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Article: The Importance of Flare: A Radiological Evaluation of Fixed-Angle Guide and Barrel-Plate in Sliding Hip Screws.

Subhash, Sadhin / Liew, Ignatius

2021 Volume 13, Issue 8, Page(s) e17416

Abstract: Background and objective The sliding hip screw (SHS) remains the main operative implant of choice for A1/2 intertrochanteric fractures. These implants are often fixed-angled with a corresponding guide to decrease inventory and implant cost. However, ... ...

Abstract	Background and objective The sliding hip screw (SHS) remains the main operative implant of choice for A1/2 intertrochanteric fractures. These implants are often fixed-angled with a corresponding guide to decrease inventory and implant cost. However, there are varying sizes of base plates on the fixed-angle device between industries. Screw placement is crucial to achieving optimal tip-apex distance (TAD) and position. Due to the flare of the greater trochanter (GT), we hypothesise that the fixed-angle guide can lead to malpositioning. In this study, we aimed to describe the discrepancy between the fixed-angle guide (short: 38 mm, long: 60 mm), the flare of the GT, and the effects on screw placement. Methods Patients who received SHS between August to December 2019 were evaluated. We measured the neck-shaft angle, GT flare angle to the femoral axis, screw-plate angle, screw position, and TAD. We templated the optimal 135° fixed-angle barrel-plate, angle guides, and measured the divergence between the angles. Results A total of 30 patients were identified to be included in the study; 24/30 (80%) were female, with 16/30 (53%) receiving SHS on the right hip. The average age of the participants was 82 ±9 years. The average neck-shaft angle was 132.4° ±5.9. The GT flare angle was 3.2° ±1.6. Of note, 66% of patients had a screw-plate angle of ≥135° with an average of 137° ±3.7. However, only 10/30 (33%) screws were placed superiorly, with an average TAD of 21 mm ±11 compared to screws placed in the centre and inferiorly at 9.5 mm ±3 (p=0.0004). The long fixed-angle guide resulted in a lower divergence angle at 3° ±1.7 compared to 5.2° ±2.6 for the short fixed-angle guide (p=0.0001). Conclusion Using the fixed-angle guide at 135° on the GT flare results in a sub-optimum screw-plate angle. This can lead to malpositioning of the screw, as well as increased TAD and screw-plate angle. Preoperative planning is crucial to measure the femoral neck-shaft angle, GT flare, as well as utilising a longer fixed-angle guide.
Language	English
Publishing date	2021-08-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.17416
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Article ; Online: Optimal posterior screw placement configuration in Sanders 2B calcaneal fractures: A biomechanical study.

Gil Monzó, E R / Liew, I / Tadikonda, P / Cutts, S / Pasapula, C

Revista espanola de cirugia ortopedica y traumatologia

2022 Volume 67, Issue 2, Page(s) 144–152

Abstract: Background: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity ... ...

