Abstract:
:Routine cross-matching places substantial demands on limited blood resources. The primary objective of this study was to identify patients with hip fractures at risk of transfusion, which may allow implementation of a more selective cross-matching policy. We also sought to determine the hemoglobin level that triggered a transfusion, the rate of urgent (intraoperative) transfusions, and these patients' characteristics. We reviewed 124 consecutive patients admitted with hip fractures. Patients' clinical and radiologic details, transfusion rates, timing of transfusion, and preoperative and postoperative hemoglobin were reviewed. Older age, low admission hemoglobin, and peritrochanteric fractures were identified as risk factors for transfusion. Eighty-six percent of patients who received transfusions had two or more risk factors, compared with 48% of the total population. The mean hemoglobin that triggered a transfusion was 7.8 g/dL. Although 30% (37/124) of patients received transfusions, only 5% (six of 124) received transfusions intraoperatively, and the majority of these patients (five of six) had at least two risk factors of transfusion. Routine cross-matching for patients with hip fractures requiring surgery can safely be converted to cross-matching on demand in all but high-risk patients. Restrictive cross-matching policies would improve costs in healthcare delivery and prevent unnecessary use of blood resources.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Dillon MF,Collins D,Rice J,Murphy PG,Nicholson P,Mac Elwaine Jdoi
10.1097/01.blo.0000173253.59827.7bsubject
Has Abstractpub_date
2005-10-01 00:00:00pages
201-6eissn
0009-921Xissn
1528-1132pii
00003086-200510000-00035journal_volume
439pub_type
杂志文章abstract::Dislocation after hip replacement occurs at an overall incidence of 2% to 3% and has significant cost and morbidity implications. Statistically increased incidence is observed in females and in the elderly, and after reoperation procedures. Specific causes include cup malrotation, trochanteric migration, and decreased...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The choice of surgical approach for THA remains controversial. Some studies suggest that the direct anterior approach (DAA) leads to less muscle damage than the miniposterior approach (MPA), but there is little high-quality evidence indicating whether this accelerates recovery, or whether this approach-which...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999.0000000000000112
更新日期:2018-02-01 00:00:00
abstract::The results of a dome-shaped osteotomy of the proximal third of the fifth metatarsal in patients with symptomatic bunionette deformity were reviewed. The series was comprised of eight patients (10 feet; mean age of patients, 21 years). The average followup was 30 months. All patients were free from pain at the fifth m...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200203000-00026
更新日期:2002-03-01 00:00:00
abstract::Complete open-talar dislocation irreducible by virtue of entrapment by the tibialis posterior and flexor digitorum longus tendons occurred in a 41-year-old woman. Two-year follow-up examination revealed no evidence of avascular necrosis. A cursory review of the literature suggests that recovery of a complete range of ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The effects of postoperative epidural infusions using local anesthetic and narcotic were assessed in reference to lower extremity blood flow. Nineteen patients who underwent unilateral total hip arthroplasty were randomly assigned to receive a postoperative epidural infusion of either 5 microg/ml fentanyl or 5 microg/...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1997-01-01 00:00:00
abstract::The clinical data, failure pattern, symptoms, roentgenographic findings, and failure mechanism of a series of 25 metal-backed patellar component failures are summarized. Diagnosis of implant failure was unknown prior to arthrotomy in seven of 25 cases (28%). Clinical findings and history were not helpful in making the...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract::Femoroacetabular impingement is a motion-based concept of conflict that occurs secondary to morphologic abnormalities of the proximal femur and/or acetabulum. Creating impingement-free motion through restoration of normal morphology serves as the goal of joint-preserving procedures. We retrospectively reviewed the sho...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0648-y
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Diffuse-type pigmented villonodular synovitis (PVNS) has a high local recurrence rate and as such can lead to erosive destruction of the involved joint. Multiple surgical modalities exist, but it is unknown which technique best minimizes local recurrence and surgical morbidity. QUESTIONS/PURPOSES:We compare...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-012-2589-8
更新日期:2013-03-01 00:00:00
abstract::Specialty boards serve the function of defining qualifications and issuing credentials to assure the public of the specialist's preparation and skill. Over the past 72 years, 23 such boards have been approved and now issue 31 different types of general specialty certificates and 57 types of subspecialty credentials. F...
