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Purpose: Acetabular fractures are injuries often surgically treated, but the surgical intervention is associated with a high risk of subsequent complications. The primary aim of this study was to explore the rate of reoperations and to identify potential risk factors for reoperation. Secondary aims were other adverse events and mortality. Methods: Patients ≥ 18 years with a surgically treated acetabular fracture at a single trauma center in Sweden between 2010 and 2019 were retrospectively included. Data were collected through review of medical records and radiographs. Logistic regression analysis was performed to investigate factors associated with reoperations and other adverse events. Results: A total of 229 patients with a surgically treated acetabular fracture were included, mean age (± SD, range) 60 (19, 19–94) years. The majority of the patients were males (n = 180, 79%), and the median (IQR) follow-up time was 1779 (1906) days (4.9 years). 47 patients (21%) underwent a reoperation. THA as surgical method was associated with a lower reoperation rate compared to ORIF (OR 0.3, 95% CI 0.1–0.8, p < 0.01). 72 patients (31%) sustained an adverse event not requiring reoperation, and admittance to ICU was associated with an increased risk (OR 2.6, 95% CI 1.2–5.7, p = 0.02). 30-day mortality was 3.1% and 1-year mortality 5.7%. Conclusion: The complication rate after acetabular fracture surgery was high, and surgical treatment with primary THA was associated with a reduced risk for reoperation. [ABSTRACT FROM AUTHOR]

Background and purpose — Fractures of the pelvis and femur are serious and potentially lethal injuries affecting primarily older, but also younger individuals. Long-term trends on incidence rates and mortality might diverge for these fractures, and few studies compare trends within a complete adult population. We investigated and compared incidence and mortality rates of pelvic, hip, femur shaft, and distal femur fractures in the Swedish adult population. Patients and methods — We analyzed data on all adult patients ≥ 18 years in Sweden with a pelvic, hip, femur shaft, or distal femur fracture, through the Swedish National Patient Register. The studied variables were fracture type, age, sex, and 1-year mortality. Results — While incidence rates for hip fracture decreased by 18% (from 280 to 229 per 105 person-years) from 2001 to 2016, incidence rates for pelvic fracture increased by 25% (from 64 to 80 per 105 person-years). Incidence rates for femur shaft and distal femur fracture remained stable at rates of 15 and 13 per 105 person-years respectively. 1-year mortality after hip fracture was 25%, i.e., higher than for pelvic, femur shaft, and distal femur fracture where mortality rates were 20–21%. Females had an almost 30% lower risk of death within 1 year after hip fracture compared with males. Interpretation — Trends on fracture incidence for pelvic and femur fractures diverged considerably in Sweden between 2001 and 2016. While incidence rates for femur fractures (hip, femur shaft, and distal femur) decreased or remained constant during the studied years, pelvic fracture incidence increased. Mortality rates were different between the fractures, with the highest mortality among patients with hip fracture. [ABSTRACT FROM AUTHOR]

Unloaded inactivity induces atrophy and functional deconditioning of skeletal muscle, especially in the lower extremities. Information is scarce, however, regarding the effect of unloaded inactivity on muscle size and function about the hip. Regional bone loss has been demonstrated in hips and knees of elderly orthopaedic patients, as quantified by computerized tomography (CT). This method remains to be validated in healthy individuals rendered inactive, including real or simulated weightlessness. In this study, ten healthy males were subjected to 5 weeks of experimental bedrest and five matched individuals served as ambulatory controls. Maximum voluntary isometric hip and knee extension force were measured using the strain gauge technique. Cross-sectional area (CSA) of hip, thigh and calf muscles, and radiological density (RD) of the proximal tibial bone were measured using CT. Bedrest decreased ( P < 0.05) average (SD) muscle strength by 20 (8)% in knee extension, and by 22 (12)% in hip extension. Bedrest induced atrophy ( P < 0.05) of extensor muscles in the gluteal region, thigh and calf, ranging from 2 to 12%. Atrophy was more pronounced in the knee extensors [9 (4)%] and ankle plantar flexors [12 (3)%] than in the gluteal extensor muscles [2 (2)%]. Bone density of the proximal tibia decreased ( P < 0.05) by 3 (2)% during bedrest. Control subjects did not show any temporal changes in muscle or bone indices ( P > 0.05), when examined at similar time intervals. The present findings of a substantial loss in hip extensor strength and a smaller, yet significant atrophy of these muscles, demonstrate that hip muscle deconditioning accompanies losses in thigh and calf muscle mass after bedrest. This suggests that comprehensive quantitative studies on impaired locomotor function after inactivity should include all joints of the lower extremity. Our results also demonstrate that a decreased RD, indicating bone mineral loss, can be shown already after 5 weeks of unloaded bedrest, using a standard CT technique. [ABSTRACT FROM AUTHOR]

It is generally held that space travelers experience muscle dysfunction and atrophy during exposure to microgravity. However, observations are scarce and reports somewhat inconsistent with regard to the time course, specificity and magnitude of such changes. Hence, we examined four male astronauts (group mean approximately 43 years, 86 kg and 183 cm) before and after a 17-day spaceflight (Space Transport System-78). Knee extensor muscle function was measured during maximal bilateral voluntary isometric and iso-inertial concentric, and eccentric actions. Cross-sectional area (CSA) of the knee extensor and flexor, and gluteal muscle groups was assessed by means of magnetic resonance imaging. The decrease in strength (P<0.05) across different muscle actions after spaceflight amounted to 10%. Eight ambulatory men, examined on two occasions 20 days apart, showed unchanged (P>0.05) muscle strength. CSA of the knee extensor and gluteal muscles, each decreased (P<0.05) by 8%. Knee flexor muscle CSA showed no significant (P>0.05) change. The magnitude of these changes concord with earlier results from ground-based studies of similar duration. The results of this study, however, do contrast with the findings of no decrease in maximal voluntary ankle plantar flexor force previously reported in the same crew. [ABSTRACT FROM AUTHOR]