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

Water quality in three potential drought refuges in an arid-land river: assessing habitat suitability for at-risk fish species

Drought is a common disturbance in arid-land streams and rivers. The survival of aquatic species depends on access to refuge habitats where water quality remains high. Over the past century, modified flow regimes and altered watershed and instream characteristics have led to the extinction and endangerment of numerous fish species endemic to the southwestern United States. We assessed the water quality of potential drought refuges in the Middle Rio Grande (MRG), with an emphasis on suitability for the endangered Rio Grande Silvery Minnow (RGSM). We examined three types of potential drought refuges: three agricultural return drain outfalls; three isolated pools that remained during streamflow intermittency; and a reach with perennial flow below an agricultural diversion dam. All potential refuges are known to contain RGSM and other fishes. Two out of three drain outfalls, one out of three isolated pools, and three out of ten kilometers of perennially wetted stream below a dam met basic water quality criteria necessary to support RGSM populations. These findings suggest that refuge habitability is context dependent, that generalizations regarding the suitability of a specific refuge type should be avoided, and that careful assessment is required to determine if a specific location will support fish assemblages. Although some areas may contain water, they may represent ecological traps if fish are exposed to poor water quality conditions compared to other potential refuge habitats