The plateau-patella angle, a new method of evaluating patellar height, can be measured rapidly with use of either a goniometer or digital software. Its range is easy to remember, it is reliably reproduced, and it correlates well with traditional methods. It is thus a valid and easy alternative method for the evaluation of patellar height.

The patients who are identified with a higher risk of a longer length of stay may warrant better education and more focused perioperative care when designing care pathways and allocating health-care resources.

Background: Optimal timing for surgical stabilization of the fractured spine is controversial. Early stabilization facilitates mobilization and theoretically reduces associated complications. Methods:We identified consecutive patients without neurologic injury requiring stabilization surgery for a spinal fracture at an academic tertiary-care hospital over a 12-year period. Incidences of postoperative complications were prospectively evaluated. We analyzed results based on the time elapsed before the final surgical stabilization procedure. Multivariate analyses were performed to explore the effects of potential confounders.Results: A total of 83 patients (60 men, 23 women; mean age 39.4 yr) met the eligibility criteria and were enrolled. The mean Injury Severity Score (ISS) was 27.1 (range 12.0-57.0); 35% of patients had a cervical fracture and 65% had a thoracolumbar fracture. No statistically significant associations were uncovered between time to surgical stabilization and age, ISS or comorbidities. Comparing patients stabilized after 24 hours with those stabilized within 24 hours, there was an almost 8-fold greater risk of a complication related to prolonged recumbency (p = 0.007). We observed similar effects for other types of complications. Delays of more than 72 hours had a negative effect on complication rates; these effects remained significant after multivariate adjustments for age, comorbidity and ISS. Conclusion:This study demonstrates a strong relation between timing of surgical stabilization of spinal fractures in multitrauma patients without neurologic injuries and complications. Further studies with larger samples may allow for better adjustment of potentially confounding factors and identify subgroups in which this effect is most pronounced.Contexte : Le moment optimal pour stabiliser chirurgicalement une fracture de la colonne soulève la controverse. Une stabilisation rapide facilite la mobilisation et réduit en théorie les complications connexes.Méthodes : Nous avons trouvé, pour une période de 12 ans, des patients consécutifs sans lésion neurologique qui ont dû subir une chirurgie de stabilisation à la suite d'une fracture de la colonne à un hôpital universitaire de soins tertiaires. Nous avons évalué prospectivement les incidences des complications postopératoires. Nous avons analysé les résultats en fonction du temps écoulé avant l'intervention de stabilisation chirurgicale finale. Nous avons procédé à des analyses multidimensionnelles pour explorer les effets de facteurs confusionnels possibles.Résultats : Au total, 83 patients (60 hommes et 23 femmes, âgés en moyenne de 39,4 ans) satisfaisaient aux critères d'admissibilité et ont été inscrits. Le score moyen de l'indice de gravité de la blessure (IGB) s'établissait à 27,1 (intervalle de 12,0 à 57,0); 35 % des patients avaient une fracture de la colonne cervicale et 65 %, une fracture au niveau thoracolombaire. Nous n'avons découvert aucun lien statistiquement significatif entre le temps écoulé avant la stabilisation chirurgicale et l'âge, ...