The Effectiveness of a Geriatric Hip Fracture Clinical Pathway in Reducing Hospital and Rehabilitation Length of Stay and Improving Short-Term Mortality Rates

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Selective upper endoscopy for foreign body ingestion in children: an evaluation of management protocol after 282 cases

Purpose: Foreign body ingestion is a common problem in both children and adults. This study aims to evaluate a management protocol where endoscopic examination was only selectively used after routine direct laryngoscopy to minimize patient discomfort and the need for general anesthesia in children. Method: A management protocol for foreign body ingestion based on symptoms was introduced in 1998 and records of children admitted to a university-affiliated hospital between January 1999 and October 2005 with suspected foreign body ingestion were evaluated. Symptoms, radiologic and endoscopic findings, and outcome were reviewed. Results: A total of 282 patients were admitted. The mean age of patients was 5.75 years (range, 9 months to 17 years). There were 167 boys and 115 girls. Based on our protocol, 84 (29.8%) patients required an upper endoscopy. Fish bones were most commonly involved (68.8%). Foreign bodies, which were either removed or dislodged, were found during upper endoscopy in only 25 (8.8%) patients overall. All patients had an uneventful outcome. No complications or mortalities were encountered. There were no readmissions for those who did not undergo endoscopic examination. Conclusion: It is safe to selectively perform upper endoscopy depending on symptoms when managing children with foreign body ingestion. © 2006 Elsevier Inc. All rights reserved.postprin

Assessment of postoperative short-term and long-term mortality risk in Chinese geriatric patients for hip fracture using the Charlson comorbidity score

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Antibiotic prophylaxis after total joint replacements

Objectives: To review the latest evidence on antibiotic prophylaxis for patients with total joint replacements to prevent prosthesis infections. Data sources: Literature search of Medline and PubMed until June 2009. Study selection: Studies of patients with total joint replacements from around the world, studies concerning antibiotic prophylaxis, as well as chemoprophylaxis guidelines from orthopaedic associations were searched. Data extraction: Literature review, original articles, case reports, best practice guidelines. Data synthesis: With the rising incidence of patients with total joint replacements, subsequent deep infection of the implants is a rare but dreaded complication which has immense physiological, psychological, financial, and social implications. Guidelines from urologists, gastroenterologists, and dental surgeons attempt to identify high-risk patients who may be more susceptible to prosthetic joint infections. These patients are provided with prophylactic antibiotics before any invasive procedure that may cause bacterial seeding to prosthetic joints. Most orthopaedic associations around the world adopt a similar policy to provide prophylaxis to cover any anticipated chance of bacteraemia. The American Association of Orthopaedic Surgeons adopts the most cautious approach in which all patients with total joint replacements who undergo any procedure that breaches a mucosal surface receive prophylactic antibiotics. Conclusion: The guidelines from the American Association of Orthopaedic Surgeons seem to have an all-encompassing policy when it comes to providing prophylactic antibiotics. Nonetheless, physicians must still exercise their judgement and customise the treatment to each patient. The benefits of prophylactic antibiotics must be balanced against the risks of drug side-effects and the emergence of antibiotic resistance.published_or_final_versio

Arthroscopic Removal of Suprapatellar Fibroma of Tendon Sheath

Fibroma of tendon sheath (FTS) is a rare dense fibrous benign tumor that majorities are found over the tendons or tendon sheaths of limbs, with predilection in order starting with fingers, hands, wrists, and other parts.1 Almost 80% of tendon sheath fibromas are found over hands and wrists.2 The typical morphological feature is a solid nodule that is painless and slow growing in nature. Fibromas of tendon sheath rarely arise from knee joints. To our best knowledge, less than 20 such cases have been reported, and none of them was a Chinese patient. We present a case of intra-articular fibroma of tendon sheath of the knee that was excised arthroscopically.published_or_final_versio

Infection after fracture osteosynthesis – Part II: Treatment

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Restoration of Humeral Bone Stock Two Years After Internal Fixation of a Periprosthetic Fracture with a Loose Stem

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Infection after fracture osteosynthesis – Part I: Pathogenesis, diagnosis and classification

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Seasonal Variation in Hip Fracture Mortality

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Is It Time to Phase Out the Austin Moore Hemiarthroplasty? A Propensity Score Matched Case Control Comparison versus Cemented Hemiarthroplasty

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