Pipkin type I fractures historically have required open treatment, with the potential-associated morbidity. Two cases of arthroscopic fracture fragment excision are described. These were completed using standard techniques and introducing the application of Steinman pins, through an accessory anterior portal, for capture of the fragment. Both the patients had satisfactory outcomes. We conclude that hip arthroscopy is a valuable option for the treatment of Pipkin I fractures.
Anterior bowing greater than 15 degrees is the most common malunion noted in this series of femur fractures that were nailed using FTN's. We conclude that final nail shoe tip orientation influences the likelihood of anterior bow deformity. The likelihood of large anterior bowing may be reduced if at least 1 of the nails is inserted with the tip pointing in an anterior direction. LEVEL OF EVIDENCE/CLINICAL RELEVANCE: Level III.
There was a statistically significant decrease in the occurrence of VAP with strict enforcement of a VAPP protocol, regardless of head AIS score. Although the difference in patients with a head AIS score <3 was not statistically significant, it was clinically meaningful, decreasing the already-low rate of VAP by half. Strict enforcement of VAPP protocols may be cost efficient for hospitals and prevent decreased reimbursement under the Medicare pay-for-performance strategies.
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