International orthopaedics
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Randomized Controlled Trial
Pre-emptive injection of peri-articular-multimodal drug for post-operative pain management in total knee arthroplasty: a double-blind randomized clinical trial.
Severe post-operative pain is one of the main problems after total knee arthroplasty. In this study, we investigated the effect of a peri-articular multimodal drugs injections pre-emptively on post-operative pain control and knee functions following total knee arthroplasty. ⋯ Level I.
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Review Meta Analysis
Meta-analysis suggests that the electromagnetic technique is better than the free-hand method for the distal locking during intramedullary nailing procedures.
To evaluate the comparative effectiveness and accuracy of electromagnetic technique (EM) verses free-hand method (FH) for distal locking in intramedullary nailing procedure. ⋯ The existing evidence suggests EM technique is a better alternative for distal locking in intramedullary nailing procedure, and this might aid in the management of diaphyseal fractures in lower extremities.
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Open tibial fractures needing soft tissue cover are challenging injuries. Infection risk is high, making treatment difficult and expensive. Delayed skin closure has been shown to increase the infection rate in several studies. We aimed at calculating the direct and indirect cost of treatment, and to determine the effect of delayed skin closure on this cost. ⋯ Severe open tibial fractures covered with free flaps, cause over a year of absenteeism. Infection increases direct cost of treatment over 60 % and roughly doubles LOS. Early soft-tissue cover and correct antibiotics have been shown to improve outcomes-underscoring the need for rapid referral to centres with an ortho-plastic set-up to handle such injuries.
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Osteoporotic vertebral fractures (OVF) can lead to late collapse which often causes kyphotic spinal deformity, persistent back pain, decreased lung capacity, increased fracture risk and increased mortality. The purpose of our study is to compare the efficacy and safety of vertebroplasty against conservative management of osteoporotic vertebral fractures without neurologic symptoms. ⋯ In our study on OVF, vertebroplasty delivered superior clinical and radiological outcomes over the first year from intervention when compared to conservative treatment of patients with osteoporotic compression fractures without neurological deficit. We believe that the possibility of evolution towards progressive kyphosis is sufficient to justify prophylactic and therapeutic intervention such as vertebroplasty, a minor gesture compared with extensive correction surgery and stabilization.
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Recent studies have reported short-term favourable results of tantalum-made components in acetabular revisions with bone loss. However, there is a lack of information regarding the mid to long-term results of such components. ⋯ When facing an acetabular revision with severe bone loss, tantalum-made components can provide a stable fixation. This study at a minimum five-year follow-up compares favourably with other reconstruction techniques, but longer follow-up is still required.