Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled TrialReactionary haemorrhage reduction with adrenaline infiltration in proximal tibial osteotomy: a randomized clinical study of safety and efficacy.
In corrective osteotomy, wound closure is undertaken with or without deflation of the tourniquet. Hypoxia from the tourniquet causes vasodilatation associated with reactionary haemorrhage and reduced haemoglobin concentration and possibly increased blood transfusion rate. Reactionary haemorrhage and related transfusion need can be reduced through vasoconstriction from adrenaline infiltration. ⋯ In conclusion, wound infiltration with adrenaline was effective in reducing the extent of reactionary haemorrhage and post-operative drop in haemoglobin concentration. There was no significant difference in the transfusion rates in both groups.
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Arch Orthop Trauma Surg · Jan 2012
Occult hip and pelvic fractures and accompanying muscle injuries around the hip.
We investigated the incidence of occult hip and pelvic fractures and associated muscle injuries around the hip. ⋯ Occult hip and pelvic fractures were almost equally seen among 113 cases with suspected hip fracture but were negative on plain radiography. Different patterns of associated muscle injuries in cases of occult hip fracture and pelvic fracture suggest that the mechanism of hip fracture and pelvic fracture is possibly different.
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Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled Trial Comparative StudyClosed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach.
Wondering if the use of drains allowing re-transfusion of shed blood as opposed to closed suction drains or no drains would improve quality of care to patients undergoing simple non-cemented primary total hip replacement (THR) using a direct anterior approach, a three-arm prospective randomized study was conducted. ⋯ The possibility to re-transfuse drained blood was not an argument for using drains and, accepting more thigh swelling, we stop to use drains in simple non-cemented primary THR using the direct anterior approach.
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Arch Orthop Trauma Surg · Jan 2012
Comparative Study Clinical TrialCushion bearings versus large diameter head metal-on-metal bearings in total hip arthroplasty: a short-term metal ion study.
Metal-on-metal total hip arthroplasty (MOM THA) has the advantage of replicating the femoral head size, but the postoperative elevation of serum metal ion levels is a cause for concern. Metal-on-polycarbonate-urethane is a new cushion bearing featuring a large diameter metal head coupled with a polycarbonate-urethane liner. ⋯ These findings warrant the continued clinical study of compliant bearing options.
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Arch Orthop Trauma Surg · Jan 2012
Clinical TrialDisplaced femoral neck fractures in the young: significance of posterior comminution and raised intracapsular pressure.
Osteosynthesis in fracture neck of femur (NOF) in young is a universally acceptable procedure. Various factors affect the outcome; with AVN (avascular necrosis) and non-union primarily contributing to adverse results in such patients. To identify factors affecting outcome of displaced fracture NOF, a prospective cohort study was carried out in the setting of a tertiary care centre in developing country. ⋯ Prognosis of displaced fracture NOF is significantly associated significant with posterior comminution and intracapsular pressure difference between fractured and normal side.