Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Dec 2019
Randomized Controlled Trial Comparative StudyHigh-dose (3 g) topical tranexamic acid has higher potency in reducing blood loss after total knee arthroplasty compared with low dose (500 mg): a double-blind randomized controlled trial.
Topical intra-articular tranexamic acid (IA-TXA) has been proven to be safe and effective in reducing postoperative blood loss after primary total knee arthroplasty (TKA). The objective of this study was to investigate the efficacy of high dose (3 g) compared with low dose (500 mg) of IA-TXA in postoperative blood loss after primary TKA. ⋯ Application of high-dose, 3 g topical IA-TXA was 43% more effective in reducing postoperative blood loss compared with low dose of 500 mg in primary TKA. Optimal doses in between the above two doses may be a worthwhile further investigation.
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Eur J Orthop Surg Tr · Dec 2019
Comparative StudyEarly versus delayed weight bearing after surgical fixation of distal femur fractures: a non-randomized comparative study.
Distal femur fractures are rare injuries with a bimodal distribution (high-energy injury in young males and low-energy fragility fractures in old females). Their management can be challenging: open reduction and internal fixation (ORIF) with distal femur locking plates is a commonly performed procedure especially in comminuted fractures with articular involvement. Anxiety regarding the stability of the fixation, especially in osteoporotic bone, leads to post-operative restrictive instructions with limitations regarding the weight-bearing status. ⋯ Distal femur fractures treated with locking plates can be rehabilitated with EWB to allow early return to function. There is no evidence that EWB increases the risk of fracture displacement or implant failure in distal femur fractures treated with distal locking plates. Instead, it is possible that post-operative non-weight-bearing status delays the fracture-healing process increasing the risk of failure of the fixation.
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Eur J Orthop Surg Tr · Dec 2019
International Standards for Neurological Classification of Spinal Cord Injury: factors influencing the frequency, completion and accuracy of documentation of neurology for patients with traumatic spinal cord injuries.
We aim to evaluate the effects of injury-related factors and clinician training grades on the frequency, completion and accuracy of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) charts in a tertiary care neurosurgery unit. ⋯ The quality of ISNCSCI documentation remained poor regardless of the clinician training grade and injury factors. Clinicians should be educated on the ISNCSCI protocol and the importance of adequate documentation.
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Eur J Orthop Surg Tr · Oct 2019
Comparative StudyThe impact of proximal femoral nail type on clinical and radiological outcomes in the treatment of intertrochanteric femur fractures: a comparative study.
The aim of the study was to compare three different proximal femoral nails in terms of functional and radiological outcomes in patients treated with closed reduction and internal fixation for intertrochanteric femur fractures (IFFs). ⋯ PFNA-II is a better option than Profin and InterTAN in the treatment of IFFs when the surgical parameters and functional and radiological results were evaluated as a whole.
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Eur J Orthop Surg Tr · Oct 2019
Randomized Controlled TrialPre-operative intravenous steroid improves pain and joint mobility after total knee arthroplasty in Chinese population: a double-blind randomized controlled trial.
This study aims to investigate the effect of pre-operative intravenous methylprednisolone on post-operative pain control and joint mobility in Chinese patients undergoing single primary total knee arthroplasty. ⋯ Pre-operative intravenous methylprednisolone improves post-operative pain and joint mobility after total knee arthroplasty up to 30 h after operation. It results in a higher patients' satisfaction. It can act as an effective adjunct in the multimodal analgesic regime.