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

Petrology and Chemistry of Recent Lavas in the Northern Marianas: Implications for the Origin of Island Arc Basalts

Petrologic and chemical data are presented for samples from five volcanically active islands in the northern Marianas group, an intra-oceanic island arc. The data include microprobe analyses of phenocryst and xenolith assemblages, whole rock major and trace element chemistry including REE, and Sr isotope determinations (87Sr/86Sr=0.7034±0.0001). Quartz-normative basalt and basaltic andesite are the most abundant lava types. These are mineralogically and chemically similar to the mafic products of other intra-oceanic islands arcs. It is suggested, however, that they are not typical of the ‘island arc tholeiitic’ series, having Fe enrichment trends and K/Rb, for example, more typical of calc-alkaline suits. Major and trace element characteristics, and the presence of cumulate xenoliths, indicate that extensive near surface (\u3c 3 Kb) fractionation has occurred. Thus, even least fractionated basalts have low abundances of Mg, Ni and Cr, and high abundances of K and other large cation, imcompatible elements, relative to ocean ridge tholeiites. However, abundances of REE and small cation lithophile elements, such as Ti, Zr, Nb, and Hf are lower than typical ocean ridge tholeiites. The REE data and Sr isotope compositions suggest a purely mantle origin for the Marianas island arc basalts, with negligible input from subducted crustal material. Thus, subduction of oceanic lithosphere may not be a sufficient condition for initiation of island arc magmatism. Intersection of the Benioff zone with an asthenosphere under appropriate conditions may be requisite. Element ratios and abundances, combined with isotopic data, suggest that the source for the Marianas island arc basalts is more chondritic in some respects, and less depleted in large cations than the shallow (?) mantle source for ocean ridge tholeiites