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Short (24-hr) versus long (5-day) prophylactic antibiotics following open tibial fracture
②
Synopsis: 84 Kenyan patients with an open tibial fracture were randomized to a 24-hour prophylactic antibiotic administration protocol or a 5-day prophylactic antibiotic administration protocol.The purpose of this study was to compare the infection rate after 14 days between these two prophylactic antibiotic administration protocols. Results demonstrated no... Read More »
Author verified Level 2 RCT
3%
Network meta-analysis evaluating injection treatments for plantar fasciopathy
①
Synopsis: 22 randomized controlled trials were included in this network meta-analysis, that included over 10 injectable treatments, to evaluate comparative efficacy for the management of plantar faciopathy.The primary outcome of this study was pain relief.At 0-2 month follow-up, micronized dehydrated human amniotic/chorionic membrane was the most likely treatment to be effective for pain relief.At 2-6 months, botulinum toxin A was the treatment most likely to be effective for pain relief, while a treatment most likely to be effective beyond 12 months could not be identified from the limited amount of evidence available at this time point.The lack of trials available was a limiting factor of this network meta-analysis, exemplified by the lack of studies reporting data on micronized dehydrated human amniotic/chorionic membrane beyond 2 months. Further trials are... Read More »
Level 1 Meta Analysis
2%
OTA 2016: Suture endobutton versus syndesmotic screw for syndemosis injury
Synopsis: 97 patients with either an isolated syndesmotic injury or concomitant with an AO/OTA type 44C ankle fracture were randomized to syndesmotic stabilization with either a suture endobutton device or a syndesmotic screw.Outcomes included the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot score, Olerud-Molander score, ankle dorsiflexion and CT-assessed tibifibular distance of the operated versus nonoperated ankle, complications, and reoperations.Follow-up was scheduled at 6 weeks, 6 months, and 12 months after surgery.Results for the AOFAS ankle-hindfoot and Olerud-Molander score significantly favoured the suture endobutton group compared to the syndesmotic screw group at 6 and 12 months postoperatively. The rate of... Read More »
Conference Report
2%
Routine thromboprophylaxis not necessary in treatment of patients with foot/ankle fracture
②
Synopsis: 814 patients scheduled for surgical fixation of open or closed fractures of the ankle or foot were randomized to 14-day thromboprophylaxis with subcutaneous low molecular weight heparin, or to placebo with subcutaneous saline.The purpose of this study was to determine if routine low molecular weight heparin significantly reduced the incidence of venous thromboembolic (VTE) complications.Results demonstrated an overall low incidence of VTE in both groups, with no significant difference between groups.All VTE complications were cases of asymptomatic deep vein thrombosis; no cases of pulmonary embolism were documented. It should be... Read More »
Level 2 RCT
2%
AAOS: Plating versus nailing for distal femur fractures
Synopsis: 126 patients with a distal femur fracture were randomized to fixation through either retrograde nailing or locked plating.The purpose was to compare radiographic, functional, and clinical outcomes up to 1 year postoperatively.The results indicated a similar rate of malalignments, although plating was associated with a greater frequency of >5 degree valgus deformity.Functional outcomes did not significantly differ between groups over the one year follow-up. It was observed... Read More »
Conference Report
1%
AAOS: Operative versus nonoperative management of Achilles tendon ruptures
Synopsis: Seven randomized controlled trials evaluating operative and nonoperative management of Achilles tendon ruptures were included in this meta-analysis.The purpose was to determine if the two treatment options differed in functional outcome over 2 years postintervention.The results indicated that while functional outcome was significantly better following surgery at 3 months, there was no significant difference between operative and conservative management at 6, 12, and 24 months.There also was no significant difference observed between groups regarding range of motion. The incidence of... Read More »
Conference Report
1%
Percutaneous vertebroplasty vs. nonoperative treatment for osteoporotic vertebral fracture
①
Synopsis: Eleven randomized controlled trials (n=1048 patients) were included in this meta-analysis for the purpose of comparing percutaneous vertebroplasty (PVP) and conservative therapy treatment for patients with osteoporotic vertebral compression fractures (OVCFs).The primary outcome of interest was pain severity at three follow-up ranges: 1 to 2 weeks, 2 to 3 months, and at 1 year.Results demonstrated that patients who received PVP had statistically significant reduced pain at all follow-up intervals when compared to those who received nonoperative treatment only, though 95% confidences intervals associated with effects did not exclude the predetermined threshold of minimal clinically important difference (1.5pts). Therefore, though statistically... Read More »
Level 1 Meta Analysis
1%
Autologous whole blood vs. corticosteroids for epicondylopathy and plantar fasciopathy
①
Synopsis: The present study is a meta-analysis evaluating the efficacy of autologous whole blood (AWB) therapy versus corticosteroid injections in the treatment of epicondylopathy and plantar fasciopathy (PF).The primary outcome was pain relief at 2-6, 8-13, and 24-26 weeks.The authors included a total of 9 RCTs, and found statistically significant results in favour of corticosteroids at 2-6 weeks for patients with plantar fasciopathy, and in favour of AWB as early as 8 weeks up to 24 weeks for individuals with epicondylopathy. Read More »
Author verified Level 1 Meta Analysis
1%
Therapeutic methylene blue for pain reduction following pedicle screw fixation of TL spine
②
Synopsis: 50 patients scheduled for posterior pedicle screw fixation of a thoracolumbar fracture were randomized to surgical wound injection of methylene blue or saline.The purpose of this study was to compare postoperative pain and disability between groups at 48 hours postoperatively and at 2- and 6-month follow-up. Results demonstrated significantly... Read More »
Level 2 RCT
1%
AAOS2017: Vitamin D supplementation in hip fracture patients
Synopsis: 573 patients included a randomized trial to compare two methods of surgical fixation for femoral neck fractures in the elderly were also included in this observational study to determine the proportion of patients taking vitamin D supplementation and its effects on physical function and reoperation rate.Patients were categorized into 3 cohorts; non-users (did not take vitamin D supplementation), inconsistent vitamin D supplementation users (1-2 visits), and consistent vitamin D supplementation users (3-4 visits).Results indicated that less than half of the patients reported consistently using vitamin D supplementation. Consistent vitamin D... Read More »
RCT