Articles: fracture-fixation.
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Review Meta Analysis
Posterior pedicle screw fixation with indirect decompression versus direct decompression in treating thoracolumbar burst fracture: A systematic review and meta-analysis.
To compare the safety and efficacy between posterior pedicle screw fixation with direct versus indirect decompression in treating patients with thoracolumbar burst fracture. ⋯ Posterior pedicle screw fixation with indirect decompression was safe and effective for thoracolumbar burst fracture with or without neurologic deficits when posterior longitudinal ligament was intact.
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Blocking screw technique has been widely applied in the treatment of long shaft fractures. However, the evidence with regard to whether intramedullary nail combined with blocking screw technique has better clinical efficacy over other is not clear. The aim of the study was to explore the clinical efficacy and complications of intramedullary nail combined with blocking screw technique in the treatment of femoral or tibial shaft fractures. ⋯ Current evidence shows that intramedullary nail combined with blocking screw technique in the treatment of lower limb long bone fracture has the advantages of good clinical efficacy, high fracture healing rate, short fracture healing time, good joint function, less complications and so on, which is worthy of clinical recommendation.
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Eur J Trauma Emerg Surg · Apr 2024
Review Meta Analysis Comparative StudyA systematic review and meta-analysis comparing suprapatellar versus infrapatellar approach intramedullary nailing for tibal shaft fractures.
The application of the suprapatellar (SP) approach has challenged the traditional infrapatellar (IP) approach in the surgery treatment of tibial shaft fractures, yet the advantages and disadvantages still remain controversial. We included more high-quality studies for this meta-analysis and systematic review to evaluate the clinical outcomes and prognosis of both approaches and thus to provide new ideas for surgeons. ⋯ The results of our meta-analysis showed that the SP approach was significantly better than the IP approach in angle and distance entrance accuracy of coronal plane, angle entrance accuracy of sagittal plane, fluoroscopy time, Lysholm score, and VAS pain score. There were no significant differences in sagittal angle accuracy, operative time, intraoperative blood loss, and ROM score.
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Arch Orthop Trauma Surg · Mar 2024
Review Meta Analysis Comparative StudyExtramedullary versus intramedullary fixation of unstable trochanteric femoral fractures (AO type 31-A2): a systematic review and meta-analysis.
The aim of this systematic review was to compare extramedullary fixation and intramedullary fixation for AO type 31-A2 trochanteric fractures in the elderly, with regard to functional outcomes, complications, surgical outcomes, and costs. ⋯ Current literature shows that several functional outcomes, complications, and surgical outcomes were statistically in favor of intramedullary fixation when compared with extramedullary fixation of AO/OTA 31-A2 fractures. However, as several of the differences found appear not to be clinically relevant and for many outcomes data remains sparse or heterogeneous, complete superiority of IM fixation for AO type 31-A2 fractures remains to be confirmed in a detailed cost-effectiveness analysis.
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Arch Orthop Trauma Surg · Feb 2024
Review Meta AnalysisSurprise positive culture rate in the treatment of presumed aseptic long-bone nonunion: a systematic review with meta-analysis of 2397 patients.
In pre-operatively presumed aseptic nonunions, the definitive diagnosis of infection relies on intraoperative cultures. Our primary objective was to determine (1) the rate of surprise positive intraoperative cultures in presumed aseptic long-bone nonunion (surprise positive culture nonunion), and (2) the rate of surprise positive cultures that represent infection vs. contamination. Secondary objectives were to determine the healing and secondary surgery rates and to identify cultured micro-organisms. ⋯ These results suggest that surprise positive cultures play a role in the clinical course of a nonunion and that culturing is important in determining the etiology of nonunion, even if the pre-operative suspicion for infection is low. High healing rates can be achieved in presumed aseptic nonunions, regardless of the definitive intraoperative culture result.