Injury
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Randomized Controlled Trial
Serious game training improves performance in combat life-saving interventions.
In modern warfare, almost 25% of combat-related deaths are considered preventable if life-saving interventions are performed. Therefore, Tactical Combat Casualty Care (TCCC) training for soldiers is a major challenge. In 2014, the French Military Medical Service supported the development of 3D-SC1®, a serious game designed for the French TCCC program, entitled Sauvetage au Combat de niveau 1 (SC1). Our study aimed to evaluate the impact on performance of additional training with 3D-SC1®. ⋯ A total of 96 subjects were evaluated: seven could not be followed-up, while 50 were randomly allocated to the Intervention group, and 39 to the Control group. Between measure 1 and measure 2, the mean (SD) performance score increased from 9.9 (3.13) to 14.1 (1.23), and from 9.4 (2.97) to 12.5 (1.83), for the Intervention group and Control group, respectively (p<0.0001). The adjusted mean difference in performance scores between 3D-SC1® and DVD training was 1.1 (95% confidence interval -0.3, 2.5) (p=0.14). Overall, the study found that supplementing SC1 training with either 3D-SC1® or DVD improved performance, assessed by a hands-on simulation. However, our analysis did not find a statistically significant difference between the effects of these two training tools. 3D-SC1® could be an efficient and pedagogical tool to train soldiers in life-saving interventions. In the current context of terrorist threat, a specifically-adapted version of 3D-SC1®may be a cost-effective and engaging way to train a large civilian public.
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Randomized Controlled Trial Comparative Study
Sliding hip screw versus intramedullary nail for trochanteric hip fractures; a randomised trial of 1000 patients with presentation of results related to fracture stability.
To determine the optimum choice of implant for a patient with a the different types of trochanteric hip fracture. ⋯ This study is the first adequately powered randomised trial on this topic and demonstrates that there are no notable differences in either process or functional outcomes between these two treatment methods, other than a tendency to better regain of mobility for those fractures fixed with an intramedullary nail.
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Randomized Controlled Trial Comparative Study
Tibial plateau fracture management: arthroscopically-assisted versus ORIF procedure - clinical and radiological comparison.
Tibial plateau fractures are articular injuries that may influence final functional outcome of the knee. Although these fractures comprise only 1% of all fractures, the fracture pattern is usually complex and requires anatomical reduction and absolutely stable fixation to achieve satisfactory results. The development of knee osteoarthritis is a common late complication and it can be strongly influenced by additional, underestimated cartilage defects, and meniscal and ligament tears. ⋯ Both ARIF and ORIF can provide equally good results; however, ARIF seems to offer a more precise evaluation and treatment of associated intraarticular lesions and to reduce the duration of hospital stay.
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Randomized Controlled Trial Comparative Study
Posterior fragment in ankle fractures: anteroposterior vs posteroanterior fixation.
The aim of this study was to compare reduction quality and functional outcome of posterior malleolus fractures treated with indirect reduction and anteroposterior (AP) fixation or with direct reduction via a posterolateral approach and posteroanterior (PA) fixation. ⋯ The direct reduction technique via a posterolateral approach and PA fixation enables higher quality of reduction and better functional outcome in the management of the posterior fragment compared with indirect reduction and percutaneous AP fixation.
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Randomized Controlled Trial Comparative Study
Comparison between Carbon-Peek volar locking plates and titanium volar locking plates in the treatment of distal radius fractures.
Unstable intra articular fractures of distal radius are frequently being managed with open reduction and internal fixation. Volar locking plate based on polyetheretherketon (PEEK) polymer has developed lately as an alternative to conventional metallic devices. The advantage of this kind of plates include the lack of metal allergies, radiolucency, low artefacts on MRI or imaging scans and the high resistance associated to loading forces. The aim of this study was to evaluate the clinical and radiological results using a new Carbon-PEEK volar locking plate compared with titanium volar locking plates for the treatment of distal radius fractures. ⋯ Volar locking plates represent the most common procedure for the treatment of displaced distal radius fractures. In our series Carbon-peek volar locking plates seems to be analogue to titanium volar locking plates in terms of radiographic parameters and functional outcome.