Effective treatment of fractures: A Synthesis of Findings from 60 Studies

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Original Abstract of the Article

Major research findings

Studies have been conducted on various fracture treatments, including clavicle fractures, ankle fractures, femur fractures, and hip fractures. For clavicle fractures, plate fixation is often the treatment of choice, but 21 reports that implant-related complications are frequent. For ankle fractures, 39 states that minor fractures are treated with splints and casts, while more serious fractures require surgery with screws, plates, and pins followed by immobilization. Regarding femur fractures, 7 indicates that treatment varies based on the child's age. For hip fractures, 10 suggests that surgical treatment might be superior to conservative treatment in terms of fracture healing. Furthermore, 50 presents research findings indicating that open surgery for bone fixation in children leads to better outcomes.

Treatment summary

21 concludes that plate fixation is effective for clavicle fractures. On the other hand, 51 suggests that surgical treatment promotes faster fracture healing and functional recovery compared to non-surgical treatment for clavicle fractures. 39 states that minor ankle fractures are treated with casts, while more serious cases require surgery with plates and screws. According to 7 , femur fracture treatments vary based on the child's age, with functional treatment used for younger children and casts for older children. 10 indicates that surgical treatment might be superior to conservative treatment in terms of fracture healing for hip fractures. However, 3 shows that surgical treatment results in shorter hospital stays and faster rehabilitation than conservative treatment. Furthermore, 50 presents research findings indicating that open surgery for bone fixation in children leads to better outcomes. Additionally, 48 emphasizes the importance of rehabilitation following surgery for intertrochanteric fractures in elderly patients.

Benefits and risks

Benefits summary

Various fracture treatments, both surgical and non-surgical, have the potential to promote fracture healing and functional recovery. 51 suggests that surgical treatment for clavicle fractures leads to higher healing rates and faster functional recovery compared to non-surgical treatment. 40 shows that surgical treatment for tibial fractures results in higher return-to-sport rates and shorter return times. 10 suggests that surgical treatment might be superior to conservative treatment in terms of fracture healing for hip fractures. Additionally, 3 indicates that surgical treatment results in shorter hospital stays and faster rehabilitation. Furthermore, 50 presents research findings indicating that open surgery for bone fixation in children leads to better outcomes.

Risk summary

Surgical treatment carries risks, including infection and nerve damage. It is crucial to discuss these risks with a doctor before undergoing surgery. 21 highlights the frequent occurrence of implant-related complications in clavicle fracture plate fixation. 46 reports the risk of facial nerve damage in surgical treatment for mandibular condylar fractures. Additionally, 35 indicates the potential for various complications arising from surgical treatment for femoral neck fractures.

Comparison between studies

Commonalities

A commonality among fracture treatment studies is that both surgical and non-surgical methods can potentially promote fracture healing and functional recovery.

Differences

The appropriate treatment varies depending on the fracture type, patient age, severity of the fracture, and other factors. Additionally, different instruments and surgical techniques used in surgical treatment can lead to varying complication risks and outcomes, as revealed by research findings.

Consistency and contradictions in results

There is a mix of consistency and contradictions in research findings regarding fracture treatment. For example, concerning clavicle fracture treatment, 21 concludes that plate fixation is effective, while 51 suggests that surgical treatment promotes faster healing and functional recovery compared to non-surgical treatment. These conflicting findings emphasize the importance of considering multiple research findings when choosing a fracture treatment option.

Points to consider when applying the results to real-life scenarios

When selecting a fracture treatment, factors like patient age, fracture type, severity, and lifestyle should be taken into account. If considering surgery, it's essential to have a thorough understanding of the risks and benefits involved and engage in a detailed discussion with your doctor. Following the instructions of a specialist is crucial for fracture treatment.

Limitations of current research

Research on fracture treatment is still in its early stages, with a limited number of studies, especially those evaluating long-term outcomes and comparing the effectiveness of different treatments. Further research is necessary to address these gaps.

Future research directions

To advance fracture treatment research, studies focusing on long-term outcomes, comparisons of different treatment effectiveness, and the development of new treatment methods are essential. Additionally, research aimed at improving patients' quality of life is crucial.

Conclusion

Fracture treatment approaches vary based on factors like patient age, fracture type, and severity. Surgical treatment holds promise for faster healing and functional recovery but also carries risks like infection and nerve damage. When selecting a fracture treatment, it is vital to consider multiple research findings, engage in a comprehensive discussion with your doctor, and prioritize following the guidance of a specialist.

