The Journal of hand surgery, European volume
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J Hand Surg Eur Vol · Mar 2018
The diagnostic accuracy of 1.5T magnetic resonance imaging for detecting root avulsions in traumatic adult brachial plexus injuries.
Identification of root avulsions is of critical importance in traumatic brachial plexus injuries because it alters the reconstruction and prognosis. Pre-operative magnetic resonance imaging is gaining popularity, but there is limited and conflicting data on its diagnostic accuracy for root avulsion. This cohort study describes consecutive patients requiring brachial plexus exploration following trauma between 2008 and 2016. ⋯ The diagnostic accuracy of magnetic resonance imaging for root avulsion(s) of C5-T1 was 79%. The diagnostic accuracy of a pseudomeningocoele as a surrogate marker of root avulsion(s) of C5-T1 was 68%. We conclude that pseudomeningocoles were not a reliable sign of root avulsion and magnetic resonance imaging has modest diagnostic accuracy for root avulsions in the context of adult traumatic brachial plexus injuries.
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J Hand Surg Eur Vol · Feb 2018
Meta Analysis Comparative StudyPercutaneous pinning versus volar locking plate internal fixation for unstable distal radius fractures: a meta-analysis.
This meta-analysis compared outcomes between percutaneous pinning/wiring and open reduction internal fixation (ORIF) with locking plates for treatment of unstable distal radius fractures. Medline, Cochrane, EMBASE, and Google Scholar were searched through December 30, 2015. Twenty randomised controlled trials (RCTs) and non-randomised two-arm studies were included. ⋯ Supination and grip strength were better with ORIF. Radiographically, ulnar variation was greater with pinning/wiring. These results suggest that ORIF/plating is the preferred method of managing unstable distal radius fractures.