Abstract	Background: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity such as hindfoot varus alters foot biomechanics. Minimally invasive approaches with indirect reduction of the calcaneal tuberosity to maintain the reduction using posterior screws is routinely being used in the treatment of joint depression fractures. Biomechanically, optimum screw numbers and configuration is not known. Biomechanical studies have evaluated and proposed different screw configurations, however, it is not clear which configuration best controls varus deformity. This study aims to determine the optimum screw configuration to control varus deformity in Sanders 2B calcaneal fractures. Methods: Sawbone models were prepared to replicate Sanders type 2-B fracture, with central bone loss and comminution. 0.5cm medial wedge of the calcaneal tuberosity was removed to create varus instability. After stabilising posterior facet with a single 4mm partial threaded screw, and applied an 8 hole contoured plate to stabilise the angle of Gissane, inserted one or two 7mm cannulated partially threaded Charlotte™ (Wright Medical Technology, Inc. 5677 Airline Road Arlington, TN) Headless Multi-use Compression (under image guidance) extra screws to control varus and subsidence deformity of the fracture. Coronal plane displacement of the dissociated calcaneal tuberosity fragment relative to the body when applying 5N, 10N and 20N force was measured in millimetres (mm). Results: 2 screws inserted (one medial screw into the sustentaculum talus from inferior to superior and, one lateral screw into the long axis anterior process) provides the least displacement (0.88±0.390 at 5N and 1.7±1.251 at 20N) and the most stable construct (p<0.05) when compared to other configurations. A single medial screw into the sustentaculum tali (conf. 3) resulted in the least stable construct and most displacement (4.04±0.971 at 5N and 11.24±7.590 at 20N) (p<0.05). Conclusion: This study demonstrates the optimal screw configuration to resist varus in calcaneal fractures using minimally invasive techniques. Optimal stability is achieved using 2 screws; one located along the long axis of the calcaneus (varus control) and the other placed in the short axis directed towards the posterior facet of the calcaneus (control varus and subsidence). Further cadaver research would help evaluate optimal screw placement in simulated fractures to further assess reproducibility.
MeSH term(s)	Humans ; Fracture Fixation, Internal/methods ; Reproducibility of Results ; Fractures, Bone ; Foot ; Foot Injuries ; Ankle Injuries ; Bone Screws ; Fractures, Comminuted ; Knee Injuries ; Hallux Varus
Language	Spanish
Publishing date	2022-07-07
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2417057-4
ISSN	1988-8856 ; 1888-4415
ISSN (online)	1988-8856
ISSN	1888-4415
DOI	10.1016/j.recot.2022.06.007
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Article ; Online: Optimal posterior screw placement configuration in Sanders 2B calcaneal fractures: A biomechanical study.

Gil Monzó, E R / Liew, I / Tadikonda, P / Cutts, S / Pasapula, C

Revista espanola de cirugia ortopedica y traumatologia

2022 Volume 67, Issue 2, Page(s) T144–T152

Title translation	[Artículo traducido] Configuración y localización óptima de los tornillos posteriores en las fracturas de calcáneo Sanders 2B: estudio biomecánico.
Abstract	Background: Calcaneal fractures can be high energy intra-articular injuries associated with joint depression. Challenges to fracture reduction include lateral wall blow out, medial wall overlap, comminution and central bone loss. Secondary deformity such as hindfoot varus alters foot biomechanics. Minimally invasive approaches with indirect reduction of the calcaneal tuberosity to maintain the reduction using posterior screws is routinely being used in the treatment of joint depression fractures. Biomechanically, optimum screw numbers and configuration is not known. Biomechanical studies have evaluated and proposed different screw configurations, however, it is not clear which configuration best controls varus deformity. This study aims to determine the optimum screw configuration to control varus deformity in Sanders 2B calcaneal fractures. Methods: Sawbone models were prepared to replicate Sanders type 2-B fracture, with central bone loss and comminution. 0.5 cm medial wedge of the calcaneal tuberosity was removed to create varus instability. After stabilising posterior facet with a single 4 mm partial threaded screw, and applied an 8 hole contoured plate to stabilise the angle of Gissane, inserted one or two 7 mm cannulated partially threaded Charlotte Results: 2 screws inserted (one medial screw into the sustentaculum talus from inferior to superior and, one lateral screw into the long axis anterior process) provides the least displacement (0.88 ± 0.390 at 5 N and 1.7 ± 1.251 at 20 N) and the most stable construct (p < 0.05) when compared to other configurations. A single medial screw into the sustentaculum tali (conf. 3) resulted in the least stable construct and most displacement (4.04 ± 0.971 at 5 N and 11.24 ± 7.590 at 20 N) (p < 0.05). Conclusion: This study demonstrates the optimal screw configuration to resist varus in calcaneal fractures using minimally invasive techniques. Optimal stability is achieved using 2 screws; one located along the long axis of the calcaneus (varus control) and the other placed in the short axis directed towards the posterior facet of the calcaneus (control varus and subsidence). Further cadaver research would help evaluate optimal screw placement in simulated fractures to further assess reproducibility.
MeSH term(s)	Humans ; Fracture Fixation, Internal/methods ; Reproducibility of Results ; Fractures, Bone ; Foot ; Foot Injuries ; Ankle Injuries ; Bone Screws ; Fractures, Comminuted ; Knee Injuries
Language	Spanish
Publishing date	2022-12-14
Publishing country	Spain
Document type	Journal Article
ZDB-ID	2417057-4
ISSN	1988-8856 ; 1888-4415
ISSN (online)	1988-8856
ISSN	1888-4415
DOI	10.1016/j.recot.2022.12.007
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Article: Standard setting for orthopaedic trauma competencies in postgraduate specialty training- catching those falling behind the curve.

