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The Journal of Bone & Joint Surgery British Volume
Vol. 71-B, Issue 5 | Pages 738 - 738
1 Nov 1989
Bliss B Mansfield A Shepherd R Bradley J Naylor H Vickery M Fairgrieve J Parry E Weale F Galloway J et A


The Journal of Bone & Joint Surgery British Volume
Vol. 69-B, Issue 2 | Pages 326 - 329
1 Mar 1987
Giladi M Milgrom C Simkin A Stein M Kashtan H Margulies J Rand N Chisin R Steinberg R Aharonson Z et A

A prospective study of 295 infantry recruits has shown that the mediolateral width of the tibia measured radiographically at each of three different levels in the bone had a statistically significant correlation with the total incidence of stress fractures as well as with those in the tibia alone or the femur alone. A narrow tibial width was shown to be a risk factor, but cortical thickness was not found to be significant.


The Journal of Bone & Joint Surgery British Volume
Vol. 67-B, Issue 4 | Pages 538 - 542
1 Aug 1985
Kakkar V Fok P Murray W Paes T Merenstein D Dodds R Farrell R Crellin R Thomas E Morley T et A

A prospective study involving 500 consecutive patients undergoing hip replacement was performed to find out whether a combination of heparin and dihydroergotamine was effective in preventing postoperative fatal and non-fatal emboli. Deep-vein thrombosis was demonstrated in 131 cases (26.2%), in 99 of whom thrombi were confined to the ipsilateral (operated) limb and in 13 to the contralateral limb; 19 patients developed bilateral thrombi. Nine patients (1.8%) died during the first four weeks after operation, before they were discharged from hospital; in one, major emboli were demonstrated in the right pulmonary artery. Three of the 500 patients developed non-fatal pulmonary emboli. Excessive bleeding occurred in 21 (4.2%) and in 19 of these prophylaxis was discontinued. Wound haematomas developed in 25 patients (5.0%); only six required evacuation but in none of these six did deep infection occur while in hospital; in three patients, however, the wound haematoma prolonged the stay in hospital. Thus the combination of heparin and dihydroergotamine proved an effective prophylaxis against pulmonary embolism in patients undergoing total hip replacement. The risk of bleeding complications is wholly acceptable when balanced against the advantages of the therapy.