International orthopaedics
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The choice between reamed and unreamed intramedullary nailing for the treatment of open and closed tibial fractures is an ongoing controversy. We carried out a comprehensive search strategy. Six eligible randomised controlled trials were included. ⋯ Our results suggested no statistical differences in risk reduction of all the complications evaluated between reamed and unreamed nails in open tibial fractures. In conclusion, our study recommended reamed nails for the treatment of closed tibial fractures. But the choice for open tibial fractures remains uncertain.
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Review Meta Analysis
Closed suction surgical wound drainage after hip fracture surgery: a systematic review and meta-analysis of randomised controlled trials.
There is still debate over the use of drains following hip fracture surgery. We have performed a systematic review and meta-analysis of the literature for randomised trials that related to the use of closed suction drains following hip fracture surgery. ⋯ All other outcomes reported failed to show any benefit from the use of drains. Further randomised trials are required and until they have been undertaken the efficacy of closed surgical drainage systems in hip fracture surgery is unknown.
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Meta Analysis
Surgical versus non-surgical treatment of chronic low back pain: a meta-analysis of randomised trials.
We performed a meta-analysis of randomised controlled trials to investigate the effectiveness of surgical fusion for the treatment of chronic low back pain compared to non-surgical intervention. Several electronic databases (MEDLINE, EMBASE, CINAHL and Science Citation Index) were searched from 1966 to 2005. The meta-analysis comparison was based on the mean difference in Oswestry Disability Index (ODI) change from baseline to the specified follow-up of patients undergoing surgical versus non-surgical treatment. ⋯ This difference in ODI was not statistically significant and is of minimal clinical importance. Surgery was found to be associated with a significant risk of complications. Therefore, the cumulative evidence at the present time does not support routine surgical fusion for the treatment of chronic low back pain.