Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2023
The standardized exploration of the radial nerve during humeral shaft fixation reduces the incidence of iatrogenic palsy.
The purpose of this study is to determine if a standardized protocol for radial nerve handling during humeral shaft repair reduces the incidence of iatrogenic nerve palsy post operatively. ⋯ Level III.
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Arch Orthop Trauma Surg · Jan 2023
Review Meta AnalysisVascularized fibular grafts for the treatment of long bone defects: pros and cons. A systematic review and meta-analysis.
To quantify union rate, complication rate, reintervention rate, as well as functional outcome after vascularized fibular bone grafts (VFGs) for the treatment of long-bone defects. ⋯ This systematic review and meta-analysis documented good long-term outcomes both in the upper and lower limb. However, VFG is a complex and demanding technique; this complexity means an average high number of complications, especially fractures, non-unions, and vascular problems. Both potential and limitations of VFG should be considered when choosing the most suitable approach for the treatment of long-bone defects.
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Arch Orthop Trauma Surg · Jan 2023
Review Meta AnalysisA systematic review and meta-analysis comparing the use of hook plates and superior plates in the treatment of displaced distal clavicle fractures.
Non-operative treatment of displaced distal clavicle fractures results in high non-union and yet there is no consensus on superior treatment modality. While there are a number of different techniques available for fixation, hook plate (HP) has been used most commonly. A number of modern techniques, including superior plate (SP), have shown less complications but equivocal union rate and shoulder function. The aim of this systematic review and meta-analysis is to compare the outcome of HP fixation with superior plate in surgical fixation of displaced distal clavicle fractures. ⋯ The current review has demonstrated that HP, SP alone or with CCLR all offer excellent union rate and appear to provide comparative functional outcomes. However, HP is associated with significantly higher complication rates.
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Arch Orthop Trauma Surg · Jan 2023
Randomized Controlled TrialResults after primary reverse shoulder arthroplasty with and without subscapularis repair: a prospective-randomized trial.
Indications for reverse shoulder arthroplasties (rTSA) have increased since their development by Paul Grammont in 1985. Prosthesis design was enhanced over time, but the management of the tendon of the M. subscapularis (SSC-tendon) in primary rTSA is still a controversial subject with regard to perform a refixation or not. ⋯ SSC-tendon repair in rTSA improves CS and internal rotation 12 months after surgery.
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Arch Orthop Trauma Surg · Jan 2023
Meta AnalysisEffect of ultrasound-guided versus landmark-guided local corticosteroid injection for carpal tunnel syndrome: a systematic review and meta-analysis.
Carpal tunnel syndrome (CTS), the commonest neuropathy of the upper limb, can be managed with different therapeutic approaches. Local corticosteroid injection has been adopted widely in clinical practice, as it showed great efficacy in treating CTS. However, the best injection technique continues to be a subject of controversy. The aim of this systematic review and meta-analysis was to evaluate the efficacy of ultrasound-guided (US-guided) versus landmark-guided (LM-guided) corticosteroid injection on the clinical and electrophysiological outcomes in patients with CTS. ⋯ This meta-analysis showed the superiority of US-guided corticosteroid injection over LM-guided corticosteroid injection in enhancing functional status, improving symptom severity, and reducing the adverse event rate in individuals with CTS.