Articles: fracture-fixation.
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Eur J Trauma Emerg Surg · Dec 2020
Multicenter StudyEffect of fracturoscopy on the incidence of surgical site infections post tibial plateau fracture surgery.
Surgical treatment of tibial plateau fracture (TPF) is common. Surgical site infections (SSI) are among the most serious complications of TPF. This multicentre study aimed to evaluate the effect of fracturoscopy on the incidence of surgical site infections in patients with TPF. ⋯ Level III.
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Multicenter Study
Predicting tibia shaft nonunions at initial fixation: An external validation of the Nonunion Risk Determination (NURD) score in the SPRINT trial data.
Predictive models are common in orthopedic research; however, most models are not validated in an external population. The Nonunion Risk Determination (NURD) score was developed using a single-center cohort of 382 patients to reliably predict tibia shaft nonunions at the time of initial intramedullary nail fixation. The purpose of this study was to externally validate the NURD score using data from the SPRINT Trial. ⋯ Based on our external validation, the NURD score lacks generalizability as it underperforms with respect to discrimination in the SPRINT trial data. However, after adjusting for case-mix differences, the performance of the NURD score is comparable between the two datasets, suggesting robust reproducibility.
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Health Technol Assess · Oct 2020
Randomized Controlled Trial Multicenter StudySurgical fixation compared with cast immobilisation for adults with a bicortical fracture of the scaphoid waist: the SWIFFT RCT.
Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. Immediate surgical fixation of this fracture has increased. ⋯ Adult patients with an undisplaced or minimally displaced scaphoid waist fracture should have cast immobilisation and suspected non-unions immediately confirmed and urgently fixed. Patients should be followed up at 5 years to investigate the effect of partial union, degenerative arthritis, malunion and screw problems on their quality of life.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
Surgery versus cast immobilisation for adults with a bicortical fracture of the scaphoid waist (SWIFFT): a pragmatic, multicentre, open-label, randomised superiority trial.
Scaphoid fractures account for 90% of carpal fractures and occur predominantly in young men. The use of immediate surgical fixation to manage this type of fracture has increased, despite insufficient evidence of improved outcomes over non-surgical management. The SWIFFT trial compared the clinical effectiveness of surgical fixation with cast immobilisation and early fixation of fractures that fail to unite in adults with scaphoid waist fractures displaced by 2 mm or less. ⋯ National Institute for Health Research Health Technology Assessment Programme.
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Multicenter Study Observational Study
Colles' type distal radial fractures undergoing manipulation in the ED: a multicentre observational cohort study.
Colles' type fractures of the distal radius are one of the most commonly manipulated fractures in the ED. Local audit data suggest that a high proportion of these injuries undergo subsequent surgical fixation. If widespread, this could represent a potential burden on patients and the NHS worthy of further research. The aims of this study were to estimate the rate of surgical fixation of Colles' type distal radial fractures after ED fracture manipulation and explore variations in their management in UK EDs. ⋯ Subsequent surgical fixation was carried out in 41% of patients who underwent manipulation of Colles' type wrist fractures in this cohort. This merits further research and represents a potential target to rationalise repeat procedures.