Injury
-
Review Meta Analysis
What's old is best again Is anterior plating best for fixation of type-C pelvic fractures? A systematic review and meta-analysis.
Type-C pelvic fractures are a rare but potentially fatal injury that often leads to poor outcomes, despite surgical fixation. Many fixation methods are used but the optimal method remains contentious, with failure and complications common. This study compared outcomes for each fixation method. ⋯ Post-operative outcomes for surgically treated type-C pelvic fractures revealed a 'less-than-good' pooled outcome rate of 23% and a revision rate of 4%. Anterior plates outperformed most other systems particularly for patient reported outcomes. Pooled revision, patient-reported outcome and complication rates for type-C pelvic fractures have not previously been reported and these data provide a benchmark for practice and future research.
-
Review Meta Analysis
RIA versus iliac crest bone graft harvesting: A meta-analysis and systematic review.
Reamer-Irrigator-Aspirator (RIA) of long bones is increasingly being used as an alternative to iliac crest harvesting for bone-grafts. This meta-analysis compares both harvesting techniques with regard to donor site morbidity, healing potency and implantation site morbidity. ⋯ The main difference between RIA and iliac crest bone graft harvesting is the considerable higher risk of chronic pain of the pelvic procedure. Although risk for infection was also higher for the iliac crest group, the absolute difference is relatively small. Evidence suggests an equal healing potential of the grafts themselves irrespective of harvesting method.
-
Randomized Controlled Trial
Is proximal femoral nailing of unstable intertrochanteric fractures in the lateral decubitus position without a traction table as safe and effective as on a traction table?
Using proximal femoral nailing (PFN) in the lateral decubitus (lateral) position may be an option when no traction table is available. We hypothesized that applying PFN would be effective and reliable in the lateral position without a traction table. To test our hypothesis, we compared the two techniques in a prospective, randomized controlled study. ⋯ We concluded that PFN is a safe and effective alternative for the treatment of unstable intertrochanteric femoral fractures when a traction table is not available in the operating room.
-
This multicentre case-control study compares Vancouver Classification System (VCS) grade and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) fracture type in interprosthetic femoral fractures (IPFFs) between primary total hip arthroplasty (THA) and ipsilateral total knee arthroplasty (TKA) to periprosthetic femoral fracture (PFF) without ipsilateral TKA. ⋯ The presence of an ipsilateral TKA affects the location of PFF with more fractures occurring distal to the stem. A greater proportion of bending type fractures occurred when an ipsilateral TKA was present. These unstable fractures often require more complex surgery.
-
Background Road Safety has become a worldwide concern due to the alarming repercussions road accidents may bear. This study examined the relationship between different geometric design elements and the accident rates on Rashid Bin Saeed Street, Arabian Gulf Street, and Sultan Bin Zayed Street in Abu Dhabi, United Arab Emirates. Methods The geometric design was collected from the satellite images of google earth in compliance with the standard geometric design manual of Abu Dhabi roads. ⋯ Regarding the road's geometric design, which is the focus of this study, a sensitivity analysis was made to determine the most influential geometric design element on accident frequency. Interpretation The number of lanes had the highest sensitivity index followed by the median width, and then came the lane width. Thus, modifying the number of lanes on a highway is anticipated to have the highest impact on accident frequency and road safety than any other geometric parameter.