Injury
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Randomized Controlled Trial Clinical Trial
Intra-articular lignocaine versus Entonox for reduction of acute anterior shoulder dislocation.
We assessed, in a prospective randomised trial, the relative analgesic effects of Entonox and intra-articular lignocaine (IAL) in patients with acute anterior dislocation of the shoulder. A statistically significant reduction in pain scores was achieved with IAL (7.9 vs 5.2, P < 0.05), but the effect with Entonox was greater (7.8 vs 2.9, P < 0.001). We conclude that Entonox provides better analgesia than IAL in patients with acute anterior shoulder dislocation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Kocher's painless reduction of anterior dislocation of the shoulder: a prospective randomised trial.
Forty-five patients with an anterior dislocation of the shoulder were randomised into one of two treatment groups and manipulation performed using Kocher's original method (without traction). A successful reduction was achieved in 80.9% of patients administered Entonox only and in 100% of patients sedated intravenously. No statistical significance was found in the pain scores between the two groups. The study shows that Kocher's original method is a reliable technique for reducing anterior dislocation of the shoulder and a successful outcome can be expected using nitrous oxide only, obviating the need for intravenous sedation and analgesia in the majority of patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of dynamic hip screw and gamma nail: a prospective, randomized, controlled trial.
We report a prospective, randomized, controlled trial, comparing the results of treatment with a dynamic hip screw (DHS) and a gamma nail in 95 consecutive patients with peri-trochanteric fractures of the femur. The DHS was used in 48 patients, the gamma nail in 47. Clinical and radiological outcomes were similar, but the gamma nail was associated with a higher incidence of complications, in particular fracture of the femur below the implant in eight cases. This is consistent with previous reports, and we do not recommend the gamma nail for the treatment of peri-trochanteric femoral fractures.