Injury
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Randomized Controlled Trial
No influence of ibuprofen on bone healing after Colles' fracture - A randomized controlled clinical trial.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may delay bone healing. This knowledge is mainly derived from retrospective uncontrolled clinical studies and from animal experiments. The purpose of this prospective controlled study was to investigate whether ibuprofen influences pain, function, and bone healing after a Colles' fracture. ⋯ Ibuprofen treatment demonstrated a tramadol-sparing effect during the postoperative period. Neither wrist function nor radiological migration were influenced. The complication rate was higher in the ibuprofen-treated group compared the placebo-treated group.
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The purpose of this systematic review was to address the treatment of multiligament knee injuries in three major aspects, specifically (1) surgical versus nonoperative treatment, (2) repair versus reconstruction of injured ligamentous structures, and (3) early versus late surgery of damaged ligaments. ⋯ Our review suggests that the best treatment does not exist, but better functional and clinical outcomes have been achieved with reconstruction rather than repair. Surgery must be performed within the first three weeks. Delayed ACL reconstruction allows to reduce arthrofibrosis rate.
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Patients with Osteogenesis Imperfecta (OI) Type 3 may exhibit both primitive deformities and secondary fracture malunions on a femoral level. The orthopaedic surgeon's objective is to cure the deformities in order to prevent fractures and to treat the fractures in order to prevent deformities, by using telescopic nails as the gold standard method of fixation. However, the titanium elastic nail (TEN) is indicated as a possible alternative in certain selected cases. ⋯ In patients under the age of 4, with narrow medullary canals, low life expectancy, few to nil rehabilitative prospectives or severe comorbidities, the use of TEN may be considered as a less invasive approach compared to telescopic nail surgery, however only temporarily, as it will still most probably require a surgical revision a few years down the line.
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To i) quantify the agreement between comorbidities documented within medical records and an orthopaedic trauma dataset; and ii) compare agreement between these sources before and after the introduction of new comorbidity coding rules in Australian hospitals. ⋯ There has been improvement in the coding of certain comorbidities since the introduction of new coding rules, suggesting that, since 2015, administrative data has improved capacity to capture patients' comorbidity profiles. Consideration must be taken when using the ICD-10-AM data due to its limitations.
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Shoulder instability and reduced range of motion are two common complications of a total reverse shoulder arthroplasty. In this work, a new approach is proposed to estimate how the glenoid component positioning can influence the stability and the range of motion of a reverse shoulder prosthesis. ⋯ Some common complications of the reverse shoulder arthroplasty could be effectively reduced by a suitable positioning of the prosthesis components. In this work, using a new method based on virtual simulations, the influence of the glenosphere positioning has been investigated. An optimal configuration for the analysed case study has been found. The proposed approach could be used to find, with no in vivo experiments, the optimal position of a reverse shoulder prosthesis depending on the different dimensions and shape of the bones of each patient.