List of treatments

Plate fixation, cast, functional treatment, open surgery, internal fixation, joint replacement, rehabilitation

Keywords
Benefit Keywords
Fracture treatment
1
Effective treatment
Faster union time
Reduced blood loss
Reduced hospital stay
2
Fracture healing
Improved rehabilitation
Shorter hospital stay
3
Improved rehabilitation
Shorter hospital stay
4
Better analgesia
Easier reduction
Reduced redislocation
5
Femur fracture treatment
6
Femoral fracture treatment
7
Fewer complications
Superior clinical results
8
Tibial fracture treatment
9
Improved rehabilitation
Reduced hospital stay
10
Fracture stabilization
Wound healing
12
Fracture healing
13
Clavicle fracture treatment
14
Improved healing
15
Hip fracture treatment
16
Fracture rate reduction
17
Distal radius fracture treatment
18
Philos fracture
Zifko fracture
19
None mentioned
20
Midshaft clavicle fracture treatment
21
Infection prevention
Open fracture treatment
22
Improved functional outcome
Reduced re-operation rate
23
Increased stiffness
Reduced displacement
25
Anatomical union
26
Fracture treatment
27
Calcaneal fracture treatment
28
Periprosthetic fracture treatment
29
Fracture healing
30
Femoral shaft fracture treatment
32
Tibial fracture treatment
33
Locking-plate fixation
34
Femoral neck fracture treatment
35
Improved function
36
Reduced non-union
37
Improved outcome
38
Ankle fracture treatment
39
Higher return rates
Shorter return times
40
Functional outcome for metastatic femoral fractures
41
Less operating room time
Similar functional outcomes
42
Trimalleolar fracture treatment
43
Improved function
Reduced nonunion
44
Nail fixation
Plate fixation
45
Mandibular Fracture Treatment
46
Faster recovery
Lower cost
47
Improved independence
Return to daily living
48
Less joint pain
Less lateral deviation
Less malocclusion
49
Effective hip fracture treatment
50
Improved functional scores
Reduced nonunion rate
Shortened time to union
51
Hospitalization reduction
52
Improved function for radius and calcaneus fractures
53
Femoral neck fracture treatment
54
Increased bone density
Reduced fracture risk
55
UDCF treatment
56
Infection-free repair
Stabilised fracture
57
Improved treatment success
58
Improved functional outcomes
Lower Disability Rating Index scores
59
Risk Keywords
Limb deformity
Slower rehabilitation
3
Surgical complications
4
Compromised reduction
Poorer analgesia
5
Hip dislocation
8
Re-operation
9
Slower rehabilitation
10
Insufficient evidence
11
None mentioned
13
Avascular necrosis
Non-union fractures
15
Lack of evidence
20
Implant irritation
Malunion
Nonunion
Plate failure
21
Avascular necrosis
Coxa vara
Delayed treatment
Nonunion
Premature physeal closure
26
Complications
27
Subtalar arthritis
Surgical site infection
28
Periprosthetic fractures
29
Laxity
Needs more research
Nonunion
ROM loss
30
Wrist fracture
34
Distal femur fracture
36
Surgical complications
40
Complications
Reoperation
41
Radiologic malunion
42
Paresthesia
Shortening
44
No superior disability
45
Facial Nerve Damage
46
Increased complications
51
Functional decline
Mortality
Reoperation
Systemic complications
52
Increased SAE risk for radius fractures
53
Clinical trauma
Early complications
Postoperative function
54
Complications
56
Deep infection
57
CRPS
Deep infection
No difference in function
58
Reoperation
Varus/valgus deformity
59
Proximal humerus fractures
Surgical complications
60
Literature analysis of 60 papers
Positive Content
49
Neutral Content
6
Negative Content
5
Article Type
21
18
30
29
60
1.

[Experiences with internal fixation of isolated fractures of the head of the radius].

Author: WallenböckE, DiethartT, PleckoM, FuchsB

Fracture treatment

This prospective study of 70 patients with fractures of the head of the radius found that functional treatment without external or internal stabilization was effective in achieving good results and was associated with fewer complications, earlier recovery of working capacity, and a shorter treatment period compared to surgical treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : German

2.

Treatment of unstable tibial fractures with interlocking nail versus Ender nail: a prospective evaluation.

Author: ChiuF Y, LoW H, ChenC M, ChenT H, HuangC K

Effective treatment
Faster union time
Reduced blood loss
Reduced hospital stay

Interlocking nails were more effective than Ender nails for treating unstable tibial shaft fractures, particularly in cases of comminuted fractures.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Conservative versus operative treatment for extracapsular hip fractures.

