Abildtrupdonnelly5096

Radiologically, satisfactory results were obtained in 32 hips (82.1%) and unsatisfactory in seven (17.9%), according to Severin's criteria. In conclusion, the results of our series show open reduction combined with Dega transiliac osteotomy to be a safe and efficient method for the surgical treatment of DDH in selected patients, and can easily and safely be combined with associated procedures for single stage correction of acetabular dysplasia.The majority of patients are pain free after total hip replacement, but some experience anterior hip pain due to iliopsoas impingement. There is evidence that a prominent or malpositioned cup may cause iliopsoas tendonitis. The purpose of this study was to determine whether oversizing the cup is a risk factor for postoperative groin pain. We retrospectively investigated 437 total hip replacements in which the femoral head diameter had been measured for other research purposes. Data regarding the cup size and positioning was collected from implant identification labels and pelvis x-rays. Clinical data were recovered from the medical files. Native femoral head size, cup size, anteversion, inclination and DS (difference between native femoral head size and cup size) and type of pain (anterior hip pain or non-anterior hip pain) were analyzed and correlations were sought. There was a strong and significant correlation between native femoral head size and cup size. Mean DS was 5.5 mm in the no pain group, 6.9 mm in the anterior hip pain group and 5.9 mm in the non-anterior hip pain group. The difference in mean DS was significant (P=0.046) in patients experiencing anterior hip pain vs. those with no pain or non-anterior hip pain. As patients with anterior hip pain had a significant larger DS of 6.9 mm, it seems that a cup size of more than 6 mm above the native femoral head size should be avoided. We therefore recommend a systematic intraoperative head size measurement prior to definite cup choice.Perioperative hypothermia (below 36°C) has been associated with post-operative morbidity. The aim of this study was to determine the incidence of post-operative hypothermia in hip arthroscopy patients and factors affecting perioperative body temperature variation. A prospective audit of 50 consecutive patients undergoing hip arthroscopy for a variety of pathologies was carried out. The final sample size was 46 due to missing data in 4 patients. Core body temperature was measured with a nasopharyngeal temperature probe at the induction of anaesthesia and at the end of the procedure. Other recorded variables were type of warming blanket, ambient theatre temperature and duration of surgery. It was noted whether the patient was shivering immediately post-operatively. The following demographic details were recorded age, sex, body mass index and the American Society of Anaesthesiologists physical status score. The statistical analysis was performed with Stata® 12 (StataCorp LP, College Station, Texas) by use of a conditional regression model to calculate associations between post-operative body temperature and other variables. The series included 30 female and 16 male patients aged 18 to 57 years (mean 35), with a mean BMI of 26.4 (standard deviation 4.2). Overall incidence of hypothermia below 36°C was 61%. Results of the conditional regression analysis suggested a positive association between post-operative body temperature and pre-operative body temperature (P less then .001). Incidence of hypothermia in hip arthroscopy patients is high (61%). We recommend warming patients pre-operatively with forced air warming devices to reduce this incidence. Level of evidence IV.Unstable trochanteric fractures and fractures with reverse obliquity pose difficulty in fixation. In recent years, intramedullary nails, for the treatment of comminuted and unstable intertrochanteric hip fractures, are becoming more popular relative to conventional, sliding hip screws. The purpose of our study was to evaluate the result of Trochanteric femoral nailing in comminuted, unstable Trochanteric femur fracture in terms of anatomical restoration and functional outcome. It is a prospective and without control study. Trochanteric femoral nailing has been done in comminuted unstable inter-trochanteric fracture femur (AO A2.2 to A3.3) of 25 patients and they are followed up postoperatively for at least 12 months. Pre-operative and post-operative clinical and radio-logical parameters are compared accordingly. Union in all cases. Overall complication rate 12% including some implant related complications. Functional outcome on Harris Hip Score is comparable with standard literature. For treatment of intertrochanteric hip fractures, particularly with comminuted fracture fragments, intramedullary devices offer beneficial features, such as closed insertion, a shorter lever arm, and controlled telescoping of the head-neck fragment. Insertion of the nail through the tip of the greater trochanter requires less dissection and may lead to less blood loss and fewer wound complications, as well as earlier postoperative mobility. Further biomechanical and clinical studies are necessary to validate the efficacy of the trochanteric femoral nail. Level of Evidence Level III therapeutic study.Antibiotic-loaded cement spacers are used in two- stage hip replacement. The aim of our study was to compare our results using a Spacer-G with previous results reported in the literature. From June 2002 to April 2010, all patients treated with a two-stage revision were retrospectively reviewed. On the basis of the results of the first-stage procedure, 52 patients underwent the second stage, six developed a dislocation, in eight the spacer was maintained, and five patients developed an acute infection