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In-hospital Complications Are More Likely to Occur After Reverse Shoulder Arthroplasty Than After Locked Plating for Proximal Humeral Fractures
CONCLUSION: The increased in-hospital risk for major adverse events and surgical complications may moderate the enthusiasm associated with RTSA for proximal humeral fractures in patients 65 years and older. Treatment decisions should be based on individual risk estimation to avoid potential harmful events. Future studies must include long-term outcomes and quality of life to enlighten these findings in a broader context.LEVEL OF EVIDENCE: Level III, therapeutic study.PMID:33938479 | DOI:10.1097/CORR.0000000000001776
Source: Clinical Orthopaedics and Related Research - May 3, 2021 Category: Orthopaedics Authors: Jeanette K öppe Josef Stolberg-Stolberg Robert Rischen Andreas Faldum Michael J Raschke J Christoph Katthagen Source Type: research

Debate Update: Surgery After 48 Hours of Admission for Geriatric Hip Fracture Patients Is Associated With Increase in Mortality and Complication Rate: A Study of 27,058 Patients Using the National Trauma Data Bank
Objective: 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). Design: Retrospective cohort study. Setting: Level I–IV trauma centers in the United States. Patients/Participants: All patients ≥65 years of age who underwent surgery for hip fracture from 2011 to 2013. Intervention: Time to surgery of 48 hours from admission. Main outcome measurements: Primary outcome was mortality by hospital discharge. Secondary outcomes were complications ...
Source: Journal of Orthopaedic Trauma - September 23, 2021 Category: Orthopaedics Tags: Original Article Source Type: research

Comparison of Extramedullary and Intramedullary Implants for Stable Intertrochanteric Fractures: Have We Swung the Pendulum Too Far the Other Way?
DISCUSSION: Our study found that extramedullary implants were associated with lower transfusions rates, lower readmissions, and better patient disposition. We recommend surgeons to consider extramedullary implants when treating stable IT fractures, especially if the patient is anemic or at high risk for hospital readmission.LEVEL OF EVIDENCE: Level III. Retrospective cohort study.PMID:35196299 | DOI:10.5435/JAAOS-D-21-00657
Source: The Journal of the American Academy of Orthopaedic Surgeons - February 23, 2022 Category: Orthopaedics Authors: Aria Darius Darbandi Ghulam H Saadat Ahmed Siddiqi Bennet A Butler Source Type: research

No Difference in Blood Loss and Risk of Transfusion Between Patients Treated with One or Two Doses of Intravenous Tranexamic Acid After Simultaneous Bilateral TKA
CONCLUSION: The findings of this study suggest that a single dose of intravenous TXA may be adequate to control excessive blood loss and reduce blood transfusion in simultaneous bilateral TKA. Despite its short half-life, TXA still appears to be effective in this demanding procedure without requiring prolonged plasma concentrations obtained from multiple doses. Additional high-quality studies are still needed to determine the most appropriate dosing regimen.LEVEL OF EVIDENCE: Level III, therapeutic study.PMID:35302971 | DOI:10.1097/CORR.0000000000002037
Source: Clinical Orthopaedics and Related Research - March 18, 2022 Category: Orthopaedics Authors: Jeffrey M Wilde Steven N Copp Kace A Ezzet Adam S Rosen Richard H Walker Julie C McCauley Audree S Evans William D Bugbee Source Type: research

A Tool to Estimate Risk of 30-day Mortality and Complications After Hip Fracture Surgery: Accurate Enough for Some but Not All Purposes? A Study From the ACS-NSQIP Database
CONCLUSION: The models of mortality and complications we developed may be accurate enough for some uses, especially personalizing informed consent and shared decision-making with patient-specific risk estimates. However, the high false discovery rate suggests the models should not be used to restrict access to surgery for high-risk patients. Deciding which measures of accuracy to prioritize and what is "accurate enough" depends on the clinical question and use of the predictions. Discrimination and calibration are commonly used measures of overall model accuracy but may be poorly suited to certain clinical questions and ap...
Source: Clinical Orthopaedics and Related Research - July 28, 2022 Category: Orthopaedics Authors: Alex H S Harris Amber W Trickey Hyrum S Eddington Carolyn D Seib Robin N Kamal Alfred C Kuo Qian Ding Nicholas J Giori Source Type: research

Pharmacological properties and mechanisms of Notoginsenoside R1 in ischemia-reperfusion injury
Chin J Traumatol. 2022 Jul 3:S1008-1275(22)00068-2. doi: 10.1016/j.cjtee.2022.06.008. Online ahead of print.ABSTRACTPanax notoginseng is an ancient Chinese medicinal plant that has great clinical value in regulating cardiovascular disease in China. As a single component of panax notoginosides, notoginsenoside R1 (NGR1) belongs to the panaxatriol group. Many reports have demonstrated that NGR1 exerts multiple pharmacological effects in ischemic stroke, myocardial infarction, acute renal injury, and intestinal injury. Here, we outline the available reports on the pharmacological effects of NGR1 in ischemia-reperfusion (I/R) ...
Source: Chinese Journal of Traumatology - August 3, 2022 Category: Orthopaedics Authors: Ting Zhu Qi Wan Source Type: research

Waiting more than 24 hours for hip fracture surgery is associated with increased risk of adverse outcomes for sicker patients: a nationwide cohort study of 63,998 patients using the Swedish Hip Fracture Register
CONCLUSION: The associations between waiting > 24 hours for hip fracture surgery and AF, CHF, and acute ischemia suggest that shorter waiting time may reduce adverse outcomes for the sicker patients.PMID:36847752 | DOI:10.2340/17453674.2023.9595
Source: Acta Orthopaedica - February 27, 2023 Category: Orthopaedics Authors: Katarina Greve Stina Ek Erzs ébet Bartha Karin Modig Margareta Hedstr öm Source Type: research

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