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This study assessed risk factors for complications after volar plate fixation of distal radial fractures. An assessment of electronic patient records from 2008 to 2016 identified 867 patients with a total of 881 distal radial fractures who underwent volar plating in our hospital. A total of 132 complications after volar plate fixation of distal radial fractures were observed (complication rate 15%). Surgery performed by a low-volume surgeon and patient age less than 40 years were the most important risk factors for plate-related complications. In logistic regression analysis, operation performed by a low-volume surgeon and patient age less than 40 years were independent predictors of plate-related complications. Patient age less than 40 years and low-volume surgeon were also found to be independent risk factors for plate-related secondary operations. Surgical delay had no effect on the complication rate. Level of evidence: IV.

Objective: To examine effects of physical and geriatric rehabilitation on institutionalisation and mortality after hip fracture., Design: Prospective randomised study., Setting: Physically oriented (187 patients), geriatrically oriented (171 patients), and health centre hospital rehabilitation (180 patients, control group)., Subjects: A total of 538 consecutively, independently living patients with non-pathological hip fracture., Main Measures: Patients were evaluated on admission, at 4 and 12 months for social status, residential status, walking ability, use of walking aids, pain in the hip, activities of daily living (ADL) and mortality., Results: Mortality was significantly lower at 4 and 12 months in physical rehabilitation (3.2%, 8.6%) than in geriatric rehabilitation group (9.6%, 18.7%, P=0.026, P=0.005, respectively) or control group (10.6%, 19.4%, P=0.006, P=0.004, respectively). At 4 months more patients in physical (84.4%) and geriatric rehabilitation group (78.0%) were able to live at home or sheltered housing than in control group (71.9%, P=0.0012 and P<0.001, respectively). No significant difference was found between physical rehabilitation and geriatric rehabilitation (P=0.278). Analysis of femoral neck and trochanteric fractures showed that significant difference was true only for femoral neck fractures (physical rehabilitation vs geriatric rehabilitation P=0.308, physical rehabilitation vs control group P<0,001 and geriatric rehabilitation vs control group P<0.001). Effects of intensified rehabilitations disappeared at 12 months. No impact on walking ability or ADL functions was observed., Conclusions: Physical rehabilitation reduced mortality. Physical and geriatric rehabilitation significantly improved the ability of independent living after 4 months especially among the femoral neck fracture patients but this effect could not be seen after 12 months., (© The Author(s) 2014.)

Background: Tibiotalocalcaneal arthrodesis is a treatment modality for severe arthrosis and malalignment of the hindfoot. Complications, such as delayed union and nonunion, are well-known risks of the procedure. Arthrodesis can be done with a plate, screws, an external fixator, or an intramedullary nail. Compression with an intramedullary nail was the focus of this report., Methods: Thirty-four consecutive patients (23 men and 11 women) with an average age range of 57 (range 25-77) years had tibiotalocalcaneal arthrodesis using retrograde intramedullary compression nail fixation. Mean followup was 24 (range 6 to 43) months. One patient died of an unrelated cause, but 30 (91%) of the remaining 33 patients answered the questionnaire., Results: Bony consolidation was achieved in 26 (76%) patients, the mean time to fusion being 16 weeks. Five patients (15%) had complications and seven (20%) had repeat surgery. Of the 30 patients who responded to the questionnaire, three patients (10%) evaluated the overall result subjectively as being of no benefit and 27 (90%) as improved. The visual analog scale (VAS) score for preoperative pain was 66 at rest and 83 when walking, and the mean postoperative scores were 19 and 32, respectively (p<0.001)., Conclusions: Tibiotalocalcaneal arthrodesis with a compressive retrograde intramedullary nail is an effective and safe procedure for patients with severe malalignment or arthrosis of the hindfoot. It is essentially a salvage procedure, and most patients benefit from it, but excellent results are rare.