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

Happy re-birthday : weight loss surgery and the 'new me'

Weight loss surgery (WLS) is one element of the contemporary 'war on obesity'. Those who undergo surgery frequently refer to it in terms of their 're-birth'. This article considers what is signified by the discourse of re-birth, and asks what material and discursive work is required to support the identity of the post-surgical 'new me'. The article argues that rather than referring to the visibly transformed body, the discourse of re-birth signals the reconfiguration of the self as a disciplined subject who is able to exercise control and restraint over consumption. This enables those undergoing WLS to position themselves as participants in the 'war on obesity', rather than its denigrated objects. However, this identity claim is difficult to claim consistently and requires the acquisition of both familiar and novel disciplinary techniques oriented towards the normalization of the post-WLS body, and which are body enabling and constraining

Lotus international : rivista di architettura

It is a peculiar fact that while the natural environment is one of geography\u27s key research and teaching foci, it is difficult to specify what the discipline\u27s distinctive contributions to environmental understanding are. In part, this is because geographical research on the environment remains theoretically and empirically diverse, indeed fragmented. In turn, this is a function of the fact that the precision of this putative focus is deceptive since the term environment is enormously. On the one side, physical geographers study the environment in their own subdisciplinary languages. On the other side, human geographers apply the tools of everything from Marxism to post-structuralism to make sense of environmental discourses and transformations

Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial

Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between Mar