Articles: fractures-therapy.
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J Hand Surg Eur Vol · Nov 2011
Review Meta AnalysisA systematic review of the treatment of acute fractures of the scaphoid.
A systematic review of the literature identified eight trials comparing surgery with cast treatment and found no significant difference in pain, tenderness, cost, functional outcome or patient satisfaction. In the group treated surgically, the rate of non-union was three times less, there was a quicker return to function and grip strength and range of movement was also transiently better. There were, however, more complications among those treated surgically. No significant differences were reported in the two trials that compared above and below elbow casts or the trial that compared scaphoid and Colles' casts.
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Review Meta Analysis
Nonoperative treatment for acute scaphoid fractures: a systematic review and meta-analysis of randomized controlled trials.
Recommendations for cast immobilization of acute scaphoid fractures vary substantially. We reviewed data from randomized controlled trials comparing nonoperative treatment methods for acute scaphoid fractures to determine the best available evidence. ⋯ There is no evidence from randomized controlled trials on physician-based or patient-based outcome to favor any nonoperative treatment method for acute scaphoid fractures.
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J Shoulder Elbow Surg · Sep 2011
Meta Analysis Comparative StudyPlating versus intramedullary pin or conservative treatment for midshaft fracture of clavicle: a meta-analysis of randomized controlled trials.
Clavicular fractures account for 2% to 2.6% of all fractures. Plating has been considered the gold standard for treating midshaft clavicular fracture. Intramedullary pinning and conservative treatments have also been commonly used. We hypothesized that intramedullary pinning and conservative treatments have the same treatment results compared with plating. ⋯ The available evidence suggests that there are no differences in treatment effects between plating and intramedullary pinning, but plating is associated with more side effects. Plating is associated with improved treatment effects when compared with conservative treatment.
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Review Meta Analysis
[Electromagnetic fields, electric current and bone healing - what is the evidence?].
For more than 30 years the potential effects of electrical stimulation on bone healing have been investigated. Up to now this therapy is controversial and not established as a standardised treatment option. This systematic review and metaanalysis focuses on the potential effects of electromagnetic fields and high-frequency electric fields on bony healing. ⋯ When performing a subgroup analysis a statistically significant result could not be confirmed by the studies with a higher methodological quality. In view of the heterogeneous physical parameters with different frequencies, time course, flux densities and in view of the methodological deficits, a general conclusion seems difficult. Recommendations or standards of therapy are so far not available.
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Cochrane Db Syst Rev · Apr 2011
Review Meta AnalysisElectromagnetic field stimulation for treating delayed union or non-union of long bone fractures in adults.
Delayed union and non-union of fractures are a considerable cause of morbidity to patients. Laboratory studies have shown that electromagnetic fields can stimulate the formation of new bone, indicating a potential role for electromagnetic stimulation in the treatment of fractures that have failed to heal. ⋯ Though the available evidence suggests that electromagnetic field stimulation may offer some benefit in the treatment of delayed union and non-union of long bone fractures, it is inconclusive and insufficient to inform current practice. More definitive conclusions on treatment effect await further well-conducted randomised controlled trials.