The Journal of hand surgery
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Comparative Study
Effect of patient age on the radiographic outcomes of distal radius fractures subject to nonoperative treatment.
Our study assessed the radiographic outcomes of nonsurgically treated distal radius fractures of patients who were 18 to 44 years old (group 1), 45 to 64 years old (group 2), and 65 years old or older (group 3). ⋯ Our study found that secondary displacement of distal radius fractures increased with increasing patient age, primarily among fractures subject to closed reduction. Older patients with these fractures require closer management after initial reduction, therefore allowing for better monitoring of expected subsequent fracture collapse. Further, given these high rates of secondary displacement after nonoperative treatment (58% to 89%), it is also important to consider that surgical treatment of these fractures may be necessary.
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Review Meta Analysis Comparative Study
Simple decompression versus anterior subcutaneous and submuscular transposition of the ulnar nerve for cubital tunnel syndrome: a meta-analysis.
Optimal surgical management of cubital tunnel syndrome remains uncertain despite the publication of numerous case series, observational studies, systematic reviews, and, in recent years, randomized controlled studies. The purpose of this meta-analysis was to compare simple decompression to anterior transposition of the ulnar nerve for the treatment of this condition, using comparative trials and randomized controlled trials. ⋯ This report represents the best cumulative evidence to date examining the surgical management of cubital tunnel syndrome. In this study, we found no statistically significant difference, but rather a trend toward an improved clinical outcome with transposition of the ulnar nerve as opposed to simple decompression. Additional prospective, randomized studies that use reproducible preoperative and postoperative objective measures might add statistical power to this finding.
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Randomized Controlled Trial Comparative Study
Comparison of 2 methods of immobilization of fifth metacarpal neck fractures: a prospective randomized study.
The objective of this study was to prospectively compare the effectiveness of 2 methods of cast immobilization for fifth metacarpal neck fractures with respect to the time required for cast application, durability and tolerability of the cast, efficacy of maintaining reduction, and postimmobilization range of motion. ⋯ There was no difference between the 2 groups on maintaining the reduction on final lateral radiographs. Stiffness was not a complication of either group. Advantages of the MCP-ext cast include quicker application and, to a much lesser degree, better tolerability, range of motion, and final grip strength.
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Comparative Study
Predictors of acute carpal tunnel syndrome associated with fracture of the distal radius.
A better understanding of the risk factors for acute carpal tunnel syndrome (CTS) associated with fracture of the distal radius might influence recommendations for prophylactic carpal tunnel release. ⋯ Fracture translation is the most important risk factor for acute CTS in patients who subsequently had ORIF of a fracture of the distal radius. On the basis of these data, prophylactic carpal tunnel release might be appropriate in women less than 48 years of age with greater than 35% fracture translation, but further investigation is needed to confirm that a true threshold exists.
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Comparative Study
Prospective 1-year follow-up study comparing joint prosthesis with tendon interposition arthroplasty in treatment of trapeziometacarpal osteoarthritis.
Osteoarthritis of the thumb basal joint is a common and disabling condition. This clinical follow-up study compares the efficacy of total basal joint replacement surgery with that of tendon interposition arthroplasty. ⋯ This study demonstrates that patients with joint prostheses achieve faster convalescence with better patient comfort and improved strength and range of motion without any increased risk of complications than do patients treated with tendon interposition arthroplasty at 1-year follow up. However, a randomized clinical trial with long-term follow-up is required.