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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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100%
23%
①
Synopsis:
One hundred and twenty-one patients undergoing a hip arthroscopy procedure were randomized to receive 90 days of automated text messages on post-operative instructions and general health guidance (n=57) or no added intervention (n=64).Outcomes of interest included pain and physical function on the Hip Disability Osteoarthritis Outcome Score (HOOS), patient compliance, and patient satisfaction with the intervention.Results revealed no significant differences between the two groups in pain, physical function, or compliance at 90 days. Patients who received...
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Level 1 RCT
20%
①
Synopsis:
Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267).The primary outcome was SSI (<6 weeks).Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay.Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year.Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest...
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Level 1 RCT
6%
①
Synopsis:
6 studies (363 patients) examining outcomes of surgical and nonsurgical treatments of undisplaced or minimally displaced scaphoid waist fractures were evaluated through pairwise meta-analysis.An additional 3 trials were also identified for inclusion in a network meta-analysis.Following assessments of fracture union, complications, range of motion, grip strength, and osteoarthritis between patients who underwent either surgical or non-surgical treatment, there was a non-significant trend to increased union with surgical treatment. However this method...
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Author verified Level 1 Meta Analysis
3%
②
Synopsis:
118 patients with displaced distal radius fractures were randomised to undergo either a long-arm sugar tong splinting intervention or a short-arm radial gutter splinting intervention.Radiographic outcomes and disability were observed.Results indicated that comparable outcomes were seen between the long- and short-arm groups. The author's recommend...
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Level 2 RCT
3%
Synopsis:
13 ACE reports (4 reviews/ meta-analyses, 9 RCTs) were included from the OrthoEvidence database that compared operative versus nonoperative or operative versus operative treatments for displaced midshaft clavicle fractures.The findings of this review demonstrated that surgical procedures led to a lower rate of nonunion and malunion with better functional outcome when compared to nonoperative treatment. Comparisons of operative treatments indicated that an optimal surgical procedure - between plate fixation, nailing, and pin fixation - could not be determined based on union rates or functional outcome. The results of...
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ACE Review
3%
①
Synopsis:
60 patients with distal interphalangeal joint (DIPj) active extensor lag were randomized to determine the efficacy between cast immobilization treatment using either a Quickcast orthosis to be worn 24 hours a day or a removable, low temperature thermoplastic, lever-type orthosis.After 24-28 weeks, there were no significant differences between the two groups in regard to success rate, orthosis discomfort, satisfaction with orthotic design, DIPj flexion stiffness, incidence of complications, and grip and tip-to-tip pinch strengths. However, the Quickcast...
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Author verified Level 1 RCT
3%
①
Synopsis:
Fifty-six patients with lateral malleolar (rotational ankle) fractures were randomized to receive 2-octyl cyanoacrylate (n=27) or n-butyl (90% n-butyl/10% 2-octyl) cyanoacrylate (n=28) for skin closure after standardized plate fixation; fifty-five completed follow-up.The primary outcome was cosmetic appearance by HWES at three and six months.Secondary outcomes included patient satisfaction with cosmesis by VAS (0–100) and 5-point Likert scales at three and six months, and ankle function by OMAS at six months.Overall, the results of the study revealed no statistically significant differences between groups for HWES, VAS, Likert satisfaction, or OMAS at six months. In short, 2-octyl...
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Level 1 RCT
3%
①
Synopsis:
One hundred fifty-eight patients with displaced fifth metacarpal neck fractures were treated with either K-wire pinning (KP; n=60), intramedullary pinning (IP; n=50), or combined intramedullary pinning with K-wire pinning (IPKP; n=48).The primary outcome was radiological correction (angulation and shortening).Secondary outcomes included range of motion (TAM), Quick-DASH scores, cosmetic scores, and complication rates.Outcomes were assessed preoperatively, postoperatively, and at 1-year follow-up.Overall, the study found that IPKP achieved significantly better angulation, less shortening, and higher cosmetic scores.Functional outcomes were similar, though stiffness occurred only in the KP and IP groups. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
The PREPARE Trial was a cluster-randomized, crossover trial part of the PREP-IT program, which compared alcohol-based anti-septic solutions of iodine povacrylex vs.chlorhexidine gluconate in operative fracture patients.THE PREPARE Trial included a total of 8485 patients who underwent fracture fixation: 1700 patients with open limb fractures and 6785 with closed lower-limb or pelvic fractures.Randomization occurred at the hospital level.The primary outcome of interest was the incidence of surgical-site infection, which included superficial incisional infections within 30 days and deep incisional or organ-space infections within 60 days post-surgery.Secondary outcomes included unplanned fracture-related reoperations and serious adverse events.The iodone povacrylex group (77/3205; 2.4%) had a lower incidence of surgical site infections compared to chlorhexidine (108/3272; 3.3%) in closed-fracture patients [OR, 0.74; 95% CI, 0.55 to 1.00; p=0.049].The rates were similar in open-fracture patients between the iodine (54/3272; 6.5%) and chlorhexidine (60/3272; 7.3%) [OR, 0.86; 95% CI, 0.58 to 1.27; p=0.45].In the closed-fracture group, 5.5% in the iodine group and 5.9% in the chlorhexidine group underwent unplanned reoperations [OR, 0.96; 95% CI, 0.77 to 1.20].In the open-fracture group, the figures were 16.1% for iodine and 14.5% for chlorhexidine [OR, 1.16; 95% CI, 0.87 to 1.54]. The results of...
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Level 1 RCT
3%
①
Synopsis:
Ninety-three patients undergoing total knee arthroplasty were randomized to receive either preoperative video-based opioid counseling (n=50) or no such intervention (n=43).The primary outcome of interest was postoperative opioid consumption in morphine milligram equivalents (MMEs).Secondary outcomes included pain levels, opioid-related side effects, and patient satisfaction with pain control.Outcomes were assessed at postoperative days (POD) 3, 7, and 14.Overall, the study revealed that patients in the video group consumed significantly fewer opioids in the first week postoperatively. The findings suggest...
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Level 1 RCT