Eur J Orthop Surg Tr
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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.
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Eur J Orthop Surg Tr · Oct 2014
Randomized Controlled Trial Comparative StudyDisplaced proximal humeral fractures: operative versus non-operative treatment--a 2-year extension of a randomized controlled trial.
Surgical treatment for displaced proximal humeral fractures is widely used. However, there are very few randomized controlled studies comparing surgical treatment to conservative treatment, and the evidence is debated. The aim of this study was to describe patients with displaced proximal humeral fractures in a 2-years extension of a randomized controlled trial, their functional outcome and quality of life. ⋯ In this randomized controlled trial, surgical treatment proved no better results than conservative treatment for patients with displaced proximal humeral fracture at 2-year follow-up.
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Eur J Orthop Surg Tr · Oct 2014
Observational StudyRole of muscle pedicle bone graft as an adjunct to open reduction and internal fixation in the management of neglected and ununited femoral neck fracture in young adults: a prospective study of 17 cases.
To evaluate the role of quadratus femoris muscle pedicle bone grafting along with open reduction and internal fixation in the treatment of neglected and ununited femoral neck fractures in young adults. ⋯ Muscle pedicle bone grafting is a useful adjunct to open reduction and internal fixation for ununited femoral neck fractures. It achieves good final functional results comparable with other methods, but requires greater expertise.
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Eur J Orthop Surg Tr · Oct 2014
Early MRI diagnostics for suspected scaphoid fractures subsequent to initial plain radiography.
In the United Kingdom, diagnostic management of patients presenting to emergency department with a scaphoid injury varies. Follow-up plain radiographs, after an initial inconclusive X-ray, are common practice. We optimised the diagnostic pathway for these patients by focusing on the most appropriate diagnostic modality and on minimising the time to follow-up diagnostics. ⋯ The introduction of early MRI enhances scaphoid injury diagnostics and accelerates patient management. We therefore endorse the introduction of this approach on a wider scale through an update of the clinical guidelines for scaphoid injuries.
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Eur J Orthop Surg Tr · Oct 2014
Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life.
Any intraoperative rotational malalignment during intramedullary nailing (IMN) of femoral shaft fractures will become permanent. We hypothesized that rotational malalignment of the femur and its compensatory biomechanics may induce problems in the hip, knee, patellofemoral and ankle joints. We purposed to clarify the influence of a femoral rotational malalignment of ≥10° on daily activities. ⋯ A femoral rotational malalignment of ≥10° is symptomatic for the patients, and the hip, knee, and patellofemoral joints were affected. Because of the possibly altered joint loadings and biomechanics, these could render patients prone to degenerative joint disease. In addition, due to the high rates of rotational malalignment after femoral shaft fracture and consequent malpractice claims, it is important for surgeons to be more aware of rotational alignment during surgery.