Orthopaedic review
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A retrospective review of 56 hip fractures in 52 patients aged 90 years and older was performed, looking specifically at perioperative morbidity and mortality, one-year mortality, and postoperative functional outcome. The one-year mortality rate was 46% as compared to 22% in younger individuals. ⋯ Only 25% of functional ambulators preoperatively gained a similar level of function postoperatively. Despite these findings, the low perioperative mortality and morbidity indicate that operative treatment is still the treatment of choice in all nonagenarians with hip fractures, as it provides for easier nursing care and maximized functional outcome, with an expected 54% one-year survival rate.
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A 13-year-old girl suffered a single gunshot wound to the abdomen that resulted in multiple small bowel perforations and an incomplete neurologic injury involving her lower extremities. Physical exam failed to locate an exit wound. Radiographs revealed the bullet within the spinal canal at the thoracolumbar junction. It was subsequently removed on a non-urgent basis.