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

From Initial Deterrence to Longterm Escalation: Short-Custody Arrest for Poverty Ghetto Domestic Violence

Persons arrested for misdemeanor domestic violence are held in custody for widely varying lengths of time. To test the effects of this variance, we randomly assigned short (X̄= 2.8 hours), full (X̄= 11.1 hours), and no arrests (warning only) to a sample of 1,200 cases with predominantly unemployed suspects concentrated in black ghetto poverty neighborhoods in Milwaukee. Victim interviews and one official measure showed that short arrest had a substantial initial deterrent effect relative to the warning group. Longer term follow‐up and before‐after analysis, however, found neither arrest group reflected any deterrence. On the most comprehensive official measure, short arrest consistently showed significantly higher long‐term recidivism than no arrest. Its deterrent effect ended at 30 days, but its criminogenic effect was significant after one year. We conclude that short‐custody arrests for domestic violence in poverty ghetto areas may pose a dilemma between short‐ and long‐term crime control, but longer custody arrests have no clear long‐term effect in either direction