Revue de chirurgie orthopédique et réparatrice de l'appareil moteur
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2004
Review[Factors affecting quality of care for elderly subjects undergoing surgery for hip fracture: review of the literature].
Hip fractures are one of the leading causes for admission of elderly subjects to healthcare facilities. Because of population aging, the incidence of hip fractures has increased considerably over the last years and will continue to increase in industrialized countries. Hip fracture in an elderly subject may be life threatening and has a significant functional and social impact not only because of the fracture itself, but also because of the risk of complications related to the patient's health status and the long hospital stay. ⋯ The rythm of rehabilitation exercises should be at least five sessions per week. Finally, there are several methods, which are effective in preventing recurrence, taking into account osteoporosis, risk of falls. Preventive measures should be instituted for all patients undergoing surgery for hip fracture.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2004
Multicenter Study[Delayed diagnosis of inferior cervical spine injury].
According to data in the literature, traumatic injury of the inferior cervical spine is not recognized in 4.5 to 33% of victims. The purpose of our study was to evaluate the rate of delayed diagnosis, search for causes, and propose a diagnostic approach. ⋯ Late diagnosis of inferior cervical spine injury is probably not uncommon. Improved management can be achieved through better medical awareness, better knowledge of cervical spine injuries, and routine imaging in application of the rule of prudence.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2004
[Total hip arthroplasty for the treatment of septic hip arthritis in adults with sickle-cell disease].
Septic hip arthritis is a recognized complication of sickle-cell disease. The incidence is difficult to assess but is significant since certain authors estimate that 11% of children with sickle-cell disease develop orthopedic complications. We report our experience with hip joint infection in adults with sickle-cell disease. ⋯ At 2 to 12 years follow-up, all seven patients had nearly normal hip function (all 10 hips). Recurrent infection nevertheless developed in 2 hips, demonstrating the limitations of this technique.
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Rev Chir Orthop Reparatrice Appar Mot · Oct 2004
[Contribution of quantitative radio-scintigraphy to diagnosis of wrist injuries undetected on plain films: a prospective study of 154 cases].
Fractures of the scaphoid must be diagnosed quickly to avoid persistent nonunion and the risk of osteoarthritis. Despite meticulous physical examination and adequate x-ray detection, numerous occult fractures still go unrecognized. The aim of this prospective study was to analyze the pertinence of quantitative radio-scintigraphy (QRS) presently used for the diagnosis of occult wrist fractures. ⋯ Occult fracture of the wrist, particularly the carpal scaphoid, is frequent. Repeated x-ray examination does not increase the rate of detection of these fractures. Bone scans may also fail to reveal occult fractures. MRI is a key examination in the assessment of wrist fracture symptoms, but is presently not available in all institutions. Bone scan is classically insufficiently precise. QRS is a rapidly available low-cost examination which we have found to be indispensable for the diagnosis of occult wrist fractures. With early QRS diagnosis, the risk of neglected carpal scaphoid fracture and subsequent nonunion and osteoarthritis together with the personal, social, and medicolegal consequences can be avoided.