Articles: fracture-fixation.
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Bmc Musculoskel Dis · May 2017
Randomized Controlled TrialMinimal invasive percutaneous plate osteosynthesis (MIPPO) through deltoid-pectoralis approach for the treatment of elderly proximal humeral fractures.
Current treatments for proximal humeral fractures include conservative treatment, conventional open reduction internal fixation (ORIF) and MIPPO through deltoid-splitting approach. The aim of this study was to evaluate the clinical outcome of MIPPO versus ORIF via the deltoid-pectoralis approach in elderly patients with proximal humeral fractures. ⋯ The results of our study have demonstrated that MIPPO through the deltoid-pectoralis approach is an effective alternative for the treatment of proximal humeral fractures in elderly patients.
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Randomized Controlled Trial Comparative Study
Management of pin tract infection in pediatric supracondylar humerus fractures: a comparative study of three methods.
The objective of this study was to prospectively compare the incidence of pin tract infection in pediatric supracondylar humerus fractures managed with pin care daily or every other day or weekly. We hypothesized that there were some differences between these three methods. From June 2012 to May 2015, 135 children with supracondylar humerus fractures were randomized to postoperative pin care by cleaning pin tracts daily (group A, 45 cases) or cleaning every 2 days (group B, 45 cases) or cleaning weekly (group C, 45 cases). ⋯ Grade I infections (Checketts-Otterburns classification) occurred around 28.9% of 270 pin and grade II around 6.7%. We found no differences between three groups as regards frequency and severity of pin tract infections (both P > 0.05). However, complain of pain was more frequent in group A than other two groups (P < 0.05).
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Randomized Controlled Trial Multicenter Study
Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial.
Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. ⋯ National Institutes of Health, Canadian Institutes of Health Research, Stichting NutsOhra, Netherlands Organisation for Health Research and Development, Physicians' Services Incorporated.
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Randomized Controlled Trial Comparative Study
Effects of scalp block with bupivacaine versus levobupivacaine on haemodynamic response to head pinning and comparative efficacies in postoperative analgesia: A randomized controlled trial.
Objective This study was performed to determine the effects of scalp blocks with bupivacaine versus levobupivacaine on the haemodynamic response during craniotomy and the efficacies and analgesic requirements of these drugs postoperatively. Methods This randomized, prospective, placebo-controlled, double-blind study included 90 patients (age, 18-85 years; American Society of Anesthesiologists physical status, I or II). The patients were randomly divided into three groups: those who received 20 mL of 0.5% bupivacaine (Group B, n = 30), 20 mL of 0.5% levobupivacaine (Group L, n = 30), or saline as a placebo (Group C, n = 30). ⋯ The additional drug requirement for intraoperative hypertension and tachycardia was significantly higher in Group C. There were no significant differences in MAP, HR, or VAS scores between Groups B and L. Conclusion Both bupivacaine and levobupivacaine can be effectively and safely used for scalp blocks to control haemodynamic responses and postoperative pain.
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Randomized Controlled Trial Multicenter Study
Shared decision making in the management of midshaft clavicular fractures: Nonoperative treatment or plate fixation.
Most patients with a displaced midshaft clavicular fracture can be treated either operatively or nonoperatively, with similar long-term outcomes. The treatment choice depends on individual preferences, and is therefore suited for a shared decision making (SDM) approach. However, little is known about SDM in fracture treatment. The purpose of this study was to evaluate the current daily practice of shared decisional behaviour in clavicular fracture treatment, in order to assess the need for improvement and set a baseline level for future research. ⋯ The patient-reported level of SDM in treatment decisions for clavicular fractures was high, but not all patients had the role in this process that they preferred. To improve patients' involvement in the treatment decision making process for clavicular fractures, it is important to create general awareness about SDM, and increase knowledge of orthopaedic trauma surgeons about SDM behaviour.