Injury
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Randomized Controlled Trial
The role of post-traumatic antifibrinolysis in the perioperative blood management of elderly patients with intertrochanteric fractures treated with PFNA: A randomised controlled trial.
This study aimed to evaluate the efficacy and safety of posttraumatic antifibrinolytic therapy with repeated doses of intravenous tranexamic acid (IV-TXA) in reducing perioperative hidden blood loss (HBL) in elderly intertrochanteric femur fracture (IFF) patients. ⋯ Post-traumatic antifibrinolytic therapy with repeated doses of intravenous TXA is effective and safe in reducing perioperative HBL for elderly IFF patients, especially for patients injured within 24 h.
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The routine collection of long-term patient health outcomes after serious traumatic injury at the health service level is uncommon. In 2019, we implemented the longitudinal Trauma Service Follow Up (TSFU) program at a level I trauma centre. Delivered by the trauma service clinicians involved in inpatient care, it assesses quality of life and disability. This study reports the 6- and 12-month outcomes of the first two years of operation of the TSFU program. ⋯ Persistent impairments in physical and emotional health continues to affect many people following serious traumatic injury. The collection of longitudinal health outcomes by trauma clinicians enables identification of factors that contribute to disability and a reduction in quality of life. This in turn can drive quality improvement initiatives within the hospital trauma system. Longitudinal follow-up programs may provide a platform to provide ongoing specialist trauma-informed care after hospital discharge.
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Comparative Study
A comparison between nail-plate constructs and the plate-on-plate technique in the treatment of proximal femoral peri-implant fracture.
A single-centre, retrospective cohort study. ⋯ The plate-on-plate technique can be considered an alternative option to reduce operation time and blood loss in the treatment of PFPIF, especially for older patients and those who are less capable of sustaining long-term operation and anaesthetic exposure.
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Longitudinal studies investigating lifestyle factors as risk factors for high-energy traumas from adolescence to adulthood are lacking. The aim of this study was to investigate the influence of 14 to 18-year old adolescent health-related behaviours, overweight, chronic disease, family socioeconomic status (SES), and adulthood education level on the risk of high-energy traumas during the average 27-year follow-up in Finland. ⋯ Smoking, monthly drunkenness, self-reported chronic diseases in adolescence, and low educational level in adulthood increased the risk of high-energy traumas during the mean follow-up of 27-years. Frequent physical activity and overweight in adolescence did not predict the occurrence of high-energy traumas. Intervention programs should also focus on the long-term consequences of these risk factors.
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Comparative Study
Comparison of elective implant removal and complication rates between mini and small fragment implants for lateral malleolar fixation.
Implant removal after open reduction and internal fixation (ORIF) of ankle fractures is common. Mini-fragment implants have gained popularity for their smaller size, with studies showing similar load to failure to small-fragment implants. We hypothesized mini-fragment implant use for ORIF of the distal fibula is associated with a lower implant removal rate and without an increase in implant failure. ⋯ Elective implant removal rates and complications requiring reoperation were similar between mini-fragment and small-fragment fixation of distal fibula fractures. The hypothetical benefit of low-profile mini-fragment implants should be balanced with the higher implant cost.