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8%
Synopsis: A total of 304 patients with isolated, unstable distal radius fractures who received either receive surgical care (n=187) or casting (n=117) were included in this study.Patients who opted for surgical treatment were randomized to receive either internal fixation with volar plate, external fixation, or percutaneous pinning.Patients who preferred conservative management received casting.The primary outcome of interest included the 24-month Michigan Hand Outcomes Questionnaire (MHQ) Summary score.Secondary outcomes of interest included MHQ domain scores.Outcomes were measured up to 24 months post-treatment.In all patients, the mean MHQ Summary score at 24 months was 86 [95%CI 83, 88] and the mean MHQ ADL score at 24 months was 88 [95%CI 80,88], representing good hand function and return to activities of daily living.No statistically significant differences in any of the MHQ domains at 24 months post-treatment.Internal fixation with volar plate had statistically significantly higher MHQ ADL and satisfaction domain scores compared to the other 3 interventions (p<0.0001) at 6 weeks post-treatment.Patients who underwent external fixation scored significantly lower in these 2 domains compared to the casting and internal fixation with volar plate groups. The external fixation... Read More »
RCT
7%
Synopsis: A total of 30 adults with distal third tibia fracture and same-level or more fibula fracture patients who underwent tibial load-sharing reamed intramedullary nailing were randomized into receiving operative fibular plating or nonoperative treatment of the fibular fracture.Outcomes of interest included pain on a Visual Analogue Scale (VAS), Short Form 36 Health Survey Questionnaire (SF-36), the Ankle-Hindfoot Scale, Hospital for Special Surgery (HSS) Knee Disability Scale, incidence of fracture healing, incidence of tibial alignment, and incidence of adverse events.No statistically significant differences were found between treatment groups in VAS pain scores at any follow-up period.The rate of tibial union higher in the plating group compared to the conservative group (92.3% vs.76.9%), and a higher rate of malalignment was reported in the non-operative group.Operative time was statistically significantly longer in the plating group compared to the conservative group (p=0.002). The time to... Read More »
Conference Report
4%
Synopsis: A total of 850 patients with low-energy intertrochanteric fractures were randomized to receive fracture fixation with an intramedullary nail or sliding hip screw.The primary outcome of interest was health-related quality of life measured via the Euro-Qol-5 Dimensions (EQ-5D) questionnaire, at 1 year post-operation.Secondary outcomes of interest include revision and fracture healing rates, the incidence of adverse events, the Parker Mobility Score, and the Harris Hip score.Fracture healing was measured at 13-weeks follow-up, whilst remaining outcomes were assessed at 1-year post-operation. The results demonstrated... Read More »
Conference Report
4%
Synopsis: A total of 124 elderly patients with displaced displaced proximal humeral fractures (PHFs) were randomized to receive a reverse shoulder arthroplasty (RA) (n=64) or plate fixation (n=60).The primary outcome of interest was the Constant score at 2-years follow-up.The secondary outcomes of interest were the Oxford Shoulder Score and radiological outcomes.The results demonstrated that a statistically significant difference in Constant scores at 2 years, favour of the reverse shoulder arthroplasty group.Stratified by OTA/AO fracture classification, Constant scores were statistically significantly in favour of the reverse arthroplasty group in type C2 proximal humeral fractures. However in type... Read More »
Conference Report
3%
Synopsis: A secondary analysis of the Fluid Lavage of Open Wounds (FLOW) Trial database was performed to assess the effectiveness of antibiotics alone in treating superficial surgical site infection in patients who were operatively treated for open fractures.A logistic binary regression analysis was performed to identify any factors associated with antibiotic treatment failure.Of the 139 patients who received antibiotics alone for superficial surgical site infection, 97 (69.8%) were successfully treated.Delay in diagnosing superficial surgical site infection was associated with a higher odds of treatment failure (OR=1.05 per week of diagnosis delay [95%CI 1.004, 1.099], p=0.03). Age, sex, fracture... Read More »
RCT
3%
Synopsis: A total of 207 patients with a flail chest injury or severe chest wall deformity were randomized to receive surgical fixation (n=107) or the non-operative management (n=99).The outcomes of interest were the Short Form 36 (SF-36) Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, assessed at 1 week, 2 weeks, 6 weeks, 3 months, 6 months, and 12 months follow-up.The results demonstrated that both the PCS and MCS were not statistically significantly different (p=0.25; p=0.98, respectively) between the 2 treatment arms at any of the follow-up periods.Patients who smoked demonstrated worse SF-36 MCS and PCS scores at 1 year. Patients who spent... Read More »
Conference Report
1%
Synopsis: A total of 49 children with acute traumatic diaphyseal fractures of the femur were randomized to receive fixation with a titanium elastic nail or intramedullary Kirshner wire (K-wire).The primary outcomes of interest was fracture union (as measured by the modified radiographic union for tibial fractures [mRUST] score), and the incidence of complications leading to unplanned surgery.Secondary outcomes of interest included Pediatric Quality of Life Inventory (PedsQL) scores and recovery milestones ( i.e., time to walking with aids, time to independent walking, time until full activity allowed).Outcomes were assessed at 2- weeks, 6-weeks, 3-months, 6-months, and 12-months post-operation.No statistically significant differences in PedsQL were reported between groups at all time-points; however, improvements from baseline were observed. Similar rates of... Read More »
Conference Report
1%
Synopsis: 220 patients with isolated pertrochanteric femoral fractures were randomized to receive surgical intervention with a short or long cephalomedullary nail.Primary outcomes of interest included the Short Form 36 (SF-36) questionnaire and the Harris Hip Score.Secondary outcomes of interest included implant failure, peri-implant failure, mortality, operative time, estimated blood loss and the incidence of re-operation.Outcomes were assessed up to 12 months post-operation.Results revealed significantly favourable 3 month Harris Hip scores, lower operative time and lower estimated blood loss in the short nail group compared to the long nail group. No significant differences... Read More »
Level 2 RCT
1%
Synopsis: Forty-nine thousand, five hundred and ninety-seven patients aged 60 years or older from Ontario who underwent either total hip arthroplasty or hemi-arthroplasty for the treatment of displaced femoral neck fractures were included in this retrospective study examining clinical outcomes and associated factors with each procedure.A matched cohort of 9,238 patients was used to compare clinical outcomes.Outcomes of interest included the risk of hip dislocation, revision surgery, and death.Results of the study found a higher risk of 1-year revision surgery and dislocation in the total hip arthroplasty group compared to the hemi-arthroplasty group. The risk of... Read More »
Conference Report
1%
Synopsis: A total of 101 patients aged 18 to 55 years old with a tibia or femoral shaft fracture receiving intramedullary nailing for fracture fixation were randomized to receive vitamin D3 supplementation of 150,000 IU at injury and 6 weeks, 4000 IU/day for 3 months, 600 IU/day for 3 months, or the placebo.The primary outcomes of interest were radiographic healing scores (Radiographic Union Scale in Tibial Fractures) and clinical healing scores (Function Index for Trauma), measured at 3 months post-treatment.Results demonstrated that no statistically significant differences were observed between the 4 groups for radiographic and clinical outcomes measured at 3-months follow-up (p>0.50).Furthermore, no statistical significant differences were observed between all high dose groups vs low dose groups (p>0.4), low dose vs placebo groups (p>0.51), high loading dose vs high daily dose groups (p>0.62). The subgroup of... Read More »
Conference Report