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

Clusters, dispersion and the spaces in between: for an economic geography of the banal

While the geographical clustering of economic activities remains an enduring feature of the industrial landscape and a perennial source of theoretical and empirical interest, the geographical scale at which external economies and agglomerative effects are now claimed to operate is on the increase. Such changes in the spatial form and potential causes of agglomeration over time pose important questions. How should we analyse changes in the spatial extent of external economies and agglomerative effects? Ought we to pay more attention to the sorts of banal economic spaces thrown up as part of increasingly diffuse forms of agglomeration? To answer the first of these questions, it is noted how economists and geographers have explained agglomerations often in the rather singular and invariant categories of pecuniary and Marshallian externalities respectively. This paper considers the relevance of neo-Marshallian analysis and the concept of 'borrowed size'--as variations on these classical principles--to an analysis of the mobility and fixity of external economies and contemporary diffuse forms of agglomeration. Whilst reflecting important changes in the spatial extent of industrial agglomerations, they are insufficiently sensitive to the interaction of different types of external economies with different scale-dependencies. In answering the second question, it is noted that part of the value of analysing the economic basis of largely overlooked 'banal' intermediate places lies in what they may reveal about the functioning of diffuse forms of agglomeration.<br/