Hatfieldtorp3393

Ten additional cases were identified from previously published reports. The best objective response rate for immune checkpoint inhibitors was 30.4% (95% CI = 11.6%-49.2%) and the clinical benefit rate was 52.2% (95% CI = 31.8%-72.6%). The clinical benefit rate was significantly better for programmed cell death protein 1 inhibitors (or a combination) compared with ipilimumab alone (Fisher exact, p = .023). Grade 3/4 adverse events were observed in 3 (13.0%) of the 23 patients.

Women with VVM constitute a high-risk group with poor overall prognosis. Immune checkpoint inhibitors are effective in the treatment of metastatic melanoma in this patient cohort.

Women with VVM constitute a high-risk group with poor overall prognosis. Immune checkpoint inhibitors are effective in the treatment of metastatic melanoma in this patient cohort.

Compare anterior minimally invasive plate osteosynthesis (MIPO) to open reduction/internal fixation (ORIF) for humeral shaft fractures, assessing complications and clinical outcomes.

Retrospective matched case-controlled cohort.

Tertiary referral trauma centre.

Humeral shaft fractures identified retrospectively over 5-years; 31 were treated by MIPO and 54 by ORIF. Case-matched cohort assembled according to fracture pattern, gender, age, and comorbidities, with 56 total patients (28 per group).

MIPO and ORIF MAIN OUTCOME MEASURES Complication rate was the primary outcome (radial nerve injury, nonunion, infection, and re-operation). Radiographic alignment and the DASH Score were secondary outcomes.

Cumulative complication rates were 3.6% following anterior MIPO, and 35.7% after ORIF (p=0.0052). The only complication following anterior MIPO was a nonunion, managed with revision ORIF and bone graft. The ORIF group had 10 complications, including 5 superficial infections, 4 iatrogenic radial nerve injuries, and 1 nonunion. The mean DASH score following MIPO was 17.0 ± 18.0, and after ORIF was 24.9 ± 19.5. The mean coronal plane angulation following MIPO was 1.8 ± 1.3, and after ORIF was 1.0 ± 1.2. The mean sagittal plane angulation following MIPO was 3.0 ± 2.9, and after ORIF was 1.0 ± 1.2.

The cumulative complication rate was 10 times higher following ORIF of humeral shaft fractures compared to the MIPO technique. MIPO achieved nearly equivalent radiographic alignment, with no clinically meaningful differences observed. MIPO is the safer option, and should be considered for patients with humeral shaft fractures that would benefit from surgical intervention.

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Therapeutic Level III. Liraglutide mouse See Instructions for Authors for a complete description of levels of evidence.

To assess agreement among experts in pelvic fracture management regarding stability and need for operative repair of lateral compression (LC) type pelvic fractures with static radiographs compared to static radiographs and exam under anesthesia (EUA).

Online surveyPatients/Participants Ten patients who presented to our level-1 trauma center with a pelvic ring injury were selected. Vignettes were distributed to 11 experienced pelvic surgeons.

Exam under anesthesia MAIN OUTCOME MEASUREMENTS Agreement regarding pelvic fracture stability, need for surgical fixation.

Agreement on stability was achieved in 4 (40%) cases without EUA compared to 8 (80%) cases with EUA. Inter-reviewer reliability was poor without EUA and moderate with EUA (0.207 vs. 0.592). Agreement on need to perform surgery was achieved in 5 (50%) cases compared to 6 (60%) cases with EUA. Inter-reviewer reliability was poor without EUA and moderate with EUA (0.250 vs. 0.432). For reference cases with agreement, surgeons were able to predict stability or instability using standard imaging in 57 of a possible 88 reviewer choices (64.8%) compared to 82 of 88 choices (93.2%) with the addition of EUA (p<0.0001).

EUA increased agreement among experienced pelvic surgeons regarding the assessment of pelvic ring stability and the need for operative intervention. Further research is necessary to define specific indications for which patients may benefit from EUA.

Diagnostic Level V. See Instructions for authors for a complete description of levels of evidence.

Diagnostic Level V. See Instructions for authors for a complete description of levels of evidence.

We hypothesize that in adequately resuscitated borderline polytrauma patients with long bone fractures (femur and tibia) or pelvic fractures; early (within 4 days) definitive stabilization (EDS) can be performed without an increase in post-operative ventilation and post-operative complications.

Retrospective Cohort Study SETTING Level 1 Trauma Centre PATIENTS In total 103 patients were included in this study of which 18 (17.5%) were female and 85(82.5%) were male. These patients were borderline trauma patients who had the following parameters prior to definitive surgery, normal coagulation profile, lactate < 2.5 mmol/L, pH ≥ 7.25, and base excess (BE) ≥ 5.5.

These patients were treated either according to Early Total Care (ETC), definitive surgery on day of admission, or Damage Control Orthopaedics (DCO) principles, temporizing external fixation followed by definitive surgery at a later date. Timing of definitive surgical fixation was recorded as EDS or late definitive surgical fixation (LDS) (>4 tions for Authors for a complete description of levels of evidence.

To determine if orthogonal or parallel plate position provides superior fixation of the separate capitellar fragment often present in intra-articular distal humerus fractures. We hypothesized that orthogonal plating would provide stiffer fixation given a greater number of opportunities for capitellar fixation as well as screw trajectories perpendicular to the fracture plane offered by a posterolateral plate compared to a parallel plate construct.

Ten matched pairs of cadaveric distal humeri were used to compare parallel and orthogonal plating in a fracture gap model with an isolated capitellar fragment. The capitellum was loaded in 20 of flexion utilizing a cyclic, ramp-loading protocol. Fracture displacement was measured using video tracking software. The primary outcome was axial stiffness for each construct. Secondary outcomes included maximum axial and angular fracture displacement.

The parallel plate construct was more than twice as stiff as the orthogonal plate construct averaged across all loads (1464.