Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Oct 2014
Delayed surgery in displaced paediatric supracondylar fractures: a safe approach? Results from a large UK tertiary paediatric trauma centre.
Displaced paediatric supracondylar humeral fractures pose a significant risk of neurovascular injury and consequently have traditionally been treated as a surgical emergency. Recently, the need for emergency surgery has been questioned. We wished to analyse our experience at a large UK tertiary paediatric trauma centre. ⋯ Our results indicate that delayed surgery appears to offer a safe management approach in the treatment of displaced supracondylar fractures, but it is important that cases are carefully evaluated on an individual basis. These results indicate that patient transfer to a specialist paediatric centre, often with consequent surgical delay, is a safe management option and also negates the obligation to carry out these procedures at night.
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Eur J Orthop Surg Tr · Oct 2014
Review Comparative StudyOperative versus nonoperative treatment of displaced midshaft clavicle fractures in adults: a systematic review.
Intervention studies of clavicle fracture treatment are numerous, but only a few high quality studies prospectively compare operative and nonoperative treatment. The objective of this study was to review evidence from randomized controlled trials on operative versus nonoperative treatment of displaced midshaft clavicle fractures in adults with focus on fracture healing, complications and functional outcome. ⋯ It seems like operative intervention leads to fewer nonunions at the cost of an increase in minor complications compared to nonoperative treatment. However, the effects of operation on functional outcome remains controversial. High quality evidence is currently sparse supporting either operative or nonoperative treatment on displaced midshaft clavicle fractures in adults.
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Eur J Orthop Surg Tr · Oct 2014
Observational StudyMinimally invasive percutaneous plate osteosynthesis for ankle fractures: a prospective observational cohort study.
The gold standard for the surgical management of ankle fractures is through open reduction and internal fixation. The rate of wound problems has been reported to be as high as 18%, especially in patients with poor vascular supply or in diabetics. Minimally invasive percutaneous plate osteosynthesis (MIPPO) has been described as a potential solution for these patients. ⋯ MIPPO technique proved to be a viable option for lateral malleolar fracture treatment with a low complication rate and high functional outcome at 1 year. It is particularly useful in patients with a high risk of wound complication.
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Eur J Orthop Surg Tr · Oct 2014
The effect of the metal-on-metal hip controversy on Internet search activity.
The recall of the articular surface replacement (ASR) hip prosthesis in 2010 represents one of the most controversial areas in orthopaedic surgery in recent years. The aim of this study was to compare the impact of the metal-on-metal hip controversy on Internet search activity in four different regions and determine whether the number of related news reports affected Internet search activity. The Google Trends, Keywords and News applications were used to record the number of news articles and Internet search activity for the terms "hip recall", "metal-on-metal hip" and "ASR hip" from October 2009 to October 2012 in the USA, the UK, Australia and Ireland. ⋯ There was a positive correlation between the number of news stories in UK and Ireland with Internet search activity but not in the USA or Australia. Differences between countries affected by the same recall highlight the complex effects of the media on public awareness. The data demonstrates a window of opportunity prior to the official recall for the development of an awareness campaign to provide patients with accurate information.
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Eur J Orthop Surg Tr · Oct 2014
Randomized Controlled Trial Comparative StudyOral oxycodone plus intravenous acetaminophen versus intravenous morphine sulfate in acute bone fracture pain control: a double-blind placebo-controlled randomized clinical trial.
Bone fracture is a common cause of acute pain in emergency and orthopedics departments. Targeting the multifaceted mechanisms of pain with combinations of multiple analgesics (multimodal analgesia) can increase the pain control efforts efficacy and decrease the adverse effects of each medication. ⋯ Intravenous acetaminophen plus oral oxycodone is as effective as intravenous morphine sulfate in acute pain control in emergency department but with a less desirable safety profile.