Articles: fracture-fixation.
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Eur J Trauma Emerg Surg · Oct 2024
Review Meta AnalysisCement augmentation for proximal humerus fractures: a meta-analysis of randomized trials and observational studies.
It is unclear if elderly patients treated with plate osteosynthesis for proximal humerus fractures benefit from cement augmentation. This meta-analysis aims to compare cement augmentation to no augmentation regarding healing, complications, and functional results. ⋯ This meta-analysis shows that cement augmentation may reduce overall complications, mainly by preventing implant-related complications. No difference was detected regarding need for re-intervention, functional scores, general quality of life, and hospital stay. This is the first meta-analysis on this topic. It remains to be seen whether conclusions will hold when more and better-quality data becomes available.
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Eur J Trauma Emerg Surg · Oct 2024
Review Meta AnalysisComplications following surgical treatment of patella fractures - a systematic review and proportional meta-analysis.
The aim of this systematic review and proportional meta-analysis was to identify complications of surgical treatment of patella fractures and to estimate their incidence. We extended existing knowledge on this topic by including several more recent and large-scale studies. ⋯ Surgically, treatment of patella fractures was associated with a high risk of complications. The most common complication was symptomatic implant removal, affecting 29.6% of patients. Other complications stated were fixation failure 5.2%, infections 3.1% and nonunion 1.7%.
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Meta Analysis Comparative Study
Extra-articular proximal tibia fracture fixation with locked plating versus intramedullary nailing: A meta-analysis.
This study compared outcomes of locked plating (LP) versus intramedullary nailing (IMN) techniques for treatment of extra-articular proximal-third tibia fractures. ⋯ Therapeutic Level III.
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Cochrane Db Syst Rev · Aug 2024
Review Meta AnalysisSurgical fixation methods for tibial plateau fractures.
Tibial plateau fractures, which are intra-articular injuries of the knee joint, are often difficult to treat and have a high complication rate, including early-onset osteoarthritis. The most common treatment for complex tibial plateau fractures is surgical fixation. Additionally, orthopaedic surgeons often use bone defect fillers to address bone defects caused by the injury. Currently, there is no consensus on the best method of fixation and on whether bone defect fillers are necessary. ⋯ There is insufficient evidence to ascertain the best method of fixation or the best method of addressing bone defects during surgery in people with tibial plateau fractures. Further well-designed RCTs with larger sample sizes are warranted.
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Review Meta Analysis
Surgical stabilisation of rib fractures: A meta-analysis of randomised controlled trials.
Rib fixation for ventilator dependent flail chest patients has become a mainstay of management in major trauma centres. However, the expansion of rib fixation for fractured ribs beyond this remains largely in the hands of enthusiasts with the benefits in non ventilator dependent groups largely unproven. Previous meta-analyses have largely included non-randomised and retrospective data, much of which is now more than two decades out of date. We wanted to perform an updated meta-analysis including only rigorous prospective trials which were randomised. Further we wanted to include quality of life outcomes which have not been previously examined in published meta-analyses. ⋯ Operative intervention for rib fractures leads to significantly lower rates of pneumonia, lengths of intensive care stay and time on mechanical ventilation compared to non-operative intervention. Further study is needed to investigate quality of life improvements after rib fractures as operative rib fixation expands to non-ventilator dependent groups.