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23%
19%
14%
12%
9%
6%
4%
4%
4%
3%
<1%
<1%
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100%
3%
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
2%
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
2%
Synopsis: 78 randomized controlled trials were included in this meta-analysis, which sought to evaluate the incidence of venous and arterial thromboembolic (VTE and ATE) events associated either intravenous, intraarticular, and oral tranexamic acid, and compare rates to placebo or control intervention groups. No analysis demonstrated a significant increase in the risk of VTE or ATE complications with either intravenous TXA, intraarticular TXA, or oral TXA. Read More »
Level 1 Meta Analysis
2%
Synopsis: 63 patients with a distal radius fracture and undergoing closed reduction prior to plaster orthosis application were randomized to reduction either with or without the aid of mini-C-am fluoroscopy guidance.Patients were assessed postreduction for reduction quality on radiograph, number of manipulations attempts, and subjective difficulty with reduction as rated by the treating resident.Radiographic results demonstrated no significant differences between groups in radial height, radial inclination, ulnar variance, or volar tilt.Subjective difficullty and number of manipulations attempted were both significantly increased in the mini-C-arm group compared to the standard group. Read More »
Level 2 RCT
2%
Synopsis: 234 patients with carpal tunnel syndrome were randomized to a single injection of 20mg methylprednisolone acetate or 6 weeks of nightly splinting.Patients were assessed primarily for outcome on the Boston Carpal Tunnel Questionnaire at 6 weeks and 6 months.In addition, cost-utility analysis was performed.Results for the BCTQ Symptom Severity Score and Functional Status Score significantly favoured the CS injection group compared to the nightly splinting group at 6 weeks, while differences at 6 months were not significant. On a 6-month... Read More »
Level 2 RCT
1%
Synopsis: 1583 patients with symptomatic knee osteoarthritis were randomized to either glucosamine monotherapy, chondroitin monotherapy, combined glucosamine and chondroitin therapy, celecoxib 200mg daily, or placebo.Patients were assessed over 24 weeks of treatment.In the primary analysis, only the celecoxib group demonstrated a significantly higher rate of patients attaining the primary efficacy endpoint - a reduction of WOMAC pain by a minimum of 20% relative to baseline - compared to placebo. However, when only... Read More »
RCT
1%
Synopsis: 664 patients scheduled for total knee arthroplasty were randomized to either topical tranexamic acid or intravenous tranexamic acid.Patients were assessed for total blood loss, postoperative blood loss, and the incidence of transfusion. Results demonstrated that... Read More »
Level 2 RCT
1%
Synopsis: 77 patients scheduled for proximal femoral nail anti-rotation fixation for an intertrochanteric fracture were randomized to either tranexamic acid administration to saline administration.Outcomes included total blood loss, hidden blood loss, and transfusion rates. All three of... Read More »
Conference Report
1%
Synopsis: 220 patients with a pertrochanteric fracture and scheduled for cephalomedullary nail fixation were randomized to receive either a short or long cephalomedullary nail.Primary outcome of interest was patient reported outcome at 3 months postoperatively on the SF-36 and Harris Hip Score measures.Secondary outcomes included incidence of complications and reoperation, and perioperative parameters (operative time, blood loss, length of stay).Results demonstrated a nonsignificant difference between groups in SF-36 scores, and statistically-significant-but-not-clinically-relevant difference in HHS. Perioperative parameters all... Read More »
Conference Report
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