J Bone Joint Surg Br
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J Bone Joint Surg Br · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialLocal corticosteroid injection versus Cyriax-type physiotherapy for tennis elbow.
We performed a prospective, randomised trial on 106 patients to compare the effects of local corticosteroid injections with physiotherapy as advocated by Cyriax in the treatment of tennis elbow. The main outcome measures were the severity of pain, pain provoked by resisted dorsiflexion of the wrist, and patient satisfaction. At six weeks 22 of 53 patients in the injection group were free from pain compared with only three in the physiotherapy group. ⋯ After one year there were no significant differences between the two groups. Half of the patients, however, had received only the initial treatment, 20% had had combined therapy and 30% had had surgery. We conclude that at six weeks, treatment with corticosteroid injections was more effective than Cyriax physiotherapy and we recommend it because of its rapid action, reduction of pain and absence of side-effects.
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J Bone Joint Surg Br · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialThe repair of a ruptured deltoid ligament is not necessary in ankle fractures.
We randomised 50 patients with ankle fractures of Weber types B and C and a ruptured deltoid ligament treated by open reduction and internal fixation to two treatment groups to examine the influence of the repair of a ruptured deltoid ligament. No differences were found except for a longer duration of surgery in the repair group. Our findings suggest that a ruptured deltoid ligament can be left unexplored without any effect either on early mobilisation or on the long-term result.
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J Bone Joint Surg Br · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialFemoral nerve block in extracapsular femoral neck fractures.
We randomised 50 patients with extracapsular fractures of the femoral neck to receive either a bupivacaine femoral nerve block or systemic analgesia alone. A femoral nerve block was found to be an easy and effective procedure which significantly reduced perioperative analgesic requirements and postoperative morbidity.
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J Bone Joint Surg Br · May 1994
Randomized Controlled Trial Clinical TrialEchocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip.
We performed transoesophageal echocardiography on 20 patients with femoral neck fractures randomly treated with an uncemented Austin-Moore or cemented Hastings hemiarthroplasty. Cemented arthroplasty caused greater and more prolonged embolic cascades than did uncemented arthroplasty. Some emboli were more than 3 cm in length. In some patients the cascades were associated with pulmonary hypertension, diminished oxygen tension and saturation, and the presence of fat and marrow in aspirates from the right atrium.
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J Bone Joint Surg Br · Jan 1994
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialTreatment of grade-IIIb open tibial fractures. A prospective randomised comparison of external fixation and non-reamed locked nailing.
Severe open fractures of the tibia have a high incidence of complications and a poor outcome. The most usual method of stabilisation is by external fixation, but the advent of small diameter locking intramedullary nails has introduced a new option. We report the early results of a randomised, prospective study comparing external fixation with non-reamed locked nails in grade-IIIb open tibial fractures. ⋯ It is the treatment preferred by patients and does not require the same high level of patient compliance as external fixation. The only factors against nailing are the longer operating time and the greater need for fluoroscopy. We consider that locked non-reamed nailing is the treatment of choice for grade-IIIb open tibial fractures.