We aimed to evaluate the short-term functional and radiological outcomes of the minimally invasive fixation of three-part proximal humerus fractures without using calcar screws. Twenty patients were treated with the minimally invasive approach using locking plate-screws. The relationship between the cephalo-diaphyseal angles and the functional outcomes were evaluated. The mean follow-up time were 22.7 months. The mean Constant-Murley score of the patients was 83.7. The modified Constant-Murley score was excellent in 16 and good in four patients. A statistically significant difference was detected between cephalo-diaphyseal angles. Osteosynthesis with minimally invasive plate-screw and deltoid splitting application is encouraging with its satisfactory results in three-part fractures of the humerus; however, the total complication rate of 35% should not be ignored. In addition, in order to prevent a significant varus collapse and angular loss, the fracture subgroups should be studied in detail and additional measures should be taken based on the fracture type.
Proximal femoral nail (PFNA) and hemiarthroplasty are the two most frequently used methods in the surgical treatment of intertrochanteric femur fractures. The study aimed to determine the priority choice for surgical treatment in elderly patients (over 80 years old). Methods: Patients treated for intertrochanteric femur fractures between 2012 and 2017 were retrospectively analyzed. Patients aged 80 years and over who were treated with hemiarthroplasty or PFNA were included in the study. The length of the operation, the need for postoperative intensive care, Harris Hip Score, postoperative complications, and mortality rates in the first year were compared. Results: A total of 120 patients with intertrochanteric femur fractures older than 80 years were evaluated. There were 43 patients (35.8) in the hemiarthroplasty group and 77 (64.2) in the PFNA group. No significant differences were found between the two groups in terms of mortality, need for postoperative intensive care, Harris Hip Score, and postoperative complications in the first year. While the median operation time was 45 minutes (IQR 40-50) in the PFNA group, it was 80 minutes (IQR 75-85) in the hemiarthroplasty group (p <0.001). The length of the operation was shorter in the PFNA group. Conclusion: In elderly patients, there were no significant differences between the surgical treatment modalities as hemiarthroplasty and PFNA in treating intertrochanteric fractures considering the postoperative outcomes and mortality rates within the first year. However, shorter operation time might be an advantage of PFNA.
Medical doctors of today are challenged with increasingly large volumes of high-dimensional, heterogeneous, and unstructured data from various sources that pose significant challenges for manual analysis. However, this unstructured data is mainly vital for decision making but there exists a shortage of intelligent tools to extract the hidden knowledge. Given these facts, the application of machine learning methods in healthcare is a growing phenomenon. This paper explores machine learning approaches for interpreting large quantities of continuously acquired, multivariate patient-based medical laboratory data, in intensive care unit (ICU) settings. The research hypothesizes that
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