Abstract:
OBJECTIVES:To compare open reduction and internal fixation (ORIF) and nonsurgical treatment outcomes in displaced midshaft clavicle fractures. DATA SOURCES:PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. STUDY SELECTION:Inclusion criteria were randomized controlled trials reporting nonunion, shoulder functional outcomes, and subsequent surgery rates or pain scores. We excluded studies with patients younger than 16 years, maximum follow-up less than 9 months, and inaccessible full text. DATA EXTRACTION:Extracted data included the first author, publication year, number of patients, number of nonunions, Constant scores, disabilities of the arm, shoulder, and hand (DASH) scores, number of subsequent surgeries, and pain measured using the visual analog scale. DATA SYNTHESIS:The risk ratio of nonunion was 0.15 [95% confidence interval (CI), 0.08-0.31] in ORIF compared with that of nonsurgical treatment. Constant and DASH scores were significantly better in ORIF up to 6 months. The mean difference (MD) in DASH scores at 12 months was statistically insignificant in both treatments (MD, -4.19; 95% CI, -9.34 to 0.96). Constant scores remained significant in ORIF (MD, 4.39; 95% CI, 1.03-7.75). Subsequent surgeries and pain scores were similar in both treatments. CONCLUSIONS:Significant reduction in nonunions and favorable early functional outcomes are associated with ORIF. Nevertheless, late functional outcomes, subsequent surgeries, and pain scores are similar to those of nonsurgical treatment. Although patients treated with ORIF mainly had subsequent elective plate removals, nonsurgically treated patients had more surgical fixations for nonunions. As a result, there remains inconsistent evidence regarding the best treatment for displaced midshaft clavicle fractures. LEVEL OF EVIDENCE:Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Ahmed AF,Salameh M,AlKhatib N,Elmhiregh A,Ahmed GOdoi
10.1097/BOT.0000000000001174subject
Has Abstractpub_date
2018-07-01 00:00:00pages
e276-e283issue
7eissn
0890-5339issn
1531-2291journal_volume
32pub_type
杂志文章,meta分析abstract:OBJECTIVES:To evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures. DESIGN:Retrospective cohort study. Data was collected from medical records and radiographs. SETTING:Two level-1 trauma centers. PATIENTS/PARTICIPANTS:Patients who sustained an open tibial frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31824133e3
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract::Autologous bone graft is usually necessary for reconstruction of nonunions with shortening or bone loss. We developed a new technique to reconstruct such nonunions or delayed unions without bone grafting by chipping and lengthening of bone at the original fracture site. Five in six nonunions with shortening or bone lo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318041f6d1
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To determine the rate of pelvic vein thrombosis following acetabular or pelvic fracture identified by enhanced computed tomography venography or magnetic resonance venography. DESIGN:Prospective evaluation of computed tomography venography and magnetic resonance venography in patients with pelvic and acetabu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200210000-00001
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVE:Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318172841c
更新日期:2008-05-01 00:00:00
abstract::In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with inter-trochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According t...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199310000-00006
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To compare the strength of fixation obtained using two unicortical 4.0 mm diameter cancellous screws versus two bicortical 3.5 mm diameter cortical screws in the fixation of intra-articular calcaneus fractures. DESIGN:In eight paired fresh frozen cadaver feet, the subtalar joint complex, consisting of the ta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199701000-00008
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the use of lag screw only fixation of noncomminuted oblique fractures of the lateral malleolus in patients younger than fifty years of age. DESIGN:Prospective evaluation. SETTING:Level I trauma center. PATIENTS AND PARTICIPANTS:Forty-seven ankle fractures with simple oblique patterns and no co...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200102000-00008
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:This study was designed to investigate the relationship between upper extremity (UE) injuries and occupant restraint systems among front seat occupants who were involved in frontal motor vehicle collisions (MVCs). DESIGN:Case-control. SETTING:The 1995 through 2002 National Automotive Sampling System (NASS)...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000161543.52643.ab
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Calcaneal fractures comprise 1 to 2 percent of all fractures. Approximately 75% of calcaneal fractures are intra-articular. The management of intra-articular calcaneal fractures remains controversial. Nonoperative treatment options include elevation, ice, early mobilization, and cyclic compression of the pla...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:
更新日期:2005-05-01 00:00:00
abstract::This case report provides background reviewing mortality rates associated with falls from height before detailing the clinical history of a patient who survived a fall from a height of 43 stories. A multidisciplinary team treated both orthopaedic and nonorthopaedic injuries with the ultimate goal of preserving potenti...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318193bc8d
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. DESIGN:Standardized proximal tibial fractures (AO classificati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200409000-00010
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PAT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000840
