Journal of orthopaedic surgery and research
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There is no comparative study with long-term follow-up between posterior-only and combined posterior-anterior approaches in treating lumbar spinal tuberculosis (LSTB) and lumbosacral spinal tuberculosis (LSSTB). This retrospective study aimed to compare and evaluate the long-term outcomes of these two surgical approaches in LSTB and LSSTB. ⋯ Both combined posterior-anterior approaches and posterior-only approach can achieve satisfactory clinical and radiological outcomes of long-term in treating LSTB and LSSTB, while posterior-only approach can safely and effectively achieve lesion debridement, decompression, and stability reconstruction and maintenance with the advantages of less invasive surgery, less bleeding, shorter surgery time, and hospital stay, and fewer complications. So, posterior-only approach seemed to be superior to the combined posterior-anterior one.
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Randomized Controlled Trial
The efficacy of Enhanced Recovery after Surgery (ERAS) for elderly patients with intertrochanteric fractures who received surgery: study protocol for a randomized, blinded, controlled trial.
Intertrochanteric fracture (ITF) is increasing with the rapid increase in the aging population, often causes a high mortality rate in old patients and increases the economic burden of the family and society. ERAS (Enhanced Recovery after Surgery) is a powerful guarantee for patients to accelerate their recovery after surgery. TCM (traditional Chinese medicine) promotes repair of injured tissues and eliminates traumatic aseptic inflammation. Therefore, this prospective randomized controlled clinical trial aims to evaluate the clinical effect of the evidence-based ERAS pathway of integrating TCM with western medicine on perioperative outcomes in ITF patients undergoing intramedullary fixation and provide reliable evidence-based data for applying the program to clinical practice. ⋯ Although an evidence-based process using the best available literature and Delphi expert-opinion method has been used to establish an ERAS pathway of integrating TCM with western medicine, there is a lack of consensus about its effectiveness. This trial will provide convincing evidence about the effect of ERAS pathway.
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To compare sagittal alignment and clinical outcomes between three-level hybrid surgery (HS) and anterior cervical discectomy and fusion (ACDF) on cervical spondylotic myelopathy (CSM) over a 5-year follow-up. ⋯ Cervical alignment was comparably improved. HS and ACDF provided identified mid-term efficacy, and it was not necessary to have to use prosthesis on three-level CSM.
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Recent studies investigating fracture development in Germany are not available especially with regard to demographic change. The primary aim of this study was to report trends in fracture development of the upper extremity in Germany between 2002 and 2017 and to evaluate changes over time. ⋯ Total count of nearly every evaluated fracture increased. Also, incidences increased especially in the older female age groups. Fracture development already seems to reflect demographic changes in Germany.
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The clinical effect of the three-incision combined approach for complex fracture of tibial plateau involving the posterior tibial plateau was discussed. ⋯ The three-incision combined approach proved safe and reliable for complex fracture of tibial plateau involving the posterior tibial plateau and is worthy of further popularization.