Publications by authors named "Martha B Holden"
PREVENTion of CLots in Orthopaedic Trauma (PREVENT CLOT): a randomised pragmatic trial protocol comparing aspirin versus low-molecular-weight heparin for blood clot prevention in orthopaedic trauma patients.
BMJ Open
March 2021
Introduction: Patients who sustain orthopaedic trauma are at an increased risk of venous thromboembolism (VTE), including fatal pulmonary embolism (PE). Current guidelines recommend low-molecular-weight heparin (LMWH) for VTE prophylaxis in orthopaedic trauma patients. However, emerging literature in total joint arthroplasty patients suggests the potential clinical benefits of VTE prophylaxis with aspirin.
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- Despite the common use of antibiotics, surgical site infections remain prevalent in patients with fractures, prompting the need to explore better prevention methods.
- An open-label randomized clinical trial tested the impact of intrawound vancomycin powder on reducing deep surgical site infections in high-risk patients undergoing tibial plateau or pilon fracture surgeries across multiple US trauma centers.
- Results showed that the treatment group had a lower incidence of deep infections (6.4%) compared to the control group (9.8%), with the vancomycin specifically showing a significant effect on gram-positive infections, indicating its potential as an effective intervention in surgical settings.
Importance: Numerous studies have demonstrated that long-term outcomes after orthopedic trauma are associated with psychosocial and behavioral health factors evident early in the patient's recovery. Little is known about how to identify clinically actionable subgroups within this population.
Objectives: To examine whether risk and protective factors measured at 6 weeks after injury could classify individuals into risk clusters and evaluate whether these clusters explain variations in 12-month outcomes.
Purpose: Treatment of posttraumatic symptomatic ulnar artery thrombosis (UAT) is controversial. This study reports the outcome at 2 years minimum follow-up of a uniform approach using reversed interpositional vein grafting to treat symptomatic patients with UAT.
Methods: The records of all patients with vascular disease of the upper extremity who were revascularized at the authors' institution were retrospectively reviewed, and the following inclusion criteria were applied: (1) arteriographically proven UAT treated with excision of the involved segment and reversed interpositional vein grafting; (2) absence of collagen vascular disease, coagulopathy, or peripheral vascular disease, (3) minimum follow-up of 24 months.
Purpose: To prospectively compare outcomes of primary anterior cruciate ligament (ACL) reconstruction with either Achilles tendon allograft with soft-tissue fixation or standard bone-patellar tendon-bone autograft with interference screw fixation.
Type Of Study: Prospective comparative case series.
Methods: A group of 41 patients who underwent soft-tissue allograft reconstruction and a group of 118 patients who underwent autograft bone-patellar tendon-bone reconstruction were included in the final results.