Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jan 2017
Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.
Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes. ⋯ Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.
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Eur J Orthop Surg Tr · Dec 2016
Randomized Controlled TrialSubacromial injection of autologous platelet-rich plasma versus corticosteroid for the treatment of symptomatic partial rotator cuff tears.
Rotator cuff tears are one of the most common causes of chronic shoulder pain and disability. They significantly affect the quality of life. Reduced pain and improved function are the goals of conventional therapy, which includes relative rest, pain therapy, physical therapy, corticosteroid injections and surgical intervention. Tendons have a relative avascular nature; hence, their regenerative potential is limited. There is some clinical evidence that the application of autologous platelets may help to revascularize the area of injury in rotator cuff pathologies. ⋯ II.
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Eur J Orthop Surg Tr · Dec 2016
Venous thromboembolism after lower limb arthroplasty: is chemical prophylaxis still needed?
Venous thromboembolism (VTE) is a significant complication of lower limb arthroplasty. The National Institute for Health and Care Excellence recommends routine use of chemical and mechanical prophylaxis to prevent VTE. Our high-volume, elective, arthroplasty unit adopted this guidance in 2008. ⋯ Although our VTE rate reduced by 0.4 % and our VTE-related mortality reduced by 0.04 % after introduction of chemical thromboprophylaxis, these differences were not statistically significant. Chemical thromboprophylaxis may not be required in all patients undergoing arthroplasty providing appropriate mechanical prophylaxis is used.
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Eur J Orthop Surg Tr · Dec 2016
Comparative StudyReducing intraoperative duration and ionising radiation exposure during the insertion of distal locking screws of intramedullary nails: a small-scale study comparing the current fluoroscopic method against radiation-free, electromagnetic navigation.
Intramedullary nailing is the standard surgical treatment for mid-diaphyseal fractures of long bones; however, it is also a high radiation dose procedure. Distal locking is regularly cited as a demanding element of the procedure, and there remains a reliance on X-ray fluoroscopy to locate the distal holes. A recently developed electromagnetic navigation (EMN) system allows radiation-free distal locking, with a virtual on-screen image. ⋯ This study has evidenced statistically significant reductions in both fluoroscopy time and radiation dose when using EMN for the distal locking of intramedullary nails. It is expected that overall operative duration would also decrease in line with similar studies, with increased usage and a larger sample.
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Eur J Orthop Surg Tr · Dec 2016
Comparison of preoperative continuation and discontinuation of aspirin in patients undergoing total hip or knee arthroplasty.
Preoperative discontinuation of aspirin (acetylsalicylic acid) can reduce bleeding risk but may increase the risk of perioperative cardiovascular events. ⋯ Continuation or discontinuation of aspirin did not show a statistically significant difference in the risk of relevant perioperative bleeding complications in our study. Continuation of aspirin was associated with a transitory increase in knee swelling, but had no effect on orthopaedic outcome. Continuation of aspirin may be associated with a favourable perioperative cardiac outcome. Our data support perioperative continuation of aspirin intake in patients undergoing THA or TKA.