Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2007
The effect of zymosan and the protective effect of various antioxidants on fracture healing in rats.
To investigate the effects of free oxygen radicals and various antioxidants on bone healing after experimental formation of fracture. ⋯ Free oxygen radicals demonstrate a negative effect on fracture healing and vitamin C (an antioxidant) partially prevents the negative effect of zymosan on fracture healing.
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Arch Orthop Trauma Surg · Sep 2007
Rofecoxib inhibits heterotopic ossification after total hip arthroplasty.
Nonsteroidal anti-inflammatory drugs (NSAIDs) prevent heterotopic ossification but gastrointestinal complaints are frequently. Selective cyclooxygenase-2 (COX-2) inhibiting NSAID produce less gastrointestinal side effects. ⋯ Using a two-stage study design for phase 2 clinical trials, a 7-day treatment of a COX-2 inhibitor (rofecoxib) prevents effectively the formation of heterotopic ossification after cemented primary total hip arthroplasty.
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Arch Orthop Trauma Surg · Sep 2007
Case ReportsSliding hip screw in pelvis: a rare intra-operative complication.
We are presenting an unusual intra-operative complication of penetration of sliding hip screw (SHS) into the pelvis during fixation of an intertrochanteric fracture neck of femur in a 78-year-old man along with the technique of retrieving it.
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Arch Orthop Trauma Surg · Sep 2007
Retention of flexible intramedullary nails following treatment of pediatric femur fractures.
Flexible intramedullary nails are commonly used for the treatment of diaphyseal femur fractures in children. Although, their removal after fracture healing is advocated by some, there are no definitive studies to support the routine removal of these implants. The purpose of this study is to determine the natural history of children with diaphyseal fractures of the femur treated with flexible intramedullary nails and no scheduled nail removal. ⋯ Among children with femur fractures treated with flexible intramedullary nailing without scheduled implant removal, about a quarter may ultimately require a second procedure for nail removal due to persistent discomfort. Moreover, up to half of patients can have residual non-debilitating pain at 2-5 years post-injury regardless of presence or absence of the implant. Whether this is a previously unrecognized adverse outcome of this injury or treatment approach, or due to routinely leaving nails in will have to be assessed in future controlled trials.
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Arch Orthop Trauma Surg · Sep 2007
Comparative StudyMethicillin resistant Staphylococcus aureus versus methicillin sensitive Staphylococcus aureus adult haematogenous septic arthritis.
Septic arthritis is an orthopaedic emergency and Staphylococcus aureus (SA) is the number one cause. Methicillin resistant Staphylococcus aureus (MRSA) is increasing in incidence but how it differs from methicillin sensitive Staphylococcus aureus (MSSA) septic arthritis is unclear. Our aim was to delineate the differences in clinical features and outcomes between patients with MRSA and MSSA septic arthritis. ⋯ MRSA septic arthritis tends to affect older patients with multiple comorbidities and has a tropism for the glenohumeral joint while MSSA has a tropism for the knee. We did not find a significant difference in required length of antimicrobials, number or requirement of operative interventions or outcomes in terms of number of recurrences or sepsis related mortality. However MRSA septic arthritis patients were found to have a strong trend towards an increased all cause 6 month mortality and were significantly more likely to receive inappropriate empirical antimicrobials.