Clinical orthopaedics and related research
-
Systematic reviews of original research are increasing in number. Systematic reviews are distinct from narrative reviews because they address a specific clinical question, require a comprehensive literature search, use explicit selection criteria to identify relevant studies, assess the methodologic quality of included studies, explore differences among study results, and either qualitatively or quantitatively synthesize study results. ⋯ Familiarity with how to do a systematic review and meta-analysis will lead to greater skill in using this type of article. For clinicians, teachers, and investigators, systematic reviews and meta-analyses are useful sources of evidence.
-
Clin. Orthop. Relat. Res. · Aug 2003
Case ReportsSecond cervical vertebrae pedicle fractures versus synchondrosis in a child.
Fractures of the second cervical vertebrae (C2) can be difficult to diagnose in young children. A 17-month-old infant sustained bilateral C2 pedicle fractures after minor trauma. The initial lateral radiograph showed pedicle defects, but even with computed tomography and a bone scan with single photon emission computed tomography this could not be differentiated from a congenital abnormality. ⋯ The fractures were treated by closed reduction and a halo vest and healed uneventfully. This child is among a small number of patients with bilateral C2 pedicle fractures that occur predominantly in young children. Diagnosis can be difficult even with a high index of suspicion.
-
Clin. Orthop. Relat. Res. · Aug 2003
Designing, conducting, and evaluating journal clubs in orthopaedic surgery.
The first record of a journal club was that founded in 1875 by Sir William Osler at McGill University for the purchase and distribution of periodicals to which he could not afford to subscribe as an individual. Evidence-based medicine is becoming an accepted educational paradigm in medical education at various levels. ⋯ The implementation of the structured article review checklist has been found to increase resident satisfaction and improves the perceived educational value of the journal club without increasing resident workload or decreasing attendance at the conference. Periodic evaluation of the conference and the institution of appropriate changes ensures that the journal club remains a valuable and successful part of the training program.