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

The effects of ferromagnesian components on the paragonite-muscovite solvus: a semiquantitative analysis based on chemical data for natural paragonite-muscovite pairs.

Chemical data for 139 natural paragonite-muscovite (Pg-Ms) pairs illustrate the effects of ferromagnesian components on the P-T-X topology of the Pg-Ms solvus. The pairs were selected on the basis of: reasonably accurate knowledge of the P-T conditions of formation; evidence for close approach to equilibrium at peak metamorphic conditions; exclusion of pairs in which paragonite contains more than 5 mol% margarite; and exclusion of pairs from polymetamorphic rocks that contain more than one set of cogenetic Pg-Ms pairs. Graphical analysis reveals considerable scatter in the data; nevertheless, it is evident that the muscovite limb of the solvus shifts markedly toward end-member muscovite with increasing pressure from approximately 7 kbar to 21 kbar. This shift is attributed to a pressure-induced increase of the ferromagnesian content of muscovite, which increases the size of the XII alkali site - to the effect that K is more readily accommodated than Na. The data also suggest that the paragonite limb of the solvus migrates slightly toward end-member paragonite with increasing pressure. Broadening of the Pg-Ms solvus with increasing pressure reflects increasingly nonideal Na-K mixing as the phengite content of muscovite increases. Due to the wide scatter of data for Pg-phengitic-Ms pairs, it is concluded that, at the present time, Pg-Ms solvus thermometry is only viable for quasibinary Pg-Ms pairs