of the spacer or the infection was not resolved. With regard to the second-stage procedure the revision was successful in 44 patients, a re-infection developed in four patients and the definitive prosthesis presented a mechanical complication in four more. The literature results reported that 97.5% of the spacers were reimplanted, although 12.09% of them developed a dislocation. Plinabulin in vivo Surgeons must assess several aspects so as to avoid mechanical complications like dislocation and re- infections during the two stages of the procedure.The aim of this study was to review the incidence, management and outcome of isolated iliac wing fractures and to compare them with other type A, B and C fractures. From 2004 to 2015, the data of 547 patient with a pelvic fracture regarding age, gender, RTS, ISS, treatment, complications and mortality were analyzed and a comparison was made between iliac wing fractures and the other pelvic fractures. We encountered 30 isolated iliac wing fractures. The ISS, shock class, transfusion rate, complications and mortality were comparable to those of patients with an unstable pelvic fracture. Concomitant injuries were observed in 93% of the patients. None of the fractures were operatively stabilized. Isolated iliac wing fractures are rare, and operative stabilization of the fracture itself is often not necessary. However, these fractures are serious injuries with characteristics resembling those of patients with an unstable pelvic ring injury.We performed a prospective study on patients with acetabular fractures treated either with internal fixation either with arthroplasty comparing clinical outcomes, quality of life, economic resources and cost efficacy in the first five years after surgery. Demographic data, diagnosis, index treatment, costs and subsequent surgeries were recorded. Patients were requested to fulfill Merle d'Aubigné and EQ-5D-5L questionnaires. Clinical differences between treatments are significant only in discharge period. Comparing respectively group with fixation and arthroplasty, cost efficacy was 5483 and 10838 euros/quality-adjusted-life years, mean global costs 23965 and 16878 € and quality of life gained in five years 2.788 and 3.175. Group of arthroplasty showed better quality of life at discharge and at one year. If choice between fixation and arthroplasty should be based only on cost-efficacy, arthroplasty should be suggested but clinical outcomes suggest to consider fixation because results at five years are not different to arthroplasty.The aim of this study was to prospectively compare different delivery forms, doses and combined application forms of TXA for the reduction of blood loss and prevention of the allogeneic blood transfusion in patients with TKA and evaluate the results. The study included patients with knee joint osteoarthritis who were unresponsive to conservative management and 168 patients met the inclusion criteria. They were divided into 5 groups randomly as, Control (1), Local (2), Systemic+short infusion (3), Systemic+long infusion (4) and Systemic+oral TXA (5). When compared with the Control group, blood loss was significantly reduced in Groups 2, 3 and 4 (p=0.001, 0.001, 0.003) but not in Group 5. Twenty- four hour drainage output was lower in all treatment groups (p=0.001, 0.001, 0.001, 0.004). Although TXA groups had no difference in terms of blood loss, 24- hour drainage outputs of the local TXA group were less than Group 4 and 5 and it yielded similar amounts in comparison with group 3. It was determined that TXA use whether local or systemic gave rise to decreased blood loss and prevent allogeneic blood transfusion. But, regarding the results above, local TXA seemed to have favorable effects when compared with systemic+long infusion and systemic+oral TXA usage, whereas local use had similar results with systemic+short infusion. Additionally, there found no difference between systemic+short, systemic+long infusion and systemic+oral combined TXA usage with respect to blood loss, transfusion rates and drain follow-up. We recommend further prospective randomized controlled studies to make clear these differences. Systemic+oral combined TXA use have promising results when compared with other systemic multiple deliveries.The purpose of this study was to assess the factors associated with high fibular head in symptomatic discoid lateral meniscus (DLM). Eighty-seven patients with complete DLM (discoid group) and 80 normal subjects (control group) were included prospectively. Plain X-rays and MRI were analyzed for level and angle of the fibular head and thickness and type of Wrisberg ligament. Multivariate regression analysis was performed to find the factors associated with levels of the fibular head and DLM. The angle of the fibular head was the only factor associated with level of the fibula in the discoid group (odds ratio 3.0, p=0.007). The 13.6mm cut off value for fibular level had 70.5% sensitivity and 77.0% specificity for diagnosis of DLM. A high fibular head was associated with larger angle and type of fibular head. Level of evidence Level II.This study is aimed to compare the clinical and radiological differences between classic locked intra- medullary nailing (LIN) and blade expandable intra- medullary nailing (BEIN) at tibia shaft fractures. Operation time, exposing of radiation time and fracture healing times were recorded. Pain visual anolog scale (VAS), shortening of tibia and angulation of fracture line were compared. All patients healed. In LIN group operation time, exposing of radiation time was longer (statistically significant). Because of shorter operation time and lower radiation exposure we recommend the BEIN technique as a preferable technique in tibia intramedullary nailing.