Author: ParkerM J, HandollH H

Fracture healing
Improved rehabilitation
Shorter hospital stay
Limb deformity
Slower rehabilitation

Limited evidence from randomized trials suggests no major differences in outcome between conservative and operative management for extracapsular femoral fractures, but operative treatment may be associated with a shorter hospital stay and improved rehabilitation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

4.

Conservative versus operative treatment for hip fractures.

Author: ParkerM J, HandollH H, BhargaraA

Improved rehabilitation
Shorter hospital stay
Surgical complications

Operative treatment for hip fractures may be associated with a reduced length of hospital stay and improved rehabilitation compared to conservative treatment. However, the evidence is limited and good quality randomized trials are needed. For undisplaced intracapsular fractures, operative treatment may reduce non-union risk.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

5.

Anaesthesia for treating distal radial fracture in adults.

Author: HandollH H, MadhokR, DoddsC

Better analgesia
Easier reduction
Reduced redislocation
Compromised reduction
Poorer analgesia

There was insufficient robust evidence from randomized trials to establish the relative effectiveness of different methods of anesthesia, different associated physical techniques, or the use of drug adjuncts in the treatment of distal radial fractures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

6.

Evaluation of criteria for temporary external fixation in risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple trauma patients: "evidence-based medicine" versus "reality" in the trauma registry of the German Trauma Society.

Author: RixenDieter, GrassGuido, SauerlandStefan, LeferingRolf, RaumMarcus R, YücelNedim, BouillonBertil, NeugebauerEdmund A M,

Femur fracture treatment

This study compares different approaches to treating femur shaft fractures in patients with multiple injuries. The study compares: 1) immediate surgery to stabilize the bone (primary-definitive osteosynthesis), 2) temporary external fixation followed by surgery (secondary-definitive osteosynthesis), and 3) a personalized approach based on patient's condition (risk-adapted damage control orthopedics). The study utilizes a combination of literature review and data from a prospective multicenter database.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

7.

Pediatric femoral fractures: a systematic review of 2422 cases.

Author: PoolmanRudolf W, KocherMininder S, BhandariMohit

Femoral fracture treatment

This study explores the various treatment options for femur (thigh bone) fractures in children. The choice of treatment often depends on the child's age. Treatment options range from non-surgical approaches like casts, braces, or traction, to surgical options like closed reduction (setting the bone without surgery), external fixation, and internal fixation (using plates or nails). The study highlights the ongoing debate about the best approach for treating these fractures, particularly comparing surgical versus non-surgical methods.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

Total hip arthroplasty and hemiarthroplasty in mobile, independent patients with a displaced intracapsular fracture of the femoral neck. A randomized, controlled trial.

Author: BakerR P, SquiresB, GarganM F, BannisterG C

Fewer complications
Superior clinical results
Hip dislocation

Total hip arthroplasty provided superior short-term clinical outcomes and fewer complications compared to hemiarthroplasty in mobile, independent patients with displaced fractures of the femoral neck.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

9.

Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): study rationale and design.

Author: , BhandariMohit, GuyattGordon, TornettaPaul, SchemitschEmil, SwiontkowskiMarc, SandersDavid, WalterStephen D

Tibial fracture treatment
Re-operation

This study investigated the effectiveness of two alternative nailing approaches for tibial fractures: reamed and non-reamed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Conservative versus operative treatment for hip fractures in adults.

Author: HandollHelen H G, ParkerMartyn J

Improved rehabilitation
Reduced hospital stay
Slower rehabilitation

Operative treatment for extracapsular femoral fractures is associated with a reduced length of hospital stay and improved rehabilitation compared to conservative treatment. However, there is a lack of evidence to inform practice for undisplaced intracapsular fractures.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

11.

Conservative interventions for treating middle third clavicle fractures in adolescents and adults.

Author: LenzaMário, BellotiJoao Carlos, AndrioloRégis B, Gomes Dos SantosJoao Baptista, FaloppaFlávio

Insufficient evidence

There is insufficient evidence from randomized controlled trials to determine which methods of conservative treatment are the most appropriate for acute middle third clavicle fractures in adolescents and adults. Further research is warranted.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

12.

Open tibial fractures in the paediatric population: a systematic review of the literature.

Author: GougouliasNikolaos, KhannaAnil, MaffulliNicola

Fracture stabilization
Wound healing

This article discusses the lack of clear guidelines for the management of open tibial fractures in children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

13.

