Injury
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Observational Study
Pelvic ring fracture in the older adults after minor pelvic trauma - is it an innocent injury?
This study aimed to evaluate the prevalence of severe hemorrhage as a potentially life-threatening complication in elderly patients with isolated, low-energy pelvic ring fractures, which may be more common than previously described. ⋯ Severe pelvic hemorrhage in the older adults due to a minor pelvic injury after a low-energy trauma is not an uncommon complication, especially with combination of ACT and posterior pelvic ring fracture. This indicates that these injuries more challenging than previously believed. Geriatric pelvic ring injuries should be monitored carefully with serial blood counts, and low threshold for imaging including contrast enhanced CT scans and angiography.
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To identify risk factors predisposing patients to poor outcomes after fixation of periprosthetic hip fractures around femoral stems. ⋯ Frail periprosthetic hip-fracture patients with poorer functional status, dysfunctional replacements, and postoperative complications are at increased risk of mortality. Postoperative complications are more common in patients with dysfunctional arthroplasties, Vancouver A fractures, and fixation using cerclages alone. Postoperative complications were the most consistent predictor of higher healthcare resource utilization.
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Comparative Study
Managing B2 periprosthetic femoral fractures: ORIF vs stem-revision.
The gold-standard treatment for Vancouver type B2 and B3 fractures is revision arthroplasty. This procedure can be prolonged and complex, posing challenges for patients with severe medical comorbidities and reduced physical status. Recently, osteosynthesis has been proposed as an alternative treatment for B2 periprosthetic femoral fractures (PFF) in frail patients, though its efficacy compared to revision arthroplasty has not been studied in detail. ⋯ IV.
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Ageing may cause a progressive pro-inflammatory environment and alter functionality of different immune-cell populations. The aim of the present study is to examine the influence of certain serum immunological parameters on hospitalization stay and complications in patients who have suffered a hip fracture. ⋯ IL-6 serum levels on admission showed a positive and significant correlation with a longer hospitalization stay in elderly patients presenting with hip fracture. Lower levels of IL-10 in peripheral blood on admission were associated with symptomatic urinary tract infections. A higher number of CD19+ cells/mm³ was significantly associated with pneumonia and symptomatic urinary tract infection. These immunological variables on admission may serve as risk indicators of complications during hospitalization.