Comparison of Side Effects and Cost Effectiveness of Proximal Femur Locking Compression Plate with Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

Background: The sub-trochanteric (ST) fracture is relatively common and does not have a single treatment. It can be repaired in a variety of ways each of which has different complications as well as different treatment costs. Accordingly, the purpose of this research is comparing the side effects and cost effectiveness of proximal femur locking compression plate (PFLCP) with intramedullary nailing in the treatment of sub-trochanteric fractures. Method: This cross-sectional study was performed on 56 patients with ST fracture who were referred to Firoozgar hospital between January 2014 and December 2018. Two methods were used for treatment of fractures by physicians. The method of surgery for group A was the PFLCP while for group B it was the nailing. The postoperative complications and treatment costs were evaluated and recorded in a specific sheet for each patient. Result: In this study, of the 56 eligible patients examined, 49 (87.5%) of the participants were male. The mean age of the all patients was 42.7±16.2 years. The motion restriction in group A was significantly (P=0.041) milder than group B. So, the total cost of treatment in group A was significantly (P=0.045) lower than in group B. Also, the results of logistic regression model revealed that sex and age could significantly reduce the incidence of side effects with males [OR=0.851] and those younger than 30 years [OR=1.629] having fewer side effects. Conclusion: Use of a PFLCP first causes fewer side effects and less motion restriction after operation. The cost of treatment is lower and it is more cost-effective

Comparison of Side Effects and Cost Effectiveness of Proximal Femur Locking Compression Plate with Intramedullary Nailing in the Treatment of Sub-Trochanteric Fractures

Background: The sub-trochanteric (ST) fracture is relatively common and does not have a single treatment. It can be repaired in a variety of ways each of which has different complications as well as different treatment costs. Accordingly, the purpose of this research is comparing the side effects and cost effectiveness of proximal femur locking compression plate (PFLCP) with intramedullary nailing in the treatment of sub-trochanteric fractures. Method: This cross-sectional study was performed on 56 patients with ST fracture who were referred to Firoozgar hospital between January 2014 and December 2018. Two methods were used for treatment of fractures by physicians. The method of surgery for group A was the PFLCP while for group B it was the nailing. The postoperative complications and treatment costs were evaluated and recorded in a specific sheet for each patient. Result: In this study, of the 56 eligible patients examined, 49 (87.5%) of the participants were male. The mean age of the all patients was 42.7±16.2 years. The motion restriction in group A was significantly (P=0.041) milder than group B. So, the total cost of treatment in group A was significantly (P=0.045) lower than in group B. Also, the results of logistic regression model revealed that sex and age could significantly reduce the incidence of side effects with males [OR=0.851] and those younger than 30 years [OR=1.629] having fewer side effects. Conclusion: Use of a PFLCP first causes fewer side effects and less motion restriction after operation. The cost of treatment is lower and it is more cost-effective

Simultaneous bilateral rupture of patellar tendons in diabetic hemodialysis patient: A case report

Background: Bilateral rupture of the patellar tendon is a very rare injury, which takes place in relation to chronic systemic diseases. These injuries are known causes. Some of these causes are particular in patellar tendon rupture and another are in quadriceps tendon rupture. Case presentation: 70-year-old diabetic man with simultaneous bilateral patellar tendon disruption of proximal insertion without trauma, receiving long-term hemodialysis. Conclusions: In the present study, we report a case of patellar tendon rupture that has two differences with literature: first, renal failure is a known risk factor for quadriceps tendon rupture, and secondly, the prevalent age of patellar tendon rupture is less than 40 years. Clinical picture, diagnosis, pathogenesis and treatment are discussed. Finally, the literature is reviewed based on previous studies

Experimental investigation of the discharge coefficient of labyrinth weirs with asymmetric cycles

This  study investigated the discharge coefficient in asymmetric rectangular labyrinth weirs. A dimensional analysis was carried out which showed that the discharge coefficient is a function of dimensionless parameters, such as the ratio of asymmetric widths of left and right cycles (wL/wR), the ratio of the total hydraulic head to the weir height (Ht/P), and the weir length ratio (B/wavg). The experimental results for the discharge coefficient were found to decline as wL/wR increased or B/wavg decreased. For wL/wR = 1.19, the ratio B/wavg = 2.76 improves the discharge coefficient by nearly 12.7% compared to B/wavg = 3.1. For wL/wR = 1.42, the ratio B/wavg = 2.76 improves the discharge coefficient by nearly 34.2% compared to B/wavg = 3.1. For wL/wR = 1.70, the ratio B/wavg = 2.76 improves the discharge coefficient by nearly 30% compared to B/wavg = 3.1

Aspirin is as effective as low molecular weight heparins in preventing symptomatic venous thromboembolism following arthroscopic anterior cruciate ligament reconstruction

Abstract Objective The optimal agent for thromboprophylaxis following arthroscopic anterior cruciate ligament reconstruction (ACLR) remains unclear, particularly in patients with a low baseline risk for venous thromboembolism (VTE). This retrospective cohort study aims to compare the effectiveness and safety of aspirin versus low molecular weight heparins (LMWHs) in this specific patient population. Methods We analyzed data from patients who underwent ACLR between March 2016 and March 2021, focusing on those with a low risk for VTE. High-risk individuals, identified by factors such as cardiac disease, pulmonary disease, diabetes mellitus, previous VTE, inflammatory bowel disease, active cancer, and a BMI > 40, were excluded (n = 33). Our approach included a thorough review of medical charts, surgical reports, and pre-operative assessments, complemented by telephone follow-up conducted over a 3-month period by a single investigator. We assessed the incidence of symptomatic VTE, including deep vein thrombosis and pulmonary thromboembolism, as the primary outcome. The secondary outcomes included to complications related to the surgery and thromboprophylaxis. Statistical analysis included descriptive statistics, univariate logistic regression models, and calculations of incidence rates. Result In our study, 761 patients (761 knees) were included, with 458 (60.18%) receiving aspirin and 303 (39.82%) receiving LMWH. The two groups showed no significant differences in demographic factors except for age. The incidence of VTE was reported at 1.31% (10 individuals). Specifically, five patients in the aspirin group (1.09%) and five patients in the LMWH group (1.65%) developed a symptomatic VTE event (p = 0.53). Additionally, the two groups did not significantly differ in terms of other complications, such as hemarthrosis or surgical site infection (p > 0.05). Logistic regression analysis revealed no statistically significant difference in VTE risk between the two groups. Conclusion This study, focusing on isolated ACLR in patients with a low baseline risk for venous thromboembolism, demonstrated that aspirin is equally effective as low molecular weight heparins for VTE prophylaxis following this surgery. Level of Evidence II

Additional file 1 of Aspirin is as effective as low molecular weight heparins in preventing symptomatic venous thromboembolism following arthroscopic anterior cruciate ligament reconstruction

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