Injury
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Review Meta Analysis Comparative Study
Post-operative outcomes of open reduction and internal fixation versus circular external fixation in treatment of tibial plafond fractures: A systematic review and meta-analysis.
Tibial plafond fractures (TPF) are complex injuries often resulting in poor outcomes. Combination of articular impaction, metaphysealcomminution and soft-tissue injury results in a significant treatment challenge. The aim of this study was to conduct a systematic review and meta-analysis to compare post-operative complications and functional outcomes of open reduction and internal fixation (ORIF) versus circular external fixation (CEF) for treatment of TPF. ⋯ CEF and ORIF are both acceptable treatment options for surgical management of TPF, with comparable post-operative complication rates and functional outcomes. This study highlights paucity of high-quality evidence regarding the optimal fixation method for TPF.
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Meta Analysis Comparative Study
Non-operative versus operative management of open fractures in the paediatric population: A systematic review and meta-analysis of the adverse outcomes.
Open fractures are at greater risk of infection and delayed bone healing. Guidelines to reduce these risks exist for adult open fracture management but not for paediatric open fractures, where there is considerable practice variability. This systematic review evaluates the quality of the evidence and clinical outcomes for paediatric open fractures treated non-operatively versus operatively. ⋯ Operative intervention was more frequent in GA III fractures, where the risk of infection was highest. Operative management of GA III fractures was not associated with a lower infection risk compared to non-operative management. Robust prospective multi-centre studies are needed to explore further the most effective management of paediatric open fractures and to inform guideline development.
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Review Meta Analysis Comparative Study
Surgical hand rubbing versus surgical hand scrubbing: Systematic review and meta-analysis of efficacy.
Surgical hand rubbing (SHR) and surgical hand scrubbing (SHS) are two common methods used by surgeons to reduce surgical site infections. To date, the optimal method that can effectively reduce these infections remains unknown. In this study, we performed a comprehensive statistical analysis to compare the efficacy of these two methods in effectively controlling surgical site infections. ⋯ From the literature, it was evident that SHR had similar efficacy to SHS, without necessarily increasing costs. Owing to advantages such as ease of application, exposure to less dermal irritation, and less time consumption, SHR is recommended as a cost-effective alternative for management of surgical site infections.
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Review Meta Analysis
Surgical outcome of chronic Lisfranc injury without secondary degenerative arthritis: A systematic literature review✰.
Chronic Lisfranc joint injuries (tarsometatarsal, TMT) can present as a variety of clinical symptoms and radiographic findings. If significant arthritis at the Lisfranc joint is present, salvage arthrodesis is an option. For patients who receive a delayed diagnosis and/or present with no signs of arthritic changes, selecting the most appropriate treatment can be challenging. This article provides a systematic review of current surgical treatment options and outcomes for patients with a chronic Lisfranc injury but no secondary degenerative changes. ⋯ Level IV; Systematic Review of Level IV Studies.
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Review Meta Analysis
The association between sarcopenia and fracture in middle-aged and elderly people: A systematic review and meta-analysis of cohort studies.
The association between sarcopenia and risk of fracture remained controversial. This systematic review and meta-analysis was conducted to evaluate the association between sarcopenia and fracture incidence in the middle-aged and elderly people. ⋯ Our meta-analysis found that sarcopenia was significantly associated with fracture in middle aged and elderly people. However, more homogeneous studies are needed to fully clarify the relationship between sarcopenia and fracture.