Articles: fracture-fixation.
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J Bone Joint Surg Am · Aug 2017
Randomized Controlled Trial Multicenter StudyThe Clavicle Trial: A Multicenter Randomized Controlled Trial Comparing Operative with Nonoperative Treatment of Displaced Midshaft Clavicle Fractures.
The treatment of displaced midshaft clavicle fractures remains controversial. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Randomized Controlled Trial
Tranexamic acid reduces hidden blood loss in the treatment of intertrochanteric fractures with PFNA: a single-center randomized controlled trial.
Hidden blood loss is a major concern for patients undergoing hip surgery for intertrochanteric fracture. The objective of this study was to investigate whether tranexamic acid (TXA) could reduce postoperative hidden blood loss in patients undergoing hip surgery for intertrochanteric fracture. ⋯ TXA significantly reduced postoperative hidden blood loss in patients with intertrochanteric fracture who underwent PFNA. (Registration number: ChiCTR-INR-16008134).
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The bone & joint journal · Aug 2017
Randomized Controlled TrialPlate fixation versus intramedullary nailing of completely displaced midshaft fractures of the clavicle: a prospective randomised controlled trial.
This is a prospective randomised controlled trial comparing the functional outcomes of plate fixation and elastic stable intramedullary nailing (ESIN) of completely displaced mid-shaft fractures of the clavicle in the active adult population. ⋯ Both methods return the patients to their pre-injury functional levels, but plate fixation has a faster recovery period in comminuted fractures than ESIN. ESIN has a shorter operative time and lower infection and implant rates of failure when using 2.5 mm nails or wider, suggesting that this is the preferred method in mid-shaft fractures with no comminution, whereas plate fixation is the superior method in comminuted fractures. Cite this article: Bone Joint J 2017;99-B:1095-1101.
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Randomized Controlled Trial Multicenter Study
Tight intra-operative blood pressure control versus standard care for patients undergoing hip fracture repair - Hip Fracture Intervention Study for Prevention of Hypotension (HIP-HOP) trial: study protocol for a randomised controlled trial.
Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control. ⋯ This is a small-scale pilot study investigating the feasibility of a trial of tight intra-operative blood pressure control in a frail elderly patient group with known high morbidity and mortality. Positive findings will provide the basis for a larger-scale study.
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Eur J Orthop Surg Tr · Jul 2017
Randomized Controlled Trial Comparative StudyPeriprosthetic fracture around a stable femoral stem treated with locking plate osteosynthesis: distal femoral locking plate alone versus with cerclage cable.
To promote rapid bone healing, an adequate stable fixation implant with a percutaneous reduction instrument should be used for Vancouver type B1 or C fractures. The objective of this study was to describe radiographic and clinical outcomes of patients with periprosthetic fracture (PPF) around a stable femoral stem, treated with a distal femoral locking plate alone or with a cerclage cable. A total of 21 patients with PPF amenable to either a reverse distal femoral locking plate (LCP DF®) alone or with a cerclage cable, with a mean age of 75.7 years, were included. ⋯ Group II had a significantly longer operation time (P = 0.019) than group I and included one patient with nonunion at the final 24-month follow-up visit after the initial fracture reduction. However, this difference in nonunion rate for the two groups is more likely to inappropriate indications than surgical techniques. When comparing the stability of the fractures in both groups, there was no statistically significant difference, which might be attributed to the stable fixed-angle implant.