Pullinger, Michael / Liew, Ignatius / Spacey, Kate / Kang, Niel / Johnston, Phillip / Sanghrajka, Anish

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

2023 Volume 21, Issue 6, Page(s) 337–343

Abstract: Background: The Curriculum for Trauma and Orthopaedics focuses on producing competent Day-One Consultants. However, the expected development trajectory is not clear. It is important, yet difficult to objectively identify trainees who are "falling behind" ...

Abstract	Background: The Curriculum for Trauma and Orthopaedics focuses on producing competent Day-One Consultants. However, the expected development trajectory is not clear. It is important, yet difficult to objectively identify trainees who are "falling behind". This project proposes practical, consensus-based thresholds of Operative Trauma Competence at each Waypoint stage of training. Methods: 32 trainers and 73 trainees in one Deanery were identified. The trainers and trainees were asked their PBA level expectation of a trainee at ST4, ST6 and ST8 for nine trauma competencies. Lower quartile values were calculated providing thresholds. Results: 53 (72%) trainees and 22 (69%) trainers responded. At ST8, the lower quartile threshold was level 4 for all procedures. At ST6, three operation groups became apparent: Group 1 (hip hemiarthroplasty, Dynamic hip screw; k-wire distal radius fracture and Weber C Ankle open reduction, internal fixation (ORIF)) Group 2 (Tibial Nail; Olecranon Tension band wire, ORIF radial shaft; distal radius plate fixation)- Group 3 (supracondylar fracture fixation)Threshold levels for procedures were: Group 1- 4a; Group 2-3b and Group 3- 3a.At ST4, there was more variation and spread in responses, however, expectations could still be similarly grouped: Group 1- 3a; Group 2- 2b and Group 3- 2a. Conclusion: In an increasingly competency-based training environment we provide tangible thresholds for expectations of orthopaedic trainees' progression and development. We identified two groups: basic trauma (Group 1 where level 4 competencies should be attained by ST6) and intermediate trauma (Groups 2 and 3 where level 4 competencies should be attained by ST8.).
MeSH term(s)	Humans ; Orthopedics/education ; Curriculum ; Education, Medical, Graduate ; Fracture Fixation, Internal ; Lower Extremity ; Clinical Competence
Language	English
Publishing date	2023-07-18
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	2102927-1
ISSN	1479-666X
ISSN	1479-666X
DOI	10.1016/j.surge.2023.06.003
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Article ; Online: Evaluation of first ray instability using the double dorsiflexion test: A prospective observational case-controlled study.

Pasapula, Chandra / Solomou, Georgios / Al-Sukaini, Ahmad / Liew, Ignatius / Goetz, James / Cutts, Steven

Foot (Edinburgh, Scotland)

2023 Volume 56, Page(s) 102019

Abstract: Background: First-Ray (FR) stability allows for foot propulsion in-stance, taking 60% weight. First-ray instability (FRI) is associated with middle column overload, synovitis, deformity and osteoarthritis. Clinical detection can still be challenging. We ...

