Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Dec 2011
Locked plating of proximal humeral fractures: is function affected by age, time, and fracture patterns?
Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether these improve function and if so for which patients. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
Randomized Controlled Trial Comparative StudySuperiority of the Bryan(®) disc prosthesis for cervical myelopathy: a randomized study with 3-year followup.
The current standard of care for cervical myopathy is anterior discectomy and fusion (ACDF). Although well tolerated in the short term, this treatment might ultimately result in progressive degeneration of adjacent motion segments. Artificial disc arthroplasty offers the theoretical advantage of preservation of motion at the operative level with consequent stress reduction at adjacent levels. ⋯ Level II, therapeutic study. See the Guidelines for Authors for a complete description of the levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
Randomized Controlled TrialFunction plateaus by one year in patients with surgically treated displaced midshaft clavicle fractures.
Based on short-term (1 year or less) followup, primary fixation of displaced midshaft clavicle fractures reportedly results in better function compared with that reported for nonoperative methods. Whether better function persists beyond 1 year is unclear. ⋯ Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
A reliable radiographic measurement technique for extra-articular scapular fractures.
Currently, neither well-defined nor standardized measurement techniques exist for assessing deformity of extra-articular scapular fractures. To properly evaluate these injuries, compare observations across studies, and make clinical decisions, a validated measurement protocol for evaluating scapular fractures is needed. ⋯ Level IV, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Dec 2011
Diagnostic performance tests for suspected scaphoid fractures differ with conventional and latent class analysis.
Evaluation of the diagnostic performance characteristics of radiographic tests for diagnosing a true fracture among suspected scaphoid fractures is hindered by the lack of a consensus reference standard. Latent class analysis is a statistical method that takes advantage of unobserved, or latent, classes in the data that can be used to determine diagnostic performance characteristics when there is no consensus reference (gold) standard. ⋯ Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.