Paaskebass5495

7 surgical revisions were required. The mean healing time was 15.5 months (range, 6 - 49 months). According to the ASAMI criteria, seven patients were rated as "excellent", and six patients were rated as "good"; one patient showed "poor" functional results. A total of 17 cases of treatment failure and 36 complications were detected.

The combination of the Masquelet technique and external fixation yielded a low healing rate and was associated with a significant number of cases of treatment failure.

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

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

To compare the early pain and functional outcomes of operative fixation versus nonoperative management for minimally displaced complete lateral compression (LC; OTA/AO 61-B1/B2) pelvic fractures.

Prospective clinical trial.

Two academic trauma centers.

Forty-eight adult patients with LC pelvic ring injuries with < 10mm of displacement were treated nonoperatively and 47 with surgical fixation. 60% of participants were randomized. Seventy-three-percent of the fractures were displaced <5mm, and 71% were LC-1 patterns.

Operative fixation versus non-operative management.

The primary outcome was patient reported pain using the 10-point Brief Pain Inventory (BPI). Functional outcome was measured using the Majeed pelvis score. Outcomes were analyzed using hierarchical Bayesian models to compare the average treatment effect from injury to 12- and 52-weeks post-injury. The probability of the mean treatment benefit exceeding a clinically important difference was determined.Results The 3-month average treatment effect of surgery compared to non-operative management was a 1.2-point reduction in pain (95% CrI 0.4 - 1.9) and an 8% absolute improvement in Majeed score (95% CrI 3 - 14%). Similar results persisted to 1 year. Patients with initial fracture displacement 5 mm experienced a larger reduction in pain (2.2, 95% CrI 0.9 - 3.5) compared to those patients with less initial displacement (0.9, 95% CrI 0.1 to 1.8).

On average, surgical fixation likely provides a small improvement in pain and functional outcome for up to 12 months; however, patients with 5mm of posterior pelvic ring displacement are more likely to experience clinically important improvements in pain.

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

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

To determine the association between surgical timing and short-term morbidity and mortality in elderly patients who sustain hip fractures using a national trauma database (OTA/AO 31A1-3, 31B1-3).

Retrospective cohort study.

Level I-IV trauma centers in the United StatesPatients/Participants All patients ≥ 65 years of age who underwent surgery for hip fracture from 2011 to 2013.

Time to surgery of <24 hours, 24-48 hours, and >48 hours from admission.

Primary outcome was mortality by hospital discharge. Secondary outcomes were complications of myocardial infarction, cardiac arrest, acute respiratory distress syndrome, unplanned reintubation, pneumonia, stroke, severe sepsis, and intensive care unit (ICU) length of stay.

27,058 patients were included in the study. Relative to the <24 hours cohort, patients in the >48 hours cohort were at increased risk for mortality (OR 1.89, 95% CI 1.52-2.33, P <.001), ARDS (OR 2.57, 95% CI 1.94-3.39, P <.001 for ARDS), myocardial infarction (OR 2.19, 95% CI 1.64-2.94, P <.0001), pneumonia (OR 2.04, 95% CI 1.71-2.44, P <.001), severe sepsis (OR 2.34, 95% CI 1.52-3.58, P =.003), and intensive care unit stay (OR 2.48, 95% CI 2.25-2.74, P <.0001). A subgroup analysis showed that healthier patients (modified Charlson Comorbidity Index less than 5) who had surgery >48 hours were not at increased risk of mortality.

For elderly patients with hip fractures, delaying surgery for more than 48 hours may be associated with increased short-term morbidity and mortality. This association may be pronounced for patients with more medical comorbidities.

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

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

To synthesize all-cause reoperations and complications data, as well as secondary clinical and functional outcomes, following the management of very distal femur periprosthetic fractures (vDFPFs) in a geriatric patient population with either a distal femoral locking plate (DFLP) or with distal femoral replacement (DFR).

MEDLINE, Embase and Web of Science, were searched for English-language articles from inception to March 16, 2020 in accordance to PRISMA guidelines.

Studies reporting the management of vDFPFs in adults over the age of 65 with either a DFLP or DFR were included. To ensure this review solely focused on very distal femoral periprosthetic fractures, only fractures of the following classifications were included (1) Lewis and Rorabeck Type II or III, (2) Su and Associates' Classification of Supracondylar Fractures of the Distal Femur Type III, (3) Backstein et al. Type F2, and/or (4) Kim et al. Type II or III.

Three reviewers independently extracted data from the included studies. Study valif evidence.

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

The iliac cortical density (ICD) is a critical fluoroscopic landmark for pelvic percutaneous screw placement. Our purpose was to evaluate the ICD as a landmark in pediatrics, and quantify the diameter of osseous pathways for three screw trajectories Iliosacral (IS) at S1 and transiliac-transsacral (TSTI) at S1 and S2.

267 consecutive pelvic CT scans in children aged 0-16 years were analyzed. ICD and S1 vertebral heights were measured at multiple regions along S1. Their height and corresponding ratios, as well as osseous screw corridor dimensions were compared between age groups and by dysmorphic status.

In the non-dysmorphic pelvises, S1 height, ICD height, and the ICD to S1 height ratio increased across age groups for all locations (p<0.001). https://www.selleckchem.com/products/phycocyanobilin.html All three screw pathway diameters increased with age (p<0.001). In the dysmorphic group, there was no increase in ICD to S1 height ratio with age. Except for the age 0-2 group, the ICD to S1 height ratios were significantly larger in the non-dysmorphic group.