Abstract	Background: First-Ray (FR) stability allows for foot propulsion in-stance, taking 60% weight. First-ray instability (FRI) is associated with middle column overload, synovitis, deformity and osteoarthritis. Clinical detection can still be challenging. We propose to develop a clinical test that helps identify FRI using two simple manual manoeuvres. Methods: 10 patients with unilateral FRI were recruited. Unaffected contralateral feet were used as controls. Stringent exclusion criteria were applied including hallux MTP pain, laxity, inflammatory arthropathy and collagen disorders. A Klauemeter directly measured the sagittal plane dorsal first metatarsal head translation of affected vs unaffected feet. Maximum passive proximal phalanx 1st MTP joint dorsiflexion was measured using a video capture and Tracker motion software analysis with and without applying a dorsal force at the 1st metatarsal head using a Newton meter. Proximal phalanx motion was compared in affected vs unaffected feet with and without dorsal metatarsal head force application and compared to direct measurements using the Klaumeter. P value of < 0.05 was considered significant. Results: FRI feet had dorsal translation greater than 8 mm (median, 11.94; interquartile range [IQR], 10.23-13.81) vs 1.77 for unaffected control feet was (median, 1.77; interquartile range [IQR], 1.23-2.96) using the Klauemeter. The percentage reduction in 1st MTP joint dorsiflexion ROM when applying the double dorsiflexion test FRI (mean reduction of 67.98%) when compared to control feet (mean reduction of 28.44%)(P < 0.01). Receiver operating characteristic (ROC) analysis showed that a 50% reduction in dorsiflexion ROM of 1st MTPJ when performing the double dorsiflexion test achieved a specificity of 100% and sensitivity of 90% (AUC =0.990, 95%CI [0.958-1.000], P > 0.0001). Conclusion: The double dorsiflexion (DDF) is easy to perform with two relatively simple manual manoeuvres that avoids the need for complex instrumented and radiation-based assessment. Greater than 50% decrease in proximal phalanx motion has an over 90% sensitivity in identifying feet with FRI. Level of evidence: This was a prospective case-controlled study of consecutive cases of a level II evidence.
MeSH term(s)	Humans ; Metatarsophalangeal Joint ; Foot ; Metatarsal Bones ; Hallux ; Arthritis ; Range of Motion, Articular
Language	English
Publishing date	2023-03-18
Publishing country	Scotland
Document type	Observational Study ; Journal Article
ZDB-ID	1070358-5
ISSN	1532-2963 ; 0958-2592
ISSN (online)	1532-2963
ISSN	0958-2592
DOI	10.1016/j.foot.2023.102019
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Article ; Online: Artificial intelligence in orthopaedics surgery: transforming technological innovation in patient care and surgical training.

St Mart, Jean-Pierre / Goh, En Lin / Liew, Ignatius / Shah, Zameer / Sinha, Joydeep

Postgraduate medical journal

2023 Volume 99, Issue 1173, Page(s) 687–694

Abstract: Artificial intelligence (AI) is an exciting field combining computer science with robust data sets to facilitate problem-solving. It has the potential to transform education, practice and delivery of healthcare especially in orthopaedics. This review ... ...

Abstract	Artificial intelligence (AI) is an exciting field combining computer science with robust data sets to facilitate problem-solving. It has the potential to transform education, practice and delivery of healthcare especially in orthopaedics. This review article outlines some of the already used AI pathways as well as recent technological advances in orthopaedics. Additionally, this article further explains how potentially these two entities could be combined in the future to improve surgical education, training and ultimately patient care and outcomes.
MeSH term(s)	Humans ; Orthopedics ; Inventions ; Artificial Intelligence ; Orthopedic Procedures ; Patient Care
Language	English
Publishing date	2023-06-30
Publishing country	England
Document type	Review ; Journal Article
ZDB-ID	80325-x
ISSN	1469-0756 ; 0032-5473
ISSN (online)	1469-0756
ISSN	0032-5473
DOI	10.1136/postgradmedj-2022-141596
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Article ; Online: Apixaban Pharmacokinetics and Bioequivalence of Two Tablet Formulations: A Randomized, Open-Label, Crossover Study, Fasting Condition in Healthy Indonesian Volunteers.

Leong, Chuei Wuei / Yee, Kar Ming / Liew, Ivan / Khaleb, Nur Athirah / Ahmad, Shahnun / Rani, Tracy Ann / Lau, Kheng Jim / Yunaidi, Danang Agung / Simanjuntak, Ronal / Ginanjar, Vicky A

Clinical pharmacology in drug development

2024

Abstract: The present study aimed to assess the bioequivalence of a new apixaban generic with reference formulation. Twenty-six healthy volunteers were recruited for an open-label, balanced, randomized, 2-treatment, 2-sequence, 2-period, single oral dose study. ... ...

