Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Global-scale tidal variability during the PSMOS campaign of June-August 1999: interaction with planetary waves

During the PSMOS Global-scale tidal variability experiment campaign of June 1-August 31, 1999, a network of radars made measurements of winds, waves and tides in the mesosphere/lower-thermosphere region over a wide range of latitudes. Clear evidence was found that fluctuations in tidal amplitudes occur on a global scale in both hemispheres, and that at least some of these fluctuations are periodic in nature. Modulation of the amplitude of the 12 h tide was particularly evident at periods of 10 and 16 days, suggesting a non-linear interaction with planetary waves of those periods to be responsible. In selected cases, the secondary waves predicted from non-linear theory could be identified and their zonal wave numbers determined. In some, but not all, cases the longitudinal structure of the secondary waves supports the theory of planetary-wave/tidal interaction being responsible for the observed tidal modulation. It was noted also that beating between a 12.4-lunar and the solar tide could produce a near 16-day modulation of the 12 h tide amplitude that is frequently observed in late summer

Global-scale tidal structure in the mesosphere and lower thermosphere during the PSMOS campaign of June-August 1999 and comparisons with the global-scale wave model

Observations of mean winds and semidiurnal and diurnal tides in the mesosphere/lower-thermosphere (MLT) region were made during the 3-month Planetary-Scale Mesopause Observing System Summer 1999 campaign. Data from 22 ground-based radars (and from two other instruments with measurements for the same period but in 1998) allow us to investigate the ability of the GSWM-00 to simulate the solar tides in the mesopause region (90-95 km). Here we have found that the GSWM-00 provides an increasingly reasonable estimate of most of the tidal characteristics in the MLT region. However, the representation of the 24 h tide appears superior to that of the 12 h tide. Some of these discrepancies are studied in detail. In particular, the observations reveal significant 12 h tidal amplitudes at high latitudes in the Northern Hemisphere summer. There is evidence for relation between the longitudinal variability of the mean zonal wind and the tidal characteristics seen from the radar wind measurements in the summer middle latitudes and a quasi-stationary planetary wave with zonal wave number one

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar