Injury
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Review Meta Analysis
What's old is best again Is anterior plating best for fixation of type-C pelvic fractures? A systematic review and meta-analysis.
Type-C pelvic fractures are a rare but potentially fatal injury that often leads to poor outcomes, despite surgical fixation. Many fixation methods are used but the optimal method remains contentious, with failure and complications common. This study compared outcomes for each fixation method. ⋯ Post-operative outcomes for surgically treated type-C pelvic fractures revealed a 'less-than-good' pooled outcome rate of 23% and a revision rate of 4%. Anterior plates outperformed most other systems particularly for patient reported outcomes. Pooled revision, patient-reported outcome and complication rates for type-C pelvic fractures have not previously been reported and these data provide a benchmark for practice and future research.
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Review Meta Analysis
Can serum biomarkers be used to rule out significant intracranial pathology in emergency department patients with mild traumatic brain injury? A Systemic Review & Meta-Analysis.
Interest has mounted into the use of objective clinical biomarkers for traumatic brain injury (TBI). This systematic review and meta-analysis aimed to synthesise the existing evidence investigating the use of serum & plasma biomarkers to exclude significant intracranial injuries seen on CT head scans in patients that present to ED with TBI. ⋯ The overall quality of evidence regarding the diagnostic accuracy of single biomarkers as a rule out for significant intracranial injury seen on CT head scans in ED patients with TBI is low. Based on current evidence, S100B is the only single biomarker with a validated clinical platform, pre-determined cut off threshold and moderate quality evidence; at this stage making it the biomarker of choice. More robust clinical outcome and economic impact data is required to support its incorporation into clinical decision tools.
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Review Meta Analysis
Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis.
Trauma accounts for nearly one-tenth of the global disability-adjusted life-years, a large proportion of which is seen in low- and middle-income countries (LMICs). Trauma can affect employment opportunities, reduce social participation, be influenced by social support, and significantly reduce the quality of life (QOL) among survivors. Research typically focuses on specific trauma sub-groups. This dispersed knowledge results in limited understanding of these outcomes in trauma patients as a whole across different populations and settings. We aimed to assess and provide a systematic overview of current knowledge about return-to-work (RTW), participation, social support, and QOL in trauma patients up to one year after discharge. ⋯ RTW and QOL are affected by trauma even a year after discharge and the social support received was moderate, especially among elderly and female patients. Future studies should move towards building more high-quality evidence from LMICs on long-term socioeconomic outcomes including social support, participation and unpaid work.
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Review Meta Analysis
RIA versus iliac crest bone graft harvesting: A meta-analysis and systematic review.
Reamer-Irrigator-Aspirator (RIA) of long bones is increasingly being used as an alternative to iliac crest harvesting for bone-grafts. This meta-analysis compares both harvesting techniques with regard to donor site morbidity, healing potency and implantation site morbidity. ⋯ The main difference between RIA and iliac crest bone graft harvesting is the considerable higher risk of chronic pain of the pelvic procedure. Although risk for infection was also higher for the iliac crest group, the absolute difference is relatively small. Evidence suggests an equal healing potential of the grafts themselves irrespective of harvesting method.
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The fifth metatarsal base avulsion fracture (i.e., Pseudo-Jones fracture) is one of the most common foot fractures. The management of pseudo-Jones fractures could be carried out surgically or conservatively. This systematic review and meta-analysis aimed to provide an update about the efficacy of orthotic removable support compared to short-leg casting for individuals with pseudo-Jones fracture. ⋯ The current meta-analysis reveals that there is no difference between orthotic removable support and short-leg casting for the conservative management of individuals sustaining pseudo-Jones fracture.