Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Aug 2018
Uncemented Thompson's hemiarthroplasty: safe, palliative and cost-effective surgery in the infirm patient-a consecutive series of 1445 cases.
Guidelines on the management of displaced intracapsular fractures recommend using an Orthopaedic Data Evaluation Panel-rated cemented implant. Prior to the National Institute for Health and Care Excellence guidelines, uncemented implants were commonly used in the UK. ⋯ Current guidelines strongly favour cemented hemiarthroplasty. Recognition that fractured hip patients are a non-homogeneous group is important. In patients with limited life expectancy, an uncemented Thompson is a quick, simple, palliative solution to early mobilisation. Correct surgical technique avoids using cement in this cohort, which is most vulnerable to bone cement implantation syndrome. Cost-effective resource utilisation with an increasingly elderly population remains a surgical responsibility.
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Eur J Orthop Surg Tr · Aug 2018
Prediction of surgical site infection in spine surgery from tests of nasal MRSA colonization and drain tip culture.
MRSA is an organism that is a possible risk factor for postoperative SSI. The purpose of the study was to examine relationships among surgical site infection (SSI) after spinal surgery, nasal methicillin-resistant staphylococcus aureus (MRSA) colonization, and wound drain culture results. ⋯ MRSA carriers were not necessarily associated with MRSA infection, but were related to a positive drain tip culture and SSI, which might be due to endogenous skin bacteria. Therefore, possible SSI should be considered in patients with nasal MRSA colonization or bacteria detected in a drain tip culture.
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Eur J Orthop Surg Tr · Jul 2018
Observational StudyC-reactive protein levels for early detection of early postoperative complications after proximal femoral fracture surgery.
We have studied the early C-reactive protein (CRP) kinetics after proximal femoral fracture (PFF) surgery and defined a chart of CRP threshold values beyond which early postoperative complications are likely. ⋯ Prospective observational study.
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Eur J Orthop Surg Tr · May 2018
Multicenter StudyA review of atypical subtrochanteric femoral fractures in Northern Ireland between 2010 and 2014.
The term atypical femoral fractures most commonly occur in the subtrochanteric area. Concerns exist regarding the role of bisphosphonate treatment in their aetiology. Which surgical intervention provides the best outcome remains contentious. ⋯ Atypical fractures often present with prodromal symptoms. Complete fractures are difficult to successfully manage with longer than expected times to union. Treatment with a dynamically locked, cephalomedullary with a good reduction provided the best results.
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Eur J Orthop Surg Tr · May 2018
Randomized Controlled Trial Comparative StudyPeriarticular multimodal drug injection is better than single anesthetic drug in controlling pain after total knee arthroplasty.
Postoperative pain is one of the issues that concern most patients after total knee arthroplasty (TKA). Periarticular multimodal drug injection and single anesthetic agent injection have been shown to effectively reduce postoperative pain. The purpose of this study was to compare the efficacy between multimodal drug injection and single anesthetic drug injection in controlling pain after TKA using a double-blinded randomized controlled trial. ⋯ Multimodal drug injection decreases pain level, reduces morphine consumption in the early postoperative period and prolongs the analgesic effect compared to single anesthetic drug. One may consider using single anesthetic agent only in patients who have high risk of opioid or NSAIDs side effect.