Injury
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Centralising complex surgeries in specialised UK hospitals improves patient outcomes by leveraging high-volume expertise and optimising resources. Supraclavicular brachial plexus exploration, a complex and high-risk procedure, requires centralisation to enhance care standards. ⋯ Centralised centres also support comprehensive rehabilitation and systematic research, promoting evidence-based practices and specialist collaboration. By adopting this approach, the UK healthcare system can ensure that patients with brachial plexus injuries receive the highest quality of care, paving the way for better health outcomes and innovations in surgical practice.
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Observational Study
Pelvic ring fracture in the older adults after minor pelvic trauma - is it an innocent injury?
This study aimed to evaluate the prevalence of severe hemorrhage as a potentially life-threatening complication in elderly patients with isolated, low-energy pelvic ring fractures, which may be more common than previously described. ⋯ Severe pelvic hemorrhage in the older adults due to a minor pelvic injury after a low-energy trauma is not an uncommon complication, especially with combination of ACT and posterior pelvic ring fracture. This indicates that these injuries more challenging than previously believed. Geriatric pelvic ring injuries should be monitored carefully with serial blood counts, and low threshold for imaging including contrast enhanced CT scans and angiography.
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Review Meta Analysis Comparative Study
A systematic review and meta-analysis of surgical approaches in pelvic fracture-associated urethral injury in children: Primary endoscopic realignment versus delayed urethroplasty.
The management of pediatric patients afflicted with pelvic fracture urethral injury (PFUI) remains a topic of ongoing debate and controversy within the realm of urology. There is persistent discourse concerning the optimal timing for intervention, specifically between immediate primary realignment (PR) and delayed urethroplasty via suprapubic cystostomy (SCDU). This study was undertaken with the objective of conducting a systematic review of the existing body of evidence, with a focus on comparing the outcomes associated with PR and SCDU as interventions for PFUI among pediatric population. ⋯ This study demonstrated that primary realignment procedure did not yield superior outcomes in terms of stricture formation, urinary incontinence, and rates of erectile dysfunction compared to SCDU in pediatric populations with PFUI. It is noteworthy that the predominant inclusion of non-randomized retrospective studies in this analysis introduces a potential for bias. Consequently, there is a pressing requirement for further high-quality research, notably prospective studies and randomized controlled trials, to bolster the robustness of the existing evidence base.
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Meta Analysis Comparative Study
Extra-articular proximal tibia fracture fixation with locked plating versus intramedullary nailing: A meta-analysis.
This study compared outcomes of locked plating (LP) versus intramedullary nailing (IMN) techniques for treatment of extra-articular proximal-third tibia fractures. ⋯ Therapeutic Level III.