Injury
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Randomized Controlled Trial
Posterior malleolar fracture morphology determines outcome in rotational type ankle fractures.
Rotational type ankle fractures with a concomitant fracture of the posterior malleolus are associated with a poorer clinical outcome as compared to ankle fractures without. However, clinical implications of posterior malleolar (PM) fracture morphology and pattern have yet to be established. Many studies on this subject report on fragment size, rather than fracture morphology based on computed tomography (CT). The overall purpose of the current study was to elucidate the correlation of PM fracture morphology and functional outcome, assessed with CT imaging and not with -unreliable- plain radiographs. ⋯ Posterior malleolar ankle fractures with medial extension of the fracture line (i.e. Haraguchi Type II) are associated with significantly poorer functional outcomes. The current dogma to fix PM fractures that involve at least 25-33% of the tibial plafond may be challenged, as posterior malleolar fracture pattern and morphology - rather than fragment size - seem to determine outcome.
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Randomized Controlled Trial
Hip precautions not meaningful after hemiarthroplasty due to hip fracture. Cluster-randomized study of 394 patients operated with direct anterolateral approach.
We aimed to compare two treatment regimes, one with and one without postoperative precautions in hemiarthroplasty patients, in terms of dislocation rate and patient-reported outcome. Direct lateral approach was used. ⋯ Rehabilitation precautions are not needed for preventing dislocation when direct lateral approach is used. Without precautions, rehabilitation personnel implement significantly shorter work effort during hospital. We found no statistically significant differences regarding PROM and complications except for somewhat more reoperations in total in the precaution group.
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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.