Articles: fractures-therapy.
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Clavicle fractures are common. An emergency physician needs to understand the diagnostic classifications of clavicle fractures, have a plan for immobilization, identify associated injuries, understand the difference between treating pediatric and adult patients, and have an approach to multimodal pain control. It is also important to understand when expert orthopedic consultation or referral is indicated. ⋯ When encountering a patient with a clavicle fracture in the emergency department the fracture pattern will help determine whether emergent consultation or urgent referral is indicated. Most patients can be discharged safely with sling immobilization and appropriate outpatient follow-up.
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Arch Orthop Trauma Surg · Jul 2021
ReviewTreatment of coracoid process fractures: a systematic review.
The coracoid process is a small hook-shaped feature on the scapula and a key structure of the superior shoulder suspensory complex (SSSC). Fractures of the coracoid are rare. Therefore, no consensus exists regarding treatment of coracoid process fractures. Systematically review indications, outcomes and complications of traumatic coracoid process fractures in adults, and to provide a treatment algorithm. ⋯ Based on moderate quality studies, surgical treatment may be considered in Ogawa type I fractures with multiple disruptions of the SSSC. A conservative treatment seems sufficient in other fracture types.
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Postgraduate medicine · May 2021
ReviewDiagnosis and conservative management of great toe pathologies: a review.
Acute great toe (Hallux) pain is a common complaint encountered by the primary care physician. Pathological conditions can vary from acute trauma to acute exacerbation of underlying chronic conditions. ⋯ The acute pathologies discussed in this review are hallux fractures and dislocations, turf toe, sand toe, and sesamoid disorders. The chronic pathologies discussed include hallux rigidus, hallux valgus, and chronic sesamoiditis.
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Review Meta Analysis Comparative Study
Comparison Between 7 Osteoporotic Vertebral Compression Fractures Treatments: Systematic Review and Network Meta-analysis.
Vertebroplasty (VP), kyphoplasty (KP), SpineJack system (SJ), radiofrequency kyphoplasty (RFK), Kiva system (Kiva), Sky kyphoplasty system (SK), and conservative treatment are widely used in the treatment of osteoporotic vertebral compression fractures (OVCFs). However, it is still unknown which is the best intervention. The aim of the current study was to evaluate the effectiveness and safety of VP, KP, SJ, RFK, Kiva, SK, and CT in the treatment of OVCFs. ⋯ SK may be the most effective treatment in relieving pain, improving the quality of life, and recovering vertebral body height and kyphotic angle, while RFK may be the safest intervention for OVCFs. However, considering the limitations of this study, more high-quality trials are needed in the future to confirm the current conclusion.
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A shortcut review was carried out to investigate whether avulsion fractures of the base of the fifth metatarsal were best treated with tubular bandage, a walking boot or a short leg plaster cast. One paper presented the only evidence to answer one of the clinical questions (plaster cast or walking boot) but no evidence was found comparing tubular bandage and a walking boot. ⋯ It is concluded that while the only evidence available shows marginal benefit of walking boot over short plaster cast during recovery, there is no benefit to final outcome. Further research comparing tubular bandage and walking boot is required.