Prospective randomised study of intra-articular fractures of the distal radius: comparison between external fixation and plate fixation.

Author: XuGermaine G Q, ChanSiew Pang, PuhaindranMark Edward, ChewWinston Y C

Fracture healing
None mentioned

There is no significant difference in the outcome of intra-articular distal radius fractures treated with either external fixation or open reduction internal fixation.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

14.

Surgical interventions for treating acute fractures or non-union of the middle third of the clavicle.

Author: LenzaMário, BellotiJoao Carlos, Gomes Dos SantosJoao Baptista, MatsumotoMarcelo Hide, FaloppaFlávio

Clavicle fracture treatment

This review discusses the treatment of broken collarbones, both immediately after the fracture and when the bone does not heal properly (non-union). Collarbone fractures account for about 4% of all fractures. While most collarbone fractures are treated without surgery, some types of fractures, as well as non-union in the middle part of the collarbone, often require surgery.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

15.

[Fractures of the neck of the femur in younger patients (15-50 years old). Systematic literature research on medial fractures of the neck of the femur in young patients].

Author: SachseD, BludauF, ObertackeU

Improved healing
Avascular necrosis
Non-union fractures

This article provides a review of the current state of proven knowledge on the biology of healing of fractures of the neck of the femur in younger patients.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

16.

Paediatric hip fractures: a systematic review of incidence, treatment options and complications.

Author: BimmelRichard, BakkerAlex, BosmaBen, MichielsenJoseph

Hip fracture treatment

This article discusses the incidence, causes, treatment options, and possible complications of hip fractures in children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

17.

The effect of treatment based on a diuretic (indapamide) +/- ACE inhibitor (perindopril) on fractures in the Hypertension in the Very Elderly Trial (HYVET).

Author: PetersRuth, BeckettNigel, BurchLisa, de VernejoulMarie-Christine, LiuLisheng, DugganJoe, SwiftCameron, Gil-ExtremeraBlas, FletcherAstrid, BulpittChristopher

Fracture rate reduction

Treatment with a thiazide-like diuretic and an ACE inhibitor did not increase and may decrease fracture rate in hypertensive individuals over 80 years of age.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

Author: BartlChristoph, StengelDirk, BrucknerThomas, RossionInga, LuntzSteffen, SeilerChristoph, GebhardFlorian

Distal radius fracture treatment

The effectiveness of open reduction and internal fixation (ORIF) for distal radius fractures in elderly patients is being compared to closed reduction and casting, as there is a lack of randomized controlled trials on this topic.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

[Surgical treatment for proximal humerus fracture].

Author: SmejkalK, LochmanP, DědekT, TrlicaJ, KočíJ, ZvákI

Philos fracture
Zifko fracture

Minimally invasive osteosynthesis (MIO) and open reduction with internal fixation (ORIF) were equally effective in treating two- and three-fragment fractures of the proximal humerus. Both groups showed similar functional outcomes and complication rates (89% good/excellent results, 33% and 39% complications, respectively). However, MIO had a significantly shorter operative time (72 min vs. 117 min) and a marginally shorter time to regain limb function (21 weeks vs. 27 weeks).

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : Czech

20.

Surgical interventions for diaphyseal fractures of the radius and ulna in children.

Author: AbrahamAlwyn, KumarSujit, ChaudhrySamena, IbrahimTalal

None mentioned
Lack of evidence

There is no evidence from randomized controlled trials to inform on when surgery is required and what type of surgery is best for treating children with fractures of the shafts of the radius, ulna or both bones.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

21.

Systematic review of the complications of plate fixation of clavicle fractures.

Author: WijdicksFrans-Jasper G, Van der MeijdenOlivier A J, MillettPeter J, VerleisdonkEgbert J M M, HouwertR Marijn

Midshaft clavicle fracture treatment
Implant irritation
Malunion
Nonunion
Plate failure

Plate fixation for displaced midshaft clavicle fractures is a safe treatment option with low nonunion and malunion rates. However, implant-related complications, such as plate irritation or failure, are frequent. Further research is needed to optimize plate types and positions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

22.

[Prevention of infection in the current treatment of open fractures: an evidence-based systematic analysis].

Author: GroteS, PolzerH, PrallW C, GillS, ShafizadehS, BanerjeeM, BouillonB, BäthisH

Infection prevention
Open fracture treatment

Early antibiotic treatment and surgical debridement are recommended for open fractures. Vacuum treatment is beneficial when wound closure is not possible.