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:We studied the safety of immediate weight bearing as tolerated (IWBAT) and immediate range of motion (IROM) following open reduction internal fixation (ORIF) of selected malleolar ankle fractures (defined as involving bony or ligamentous disruption of two or more of the malleoli or syndesmosis without articu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002003
更新日期:2020-11-09 00:00:00
abstract:OBJECTIVE:To evaluate the difference in quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative CT scans in displaced intra-articular calcaneal fractures (DIACFs). DESIGN:Retrospective SETTING:: Level 1 and Level 2 academic centers. PATIENTS:Consec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001971
更新日期:2020-09-18 00:00:00
abstract:OBJECTIVES:To evaluate the incidence of unplanned reoperations after pelvic ring injuries and to develop a risk prediction model. DESIGN:Retrospective review. SETTING:Level I Trauma Center. PATIENTS:The medical records of 913 patients (644 male and 269 female patients; mean age, 39 years; age range, 16-89 years) wit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001170
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN:Prospective, cohort. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:A total...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000556
更新日期:2016-08-01 00:00:00
abstract::Acute compartment syndrome of the deltoid is rare with only 6 cases reported in the literature. To our knowledge, there are no reported cases of deltoid compartment syndrome after surgery on the shoulder. In this case, the patient developed a tense painful anterior deltoid 3 hours after antegrade nailing of a segmenta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318199e83c
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:To determine if distal femoral traction pins result in knee dysfunction in patients with femoral or pelvic fracture, and to determine if skeletal traction relieves pain more effectively than splinting for femoral shaft fractures. DESIGN:Prospective cohort trial. SETTING:Level I urban trauma center. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000202
更新日期:2015-02-01 00:00:00
abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001407
更新日期:2019-05-01 00:00:00
abstract:SUMMARY:We present the previously unreported complication of symptomatic heterotopic ossification of the quadriceps following placement of a large-diameter Steinmann pin for the purpose of temporary skeletal traction. Following the development of distal quadriceps heterotopic bone formation in three patients, we conduc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200404000-00010
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this prospective study was to evaluate the safety, efficacy, and functional outcome of the locked proximal humerus plate (LPHP) to treat proximal humerus fractures. DESIGN:Prospective clinical trial. SETTING:University orthopedic center. PATIENTS:Over a 25-month period, 64 consecutive patie...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e3181d2d04c
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:The increasing number of fractures of the proximal humerus, especially in the elderly, carries with it the unsolved problem of the optimal treatment for the displaced or unstable fractures. The authors' goal was to analyze whether fixation with a bent valgus angled blade plate could improve the outcomes repo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200604000-00004
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVES:Hand dominance has been reported to be an important factor affecting outcomes after upper extremity trauma but remains unstudied after hemiarthroplasty for fracture. This study determined whether dominance affected outcomes after hemiarthroplasty for proximal humerus fractures. DESIGN:Retrospective cohort s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000294
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:To characterize the presentation and outcomes of calcaneal avulsion fractures. DESIGN:Case series. SETTING:Two ACS Level I trauma centers. PATIENTS/PARTICIPANTS:Forty-seven calcaneal avulsion fractures isolated from a cohort of 1365 calcaneus fractures treated over a 17-year period. MAIN OUTCOME MEASUREME...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001582
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:To identify the fracture characteristics that can be reliably assessed by analysis of plain radiographs of tibial plateau fractures. DESIGN:Radiographic review study. PARTICIPANTS:Five orthopaedic traumatologists served as observers. INTERVENTION:Observers made assessments based on the radiographs of fifty...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200008000-00001
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:Much attention has been given to lower extremity amputations that occur more than 90 days after injury, but little focus has been given to analogous upper extremity amputations. The purpose of this study was to determine the reason(s) for desired amputation and the common complications after amputation for t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182a665f5
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:To assess the recovery of ankle function and general health status at multiple time points during the first 24 months after an isolated tibial plafond fracture treated with joint-spanning external fixation and to determine factors that affect a rapid versus a slow recovery and factors that influence patient ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c8ad52
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVES:To evaluate the role of a modified Pauwels' intertrochanteric osteotomy (MPIO) in neglected femoral neck fractures in children. DESIGN:Prospective study with retrospective analysis. SETTING:Tertiary care Postgraduate Institute of Medical Sciences. PATIENTS:Ten children (8 males, 2 females) with an average...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31804cfdad
更新日期:2007-04-01 00:00:00