Abstract	The present study aimed to assess the bioequivalence of a new apixaban generic with reference formulation. Twenty-six healthy volunteers were recruited for an open-label, balanced, randomized, 2-treatment, 2-sequence, 2-period, single oral dose study. Following overnight fasting, each volunteer received 5 mg of apixaban test and reference formulations as single doses, separated by a 1-week washout period. Twenty blood samples were collected at predose and multiple time points between 0.5 and 72 hours after dosing. A validated ultra-performance liquid chromatography-tandem mass spectrometry detection method following a protein precipitation step was implemented to determine apixaban concentrations. Noncompartmental analysis was used to derive the pharmacokinetic parameters, which were then compared between the test and reference products using a multivariate analysis of variance. The pharmacokinetic parameters of the test product were not statistically different from the reference product, and the 90% confidence intervals of apixaban natural log-transformed area under the concentration-time curve from time 0 to infinity, area under the concentration-time curve from time 0 to the last measurable concentration, and maximum concentration were within 80%-125% based on the bioequivalence acceptance range criteria. The test and reference formulations of apixaban are bioequivalent in healthy subjects under fasting conditions.
Language	English
Publishing date	2024-04-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2649010-9
ISSN	2160-7648 ; 2160-763X
ISSN (online)	2160-7648
ISSN	2160-763X
DOI	10.1002/cpdd.1409
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Article ; Online: Requesting spinal MRIs effectively from primary care referrals.

Liew, Ignatius / Dean, Fraser / Anderson, Gillian / Murray, Odhrán

European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society

2018 Volume 27, Issue 10, Page(s) 2436–2441

Abstract: Objective: To define if MRI scans can accurately be requested based on information provided in the primary care referral and, therefore, streamline the patient journey. The demand for outpatient spinal appointments significantly exceeds our services' ... ...

Abstract	Objective: To define if MRI scans can accurately be requested based on information provided in the primary care referral and, therefore, streamline the patient journey. The demand for outpatient spinal appointments significantly exceeds our services' ability to provide efficient, high-quality patient care. Currently, magnetic resonance imaging (MRI) of the spine is requested following first consultation. Methods: During routine vetting of primary care referral letters, three consultant spinal surgeons recorded how likely they thought each patient would be to have an MRI scan. Following the first consultation with the spinal service, the notes of each patient were reviewed to see if an MRI was requested. We measured the positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity of ordering MRI scans based on primary care referral letters. Results: 149 patients were included [101 females, 48 males, mean age 49 (16-87)]. There were 125 routine, 21 urgent, and 3 'urgent-suspected cancer' referrals. The PPV of ordering MRIs before first consultation was 84%, NPV was 56% with the sensitivity and specificity being 82 and 59%, respectively. Ordering MRIs during initial vetting could shorten the patient journey with potential socioeconomic benefits. Conclusions: MRI scans can be effectively ordered based on the information provided by the primary care referral letter. Requesting MRI scans early in the patient journey can save considerable time, improve care, and deliver cost savings. These slides can be retrieved under Electronic Supplementary Material.
MeSH term(s)	Adolescent ; Adult ; Aged ; Aged, 80 and over ; Correspondence as Topic ; Early Diagnosis ; Female ; Humans ; Magnetic Resonance Imaging/statistics & numerical data ; Male ; Middle Aged ; Predictive Value of Tests ; Primary Health Care/standards ; Primary Health Care/statistics & numerical data ; Prospective Studies ; Quality Improvement/organization & administration ; Referral and Consultation/standards ; Referral and Consultation/statistics & numerical data ; Scotland ; Sensitivity and Specificity ; Spine/diagnostic imaging ; Young Adult
Language	English
Publishing date	2018-04-10
Publishing country	Germany
Document type	Journal Article ; Video-Audio Media
ZDB-ID	1115375-1
ISSN	1432-0932 ; 0940-6719
ISSN (online)	1432-0932
ISSN	0940-6719
DOI	10.1007/s00586-018-5578-0
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Article ; Online: Correlation between the length from the elbow to the distal interphalangeal joint of the little finger and the length of the intramedullary nail selected for femoral fracture fixation.

