Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Nov 2019
Comparative StudySuprapatellar versus infrapatellar approaches in the treatment of tibia intramedullary nailing: a retrospective cohort study.
Tibial shaft fractures are routinely managed with intramedullary nailing (IMN). An increasingly accepted technique is the suprapatellar (SP) approach. The purpose of this study was to compare the clinical and functional outcomes of knee joint after tibia IMN through an suprapatellar (SP) or traditional infrapatellar (IP) approach. ⋯ Both SP and IP approach results in equivalent overall HSS knee scores. However, for the HSS component, the IP approach was superior to SP approach regarding the ROM.
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Bmc Musculoskel Dis · Nov 2019
Meta AnalysisComparison between minimally invasive plate osteosynthesis and open reduction-internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals.
This meta-analysis aimed to compare the clinical outcomes and complications of minimally invasive plate osteosynthesis (MIPO) and open reduction-internal fixation (ORIF) in patients with proximal humeral fractures. ⋯ The present evidence indicates that compared to ORIF, MIPO had advantages in functional outcomes, operation time, blood loss, postoperative pain, and fracture union time for the treatment of PHFs. However, the MIPO technique had a higher rate of axillary nerve injury and longer radiation time compared to ORIF.
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Bmc Musculoskel Dis · Nov 2019
Non-inferior comparative study comparing one or two day antimicrobial prophylaxis after clean orthopaedic surgery (NOCOTA study): a study protocol for a cluster pseudo-randomized controlled trial comparing duration of antibiotic prophylaxis.
Antimicrobial prophylaxis (AMP) is one of the most important measures for preventing surgical site infections (SSIs); however, controversies remain regarding its adequate duration. Although the World Health Organization and the Center for Disease Control and Prevention do not recommend additional AMP after closure, the American Society of Health-System Pharmacists and the Musculoskeletal Infection Society permit the use of postoperative AMP, but recommend discontinuation within 24 h. Similarly, the Japanese Society of Chemotherapy and the Japan Society for Surgical Infection also permit AMP within 24-48 h after various orthopaedic procedures. In these guidelines, recommendations regarding AMP duration were weak due to a relative lack of evidence, and currently, there is no high-quality evidence comparing AMP use within 24 h versus 24-48 h regarding orthopaedic procedures. Urinary tract infection (UTI) and respiratory tract infection (RTI) are also important health care-associated infections (HAIs) faced after surgery. Although AMP duration may affect these HAIs, its effects have not been well evaluated. ⋯ This study may provide valuable information for developing future recommendations for adequate AMP duration after clean orthopaedic surgery.
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Bmc Musculoskel Dis · Nov 2019
Comparative StudyOpen reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation.
Fractures of the humeral shaft represent 2-4% of all fractures. Fractures of the humerus have traditionally been approached posteriorly for open reduction and internal fixation. Reports of treating midshaft fractures with an open anterolateral approach and anterior plating are limited. The purpose of this study was to evaluate a series of humeral shaft fractures treated with plate osteosynthesis regarding the effect of the approach and plate location on the healing rate and occurrence of complications. ⋯ Open reduction and internal fixation using an anterior approach with plate fixation provides a safe alternative to posterior plating in the treatment of humeral shaft fractures. An anterior approach allows supine positioning of the patient and yields union and complication rates comparable to those of a posterior approach with plate fixation for the treatment of humeral shaft fractures.
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Bmc Musculoskel Dis · Nov 2019
Evaluation of tibial tunnel placement in single case posterior cruciate ligament reconstruction: reducing the graft peak stress may increase posterior tibial translation.
The killer turn has been documented as the primary drawback of posterior cruciate ligament (PCL) reconstruction. Fanelli advocated placing the tibial tunnel outlet in the inferior lateral part of the PCL fovea to reduce the killer turn. This study aimed to confirm the validity of Fanelli's viewpoint regarding PCL reconstruction technique and to assess the specific Fanelli tunnel area on the inferior lateral part of the PCL fovea. ⋯ PCL reconstruction in the Fanelli area, especially 10 mm inferior and 5 mm lateral to the PCL anatomical insertion, could reduce the peak stress of the graft and may reduce the killer turn. However, whether the posterior stability of the knee is affected needs to be further studied.