Journal of shoulder and elbow surgery
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J Shoulder Elbow Surg · Mar 2013
Meta Analysis Comparative StudyPlate versus intramedullary nail fixation in the treatment of humeral shaft fractures: an updated meta-analysis.
Regarding the treatment of humeral shaft fractures, the choice of plating or intramedullary nailing remains controversial. Previous randomized controlled trials and meta-analyses failed to draw a unanimous conclusion. To guide clinical decision making, we conducted an updated meta-analysis on the optimal treatment of humeral shaft fractures. ⋯ Level II, Meta-analysis of prospective comparative trials.
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J Shoulder Elbow Surg · Mar 2013
Randomized Controlled Trial Comparative StudyDiaphragm function after interscalene brachial plexus block: a double-blind, randomized comparison of 0.25% and 0.125% bupivacaine.
Interscalene brachial plexus block (ISBPB) provides excellent analgesia after rotator cuff surgery but is associated with diaphragm dysfunction. In this study, ISBPB with 20 mL of 0.125% or 0.25% bupivacaine were compared to assess the effect on diaphragm function, oxygen saturation, pain control, opioid requirements, and patient satisfaction. ⋯ In this randomized, double-blind comparison of ISBPB performed with 20 mL of 0.125% or 0.25% bupivacaine, diaphragm function and oxygen saturation were superior in patients treated with more dilute bupivacaine. Furthermore, there were no clinically significant differences in pain scores, and no statistically significant differences in opioid requirements and patient satisfaction.
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J Shoulder Elbow Surg · Mar 2013
ReviewPreventing venous thromboembolism in elective upper limb surgery.
Deep venous thrombosis (DVT) and pulmonary embolism (PE) have considerable clinical and economic consequences. The prevention of venous thrombosis and PE are increasingly seen as quality markers for surgery. Guidance is available from a number of sources to stratify risk for different patients and procedures and to define an appropriate standard of care. Despite this, best practice is unclear. ⋯ Review Article.