Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Clinical TrialThe epidemic of ankle fractures in the elderly--is surgical treatment warranted?
Ankle fractures in the elderly are extremely common (up to 184 fractures per 100,000 persons per year, and of these approximately 20%-30% occur in the elderly). The medical literature contains no research that has investigated ankle fractures in the elderly. A prospective, randomised study was conducted of 84 patients with displaced ankle fractures, who were over the age of 65 years and were assigned to operative or conservative treatment after closed reduction. ⋯ The costs of treatment were accordingly higher. These results call for consideration of a non-operative approach to the treatment of well-reduced ankle fractures in the elderly. Increased efforts should be invested in the prevention of these common fractures.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe treatment of pulled elbow: a prospective randomized study.
To evaluate the effectiveness in decreasing recurrence of cast application after manual reduction of pulled elbow. Sixty-four children with pulled elbow were randomized into two treatment groups: Group A underwent manipulative reduction followed by splinting the elbow in a flexed and supinated position for 2 days; group B underwent manipulative reduction only. ⋯ Four (13%) of 31 patients in group B had a pulled elbow 2-5 days later. Immobilizing the elbow for 2 days after manipulative reduction improves the success of treatment of a pulled elbow.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe incidence of thrombosis in high tibial osteotomies with and without the use of a tourniquet.
In a prospective randomised study, 65 high tibial osteotomies were performed in cases of varus osteoarthritis of the knee, and the incidence of thrombosis with and without the use of a tourniquet was studied. With an average incidence of thrombosis of 10.8%, no statistically significant differences between these two groups were seen.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Clinical TrialDo Colles' fracture patients benefit from routine referral to physiotherapy following cast removal?
Colles' fracture patients who received physiotherapy immediately following cast removal were compared with patients who received no active therapy following cast removal in a prospective randomised study. Patients who attended physiotherapy achieved significantly greater increases in wrist extension and grip strength after 6 weeks compared to patients who received no active therapy.
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Arch Orthop Trauma Surg · Jan 2000
Randomized Controlled Trial Clinical TrialTransesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty. A randomized study in patients with a femoral neck fracture.
Forty patients suffering from a medial femoral neck fracture participated in a prospective, randomized study. In 20 patients, the femoral component was cemented using a contemporary technique. In the patient group operated on with the bone vacuum technique, the medullary cavity was drained during the insertion of the stem. ⋯ These distinct hemodynamic changes were not observed in the bone vacuum group. This study was able to show a clearly reduced risk of pulmonary emboli using the bone vacuum cementing technique. The presence of pre-existing disease greatly magnified the clinical relevance of fat embolism.