Orthop Traumatol Sur
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Alternatives to internal fixation of long-bone fracture comprise, depending on location, external fixation or joint replacement. Limitations comprise risk of infection and functional outcome quality, which vary according to technique. The present study examines these limitations, based on comparative or large-scale studies from which certain significant results emerge. ⋯ The pulmonary and systemic impact of peripheral lesions or definitive anterograde intramedullary nailing of femoral fracture in multiple trauma calls for caution and what is known as "damage-control orthopedics" (DCO), a term covering the general consequences of both the initial trauma and its treatment. Femoral intramedullary nailing is thus contraindicated in case of hemorrhagic shock (blood pressure<90mmHg), hypothermia (<33°C), coagulation disorder (platelet count<90,000) or peripheral lesions such as multiple long-bone fractures, crushed limb or primary pulmonary contusion. In such cases, external fixation or retrograde nailing with a small-diameter nail and without reaming are preferable.
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Orthop Traumatol Sur · Feb 2017
Does weight-bearing assignment after intramedullary nail placement alter healing of tibial shaft fractures?
There is no consensus regarding postoperative weight-bearing (WB) assignment after treatment of tibial shaft fractures with an intramedullary nail. This study aims to determine if the postoperative WB assignment after tibia intramedullary nail placement alters healing. ⋯ IV.
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Orthop Traumatol Sur · Feb 2017
Randomized Controlled Trial Multicenter StudyTreatment of pediatric forearm midshaft fractures: Is there a difference between types of orthopedic surgeon?
The objective of this study was to compare the clinical and radiological outcomes of pediatric forearm midshaft fractures treated operatively with titanium elastic nails (TENs) by pediatric orthopedists and non-pediatric orthopedists. ⋯ Level II prospective randomized study.
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Orthop Traumatol Sur · Feb 2017
Multicenter StudyInternal fixation of intra-capsular proximal femoral fractures in patients older than 80 years: Still relevant? Multivariate analysis of a prospective multicentre cohort.
Arthroplasty is now widely used to treat intra-capsular proximal femoral fractures (PFFs) in older patients, even when there is little or no displacement. However, whether arthroplasty is associated with lower mortality and complication rates in non-displaced or mildly displaced PFFs is unknown. The objectives of this prospective study were: (1) to evaluate early mortality rates with the two treatment methods, (2) to identify risk factors for complications, (3) and to identify predictors of functional decline. ⋯ III, prospective case-control study.
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Orthop Traumatol Sur · Feb 2017
Randomized Controlled TrialSuprascapular block associated with interscalene block: an alternative to isolated interscalene block for analgesia in shoulder instability surgery?
Interscalene brachial plexus block (ISB) is the gold standard for postoperative pain management in shoulder surgery. However, this technique has side effects and potentially serious complications. The aim of this study was to compare the combinations of ultrasound-guided suprascapular (SSB) associated with supraclavicular nerve block (SCB) and ultrasound-guided ISB for postoperative analgesia after shoulder instability surgery. ⋯ US-guided SCB combined with US-guided SSB was as effective as ISB for postoperative analgesia after shoulder instability surgery without decreasing potential side effects.