The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2004
Randomized Controlled Trial Comparative Study Clinical TrialTreatment of lumbar disc herniation: epidural steroid injection compared with discectomy. A prospective, randomized study.
Epidural steroid injection is a low-risk alternative to surgical intervention in the treatment of lumbar disc herniation. The objective of this study was to determine the efficacy of epidural steroid injection in the treatment of patients with a large, symptomatic lumbar herniated nucleus pulposus who are surgical candidates. ⋯ Epidural steroid injection was not as effective as discectomy with regard to reducing symptoms and disability associated with a large herniation of the lumbar disc. However, epidural steroid injection did have a role: it was found to be effective for up to three years by nearly one-half of the patients who had not had improvement with six or more weeks of noninvasive care.
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J Bone Joint Surg Am · Mar 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of handheld computer-assisted and conventional paper chart documentation of medical records. A randomized, controlled trial.
Daily documentation and maintenance of medical record quality is a crucial issue in orthopaedic surgery. The purpose of the present study was to determine whether the introduction of a handheld computer could improve both the quantitative and qualitative aspects of medical records. ⋯ Therapeutic study, Level I-1a (randomized controlled trial [significant difference]). See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialLigament reconstruction with or without tendon interposition to treat primary thumb carpometacarpal osteoarthritis. A prospective randomized study.
Trapezial excision with ligament reconstruction and trapezial excision with ligament reconstruction combined with tendon interposition have proven to be highly effective techniques for treating primary osteoarthritis of the thumb carpometacarpal joint. To determine whether tendon interposition and proximal migration of the thumb metacarpal affect the objective and subjective outcomes, we compared the long-term outcomes of these two procedures performed in similar patient groups. ⋯ Tendon interposition does not affect the outcome after the ligament reconstruction for the treatment of osteoarthritis of the thumb carpometacarpal joint. Furthermore, proximal migration of the thumb metacarpal does not appear to influence the functional outcome.
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J Bone Joint Surg Am · Dec 2003
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized trial comparing the limited contact dynamic compression plate with the point contact fixator for forearm fractures.
The most effective type of plate fixation for diaphyseal forearm fractures has not been defined. We performed a prospective, randomized trial in which the limited contact dynamic compression plate (LC-DCP) was compared with the Point Contact Fixator (PC-Fix) for the treatment of forearm fractures at one center. ⋯ Despite the differences in the concept of fracture fixation, these two implants appear to be equally effective for the treatment of diaphyseal forearm fractures.
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J Bone Joint Surg Am · Dec 2003
Comment Letter Randomized Controlled Trial Comparative Study Clinical TrialPreoperative autologous donation for hip replacement.