Serum kinetics of soluble triggering receptor expressed on myeloid cells-1 differs in relation to the type of arthroplasty.

CONTEXT: Soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) participates in the inflammatory process. PURPOSE: To describe changes of sTREM-1 in the serum after hemiarthroplasty (HA) and total hip arthroplasty (THA). METHODS: Serial blood samples were drawn from 122 patients with hip fracture. Interleukin-6 (IL-6), sTREM-1, and C-reactive protein (CRP) were measured. RESULTS: IL-6 and CRP were similarly increased after both HA and THA. sTREM-1 was increased early in HA and late after THA. The only parameter that was higher among patients who developed systemic inflammatory response syndrome was IL-6. CONCLUSIONS: Kinetics of sTREM-1 differs among patients undergoing HA of the hip and those undergoing THA.

Undiagnosed osteoid osteoma of the spine presenting as painful scoliosis from adolescence to adulthood: a case report.

Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood. A more thorough investigation, years after the initial one, revealed the tumor. Surgical excision and stabilization offered the long-awaited cure. Misdiagnosis resulted in intractable pain for years, deformity, the discomfort of brace therapy, and the frustration of a prolonged yet ineffective treatment.

Intramedullary fixation of intertrochanteric hip fractures: a comparison of two implant designs.

We report a randomised prospective study comparing two implants, the Gamma trochanteric nail and the ACE trochanteric nail, in the treatment of intertrochanteric femoral fractures in the elderly. One hundred and twelve patients were randomised on admission into two treatment groups. Fifty-six patients were treated with Gamma nail implants, and 56 were treated with ACE trochanteric nail. The average age of these patients was 78 years. Twenty fractures were stable and 92 unstable. The mean follow-up time was 8 months (6 -12). Regular clinical and radiological review was done 1, 3 and 6 months postoperatively. Operation time, fluoroscopy time, blood transfusion and complications were recorded. The mobility score was used to assess the pre-injury and postoperative mobility status. All the patients were treated within 36 h of their accident. There were no complications during surgery. All the patients were mobilised in the first 24 h postoperatively, regardless of the fracture type, and weight bearing was permitted as tolerated. Union of the fracture was achieved in all patients. There was no statistically significant difference between the two groups with regard to the studied parameters. There was no mechanical failure of the implants despite the early patient mobilisation. Early operation and early mobilisation resulted in a good functional outcome in all patients. Both the trochanteric gamma nail and ACE trochanteric nail provide effective methods of treatment for intertrochanteric fractures in elderly patients.