journal_title:Clinical orthopaedics and related research
pub_type: 历史文章,杂志文章
doi:
更新日期:1990-08-01 00:00:00
abstract::Nonoperative treatment of patellofemoral pain has a long-standing tradition of success. I will discuss the scientific background and practical application of such treatment. Evaluation and treatment should include lower extremity flexibility, muscular control, and careful evaluation of tender structures. Avoiding pain...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-01 00:00:00
abstract:UNLABELLED:Fractures of the proximal humerus can be treated effectively but require proper characterization. None of the existing classifications intended to facilitate characterization have been satisfactory. We studied proximal humerus fractures using radiographs alone and radiographs plus computed tomography scans t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000205899.28856.98
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:Alternative dispute resolution (ADR) refers to techniques used to resolve conflicts without going to the courtroom. As healthcare and malpractice costs continue to rise, there is growing interest in tactics such as early apology, mediation, and arbitration in the medical arena. QUESTIONS/PURPOSES:(1) Why is...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2206-2
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-1935-6
更新日期:2011-12-01 00:00:00
abstract::Many situations in revision THA require the exchange of a PE liner in the setting of a well-fixed cementless acetabular shell. Unfortunately, a replacement liner is not always available, the locking mechanism of the metal shell may be damaged or incompatible with the desired liner, or the shell is malpositioned. Revis...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/01.blo.0000096805.78689.8b
更新日期:2003-12-01 00:00:00
abstract::To evaluate the effects of methotrexate (MTX) on the biology of a vascularized bone graft (VBG), a study of adult dogs was performed. Different protocols of treatment using MTX, with or without the administration of citrovorum rescue factor (CRF), were studied. A controlled experiment involving 18 dogs was performed t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-04-01 00:00:00
abstract::A large, well-encapsulated intraneural lipoma occurred within the sciatic nerve of a 34-year-old woman. In a review of the literature, significant differences were noted between the well-encapsulated and the diffusely infiltrative lipofibromatous hamartoma types of intraneural lipomas. The average age at the time of a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::The purpose of this investigation was to determine the effects of continuous passive motion (CPM) on the chondrogenic potential of autogenous osteoperiosteal grafts to repair major osteochondral defects. A 3.5-mm-wide circular full-thickness defect was drilled in one medial femoral condyle of 55 adolescent New Zealand...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-07-01 00:00:00
abstract::External fixation is the treatment of choice for fractures of the leg involving severe damage to the soft tissue. Each of the various patterns of application has advantages and disadvantages. Based on various biomechanical studies and clinical experience, the authors use a right-angle arrangement for the screws. If th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-09-01 00:00:00
abstract::The primary indication for arthroplasty of the hip is the elimination of pain and the restoration of function. This paper addresses the progression of developments leading to the present satisfactory attainment of this goal. Having achieved this goal, patients and surgeons have come to expect far more than the necessi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1985-11-01 00:00:00
abstract::Fifty years ago Albright contributed the following to understanding osteoporosis: (1) He recognized it as a deficiency of formation, not of mineralization of bone matrix; (2) he observed that 40 of 42 patients with osteoporosis before age 65 were women past menopause or young women postoophorectomy; (3) he concluded t...
journal_title:Clinical orthopaedics and related research
pub_type: 传,历史文章,杂志文章
doi:
更新日期:1991-08-01 00:00:00
abstract::An aggregate of biodegradable beta-tricalcium phosphate and bone morphogenetic protein (BMP/TCP) induces the differentiation of cartilage within eight days, cartilage and woven bone within 12 days, and lamellar bone, including bone marrow, within 21 days. The yield of new bone from a 1-mg dose was more than 12 times g...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-07-01 00:00:00
abstract::In the case of fractures of the middle one-third of the forearm that are several weeks old, the procedure is as follows. Use a brachial block or general anesthesia. Open the radial fracture by freeing up the fracture site and clearing the medullary canals. About a 4-cm longitudinal incision is made over the dorsal asp...
journal_title:Clinical orthopaedics and related research
pub_type: 传,古典文章,历史文章,杂志文章
doi:
更新日期:1988-09-01 00:00:00
abstract::The factors which determine the rate and amount of acetabular growth in congenital dislocation of the hip are ill-understood. A prospective radiological study has been devised in order to assess the influence of the age of congruity, femoral anteversion and neck/shaft angles on acetabular growth. To be included, the c...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract:BACKGROUND:Reverse total shoulder arthroplasty (RTSA) is widely used; however, the effects of RTSA geometric parameters on joint and muscle loading, which strongly influence implant survivorship and long-term function, are not well understood. By investigating these parameters, it should be possible to objectively opti...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4526-0
更新日期:2015-11-01 00:00:00
abstract::A review of CT-based orthopaedic navigation is presented with a specific emphasis on arthroplasty for the hip and the knee. Fundamental issues about the laboratory and clinical validation of the applications are addressed. The ability to compute the position and orientation of an acetabular implant using a postoperati...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000126866.29933.42
更新日期:2004-04-01 00:00:00
abstract::The use of aggressive chemotherapy undoubtedly has brought about a dramatic increase in the cure rate of osteosarcoma. The authors' investigations have increased the authors' knowledge of chemotherapy for osteosarcoma, the differential efficacy of currently used agents, and the pronounced schedule dependency and relat...
journal_title:Clinical orthopaedics and related research
pub_type: 临床试验,杂志文章,多中心研究,评审
doi:
更新日期:1991-09-01 00:00:00
abstract::A theory for the mechanism of electrical bone stimulation proposes that passage of an electric current reduces the local PO2 and raises the pH near the cathode, thereby creating a favorable environment for osteogenesis. To study the effects of electric current passage on the PO2, PCO2 and pH in the vicinity of the ele...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::External malrotation is a frequent complication following Ender nailing. Biomechanical studies demonstrate that the standard Ender nail tends to produce external malrotation when the fracture is unstable. This type of malrotation does not develop to the same degree if the nails are bent into a 25 degree angle of antev...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-03-01 00:00:00
abstract::Palsies of the lower cranial nerves occurred in association with traumatic atlantoaxial dissociations in two patients. The fracture-dislocations sustained were rare injuries and the neurologic complications contributed greatly to their morbidity and mortality. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract::This study examines effects of acute stretch on electrophysiologic properties of rabbit tibial nerve. Compound motor action potentials (CMAP) were measured in 30 rabbits, during and after two hours of acute, graded strain. The rabbits were assigned to one of three groups defined by the degree of stretch (0%, 8%, or 15...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00