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.
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The use of patient-controlled analgesia systems in the postoperative period has become quite popular over the past several years. The systems to date have been limited to analgesics administered intravenously. The purpose of this study was to extend the use of a patient-controlled analgesia system to include oral analgesics during a patient's hospital stay.
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Comparative Study
Patient-controlled analgesia in orthopedic procedures.
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Case Reports
Asymptomatic innominate vein tamponade with retromanubrial clavicular dislocation. A case report.
Traumatic sternoclavicular joint dislocations are uncommon and posterior dislocations are rare; however, reports in the orthopaedic literature focus predominantly on retrosternal dislocations owing to their potentially dangerous sequelae. We report a case of asymptomatic complete innominate vein obstruction secondary to retromanubrial dislocation of the sternoclavicular joint with restoration of flow after closed reduction.