Injury
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Review Meta Analysis Comparative Study
External fixation versus open reduction with plate fixation for distal radius fractures: a meta-analysis of randomised controlled trials.
Both external fixation and open reduction with internal fixation (ORIF) using plates have been recommended for treatment of distal radius fractures. We conducted a systematic review and meta-analysis of randomised controlled trials comparing external fixation to ORIF. ⋯ ORIF with plate fixation provides lower DASH scores, better restoration of radial length and reduced infection rates as compared to external fixation for treatment of distal radius fractures.
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Randomized Controlled Trial Multicenter Study Comparative Study
Re-displacement of stable distal both-bone forearm fractures in children: a randomised controlled multicentre trial.
Displaced metaphyseal both-bone fractures of the distal forearm are generally reduced and stabilised by an above-elbow cast (AEC) with or without additional pinning. The purpose of this study was to find out if re-displacement of a reduced stable metaphyseal both-bone fracture of the distal forearm in a child could be prevented by stabilisation with Kirschner wires. ⋯ Pinning of apparent stable both-bone fractures of the distal forearm in children might reduce fracture re-displacement. The frequently seen complications of pinning might be reduced by a proper surgical technique.
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Randomized Controlled Trial
Proximal humeral fractures treated with hemiarthroplasty: does tenodesis of the long head of the biceps improve results?
Pathology of the long head of the biceps (LHB) may be the cause of anterior shoulder pain after hemiarthroplasty for treatment of fractures of the proximal humerus. The currently available literature lacks adequate randomised trials examining whether tenodesis of the LHB improves results. The purpose of this study was to evaluate the effects of tenodesis of the LHB on the clinical outcome following hemiarthroplasty for fractures of the proximal humerus. ⋯ Level I therapeutic.
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Comparative Study
Fracture of the distal radius with radial artery injury: injury description and outcome of vascular repair.
The ideal treatment of an isolated radial artery injury that is associated with a fracture of the distal radius is unknown. Our purposes were to assess the incidence of this injury pattern and to describe the outcomes of our treatment protocol. We hypothesised that combined routine repair of the artery during operative treatment results in a satisfactory outcome. ⋯ Our protocol resulted in adequate outcomes, a 71% patency rate (five of seven fractures with adequate vascular follow-up) and no evidence of symptoms related to a poorly perfused hand.
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Antegrade and retrograde nails are widely used for intramedullary fixation of humeral shaft fractures. Creating the rear entry is the crucial step for retrograde nailing. The common manual technique is associated with considerable risks of additional iatrogenic comminution of the distal humerus. ⋯ Use of access reamer and guide instrument is a safe and reproducible way of creating a rear entry hole for retrograde humeral nailing. The risk of additional comminution seems to be eliminated.