Injury
-
Randomized Controlled Trial Comparative Study
Application of rhBMP-7 and platelet-rich plasma in the treatment of long bone non-unions: a prospective randomised clinical study on 120 patients.
The purpose of this prospective randomised clinical study was to compare the efficacy of recombinant bone morphogenetic protein 7 (rhBMP-7) and platelet-rich plasma (PRP) as bone-stimulating agents in the treatment of persistent fracture non-unions. One hundred and twenty patients were randomised into two treatment groups (group rhBMP-7 vs. group PRP). Sixty patients with sixty fracture non-unions were assigned to each group (median age: 44 years, range 19-65, for the rhBMP-7 group and 41 years, range 21-62, for the PRP group, respectively). ⋯ The median number of operations performed prior to our intervention was 2 (range 1-5) and 2 (range 1-5) with autologous bone graft being used in 23 and 21 cases for the rhBMP-7 and PRP groups, respectively. Both clinical and radiological union occurred in 52 (86.7%) cases of the rhBMP-7 group compared to 41 (68.3%) cases of the PRP group, with a lower median clinical and radiographic healing time observed in the rhBMP-7 group (3.5 months vs. 4 months and 8 months vs. 9 months, respectively). This study supports the view that in the treatment of persistent long bone non-unions, the application of rhBMP-7 as a bone-stimulating agent is superior compared to that of PRP with regard to their clinical and radiological efficacy.
-
Randomized Controlled Trial Comparative Study
Outcome after femoral neck fractures: a comparison of Harris Hip Score, Eq-5d and Barthel Index.
The objective of this study was to evaluate the discriminatory ability and responsiveness of the Harris Hips Score, the Barthel Index and the Eq-5d (Euroqol) in an unselected population of patients with displaced femoral neck fracture. ⋯ All the scales may be used for this patient group, but Harris Hip Score performed better than the other scales.
-
Randomized Controlled Trial Comparative Study
A comparison of RhBMP-7 (OP-1) and autogenous graft for metaphyseal defects after osteotomy of the distal radius.
SUMMARY AIM: The aim of the study was to demonstrate whether RhBMP-7 is an effective alternative to autogenous bone graft in the healing of metaphyseal defects in the distal radius following corrective osteotomies for symptomatic malunion after distal radial fractures. ⋯ RhBMP-7 does not confer the same stability as bone graft, allowing shear forces across the osteotomy site when used in conjunction with non-bridging external fixation, reducing the capacity for healing and resulting in osteolysis. Using the RhBMP-7 with a pi-plate resulted in healing of the osteotomy, but at a slower rate than autogenous bone graft.
-
Randomized Controlled Trial
Gender differences in outcome in patients with hypotension and severe traumatic brain injury.
Animal studies have identified hormonal influences on responses to injury and recovery, creating a potential gender effect on outcome. Progesterone and oestrogen are thought to afford protection in the immediate post-injury period, suggesting females have an advantage, although there has been limited evidence of this in human outcome studies. ⋯ The study provides no evidence that females fare better than males following severe TBI, suggesting rather that females may fare worse.
-
Randomized Controlled Trial Comparative Study
A randomised study in all cervical hip fractures osteosynthesis with Hansson hook-pins versus AO-screws in 199 consecutive patients followed for two years.
A consecutive series of patients with all types of cervical hip fracture (both undisplaced and displaced) were randomised to osteosynthesis with Hansson hook-pins (n = 98) or AO-screws (n = 101). Background parameters, fracture type and reduction of the fracture did not differ significantly between the groups. Fifty-seven percent of the patients were operated on within 6 h of admission to hospital, 74% within 12 h and 92% within 24 h. ⋯ The remaining patients had only undergone removal of metalwork. Osteosynthesis thus proved to be a successful operation in many of the patients with displaced fractures. A preoperative, prognostic-based selection between osteosynthesis and arthroplasty is the future goal for optimised femoral neck fracture treatment.