reduce time-to-union (TTU) and fixation failure as compared to static locking. ⋯ Dynamic locking of intramedullary nails in AFFs is associated with faster time to union, lower rate of non-union, and fewer treatment failures.