Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Apr 2018
Evaluation of inter- and intra-observer reliability of current classification systems for subtrochanteric femoral fractures.
To evaluate the inter- and intra-observer reliability of the Russell Taylor, Seinsheimer and AO classification systems, and to investigate whether or not the experience of the surgeon had any effect on the classification. ⋯ As both the Russell Taylor and Seinsheimer classifications were found to be more reliable and reproducible than the AO classification for subtrochanteric femoral fractures, they can be considered to be more valuable in clinical practice and communication. The experience of the surgeons was not found to have any significance in the evaluation of these three classification systems in these types of fractures.
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Eur J Orthop Surg Tr · Feb 2018
Review Meta AnalysisA systematic review and meta-analysis of the direct anterior approach for hemiarthroplasty for femoral neck fracture.
We performed a systematic review and meta-analysis to assess whether the direct anterior approach (DAA) is associated with improved functional and clinical outcomes compared to other surgical approaches for hemiarthroplasty for displaced femoral neck fractures. ⋯ This is the first systematic review and meta-analysis of the DAA for hemiarthroplasty. Available evidence suggests superior early functional mobility with the DAA. The DAA is associated with a significantly lower dislocation rate compared to posterior capsular approaches for hemiarthroplasty.
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Eur J Orthop Surg Tr · Feb 2018
Comparative StudyPelvic fractures in the Netherlands: epidemiology, characteristics and risk factors for in-hospital mortality in the older and younger population.
To examine nationwide epidemiology of pelvic fractures in the Netherlands and to compare characteristics and outcome of older versus younger patients as well as predictors for in-hospital mortality. ⋯ The annual incidence of (both minor and major) pelvic fractures in the older population was substantially higher than in the younger population. Elderly patients had a disproportionately high in-hospital mortality rate considering they were less severely injured. Among other factors, age was the greatest independent predictor for in-hospital mortality in all pelvic fracture patients.
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Eur J Orthop Surg Tr · Jan 2018
The impact of acute compartment syndrome on the outcome of tibia plateau fracture.
Acute compartment syndrome (ACS) is often associated with tibial plateau fractures and is a limb-threatening injury. Staged management through fasciotomy with delayed definitive fixation can prevent muscle necrosis and increase limb salvage rates. This procedure opens a large area for potential contamination and infection in the lower extremity. Recent studies have shown an increased risk of infection following fasciotomy and staged management for tibial plateau fractures. This study reports the rate of infection, delayed union, and nonunion in patients with this injury pattern. ⋯ Level IV prognostic.
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Eur J Orthop Surg Tr · Jan 2018
Intra-operative fluoroscopic radiation exposure in orthopaedic trauma theatre.
Radiation exposure from intra-operative fluoroscopy in orthopaedic trauma surgery is a common occupational hazard. References for fluoroscopy use in the operating room for commonly performed operations have not been reported adequately. This study aimed to report appropriate intra-operative fluoroscopy use in orthopaedic trauma and compare the effect of surgery type and surgeon grade on radiation exposure. ⋯ This study reports reference values for common trauma operations. These can be utilized by surgeons in the operating room to raise awareness and perform clinical audits of appropriate fluoroscopy use for orthopaedic trauma, using this study as guidance for standards. We demonstrated a significant reduction in fluoroscopy usage with increasing surgeon experience.