English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : German

23.

A meta-analysis of total hip arthroplasty and hemiarthroplasty outcomes for displaced femoral neck fractures.

Author: LiaoLiang, ZhaoJin min, SuWei, DingXiao fei, ChenLiang jun, LuoShi xing

Improved functional outcome
Reduced re-operation rate

Total hip arthroplasty is associated with better functional outcomes and lower reoperation rates than hemiarthroplasty in treating displaced femoral neck fractures in the elderly.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

24.

Hemiarthroplasty for humeral four-part fractures for patients 65 years and older: a randomized controlled trial.

Author: BoonsHarm W, GoosenJon H, van GrinsvenSusan, van SusanteJob L, van LoonCorné J

Four-part proximal humerus fractures are a challenging type of fracture in elderly patients. Current research does not offer a definitive conclusion on whether nonoperative treatment or hemiarthroplasty leads to better quality of life and function.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

25.

The potential of implant augmentation in the treatment of osteoporotic distal femur fractures: a biomechanical study.

Author: WähnertD, LangeJ H, SchulzeM, LenschowS, StangeR, RaschkeM J

Increased stiffness
Reduced displacement

Implant augmentation with Vertecem V+ significantly improves the biomechanical strength of LCP DF constructs in osteoporotic distal femur fractures. The augmented group showed a higher axial stiffness and reduced displacement after 45,000 cycles compared to the non-augmented group.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

26.

Factors affecting the outcome of fractures of the femoral neck in children and adolescents: a systematic review.

Author: YeranosianM, HorneffJ G, BaldwinK, HosalkarH S

Anatomical union
Avascular necrosis
Coxa vara
Delayed treatment
Nonunion
Premature physeal closure

A review of 30 studies found that surgical treatment for femoral neck fractures in children was associated with a higher rate of avascular necrosis. Delbet types I and II fractures were more likely to be treated surgically. A delay in treatment beyond 24 hours was associated with a higher incidence of avascular necrosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Systematic review of complications after intramedullary fixation for displaced midshaft clavicle fractures.

Author: WijdicksFrans-Jasper G, HouwertR M, MillettPeter J, VerleisdonkEgbert J J M, Van der MeijdenOlivier A J

Fracture treatment
Complications

This review examines the increasing use of surgical treatment for displaced midshaft clavicle fractures. The study explores the emerging surgical option of open reduction and intramedullary fixation and assesses the quality of evidence regarding potential complications associated with this treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

28.

Surgical versus conservative interventions for displaced intra-articular calcaneal fractures.

Author: BruceJulie, SutherlandAlasdair

Calcaneal fracture treatment
Subtalar arthritis
Surgical site infection

There is insufficient high-quality evidence to determine whether surgical or conservative treatment is better for adults with displaced intra-articular calcaneal fractures. More research is needed.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

29.

Interprosthetic femoral fractures-A challenge of treatment. A systematic review of the literature.

Author: SolarinoG, VicentiG, MorettiL, AbateA, SpinarelliA, MorettiB

Periprosthetic fracture treatment
Periprosthetic fractures

This study focuses on fractures that occur around prosthetic implants, particularly in the thigh bone (femur) of people who have multiple implants. These fractures are challenging to treat due to the presence of implants and are associated with significant risks. The study aims to provide a current overview of accepted diagnostic and treatment approaches for these fractures, acknowledging that these methods are constantly evolving as experience grows. While some case reports exist, there is limited research on this specific type of fracture.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

30.

Treatment and Management Outcomes of Tibial Eminence Fractures in Pediatric Patients: A Systematic Review.

Author: GansItai, BaldwinKeith D, GanleyTheodore J

Fracture healing
Laxity
Needs more research
Nonunion
ROM loss

This systematic review examined the clinical results, functional outcomes, and complications of tibial eminence fractures in children and adolescents. The review found that there is insufficient evidence to conclude the superiority of open versus arthroscopic fixation or screw versus suture fixation techniques. Nonoperative treatment of completely displaced fractures resulted in higher rates of nonunion, and type III and IV fractures healed with greater laxity and loss of range of motion.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

31.

Conservative interventions for treating middle third clavicle fractures in adolescents and adults.

Author: LenzaMário, BellotiJoão Carlos, AndrioloRégis B, FaloppaFlávio

There is limited evidence available from randomised controlled trials to determine which methods of conservative treatment are the most appropriate for acute middle third clavicle fractures in adolescents and adults.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

32.

