Articles: fracture-fixation.
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Randomized Controlled Trial Comparative Study
Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures: Zimmer natural nail versus proximal femoral nail antirotation II.
Although both clinical and biomechanical studies suggest that cephalomedullary implants have a mechanical advantage over extramedullary implants, a high rate of complications or implant failure remains in elderly patients with osteoporosis. In an attempt to address some of these challenges, new implants with improved designs named proximal femoral nail antirotation II (PFNA II) and Zimmer natural nail (ZNN) were developed for elderly patients. Although the PFNA II reportedly has good clinical outcomes, it is unclear which implant achieves better safety and efficacy for treating intertrochanteric hip fractures. The primary objective of this prospective, randomized trial involved 353 patients was to evaluate Harris Hip Score (HHS). The secondary objective was to compare results associated with clinical outcome such as operation time, fluoroscopy time, lateral hip pain, walking ability, and reoperation rate as well as the incidence of cut-out by using implant position and fracture reduction quality. ⋯ Although group I had significant longer operation and fluoroscopy time than group II, both implants are useful tools in the treatment of elderly intertrochanteric fractures as well as only TAD, but not Cleveland zone significantly correlated with lag screw cut-out.
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Randomized Controlled Trial Comparative Study
Role of acute negative pressure wound therapy over primarily closed surgical incisions in acetabular fracture ORIF: A prospective randomized trial.
Negative pressure wound therapy use over closed surgical incisions (iNPWT) has proven to be effective at reducing hematoma, wound drainage and infection in high-risk wounds. The purpose of this study was to determine if iNPWT decreased the risk of infection in patients undergoing open reduction internal fixation (ORIF) for acetabular fractures. ⋯ In this randomized prospective trial, iNPWT did not decrease the incidence of deep infections when compared to gauze dressings in patients with acetabular fractures. Although not statistically significant, patients in the iNPWT cohort were 2.77 times more likely to develop a deep infection.
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Randomized Controlled Trial Comparative Study
Outcome evaluation of minimally invasive surgery versus extensile lateral approach in management of displaced intra-articular calcaneal fractures: A randomised control trial.
Minimally invasive surgery has a significant and evolving role in the treatment of DIACFs, but there is limited literature on this topic. ⋯ MIS methods minimized soft tissue complications and achieved comparable radiological reductions but clinical outcomes were poorer, with percutaneous methods having the worst outcomes.
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Randomized Controlled Trial
Evaluation of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow: A retrospective study.
This retrospective study aims to investigate the efficacy and safety of a combined posterior lateral and anteromedial approach in the treatment of terrible triad of the elbow (TTE). ⋯ Patients with TTE who received a combined posterior lateral and anteromedial treatment had an increased fracture healing rate, showed improved recovery of elbow functions and had fewer complications.
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Randomized Controlled Trial Comparative Study
Clinical comparison between open plating and minimally invasive plate osteosynthesis for displaced proximal humeral fractures: A prospective randomized controlled trial.
Recently, minimally invasive plate osteosynthesis (MIPO) has been widely used for the treatment of proximal humeral fractures. However, there is concern about whether the MIPO in comminuted proximal humeral fractures is also comparable to open plating. The purpose of this study was to compare the clinical and radiographic outcomes of open plating and MIPO for acute displaced proximal humeral fractures. ⋯ This study showed MIPO in proximal humerus fractures had similar clinical and radiographic outcomes compared to the open plating. However, the MIPO technique in proximal humerus fracture provided significantly shorter operation time than the open plating.