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Synopsis: 150 patients with an acute displaced midshaft clavicle fracture were randomized to treatment through either open reduction and internal fixation with a plate or nonoperative management with sling immobilization.Patients were followed-up at 6 weeks, 3 months, 6 months, and 12 months for outcome related to the Disabilities of the Arm, Shoulder, and Hand score, the Constant score, and the incidence of nonunion.Outcome on both the DASH score and the Constant score significantly favoured the plate group compared to the sling group at 6-week and 3-month follow-up, but no significant between-group differences were observed in the measures at 6 months or 12 months. The incidence of... Read More »
Level 2 RCT
3%
Synopsis: 9 studies (8 RCTs, 1 controlled clinical trial) were selected for a systematic review of elderly patients with a proximal humerus fracture.The goal of this study was to determine whether surgical or nonoperative treatment is the optimal intervention in patients over the age of 60.Operative treatments identified in the included trials were the tension band technique, locking plates, pinning and hemiarthroplasty.The results of this review indicated that many studies did not find a significant difference in functional outcomes when comparing locking plates or tension bands to nonoperative treatment at 1 year.There was a significantly better health-related quality of life and Euroqol-5D in patients that received a hemiarthroplasty compared to the nonoperative group for patients with 4-part fractures.Complications were common in the operative treatment groups. This study highlights... Read More »
Level 2 Meta Analysis
2%
Synopsis: 8 randomized controlled trials were selected for this meta-analysis, which sought to compare postoperative outcome between minimally invasive percutaneous repair (MIS) and open repair in treatment of Achilles tendon ruptures.Pooled analyses which demonstrated a significant difference between methods included American Orthopaedic Foot and Ankle Society (AOFAS) scores, incidence of superficial infection, and incidence of adhesion development, all of which favoured MIS groups.Analyses which demonstrated no significant differences between groups included time to return to work, rate of return to pre-injury activity level, and incidences of deep infection, delayed wound healing, and sural nerve complications, among other complications. Grading of Recommendations... Read More »
Level 1 Meta Analysis
2%
Synopsis: Three randomized controlled trials were included in this meta-analysis comparing pain and functional improvement between operative and nonoperative treatment for full-thickness rotator cuff tears.Follow-up was 12 months in each study. Results demonstrated that... Read More »
Author verified Level 1 Meta Analysis
2%
Synopsis: 3424 patients scheduled for or who had undergone either total knee or hip arthroplasty with a 5-day course of rivaroxaban 10mg postoperatively were randomized to extended thromboprophylaxis with either aspirin 81mg daily or continued rivaroxaban 10mg daily.Patients were assessed for the incidence of venous thromboembolism and bleeding events over the first 90 days after surgery, Noninferiority analysis for efficacy demonstrated that extended aspirin was noninferior to extended rivaroxaban. Groups also demonstrated... Read More »
Conference Report
1%
Synopsis: 18 patients with a displaced (>2mm) base of the 5th metatarsal fracture were randomized to be treated with either open reduction and internal fixation (ORIF) or nonoperative management with a short leg cast.The purpose of this study was to compare clinical measures of pain and function, time to union, and restoration of injured metatarsal length between groups.Follow-up was performed for an average of 8.5 weeks.Results demonstrated no significant differences in pain or functional scores, despite a significantly shorter time to union in the operative group. Read More »
Level 2 RCT
1%
Synopsis: Seven randomized controlled trials were included in this meta-analysis evaluating the efficacy of corticosteroid injections in the treatment of enthesopathy of the extensor carpi radialis brevis origin.Included RCTs featured local anesthetic or placebo saline injections as a control.Results demonstrated significantly lower pain at 1 month with corticosteroid versus control injections, but no significant difference at 3 and 6 months. Functional scores and... Read More »
Author verified Level 1 Meta Analysis
1%
Synopsis: 167 patients (190 knees) were randomized to receive either a mobile bearing system or a rotating-platform fixed bearing system in a total knee arthroplasty for the treatment of osteoarthritis.Follow-up was performed at 5 and 10 (minimum) years post-surgery.Outcomes reported included seven knee scoring systems (Knee Society Score, Knee Society Functional Score, Oxford Knee Score, Western Ontario and McMaster Universities Arthritis Index, Short-Form Health Survey Physical and Mental Components (SF-12 PCS; SF-12 MCS), Knee Injury and Osteoarthritis Outcome Score), the presence of radiolucent lines and implant survival (measured by revision).At 5 years post-operation, there were no significant differences between the fixed bearing and mobile bearing groups in all knee scoring systems.At 10 years, there were significantly better outcomes in the mobile bearing group compared to the fixed bearing group in the Oxford Knee Score, WOMAC Score, SF-12 PCS, KOOS ADL and KOOS Sport/Rec Score systems. There were no... Read More »
Level 1 RCT
1%
Synopsis: 240 patients scheduled for short intramedullary nail fixation for an intertorchanteric fracture were randomized to one of three distal locking configurations: static locked, dynamic locked, or unlocked.Patients were assessed for intraoperative variables - including operative and fluoroscopy times, blood loss, and transfusion rate - and postoperative outcomes related to fracture healing, function, pain, and complications.Results demonstrated significant differences only in operative variables, with operative time, fluoroscopy time, and blood loss favoured in the unlocked group compared to the two distal locking groups. Postoperative outcomes did... Read More »
Level 2 RCT
1%
Synopsis: 120 patients scheduled for total hip arthroplasty through a direct anterior approach were randomized to one of three groups: oral tranexamic acid administration, intravenous tranexamic acid administration, or control.The purpose of this study was to compare blood loss parameters, transfusion measures, and incidence of complications between the three groups.Results demonstrated significant differences in favour of both the oral TXA group and the IV TXA group compared to the control group for hemoglobin drop, total blood loss, and transfusion rate, while there were no significant differences between the two TXA groups. No patient in... Read More »
Level 1 RCT