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You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
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9%
①
Synopsis:
Twenty-nine elderly patients (≥80 years) with displaced 3- or 4-part proximal humerus fractures were randomized to receive reverse shoulder arthroplasty (RSA) (n=17) or nonoperative treatment (n=12).The primary outcome was the Constant score.Secondary outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) score, range of motion (ROM), pain (VAS), SF-12, EQ-5D, and radiographic findings.Outcomes were assessed at a mean follow-up of approximately 7.5 years.Overall, the results revealed that RSA achieved significantly higher Constant scores and better ROM, with no significant differences in quality-of-life measures or pain.Radiographically, all nonoperative cases healed in malposition without revision, whereas one RSA patient required revision for dislocation. These findings suggest...
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Level 1 RCT
9%
①
Synopsis:
Ten thousand one hundred three patients with open or closed extremity or pelvic fractures were randomized as part of a cluster-randomized crossover trial to receive either a preoperative chlorhexidine gluconate (CHG) bath (n=2,674) or no CHG bath (n=7,429).The primary outcome of interest was surgical site infection (SSI) within 90 days of surgery.Secondary outcomes included SSI within 1 year, Staphylococcus aureus infection within 1 year, reoperation for infection, and reoperation for wound-healing complications, all within 1 year.Outcomes were assessed up to 90 days and 1 year postoperatively.Overall, the results of the study revealed no significant reduction in the risk of SSI with CHG bathing, even after adjusting for confounders or using instrumental variable analysis. These findings suggest...
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Level 1 RCT
4%
②
Synopsis:
144 patients with primary complete Achilles tendon rupture were randomized to be treated with either a surgical repair and accelerated functional rehabilitation or with only the accelerated functional rehabilitation. Over the course of a two year follow up, it was observed that Achilles tendon rupture led to clinically similar results between the two treatment groups.
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Level 2 RCT
4%
②
Synopsis:
52 patients were randomized to receive one of two treatments for acute scaphoid fracture.One group underwent a surgical (internal fixation) procedure while the second group underwent a closed (cast treatment) procedure.The primary outcomes examined were total (indirect and direct) costs of either treatment as well as length of work absences.Results demonstrated that there was a higher total cost incurred from surgical treatment in both manual and non-manual workers. However, closed treatment...
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Level 2 RCT
4%
②
Synopsis:
Sixty patients, over the age of 50, with acute, minimally displaced subcapital neck of femur fractures were randomly assigned into one of two groups to receive treatment with two-hole dynamic hip screws or cannulated screws.Results indicated that while both methods are effective in treating femoral neck fractures, neither one was superior. Functionality at 1...
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Author verified Level 2 RCT
4%
②
Synopsis:
79 women aged 40 years and older diagnosed with severe stage IV osteoarthritis (OA) were randomly assigned to undergo ligament reconstruction and tendon interposition (LRTI) of the basal thumb joint using either the Burton-Pellegrini (BP) or the Weilby technique.The BP technique uses a bone tunnel at the base of the thumb, while the Weilby technique does not.The purpose of this study was to compare the short- and long-term pain and physical function outcomes of both techniques.Findings suggested the BP technique prompted faster recovery than the Weilby technique, with better clinical outcome at 3 months. Outcome at 12...
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Author verified Level 2 RCT
4%
②
Synopsis:
68 pediatric patients with displaced supracondylar humeral fractures were randomized to one of two methods of closed reduction.In one group, if closed manipulation did not yield acceptable reduction, the joystick technique was used to facilitate reduction.In the other group, only manual traction was used for reduction.Once reduction was achieved, all patients received fracture fixation with percutaneous pinning.Results demonstrated a significantly shorter operative time, shorter fluoroscopy time, and higher reduction success rate in the joystick group compared to the manual traction group. The time to...
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Level 2 RCT
4%
Synopsis:
40 patients scheduled for total shoulder arthroplasty were randomized to either a stemless implant or a standard stemmed implant.Clinical and radiographic outcomes were assessed over 5-year follow-up.After 5 years, Constant scores did not significantly differ between groups. No cases of...
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RCT
4%
②
Synopsis:
41 women with carpal tunnel syndrome were randomized to 8 weeks of nightly splinting with or without the addition of a single injection of platelet-rich plasma.Patients were followed up after 10 weeks from the beginning of treatment for results related to pain, outcome on the Boston Carpal Tunnel Questionnaire, and electrophysiological measures of peak latency of sensory nerve action potential (PL-SNAP) and onset latency of the compound muscle action potential (OL-CMAP). Results demonstrated no...
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Level 2 RCT
4%
①
Synopsis:
12,211 patients from 21 trauma centers in the United States and Canada were included in this non-inferiority randomized trial comparing aspirin (n=6,101) and low molecular-weight heparin (n=6110).The primary outcome of interest was death by any cause at 90 days.Secondary outcomes of interest included the risk of thromboembolic events (pulmonary embolism; deep-vein thrombosis), cause-specific death, bleeding & wound complications, and the rate of infection.Aspirin was found to be non-inferior to low molecular-weight heparin with respect to the primary outcome of death by any cause. No differences in...
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Level 1 RCT