Journal of the Southern Orthopaedic Association
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J South Orthop Assoc · Jan 1996
Comparative StudyPneumatic compression or aspirin prophylaxis against thromboembolism in total hip arthroplasty.
We prospectively studied the use of either aspirin or intermittent pneumatic compression (IPC) as prophylaxis against thromboembolism after 330 consecutive total hip arthroplasties. Duplex ultrasonography of the veins of both lower extremities and ventilation-perfusion lung scans were done preoperatively and 7 to 14 days postoperatively. Eight patients in the IPC group (5%) had asymptomatic deep vein thrombosis; there were no symptomatic thrombi. ⋯ In the aspirin group, two patients (1%) had symptomatic pulmonary embolism and 26 patients (18%) had asymptomatic pulmonary embolism. This difference in asymptomatic pulmonary embolism between the two groups was statistically significant. Both groups had a low incidence of deep vein thrombosis, as shown by Duplex ultrasonography, but IPC was more effective than aspirin in preventing asymptomatic pulmonary embolism after total hip arthroplasty.
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We evaluated the results of short-segment pedicle screw instrumentation in 54 patients with unstable thoracolumbar fractures. Follow-up averaged 25 months (range, 11 to 36 months); 42 patients completed the study. Kyphosis was corrected by an average of 7 degrees at surgery and loss of correction averaged 5 degrees at the end of follow-up. ⋯ Solid fusion was achieved in all cases at an average of 3 months. Of the 31 patients with normal neurologic function, 24 (77%) were pain-free at follow-up and had returned to previous levels of activity. We conclude that short-segment fixation with posterolateral fusion is effective in the treatment of unstable thoracolumbar fractures; it prevents progression of kyphotic deformity and neurologic deterioration, results in a stable fusion, and preserves uninvolved motion segments above and below the fracture site.