The American journal of orthopedics
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Total hip arthroplasty is an operative procedure in which the diseased and destroyed hip joint is resected and replaced with a new bearing surface. Since its introduction into the surgical management of the arthritic hip in the early 1960s, total hip arthroplasty has helped alleviate the suffering of millions of patients throughout the world. ⋯ While the operation has been successful over the years, problems have manifested themselves as the length of follow-up has increased. As total hip arthroplasty approaches its fourth decade of use, we outline these problems and the proposed solutions.
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In the United States, train-related accidents account for more than 18,000 injuries and 1,200 fatalities annually, yet there is a paucity of literature pertaining to this unique injury. We reviewed the medical records of 98 of 135 cases of train-related trauma treated at Ben Taub General Hospital, Baylor College of Medicine, Houston, Texas, from 1990 to 1995. There were 50 train-pedestrian accidents, 47 train-automobile accidents, and 1 train-motorcycle accident, with a mean patient age of 30.1 years (range, 2 to 66 years). ⋯ However, when serious injury is sustained, it is often of high morbidity (amputation) and mortality, which appears to correlate well with the initial MESS and ISS. Extrapolating our cost data to include all train-related accident injuries and deaths indicates that the direct costs to society may exceed 300 million dollars annually. Greater public awareness and preventive measures may reduce the tremendous human and financial costs of train-related accidents.