Nonoperative treatment of the medial malleolus in bimalleolar and trimalleolar ankle fractures: a randomized controlled trial.

Objectives: To compare internal fixation with no fixation of the medial malleolus after open reduction and internal fixation of the lateral malleolus and if needed, the posterior malleolus.

Design: Randomized prospective trial.

Setting: Level III trauma center in a metropolitan area.

Thrombosis markers in hip versus knee arthroplasty: a pilot study.

Purpose: To compare the thrombosis markers for thrombosis and fibrinolysis in patients undergoing hip versus knee arthroplasty.

Methods: Seven women aged 38 to 61 years who underwent total hip arthroplasty (THA) and 7 women aged 57 to 67 years who underwent total knee arthroplasty (TKA) were studied. Thromboprophylaxis was given before and after surgery.

Time course of thrombosis and fibrinolysis in total knee arthroplasty with tourniquet application. Local versus systemic activations.

Background: Venous thrombosis is common in knee surgery, and it has been assumed that vein occlusion by tourniquet in itself may induce thrombogenic and fibrinolytic activity. Prophylactic treatment is used up to 12 h before or after surgery, and recent clinical trials suggest that the timing of initiating prophylaxis significantly influences antithrombotic effectiveness.

Materials And Methods: We studied the time course of coagulation and fibrinolysis locally and systemically during total knee arthroplasty.

Cytokine patterns after tourniquet-induced skeletal muscle ischaemia reperfusion in total knee replacement.

Objective: Extremity surgery performed under tourniquet control causes one of the most common forms of skeletal muscle ischaemia-reperfusion injury in clinical practice. The aim of this study was to investigate the systemic and local inflammatory response after tourniquet-induced skeletal muscle ischaemia-reperfusion injury in patients undergoing total knee replacement. It was our hypothesis that local inflammatory responses in a surgical wound under tourniquet-induced ischaemia cause an excessive overflow of cytokines to the systemic circulation in the reperfusion phase.

Systemic and local cytokine patterns during total hip surgery.

Objective: Increased levels of inflammatory cytokines have been described in musculoskeletal injury. Total hip replacement is major musculoskeletal surgery, and in the present study this operation was used to investigate systemic and local cytokine patterns during musculoskeletal trauma.

Material And Methods: Blood was sampled before, during and after surgery in 10 patients given total hip replacement.