Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2013
Is there a difference in timing and cause of death after fractures in the elderly?
Patients who sustain osteoporotic fractures have excessive mortality compared to age-matched controls, which is most pronounced within the first 6 months postfracture. However, the timing and cause of death in the first 3 months after sustaining a fracture are unclear. ⋯ This shows the severity and impact of a spinal injury compared to other typical fragility fractures.
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Clin. Orthop. Relat. Res. · Sep 2013
Randomized Controlled TrialPreemptive low-dose dexamethasone reduces postoperative emesis and pain after TKA: a randomized controlled study.
Dexamethasone is a potent analgesic and antiemetic. However, the benefit of dexamethasone after TKA is unclear, as is the efficacy in a current multimodal regime. ⋯ Patients who received prophylactic dexamethasone in addition to ramosetron had reduced postoperative emesis and pain without increased risks for wound complications, compared with patients who received ramosetron alone in patients managed using a multimodal regimen after TKA.
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Clin. Orthop. Relat. Res. · Sep 2013
Randomized Controlled TrialWhich implant is better for treating reverse obliquity fractures of the proximal femur: a standard or long nail?
Reverse obliquity fractures of the proximal femur have biomechanical characteristics distinct from other intertrochanteric fractures and high implant failure rate when treated with sliding hip screws. Intramedullary hip nailing for these fractures reportedly has less potential for cut-out of the lag screw because of their loadbearing capacity when compared with extramedullary implants. However, it is unclear whether nail length influences healing. ⋯ Our preliminary data suggest reverse obliquity fractures of the trochanteric region of the femur can be treated with either standard or long intramedullary nails.
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Clin. Orthop. Relat. Res. · Sep 2013
Are pentraxin 3 and transsignaling early markers for immunologic injury severity in polytrauma? A pilot study.
Inflammatory-related conditions and organ failure (OF) lead to late trauma mortality. Cytokine profiles can predict adverse events and mortality, potentially guiding treatment strategies (damage control surgery versus early total care). However, the specific cytokines to predict the clinical course in polytraumatized patients are not fully identified. ⋯ PTX3, sIL-6R, and TSR were early markers for posttraumatic inflammatory status, OF, injury severity, and TSR for survival after polytrauma. The temporal profile of PTX3 and TSR might be used to anticipate the total injury severity and the clinical course and thereby guide decision making in polytraumatized patients.
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Clin. Orthop. Relat. Res. · Sep 2013
Severity of injury predicts subsequent function in surgically treated displaced intraarticular calcaneal fractures.
The treatment of displaced, intraarticular calcaneal fractures (DIACFs) remains challenging and the best treatment choices remain controversial. The majority of patients will have some lasting functional restrictions. However, it is unclear which patient- or surgeon-related factors predict long-term function. ⋯ We found the severity of a DIACF related to subsequent foot function and quality of life. Both fracture severity classifications predicted function. Anatomic reconstruction of the shape and articular surfaces of the calcaneus leads to predictable function in the medium to long term.