Hip international : the journal of clinical and experimental research on hip pathology and therapy
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Randomized Controlled Trial
Local anaesthetic wound infiltration after internal fixation of femoral neck fractures: a randomized, double-blind clinical trial in 33 patients.
Pain control may assist early mobilisation after internal fixation of femoral neck fractures. Systemic opioids have significant side effects in elderly patients. We present an evaluation of the effect of local anaesthetic infiltration in such cases , the objective being to decrease the need for postoperative opioids and to improve pain control for patients after surgery. 33 patients undergoing internal fixation with 2 parallel hook pins were randomized into 2 groups in a double blind study (ClinicalTrials.gov: NCT00529425). 33 patients received intraoperative infiltration followed by 6 postoperative injections through an intraarticular catheter in eight-hour intervals. 19 patients received ropivacaine and 14 received saline. ⋯ Apart from a reduction in nausea in the study group on the second postoperative day, there were no significant differences in the occurrence of side effects between the groups. On day 2 the placebo group had less pain than the study group. Local anaesthetic infiltration after fixation of femoral neck fractures does not reduce opioid consumption or pain'.
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Case Reports
Late laceration of the superficial femoral artery by an intertrochanteric fracture fragment.
Injury to the femoral vessels is a rare complication after intertrochanteric fractures, and usually involves the profunda femoris artery. We report the case of a 79-year-old male with an intertrochanteric fracture, treated by closed antegrade intramedullary nailing, which was complicated by late injury to the superficial femoral artery 5 weeks after surgery. The injury was caused by a spike of bone from the anteriorly displaced lesser trochanter fragment. Direct suture of the injured artery was possible without subsequent complications.