Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 2014
Comparative StudyFixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis?
Surgical treatment for terrible triad injuries of the elbow (defined as elbow dislocations with concomitant fractures of the radial head and coronoid) remains a challenging clinical problem. Specifically, the question of whether to repair or replace the radial head remains controversial. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
Comparative StudyComplications of hinged external fixation compared with cross-pinning of the elbow for acute and subacute instability.
Elbows that are unstable after injury or reconstructive surgery often are stabilized using external fixation or cross-pinning of the joint supplemented by cast immobilization. The superiority of one approach or the other remains a matter of debate. ⋯ Level III, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
ReviewHip resurfacing versus total hip arthroplasty: a systematic review comparing standardized outcomes.
Metal-on-metal hip resurfacing was developed for younger, active patients as an alternative to THA, but it remains controversial. Study heterogeneity, inconsistent outcome definitions, and unstandardized outcome measures challenge our ability to compare arthroplasty outcomes studies. ⋯ Revisions and reoperations are more frequent and occur earlier with metal-on-metal hip resurfacing, except when discontinued devices are removed from the analyses. Results from the literature may be misleading without consistent definitions, standardized outcome metrics, and accounting for device market status. This is important when clinicians are assessing and communicating patient risk and when selecting which device is most appropriate for individual patients.
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Clin. Orthop. Relat. Res. · Jul 2014
Multicenter Study Comparative StudyComparative study of simple and complex open elbow dislocations.
Open elbow dislocations are rare injuries. Most of the evidence related to these dislocations is found in case reports or in series with closed injuries. We reviewed the experiences of three centers in the treatment of open elbow dislocations. ⋯ Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Jul 2014
Multicenter StudyAre there risk factors for complications of perforator-based propeller flaps for lower-extremity reconstruction?
Conventional pedicled flaps for soft tissue reconstruction of lower extremities have shortcomings, including donor-site morbidity, restricted arc of rotation, and poor cosmetic results. Propeller flaps offer several potential advantages, including no need for microvascular anastomosis and low impact on donor sites, but their drawbacks have not been fully characterized. ⋯ Level IV, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.