检索结果-南通市图书馆

Assessment of the effectiveness of weight-adjusted antibiotic administration,for reduced duration,in surgical prophylaxis of primary hip and knee arthroplasty

引用

World Journal of Orthopedics 2024年第2期15卷 170-179页

作者： tosan okoro Michael Wan Takura Darlington Mukabeta Ella Malev Marketa Gross Claudia Williams Muhammad Manjra Jan Herman Kuiper John Murnaghan Department of Arthroplasty Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestry SY107AGUnited Kingdom School of Medicine Keele UniversityStaffordshire ST55BGUnited Kingdom St Joseph’s Health Centre Unity Health TorontoToronto M6R 1B5Canada Department of Arthroplasty The Royal London HospitalBarts Health NHS TrustLondon E11BBUnited Kingdom Department of Arthroplasty Sunnybrook Holland Orthopaedic and Arthritis CentreToronto M4Y 1H1Canada Institute for Science and Technology in Medicine Keele UniversityStaffordshire ST51BGUnited Kingdom

BACKGROUND Prophylactic antibiotics have significantly led to a reduction in the risk of postoperative surgical site infections(SSI)in orthopaedic *** aim of using antibiotics for this purpose is to achieve serum and tissue drug levels that exceed,for the duration of the operation,the minimum inhibitory concentration of the likely organisms that are *** antibiotics reduce the rate of SSIs in lower limb arthroplasty from between 4%and 8%to between 1%and 3%.Controversy,however,still surrounds the optimal frequency and dosing of antibiotic *** To evaluate the impact of introduction of a weight-adjusted antibiotic prophylaxis regime,combined with a reduction in the duration of administration of post-operative antibiotics on SSI incidence during the 2 years following primary elective total hip and knee arthroplasty METHODS Following ethical approval,patients undergoing primary total hip arthroplasty(THA)/total knee arthroplasty(TKA)with the old regime(OR)of a preoperative dose[cefazolin 2 g intravenously(IV)],and two subsequent doses(2 h and 8 h),were compared to those after a change to a new regime(NR)of a weight-adjusted preoperative dose(cefazolin 2 g IV for patients120 kg)and a post-operative dose at 2 *** primary outcome in both groups was SSI rates during the 2 years *** A total of n=1273 operations(THA n=534,TKA n=739)were performed in n=1264 *** was no statistically significant difference in the rate of deep(OR 0.74%(5/675)vs NR 0.50%(3/598);fishers exact test P=0.72),nor superficial SSIs(OR 2.07%(14/675)vs NR 1.50%(9/598);chi-squared test P=0.44)at 2 years *** propensity score weighting and an interrupted time series analysis,there was also no difference in SSI rates between both groups[RR 0.88(95%CI 0.61 to 1.30)P=0.46].CONCLUSION A weight-adjusted regime,with a reduction in number of post-operative doses had no adverse impact on S

关键词： Antibiotics Weight-adjusted Hip and knee arthroplasty Surgical site infection

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Fibula pro-tibia vs standard locking plate fixation in an ankle fracture saw bone model

引用

World Journal of Orthopedics 2021年第8期12卷 548-554页

作者： tosan okoro Kar Hao Teoh Hiro Tanaka Department of Arthroplasty Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestry SY107AGUnited Kingdom Department of Orthopaedic Surgery Princess Alexandra Hospital NHS TrustHarlow CM201QXUnited Kingdom Department of Orthopaedics Royal Gwent HospitalNewport NP202UBUnited Kingdom

BACKGROUND Locking plate fixation in osteoporotic ankle fractures may fail due to cut-out or metalwork *** pro-tibia fixation was a technique prior to the advent of locking plates that was used to enhance stability in ankle fractures by achieving tri or tetra-cortical *** locking plates,the strength of this fixation construct can be further *** is lack of evidence currently on the merits of tibiapro-fibula augmented locking plate fixation of unstable ankle *** To assess if there is increased strength to failure,in an ankle fracture saw bone model,with a fibula pro-tibia construct when compared with standard locking plate *** Ten osteoporotic saw bones with simulated supination external rotation injuries were *** saw bones were fixed with standard locking plates whilst the other 5 saw bones were fixed with locking plates in a fibula pro-tibia *** fibula pro-tibia construct involved fixation with 3 consecutive locking screws applied across 3 cortices proximally from the level of the *** fixations were tested in axial external rotation to failure on an electromagnetic test frame(MTS 858 Mini-Bionix test machine,MTS Corp,Eden Praire,MN,United States).Torque at 30 degrees external rotation,failure torque,and external rotation angle at failure were compared between both groups and statistically *** The fibula pro-tibia construct demonstrated a statistically higher torque at 30 degrees external rotation(4.421±0.796 N/m vs 1.451±0.467 N/m;t-test P=0.000),as well as maximum torque at failure(5.079±0.694N/m vs 2.299±0.931 N/m;t-test P=0.001)compared to the standard locking plate *** fibula pro-tibia construct also had a lower external rotation angle at failure(54.7±14.5 vs 67.7±22.9).CONCLUSION The fibula pro-tibia locking plate construct demonstrates biomechanical superiority to standard locking plates in fixation of unstable ankle fractures in this saw bone ***

关键词： Unstable ankle fractures Pro-tibia fixation Improved stability Simulated biomechanical analysis Osteoporotic fractures Ankle injuries

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Clinical outcome of open ankle fractures in patients above 70 years of age

引用

World Journal of Orthopedics 2023年第7期14卷 554-561页

作者： Wajiha Zahra Mina Seifo Paul Cool David Ford tosan okoro Department of Trauma and Orthopedics Royal Shrewsbury HospitalShrewsbury SY38XQUnited Kingdom Department of Trauma and Orthopedics Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestry SY107AGUnited Kingdom Department of Trauma and Orthopedics Keele UniversityStafford ST55BGUnited Kingdom

BACKGROUND Open fractures of the ankle are complex injuries requiring multidisciplinary input and are associated with significant morbidity and ***,data on the clinical outcomes of open ankle fracture management in patients older than 70 is *** To evaluate the clinical outcomes following open ankle fracture management in patients older than *** secondary aim is to look at predictors of poor *** Following local research and audit department registration,22 years of prospectively collated data from an electronic database in a district general hospital were *** patients older than 70 years of age with an open ankle fracture requiring surgical intervention were *** information,the nature,and the number of surgical interventions were ***,including surgical site infection(SSI),venous thromboembolic events(VTEs)during hospital stay,and mortality rate,were *** A total of 37 patients were identified(median age:84 years,range:70-98);n=30 females median age:84 years,range:70-97);n=7 males median age:74 years,range:71-98))who underwent surgical intervention after an open ankle *** patients developed SSIs(43%).Superficial SSIs(n=8)were managed without surgical intervention and treated with antibiotics and regular dressing *** SSIs(n=8;20%)required a median of 3(range:2-9)surgical interventions,with four patients requiring multiple washouts and one patient having metalwork *** incidence was 5%during the hospital *** patients died within 30 d,and mortality at one year was 19%.The 10-year mortality rate was 57%.The presence of a history of stroke,cancer,or prolonged inpatient stay was found to be predictive of lower survivorship in this population(log-rank test:cancer P=0.008,stroke P=0.001,length of stay>33 d P=0.015).The presence of a cardiac history was predictive of wound complications(logistic regression,P=0.045).Age,number of operations,and di

关键词： Fragility fracture Open fracture Clinical outcome Mortality Infection Survival

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：