The bone & joint journal
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The bone & joint journal · Apr 2016
Epidemiology of periprosthetic fracture of the femur in 32 644 primary total hip arthroplasties: a 40-year experience.
The goals of this study were to define the risk factors, nature, chronology, and treatment strategies adopted for periprosthetic femoral fractures in 32 644 primary total hip arthroplasties (THAs). ⋯ Intra-operative fractures occur 14 times more often with uncemented stems, particularly with female patients over 65 years of age, while post-operative fracture risk is independent of age or gender, but still increased with uncemented stems.
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The bone & joint journal · Apr 2016
Multicenter StudyThe outcome and prognostic factors in children with bilateral Perthes' disease: a prospective study of 40 children with follow-up over five years.
The aims of this study were to describe the course of non-operatively managed, bilateral Perthes' disease, and to determine specific prognostic factors for the radiographic and clinical outcome. ⋯ These results imply that we need to distinguish between children with concurrent onset and those with sequential onset of bilateral Perthes' disease, as the outcomes may be different. This has not been previously described. Children with concurrent onset of bilateral disease had a similar outcome to our previous series of those with unilateral disease, whereas children with sequential onset of bilateral disease had a worse prognosis. The increased risk of developing Perthes' disease in the contralateral hip in those with unilateral disease is important information for the child and parents.
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The bone & joint journal · Apr 2016
Comparative StudyAmputation in patients with complex regional pain syndrome: a comparative study between amputees and non-amputees with intractable disease.
Amputation in intractable cases of complex regional pain syndrome (CRPS) remains controversial. The likelihood of recurrent Complex Regional Pain Syndrome (CRPS), residual and phantom limb pain and persistent disability after amputation is poorly described in the literature. The aims of this study were to compare pain, function, depression and quality of life between patients with intractable CRPS who underwent amputation and those in whom amputation was considered but not performed. ⋯ Amputation should be considered as a form of treatment for patients with intractable CRPS.
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The bone & joint journal · Apr 2016
Exchange nailing for nonunion of diaphyseal fractures of the tibia: our results and an analysis of the risk factors for failure.
The aim of this study was to identify risk factors for the failure of exchange nailing in nonunion of tibial diaphyseal fractures. ⋯ Exchange nailing is an effective treatment for aseptic tibial diaphyseal nonunion.
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The bone & joint journal · Apr 2016
Observational StudyCoccygectomy for patients with chronic coccydynia: a prospective, observational study of 98 patients.
The purpose of this prospective study was to evaluate the outcomes of coccygectomy for patients with chronic coccydynia. ⋯ Coccygectomy for chronic coccydynia results in significant improvement in patient-reported outcomes at two years. Failure is associated with certain pre-operative characteristics such as psychiatric illness, poor quality of life features, higher levels of pain, and use of opiates.