Injury
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Titanium implants are commonly used for surgical fixation in orthopedic trauma, and have many benefits compared to stainless steel implants. Despite these benefits, some orthopedic surgeons remain hesitant to use titanium implants due to concerns of difficulty with future implant removal, given concerns with cold-welding and screw strippage. The objective of this study was to assess difficulties associated with titanium plate and screw implant removal. ⋯ IV.
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Midshaft clavicle fractures are often subject to increased complications when treated nonoperatively, so surgical treatment with open reduction and internal fixation (ORIF) is a favored alternative. Despite safer outcomes, adverse events such as surgical site infections may still persist, particularly in the presence of certain patient characteristics. The objective of this study was to determine risk factors for and the frequency of adverse events following ORIF for clavicle fractures. ⋯ The present study noted significantly increased risk of postoperative adverse events in older patients, as well as patients who smoke. Outpatient setting was significantly protective for adverse events. These findings help to provide further clinical context to guide surgical decision making and inform surgeons on current risks and outcomes.
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To summarize the clinical features of pediatric femoral neck fractures and analyze the risk factors for avascular necrosis of the femoral head. ⋯ Pediatric femoral neck fractures have a low incidence rate and are mostly caused by high-energy trauma, often resulting in severe injuries. Therefore, actively maintaining stable vital signs and properly managing associated injuries, timely surgical intervention for femoral neck fractures, achieving good reduction and fixation of displaced fractures are crucial in the treatment of pediatric femoral neck fractures.
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This study aimed to use machine learning (ML) to establish risk factor and prediction models of osteonecrosis of the femoral head (ONFH) in patients with femoral neck fractures (FNFs) after internal fixation. ⋯ The logistic regression model had excellent performance in predicting ONFH in patients with FNFs after internal fixation and could provide valuable guidance in clinical decision-making. When choosing treatment options for patients with FNFs, doctors should identify the risk factors and consider using the presented models to help anticipate outcomes and select individualised treatment.
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Observational Study
Regional disparities in the risk of secondary fractures in patients with hip fractures.
We aimed to examine the regional disparities in secondary fracture incidence among patients with hip fractures in South Korea. ⋯ Patients living in vulnerable regions had a higher risk of secondary fractures than that of those in non-vulnerable regions. Prevention and medication policies should thus be implemented to reduce regional healthcare disparities.