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10.1259/bjr.20140398 http://scihub22266oqcxt.onion/10.1259/bjr.20140398 C4170872!4170872 !25089852     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=25089852 &cmd=llinks): Failed to open stream: HTTP request failed! 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Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk |pdf=|usr=}}{{25089852 }} gab.com Text Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk JO: Br J Radiol http://www.kidney.de/pget.php?&tw=1&pmid=25089852 #FOAvip OBJECTIVE: Radiotherapy (RT) is effective in preventing heterotopic ossification (HO) around acetabular fractures requiring surgical reconstruction. We audited outcomes and estimated risks from RT prophylaxis, and alternatives of indometacin or no prophylaxis. METHODS: 34 patients underwent reconstruction of acetabular fractures through a posterior approach, followed by a 8-Gy single fraction. The mean age was 44 years. The mean time from surgery to RT was 1.1 days. The major RT risk is radiation-induced fatal cancer. The International Commission on Radiological Protection (ICRP) method was used to estimate risk, and compared with a method (Trott and Kemprad) specifically for estimating RT risk for benign disease. These were compared with risks associated with indometacin and no prophylaxis. RESULTS: 28 patients (82%) developed no HO; 6 developed Brooker Class I; and none developed Class II-IV HO. The ICRP method suggests a risk of fatal cancer in the range of 1 in 1000 to 1 in 10,000; the Trott and Kemprad method suggests 1 in 3000. For younger patients, this may rise to 1 in 2000; and for elderly patients, it may fall to 1 in 6000. The risk of death from gastric bleeding or perforation from indometacin is 1 in 180 to 1 in 900 in older patients. Without prophylaxis risk of death from reoperation to remove HO is 1 in 4000 to 1 in 30,000. CONCLUSION: These results are encouraging, consistent with much larger series and endorse our multidisciplinary management. Risk estimates can be used in discussion with patients. ADVANCES IN KNOWLEDGE: The risk from RT prophylaxis is small, it is safer than indometacin and substantially overlaps with the range for no prophylaxis. Twit Text FOAVip Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk ????Br J Radiol http://www.kidney.de/pget.php?&tw=1&pmid=25089852 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=25089852 #FOAvip English Wikipedia <ref>{{Cite pmid|25089852 }}</ref> Prophylactic radiotherapy against heterotopic ossification following internal fixation of acetabular fractures: a comparative estimate of risk #MMPMID25089852 Burnet NG ; Nasr P ; Yip G ; Scaife JE ; House T ; Thomas SJ ; Harris F ; Owen PJ ; Hull P Br J Radiol 2014[Oct]; 87 (1042 ): 20140398 PMID25089852 show ga OBJECTIVE: Radiotherapy (RT) is effective in preventing heterotopic ossification (HO) around acetabular fractures requiring surgical reconstruction. We audited outcomes and estimated risks from RT prophylaxis, and alternatives of indometacin or no prophylaxis. METHODS: 34 patients underwent reconstruction of acetabular fractures through a posterior approach, followed by a 8-Gy single fraction. The mean age was 44 years. The mean time from surgery to RT was 1.1 days. The major RT risk is radiation-induced fatal cancer. The International Commission on Radiological Protection (ICRP) method was used to estimate risk, and compared with a method (Trott and Kemprad) specifically for estimating RT risk for benign disease. These were compared with risks associated with indometacin and no prophylaxis. RESULTS: 28 patients (82%) developed no HO; 6 developed Brooker Class I; and none developed Class II-IV HO. The ICRP method suggests a risk of fatal cancer in the range of 1 in 1000 to 1 in 10,000; the Trott and Kemprad method suggests 1 in 3000. For younger patients, this may rise to 1 in 2000; and for elderly patients, it may fall to 1 in 6000. The risk of death from gastric bleeding or perforation from indometacin is 1 in 180 to 1 in 900 in older patients. Without prophylaxis risk of death from reoperation to remove HO is 1 in 4000 to 1 in 30,000. CONCLUSION: These results are encouraging, consistent with much larger series and endorse our multidisciplinary management. Risk estimates can be used in discussion with patients. ADVANCES IN KNOWLEDGE: The risk from RT prophylaxis is small, it is safer than indometacin and substantially overlaps with the range for no prophylaxis. |*Acetabuloplasty/adverse effects [MESH] |Acetabulum/diagnostic imaging/*injuries/radiation effects [MESH] |Adult [MESH] |Aged [MESH] |Aged, 80 and over [MESH] |Anti-Inflammatory Agents, Non-Steroidal/therapeutic use [MESH] |Female [MESH] |Fracture Fixation, Internal/*methods [MESH] |Fractures, Bone/diagnostic imaging/*surgery [MESH] |Humans [MESH] |Indomethacin/therapeutic use [MESH] |Male [MESH] |Middle Aged [MESH] |Ossification, Heterotopic/diagnostic imaging/etiology/prevention & control/*radiotherapy [MESH] |Postoperative Complications/prevention & control/radiotherapy [MESH] |Radiography [MESH] |Reoperation [MESH] |Risk Assessment [MESH]Prophylactic radiotherapy against heterotopic ossification following i(epmc).pdf DeepDyve Pubget Overpricing