Personalized hip joint kinetics during deep squatting in young, athletic adults

The goal of this study was to report deep squat hip kinetics in young, athletic adults using a personalized numerical model solution based on inverse dynamics. Thirty-five healthy subjects underwent deep squat motion capture acquisitions and MRI scans of the lower extremities. Musculoskeletal models were personalized using each subject's lower limb anatomy. The average peak hip joint reaction force was 274 percent bodyweight. Average peak hip and knee flexion angles were 107 degrees and 112 degrees respectively. These new findings show that deep squatting kinetics in the younger population differ substantially from the previously reported in vivo data in older subjects

Evaluation of cerclage wiring in the treatment of subtrochanteric fractures

Treatment of subtrochanteric fractures is challenging because of their typical displacement pattern. Use of circumferential cerclage wires can be added to intramedullary nailing to facilitate better anatomical reduction. Concerns exist regarding additional soft tissue damage and ischemia of the periosteum. The aim of this study was to assess the effect of cerclage on union and infection rates. The postoperative results of 115 patients over 11 years were retrospectively viewed. Twenty-three patients were treated with cerclage. The primary outcome measure was 'return to theatre for fixation failure'. There was no difference in reoperation rate or in infection rate. Average displacement of the lateral wall was larger (9mm vs 1,3mm) in the no-cerclage group (p=0,003). The mean duration of surgery in the cerclage group was 28 minutes longer (p=0.003). Cerclage wiring does not lead to higher re-operation, nor higher infection rates. The use of cerclage wire in open reduction is advocated when closed reduction is not satisfactory

Frailty as a predictor of mortality in the elderly emergency general surgery patient

Background: The number of surgical procedures performed in elderly and frail patients has greatly increased in the last decades. However, there is little research in the elderly emergency general surgery patient. The aim of this study was to assess the prevalence of frailty in the emergency general surgery population in Belgium. Secondly, we examined the length of hospital stay, readmission rate and mortality at 30 and 90 days. Methods: We conducted a prospective observational study at Ghent University Hospital. All patients older than 65 admitted to a general surgery ward from the emergency department were eligible for inclusion. Primary endpoint was mortality at 30 days. Secondary outcomes were mortality at 90 days, readmissions and length of stay. Cross-sectional observations were performed using the Fisher exact test, Mann-Whitney U-test, or one-way ANOVA. We performed a COX multivariable analysis to identify independent variables associated with mortality at 30 and 90 days as well as the readmission risk. Results: Data were collected from 98 patients in a four-month period. 23.5% of patients were deemed frail. 79% of all patients underwent abdominal surgery. Univariate analyses showed that polypharmacy, multimorbidity, a history of falls, hearing impairment and urinary incontinence were statistically significantly different between the non-frail and the group. Frail patients showed a higher incidence for mortality within 30 days (9% versus 1.3% (p = .053)). There were no differences between the two groups for mortality at 90 days, readmission, length of stay and operation. Frailty was a predictor for mortality at 90 days (p = .025) (hazard ratio (HR) 10.83 (95% CI 1.34-87.4)). Operation (p = .084) (HR 0.16 (95% CI 0.16-1.29)) and the presence of chronic cardiac failure (p = .049) (HR 0.38 (95% CI 0.14-0.99)) were protective for mortality at 90 days. Conclusion: Frailty is a significant predictor for mortality for elderly patients undergoing emergency abdominal/general surgery

Personalized hip joint kinetics during deep squatting in young, athletic adults

The goal of this study was to report deep squat hip kinetics in young, athletic adults using a personalized numerical model solution based on inverse dynamics. Thirty-five healthy subjects underwent deep squat motion capture acquisitions and MRI scans of the lower extremities. Musculoskeletal models were personalized using each subject's lower limb anatomy. The average peak hip joint reaction force was 274 percent bodyweight. Average peak hip and knee flexion angles were 107 degrees and 112 degrees respectively. These new findings show that deep squatting kinetics in the younger population differ substantially from the previously reported in vivo data in older subjects