The 'nightstick' ischial fracture: a unique oddity of the pelvic injury family.

We present an unusual ischial fracture unreported in the literature. We discuss the mechanism and describe the appropriate investigations and surgical management of this fracture. A 36-year-old man sustained a direct blow to his right buttock following a fall from a dirt bike.

A pilot cohort study of the determinants of longitudinal opioid use after surgery.

Background: Determinants of the duration of opioid use after surgery have not been reported. We hypothesized that both preoperative psychological distress and substance abuse would predict more prolonged opioid use after surgery.

Methods: Between January 2007 and April 2009, a prospective, longitudinal inception cohort study enrolled 109 of 134 consecutively approached patients undergoing mastectomy, lumpectomy, thoracotomy, total knee replacement, or total hip replacement.