International orthopaedics
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Randomized Controlled Trial Comparative Study
Distal locked and unlocked nailing for perthrochanteric fractures--a prospective comparative randomized study.
Intramedullary nailing is widely used in the treatment of stable pertrochanteric fractures. However, it remains controversial whether the distal locking with intramedullary nailing is necessary. ⋯ This study suggests that intramedullary nails without distal locking may be a reliable and acceptable option for treating stable pertrochanteric fractures (AO/OTA 31-A1 and A2) in elderly people. Distal unlocked nails showed subtle advantages in reducing blood loss, operation time, fluoroscopy exposure time, and size of the incision.
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Randomized Controlled Trial
Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement.
The purpose of this study was to evaluate pre-operative education versus no education and mini-invasive surgery versus standard surgery to reach complete independence. ⋯ Neither pre-operative education nor mini-invasive surgery reduces the time to reach complete functional independence. Mini-invasive surgery significantly reduces blood loss and the need for morphine consumption.
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The purpose of our study was to compare the outcome of radial head fractures (modified Mason type III and IV) treated by open reduction and internal fixation (ORIF) versus radial head arthroplasty (RHA). ⋯ The treatment of closed comminuted radial head fracture (modified Mason type III and IV) with ORIF and RHA demonstrates similar findings despite less surgical time for performing RHA.
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Surgical management of humeral fractures associated with radial nerve palsy remains controversial. Some advocate surgical treatment in emergency while others recommend nonoperative treatment. ⋯ Level IV, retrospective study.
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Clinical studies in diabetic patients have demonstrated that there is a high incidence of complications in distal tibia and ankle fracture treatments. One strategy to mitigate issues with wound healing and infection in diabetic patients is to use a percutaneous technique in which autologous, bone marrow-derived, concentrated cells are injected at the site of non-unions. ⋯ In diabetic patients with ankle non-unions, treatment with BM-MSCs from bone marrow concentrate may be preferable in view of the high risks of major complications after open surgery and iliac bone grafting, and improved healing rates compared with standard iliac bone autograft treatment.