Eur J Orthop Surg Tr
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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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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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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.
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Eur J Orthop Surg Tr · Feb 2019
Treatment for proximal pole scaphoid nonunion with capsular-based vascularized distal radius graft.
We retrospectively reviewed the results of 89 patients with proximal pole scaphoid nonunion, 58 with avascular necrosis, treated with a capsular-based vascularized distal radius graft. ⋯ The capsular-based vascularized bone graft from the distal radius is a reliable alternative technique for scaphoid nonunions. It is a simple and expedient harvesting technique without the need for a microsurgical anastomoses. The supplemental fixation with a microsuture anchor eliminates the risk of graft displacement.
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Eur J Orthop Surg Tr · Jan 2019
Comparative StudyPoCUS evaluating blunt thoracic trauma: a retrospective analysis of 18 months of emergency department activity.
Blunt thoracic injury (BTI) constitutes a common presentation in emergency department: rib fractures are the most common injuries. Chest X-ray (CXR) has a limited sensitivity to identify rib fractures. We perform this retrospective study in our emergency department collecting all patients with BTI during an 18-month period. ⋯ PoCUS in emergency medicine has an increasing role, especially in BTI, but less clear is its role in detecting ribs fracture. PoCUS seems to be an effective method for diagnosing rib fracture in patients with blunt chest trauma if collaborative and with a well-isolated trauma. We used the trick of patients' self-positioning probe in the most painful site, and this could reduce the time and the pain of the examination.