Alao, Uthman / Liew, Ignatius / Yates, Jonathan / Kerin, Cronan

Injury

2018 Volume 49, Issue 11, Page(s) 2058–2060

Abstract: Aim: To determine whether there is a correlation between the length of forearm to the distal interphalangeal joint (DIPJ) of the little finger and length of antegrade intramedullary (IM) femoral nails in adults.: Study design and methods: ... ...

Abstract	Aim: To determine whether there is a correlation between the length of forearm to the distal interphalangeal joint (DIPJ) of the little finger and length of antegrade intramedullary (IM) femoral nails in adults. Study design and methods: Measurements from the tip of the olecranon to the DIPJ of the ipsilateral upper limb was taken in 30 patients undergoing antegrade IM femoral nails. The length of the IM nails inserted was determined by intra-operative measurements using a guide wire. The two measurements were analysed for correlation and mean difference. Results: The mean forearm to DIP of little finger length was 38.86 with a standard deviation of 2.83. The mean IM length and standard deviation were 38.56 and 2.77 respectively. The difference between the two means 0.3 (95% CI). Correlation testing between the two variables shows a positive relationship (Pearson Correlation factor of 1). The scatter plot shows a positive linear relationship. Conclusions: Length of the forearm from the tip of the olecranon to the DIP joint of the little finger represents the ideal length of IM nail for the femur. It can be readily performed with the use of a tape measure and can serve as a useful adjunct to determining ideal length in cases where the contralateral femur cannot be used.
MeSH term(s)	Body Weights and Measures ; Bone Nails ; Elbow/anatomy & histology ; Femoral Fractures/surgery ; Fingers/anatomy & histology ; Forearm/anatomy & histology ; Fracture Fixation, Intramedullary/instrumentation ; Fracture Fixation, Intramedullary/methods ; Guidelines as Topic ; Humans ; Middle Aged ; Olecranon Process/anatomy & histology
Language	English
Publishing date	2018-08-30
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2018.08.024
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Article ; Online: CRP monitoring in fractured neck of femur. A waste of resource?

Qureshi, Mobeen / Liew, Ignatius / Bailey, Oliver

Injury

2018 Volume 49, Issue 10, Page(s) 1855–1858

Abstract: Aim: We aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively.: Study design and ... ...

Abstract	Aim: We aim to assess post-operative CRP serum values in a cohort of patients who underwent surgical treatment for neck of femur fracture (NOF#), and whether CRP is a valid tool for the assessment of these patients post-operatively. Study design and methods: Retrospective analysis was carried out on all NOF#'s admitted for surgical fixation between August 2015 and July 2016 in a district general hospital. Primary analysis included serum CRP levels until day 7 post-operatively, with secondary analysis of any documented evidence of post-operative complications (medical and surgical) within 30 days post-operatively. Results: A total of 365 patients were surgically treated for NOF#'s over the study period. CRP serum levels peaked over the first two days post-operatively to median (IQ range) of 226 mg/L (158-299 mg/L), decreasing to 67 mg/L (45.5-104 mg/L) by day 7 post-operatively. 116 patients had documented post-operative complications within 30 daysof operation. CRP levels in patients with and without complications showed no statistical significance in day-1, day-2 and day-3 post-operatively. However, a significant difference was demonstrated on day-4 (p = 0.017), day-5 (p = 0.003), day-6 (p = 0.02) and day-7 (p = 0.031). Conclusions: During the first three days of the postoperative period we cannot recommend routine CRP serum blood test monitoring in NOF# patients, as it is not diagnostic in the acute inflammatory phase for medical or surgical complications.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Biomarkers/blood ; C-Reactive Protein/metabolism ; Female ; Femoral Neck Fractures/surgery ; Fracture Fixation, Internal ; Humans ; Male ; Middle Aged ; Postoperative Complications/metabolism ; Postoperative Period ; Predictive Value of Tests ; Retrospective Studies ; Time Factors ; Unnecessary Procedures
Chemical Substances	Biomarkers ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2018-07-11
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	218778-4
ISSN	1879-0267 ; 0020-1383
ISSN (online)	1879-0267
ISSN	0020-1383
DOI	10.1016/j.injury.2018.07.005
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In stock of ZB MED Cologne/Königswinter

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In stock of ZB MED Cologne/Königswinter

Order via subito