Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2005
Discrepancies between proceedings abstracts and posters at a scientific meeting.
The proceedings handbook of abstracts from scientific meetings aims to provide meeting attendees with an accurate summary of scientific presentations. Given that posters are prepared closer to the meeting than the abstracts for the proceedings book, we hypothesized that there is a high rate of inconsistency between abstracts in the proceedings handbook and the corresponding posters. We compared the poster abstracts printed in the proceedings handbook with the actual posters at the 71st annual meeting of the American Academy of Orthopaedic Surgeons in 2004. ⋯ Our findings suggest that discrepancies between the poster abstracts in the proceedings handbook and actual poster presentations are common, but changes in conclusions are rare. Meeting attendees should not assume that the proceedings handbook provides an accurate reflection of poster presentations. Visiting the poster section is recommended.
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Clin. Orthop. Relat. Res. · Jun 2005
Comorbidities increase complication rates in patients having arthroplasty.
The objective of our study was to assess the effect of comorbidities (hypertension, diabetes, obesity, and their combinations) on postoperative complications and discharge status in patients having shoulder, hip, and knee arthroplasty (n = 959,839). The association between outcomes and each of the comorbidities was assessed using multivariable logistic regression after adjusting for age, race, household income, gender, and hospital volume. In the multivariable models, postoperative complications were more likely in patients with hypertension, diabetes, or obesity as compared with patients without these comorbidities (for hypertension, odds ratio = 1.07; 95% confidence interval range, 1.04-1.11; for obesity, odds ratio = 1.3; 95% confidence interval range, 1.22-1.41). The likelihood of a nonhomebound disposition of patients on discharge was 1.30 times (95% confidence interval range, 1.27-1.32) in patients with diabetes and 1.45 times (95% confidence interval range, 1.40-1.49) in patients who were obese as compared with patients without these respective comorbidities. Patients with a combination of comorbidities also had a higher likelihood of postoperative complications and nonhomebound discharge. Results of our study showed that hypertension, diabetes, and obesity are independent predictors of increased postoperative complications and non-homebound discharge in patients undergoing shoulder, hip, or knee arthroplasty. ⋯ Prognostic study, Level II-1 (retrospective study). See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · May 2005
ReviewOperative treatment of femoral shaft fractures in children and adolescents.
Although femoral shaft fractures constitute fewer than 2% of all fractures in children and adolescents, their treatment has produced many pieces of literature and years of controversy. Prevailing opinion has favored nonoperative and operative treatment, and a variety of techniques have been advocated to avoid complications such as nonunion, limb-length discrepancy, malalignment, osteonecrosis, and growth disturbance. Currently, operative methods of treatment generally are favored to allow early ambulation and shorter hospital stays and to avoid detrimental psychological and social effects often associated with prolonged nonoperative treatment, and to avoid complications. ⋯ My choice for fixation of each fracture is based on consideration of a number of factors, including the age and size of the child, associated injuries, the location and pattern of the fracture, and the social situation of the child. In general, I prefer flexible nailing for younger children (6-10 years old) and locked nailing for adolescents at or near skeletal maturity. Bridge plating may be chosen for segmental, grossly comminuted fractures, whereas external fixation usually is reserved for severely comminuted or severe open fractures for which internal fixation is not appropriate.