Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Oct 2015
Randomized Controlled Trial Comparative StudyHOPE-trial: hemiarthroplasty compared to total hip arthroplasty for displaced femoral neck fractures in the elderly-elderly, a randomized controlled trial.
A femoral neck fracture (FNF) is a common cause of suffering and premature death in the elderly population. Optimizing the treatment for improved outcome and a reduced need for secondary surgery is important both for the patient and the society. The choice of primary total or hemiarthroplasty in patients over eighty years are controversial. We hypothesized that total hip arthroplasty has an equal or better outcome in patient-reported outcome compared with hemiarthroplasty. ⋯ To our knowledge, this is the first randomized controlled trial comparing total hip arthroplasty and hemiarthroplasty for displaced femoral neck fracture in patients age 80 years and over.
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Bmc Musculoskel Dis · Oct 2015
Randomized Controlled TrialPersistence of pain in patients with chronic low back pain reported via weekly automated text messages over one year.
A previous study has suggested that it is uncommon for patients with chronic bothersome low back pain (LBP), who consult the secondary health care sector, to report at least four consecutive weeks without such bothersome pain in 1 year. It is not yet known, however, how many days of the week they experience pain throughout the year. ⋯ This study revealed there to be considerable variation in weekly persistence of symptoms during 1 year in patients from the secondary care sector with chronic LBP. The results range from bothersome pain each day of the week, every week of the year, to no weeks at all with 7 days of pain. Interestingly, this pattern is near-identical in the two study samples; those with non-specific LBP and those with LBP and Modic changes. This heterogeneic pain profile in patients with chronic LBP deserves to be further investigated.
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Bmc Musculoskel Dis · Oct 2015
Randomized Controlled Trial Comparative StudyComparison of the outcomes of cannulated screws vs. modified tension band wiring fixation techniques in the management of mildly displaced patellar fractures.
K wire fixation with tension band wiring has conventionally been used for the open reduction and internal fixation of the patella. However, it suffers from distinct disadvantages such as implant irritation, need for open reduction, incidence of palpable implants, and need for subsequent implant removal. A smaller incision with percutaneous fixation may be an alternative to this established conventional technique. Thus, the purpose of this trial was to compare the treatment outcomes of patients with mildly displaced patellar fractures treated with closed reduction and percutaneous cannulated screw fixation (CRCF) as compared to open reduction and tension band wiring fixation (ORTF). Specifically, we aimed to determine whether cannulated screw fixation was associated with improved clinical outcomes at 12 months as measured using the Lysholm score, pain scores, degree of flexion, range of motion, time to radiographic union, radiographic outcomes, and complication rates. ⋯ Surgical treatment of mild displaced (less than 8 mm) transverse patellar fractures by the CRCF technique provides satisfactory clinical results and excellent knee function, with little pain and a low incidence of complications at early follow-up (up to 6 months). These results suggest that the CRCF technique may be a superior alternative to conventional ORTF. Registration Trial (Chinese Clinical Trial Register): Current Controlled Trials ChiCTR-PRCH-14005017, registration dates 2014-06-14.