Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Feb 2019
Fasciotomy for chronic exertional compartment syndrome of the leg: clinical outcome in a large retrospective cohort.
Chronic exertional compartment syndrome (CECS) is an overuse disorder typically affecting an athletic population. CECS is a diagnosis based on history and intracompartmental pressure (ICP) testing. CECS patients can be treated surgically by fasciotomy; however, research on the relationship between ICP and patient symptoms and also between ICP and patient-reported outcome post-fasciotomy is limited. This study aims to (1) assess functional outcome and patient satisfaction post-fasciotomy and (2) identify any potential correlation between ICP and reported levels of pain. ⋯ Fasciotomy significantly reduces pain and increases activity levels in CECS patients. ICP was found to positively correlate with patient-reported pain.
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Eur J Orthop Surg Tr · Feb 2019
ReviewTraumatic upper plexus palsy: Is the exploration of brachial plexus necessary?
Brachial plexus injuries are major injuries of the upper limb resulting in severe dysfunction usually in young patients. Upper trunk injuries of the brachial plexus account for approximately 45% of brachial plexus injuries. ⋯ Several published studies presented the results of both techniques, but there are few studies which compared these two techniques. This article summarizes the treatment options for upper trunk brachial plexus injuries, discusses the merits and demerits of each technique, and presents authors' proposed treatment for these injuries.
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Eur J Orthop Surg Tr · Feb 2019
The impact of metabolic syndrome on 30-day outcomes in geriatric hip fracture surgeries.
Past literature has reported metabolic syndrome (MetS) to complicate postoperative care in patients undergoing various surgical procedures. We sought to analyze the impact of MetS on 30-day outcomes following hip fracture surgeries in the geriatric population. ⋯ MetS is associated with a significantly increased risk of several postoperative complications, readmissions and non-home discharge dispositions. Providers can utilize these data to promote the need for better perioperative care in these high-risk patients.
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Eur J Orthop Surg Tr · Feb 2019
Incidence, risk factors and clinical impact of postoperative delirium following open reduction and internal fixation (ORIF) for hip fractures: an analysis of 7859 patients from the ACS-NSQIP hip fracture procedure targeted database.
Delirium is one of the most common acute psychiatric disturbances taking place in patients, particularly elderly, following hip fractures. Using a validated national surgical database, we sought to define the incidence, risk factors and clinical impact associated with the occurrence of delirium following open reduction and internal fixation (ORIF) for hip fracture. ⋯ This study identifies several risk factors associated with the occurrence of postoperative delirium in patients undergoing ORIF for hip fracture. Surgeons can utilize these data to risk stratify and consequently tailor an appropriate preoperative and postoperative care protocol to prevent the occurrence of delirium.
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After a long history in flaps' surgery, the perforator flaps became the most used flaps nowadays. From the beginning, their use as free flaps diminished substantially the donor site morbidity. ⋯ They can be used as V-Y advancement flaps, transposition flaps, propeller flaps, and keystone flaps (multiperforator flaps). The present study will refer to the use of local perforator flaps in forearm and hand reconstruction, and will point on the most important technical aspects of their harvesting, the main indications, advantages and disadvantages, and possible complications.