Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2004
Review Comparative StudyHierarchy of evidence: differences in results between non-randomized studies and randomized trials in patients with femoral neck fractures.
There have been a number of non-randomized studies comparing arthroplasty with internal fixation in patients with femoral neck fractures. However, there remains considerable debate about whether the results of non-randomized studies are consistent with the results of randomized, controlled trials. Given the economic burden of hip fractures, it remains essential to identify therapies to improve outcomes; however, whether data from non-randomized studies of an intervention should be used to guide patient care remains unclear. We aimed to determine whether the pooled results of mortality and revision surgery among non-randomized studies were similar to those of randomized trials in studies comparing arthroplasty with internal fixation in patients with femoral neck fractures. ⋯ Similar to other reports in medical subspecialties, non-randomized studies provided results dissimilar to randomized trials of arthroplasty vs internal fixation for mortality and revision rates in patients with femoral neck fractures. Investigators should be aware of these discrepancies when evaluating the merits of alternative surgical interventions, especially when both randomized trials and non-randomized comparative studies are available.
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Arch Orthop Trauma Surg · Jan 2004
Surgical correction of deformities of the distal radius due to fractures in pediatric patients.
The indication and treatment of malunited fractures of the distal radius in the growing skeleton differ from those for adults. The literature results are scarce. In this study we examined the results of surgical correction following fractures of the distal radius in infants. ⋯ Surgical correction for malunited fractures of the distal radius provides good and excellent radiological and functional results in the growing skeleton. It should be considered immediately if there is poor remodeling capacity and disabling loss of function.
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Arch Orthop Trauma Surg · Jan 2004
Predictors of early and late instability following conservative treatment of extra-articular distal radius fractures.
The purpose of this study was to identify radiological predictors of early and late instability following conservative treatment of extra-articular distal radius fractures. ⋯ An awareness of independent predictors of instability in extra-articular distal radius fractures is helpful in anticipating the final alignment outcome.
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Arch Orthop Trauma Surg · Jan 2004
Comparative StudyIntramedullary fixation of pertrochanteric hip fractures with the short AO-ASIF proximal femoral nail.
The advantages of intramedullary fixation of pertrochanteric hip fractures over dynamic screw-plate devices in the clinical setting are still a matter of debate. We performed a case series study in a teaching hospital to analyse the results of the recent AO-ASIF proximal femoral nail (PFN). ⋯ In view of only one loss of reduction with varus collapse clearly caused by a technical error, we concluded that the PFN is a suitable implant for unstable fractures, but the high re-operation rate precludes its routine use for every pertrochanteric fracture.
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Arch Orthop Trauma Surg · Jan 2004
Case ReportsGiant cell tumor of the distal fibula: fifteen-year result after en bloc resection and fibula reconstruction.
Giant cell tumor of the distal fibula is a very rare condition. The treatment of advanced tumors at this location can be challenging and has been described in the literature only in single cases. ⋯ We suggest the method to be worthwhile for treatment of this uncommon lesion in terms of recurrence and functional outcome.