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Synopsis: Seven randomized controlled trials including 658 patients with intertrochanteric femur fractures were included in this systematic review and meta-analysis comparing short versus long cephalomedullary nails (CMN).Pooled outcomes of interest included Harris hip score, 1-year mortality, overall complication rates, reoperation rates, duration of surgery, intraoperative blood loss, tip-apex distance, and hospital stay length.The pooled results showed no significant differences in Harris hip score, mortality, complications, or reoperations.However, short nails were associated with shorter surgery time, lower blood loss, and reduced tip-apex distace. These findings suggest... Read More »
Level 1 Meta Analysis
4%
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. Read More »
Level 2 RCT
4%
Synopsis: 154 patients with Dupuytren's disease were randomized to receive hand therapy either with or without nightly splinting for 6 months following fasciectomy or dermofasciectomy, in order to determine if splinting provided a beneficial effect to patients 1 year postoperatively.Patients were primarily assessed with the Disabilities of the Arm, Hand, and Shoulder questionnaire, and secondarily through total active flexion, total active extension, and patient satisfaction.The results of the study reflected no significant differences between the primary outcome or any of the secondary outcomes, and that there was no beneficial effect of nightly splinting combined with hand therapy. Read More »
Author verified Level 2 RCT
4%
Synopsis: 186 patients with a severe lateral ankle sprain (type III) were randomized to treatment to 3 weeks of rigid immobilization with a walking boot followed by 3 weeks of immobilization with a functional brace, or to a functional brace for 6 weeks.The purpose was to compare these two conservative treatment methods for outcomes in pain, function, and ankle stability up to 12 weeks after the injury.AOFAS scores were better for the first 6 weeks in patients receiving the functional brace, and pain and comfort outcomes also benefited within the first few weeks from using a functional brace. By 12 weeks,... Read More »
Author verified Level 2 RCT
4%
Synopsis: High quality evidence has revealed that non-operative management of acute Achilles tendon rupture achieves optimal outcomes in most patients.Among non-operative treatment options, the most commonly used are functional bracing (walking boot with heel wedges) and casting in equinus position.There has been a recent move towards early mobilization and more use of functional bracing over casts in a number of different areas, and it is unclear if there is a benefit in favour of either strategy in the context of Achilles tendon ruptures.In this study, the authors randomized patients to plaster cast versus functional bracing, and performed an accompanying economic evaluation.They found that patients treated with functional brace had significantly better functional scores at eight weeks, and that bracing was dominant from a cost-effectiveness perspective, with modest savings and slightly better utility. There was no... Read More »
Level 1 RCT
4%
Synopsis: One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52).The primary outcome was total blood loss.Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events.Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months.Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes... Read More »
Level 1 RCT
4%
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... Read More »
Level 1 RCT
2%
Synopsis: 101 patients with an acute grade 1 or 2 ankle sprain were randomized to be managed with an early therapeutic exercise program or a conventional PRICE (protection, rest, ice, compression and elevation) protocol.It was observed that after early incorporating therapeutic exercises during the first week after an ankle sprain brings about significant improvements in physical activity and improved functional status compared to the standard treatment at weeks 1 and 2. At 16-week follow-up,... Read More »
Author verified Level 2 RCT
2%
Synopsis: 60 patients with dominant-hand thumb carpometacarpal osteoarthritis (OA) were randomized into two groups to measure the effects of either radial nerve mobilization treatment or a nontherapeutic placebo treatment on pain sensitivity and pinch strength. At 2 months follow-up, patients who underwent radial nerve mobilization experienced a decrease in pain sensitivity in the trapeziometacarpal joint and an increase in tip and tripod pinch strength. Read More »
Author verified Level 2 RCT
2%
Synopsis: 2945 women presenting to orthopaedic injury clinics were included in this multinational survey study to investigate the prevalence of intimate partner violence (IPV).Female patients who met eligibility criteria at one of the 12 orthopaedic fracture clinics in Canada, USA, Denmark, the Netherlands, or India anonymously answered direct questions about physical, emotional and sexual IPV.Additionally, these patients completed the Women Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS) questionnaires to determine the prevalence of women suffering from IPV within the past year and over their lifetime.Results indicated that approximately 1 in 6 women presenting to an orthopaedic injury clinics have experienced IPV in the past year, and 1 in 3 women experience IPV in their life time.In addition, 1 in 50 women were presenting to the clinic as a direct result of IPV.Few of the women had ever been asked about IPV by any physician. Most patients thought... Read More »
Author verified RCT