Articles: fracture-fixation.
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Randomized Controlled Trial Multicenter Study Comparative Study
Continuous Popliteal Sciatic Nerve Block Versus Single Injection Nerve Block for Ankle Fracture Surgery: A Prospective Randomized Comparative Trial.
To compare rebound pain and the need for narcotic analgesia after ankle fracture surgery for patients receiving perioperative analgesia through either a continuous infusion or a single injection nerve block. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Randomized Controlled Trial Comparative Study
Management of Humeral Shaft Fractures With Intramedullary Interlocking Nail Versus Locking Compression Plate.
Surgical fixation of humeral shaft fractures generally involves plating or nailing. It is unclear whether one method is more effective than the other. The aim of this study was to compare the results of the intramedullary nail and locking compression plate for the treatment of humeral shaft fractures. ⋯ The average union time was found to be significantly lower for the intramedullary interlocking nail compared with the locking compression plate. The incidence of complications such as radial nerve palsy was found to be higher with the locking compression plate compared with the intramedullary interlocking nail. The intramedullary interlocking nail can be considered a better surgical option for the management of humeral shaft fractures because it offers decreased intraoperative blood loss; shorter operative times, hospital stays, and union times; and a lower incidence of serious complications such as radial nerve palsy.
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The bone & joint journal · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyCost effectiveness of treatment with percutaneous Kirschner wires versus volar locking plate for adult patients with a dorsally displaced fracture of the distal radius: analysis from the DRAFFT trial.
We present an economic evaluation using data from the Distal Radius Acute Fracture Fixation Trial (DRAFFT) to compare the relative cost effectiveness of percutaneous Kirschner wire (K-wire) fixation and volar locking-plate fixation for patients with dorsally-displaced fractures of the distal radius. The cost effectiveness analysis (cost per quality-adjusted life year; QALY) was derived from a multi-centre, two-arm, parallel group, assessor-blind, randomised controlled trial which took place in 18 trauma centres in the United Kingdom. Data from 460 patients were available for analysis, which includes both a National Health Service cost perspective including costs of surgery, implants and healthcare resource use over a 12-month period after surgery, and a societal perspective, which includes the cost of time off work and the need for additional private care. ⋯ Sensitivity analyses were undertaken to assess the ICER of locking-plate fixation compared with K-wires. These were greater than £30,000. Compared with locking-plate fixation, K-wire fixation is a 'cost saving' intervention, with similar health benefits.
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Eur J Trauma Emerg Surg · Aug 2015
Randomized Controlled Trial Comparative StudyProximal femoral nail antirotation against dynamic hip screw for unstable trochanteric fractures; a prospective randomized comparison.
We sought to determine whether intramedullary fixation with proximal femoral nail antirotation produces comparable outcomes to dynamic hip screw in the treatment of unstable trochanteric fractures. ⋯ Proximal femoral nail antirotation technique offers better recovery than dynamic hip screw, whereas both techniques possess the same risk of postoperative complications.
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Randomized Controlled Trial Comparative Study
Distal locked and unlocked nailing for perthrochanteric fractures--a prospective comparative randomized study.
Intramedullary nailing is widely used in the treatment of stable pertrochanteric fractures. However, it remains controversial whether the distal locking with intramedullary nailing is necessary. ⋯ This study suggests that intramedullary nails without distal locking may be a reliable and acceptable option for treating stable pertrochanteric fractures (AO/OTA 31-A1 and A2) in elderly people. Distal unlocked nails showed subtle advantages in reducing blood loss, operation time, fluoroscopy exposure time, and size of the incision.