Epidemiology study, level III.

The zones for safe screw positioning are very narrow, making percutaneous screw fixation of the acetabulum a challenging procedure. The predefined angles for the most frequently positioned percutaneous screws may aid in preoperative planning, decrease operative and radiation times and help to increase safe insertion of screws.

This report describes the case of a young athlete, who presented with a painful foot and was eventually diagnosed with early-stage Mueller-Weiss syndrome (spontaneous osteonecrosis of the navicular) by MRI. As non-operative management was unsuccessful, a percutaneous decompression of the navicular was performed. The patient made a full recovery and was able to return to her previous level of sporting activity. Subsequent imaging showed complete remodelling of the bony architecture of the affected navicular.

Implementation of MTP resulted in earlier balanced transfusion. The difference between the FFP/PRBC ratios of the two types of resuscitations levelled by 24 h. The efficacy of component therapy delivery should be measured earlier than 24 h.

This study identified a large number of preventable errors for ICC insertion in trauma patients. Standardized institutional credentialing systems may be required to ensure adequate proficiency of trainees performing this procedure.

No abstract

Based on subjective assessments, trauma surgeons do not agree on the definition of polytrauma, with the subjective definition differing both within and across institutions.

Metaphyseal, proximally anchored uncemented stems for total hip arthroplasty provide bone preservation and decrease the incidence of proximal stress shielding and thigh pain. Our study investigated the clinical and radiological outcome of the DePuy Proxima™ short stem at a minimum of 7 years. Methods: Eighty-one consecutive patients (86 procedures) under the age of 70 undergoing primary total hip replacement at two arthroplasty centres were enrolled. Follow-up was clinical (Harris Hip Score (HHS), thigh pain and satisfaction) and radiological (subsidence, malalignment and loosening) at 6 months and yearly thereafter. Results: Average age was 50 (range 32-65) with 79% (68 of 86) being male. Preoperative diagnosis included primary osteoarthritis (OA) 36%, avascular necrosis of femoral head 51%, dysplasia 9% and post-traumatic OA 4%. HHS improved 51 points at latest follow-up (from 40 to 91). We had 3.5% (3 of 86) periprosthetic fractures, one requiring revision. We had one dislocation, no infections and no thigh pain. Malalignment rate (5 off neutral) was 12% (10 of 86), not affecting clinical results. Conclusion: Overall stem survival was over 97% at 7 years. The DePuy Proxima provides excellent clinical results at a minimum of 7 years post-operatively.