Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2014
Review Meta AnalysisIs unilateral kyphoplasty as effective and safe as bilateral kyphoplasties for osteoporotic vertebral compression fractures? A meta-analysis.
An osteoporotic vertebral compression fracture is a common condition in elderly people, especially women. The percutaneous kyphoplasty is an effective treatment for osteoporotic vertebral compression fractures. Controversy remains regarding whether a unilateral or a bilateral approach is superior, and to our knowledge, there have been no large studies comparing these two approaches, therefore a meta-analysis synthesizing the data on this question is warranted. ⋯ Unilateral and bilateral percutaneous kyphoplasties appear to be safe and effective for treating osteoporotic vertebral compression fractures. No clinically important differences were found between them. Considering less operation time and less cost, we suggest that a unilateral percutaneous kyphoplasty is advantageous, but because of the poor quality of the evidence, high-quality randomized controlled trials are required to resolve this issue.
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Clin. Orthop. Relat. Res. · Sep 2014
Biography Historical ArticleObituary: A remembrance: Joseph H. Skoot Dimon III MD (1930-2014).
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Clin. Orthop. Relat. Res. · Sep 2014
ReviewVascular and nerve injury after knee dislocation: a systematic review.
Vascular injury is a devastating complication of acute knee dislocation. However, there are wide discrepancies in the reported frequency of vascular injury after knee dislocations, as well as important differences among approaches for diagnosis of this potentially limb-threatening problem. ⋯ This review enhances our understanding of the frequency of vascular injury and repair, amputation, and nerve injuries after knee dislocation. It also illustrates the lack of consensus among practitioners regarding the diagnostic and treatment algorithm for vascular injury. After pooling existing data on this topic, no outcomes-driven conclusions could be drawn regarding the ideal diagnostic modality or indications for surgical repair. In light of these findings and the morbidity associated with a missed diagnosis, clinicians should err on the side of caution in ruling out arterial injury.
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Clin. Orthop. Relat. Res. · Sep 2014
Comparative StudyMedial injury in knee dislocations: what are the common injury patterns and surgical outcomes?
When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment. ⋯ Medial ligament injury is common in knee dislocations. Females who sustain these injuries and patients who have an ultra-low-velocity mechanism should be counseled at the time of injury about the likelihood of inferior outcomes. As ROM deficits are the most commonly encountered complication, postoperative rehabilitation should focus on early ROM exercises as stability and wound healing allow. Future prospective studies are needed to definitively determine whether operative or nonoperative management is appropriate for particular medial ligamentous injury patterns.
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Clin. Orthop. Relat. Res. · Sep 2014
Obesity does not affect survival outcomes in extremity soft tissue sarcoma.
Obesity is a growing epidemic and has been associated with an increased frequency of complications after various surgical procedures. Studies also have shown adipose tissue to promote a microenvironment favorable for tumor growth. Additionally, the relationship between obesity and prognosis of soft tissue sarcomas has yet to be evaluated. ⋯ Level III, therapeutic study. See the Instructions for Authors for a complete description of levels of evidence.