Interventions for treating femoral shaft fractures in children and adolescents.

Author: MadhuriVrisha, DuttVivek, GahukambleAbhay D, TharyanPrathap

Femoral shaft fracture treatment

Broken thigh bones (femoral shaft fractures) in children are not common, but they can be serious injuries, impacting both the child and their family. Treatment options include surgery (using rods or external devices to stabilize the bone) or non-surgical methods involving prolonged immobilization, often in a hospital.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

33.

Bone tissue repair in patients with open diaphyseal tibial fracture treated with biplanar external fixation or reamed locked intramedullary nailing.

Author: RodriguesFábio Lucas, de AbreuLuiz Carlos, ValentiVitor Engrácia, ValenteAndre Lage, da Costa Pereira CestariRafael, PohlPedro Henrique Isoldi, RodriguesLuciano Miller Reis

Tibial fracture treatment

Open fractures of the shinbone (tibia) are typically caused by serious injuries. While there's no universal agreement on the best treatment, studies suggest that fixing the bone with screws or plates in two directions provides stability similar to the bone's natural structure. However, using a rod inside the bone (interlocking intramedullary nailing) is a common and often successful approach for healing these fractures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

34.

UK DRAFFT: a randomised controlled trial of percutaneous fixation with Kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius.

Author: CostaMatthew L, AchtenJuul, PlantCaroline, ParsonsNick R, RanganAmar, TubeufSandy, YuGe, LambSarah E

Locking-plate fixation
Wrist fracture

By age 80, 6% of women in high-income countries will have broken their wrist, and this rises to 9% by age 90. While many fractures can be healed with a cast, some require surgery. Modern locking plates provide better function than traditional wire fixation, but they are more expensive.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

35.

Should full threaded compression screws be used in adult femoral neck fractures?

Author: OkcuGüvenir, ÖzkayınNadir, ErkanSerkan, TosyaliH Koray, AktuğluKemal

Femoral neck fracture treatment

The most common treatment for broken hip bones (femoral neck fractures) is surgery to set the bone and either fix it with screws or replace the hip joint. While many types of implants have been used, the most current recommendation is to use multiple screws in a parallel arrangement.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

36.

Interventions for treating fractures of the distal femur in adults.

Author: GriffinXavier L, ParsonsNick, ZbaedaMohamed M, McArthurJohn

Improved function
Distal femur fracture

The currently available evidence is incomplete and insufficient to inform current clinical practice. Priority should be given to a definitive, pragmatic, multicentre randomised controlled clinical trial comparing contemporary treatments such as locked plates and intramedullary nails.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

37.

Conservative versus surgical treatment for type II odontoid fractures in the elderly: Grading the evidence through a meta-analysis.

Author: YangZ, YuanZ-Z, MaJ-X, MaX-L

Reduced non-union

This meta-analysis found that conservative treatment and surgical treatment are both effective for treating type II odontoid fractures in the elderly. There was no significant difference in mortality between the two treatments, but surgical treatment was associated with a lower incidence of non-union.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

38.

Randomized, controlled, two-arm, interventional, multicenter study on risk-adapted damage control orthopedic surgery of femur shaft fractures in multiple-trauma patients.

Author: RixenDieter, SteinhausenEva, SauerlandStefan, LeferingRolf, MaegeleMarc G, BouillonBertil, GrassGuido, NeugebauerEdmund A M,

Improved outcome

This study investigates whether a risk-adapted approach to treating femoral fractures in multiple-trauma patients is more effective than an early definitive treatment strategy.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

39.

Interventions for treating ankle fractures in children.

Author: YeungDenise E, JiaXueli, MillerClare A, BarkerSimon L

Ankle fracture treatment

This article discusses the different types, severity, and treatment options for ankle fractures in children.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

40.

Return to Sport After Tibial Shaft Fractures: A Systematic Review.

Author: RobertsonGreg A J, WoodAlexander M

Higher return rates
Shorter return times
Surgical complications

Surgical management is recommended for displaced tibial shaft fractures, while nonsurgical management may be attempted for undisplaced fractures. Surgical management results in higher return-to-sport rates and shorter return times.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

41.

Outcome after fixation of metastatic proximal femoral fractures: A systematic review of 40 studies.

Author: JanssenStein J, TeunisTeun, HornicekFrancis J, van DijkC Niek, BramerJos A M, SchwabJoseph H

Functional outcome for metastatic femoral fractures
Complications
Reoperation

This review compares functional outcomes, local, and systemic complications of three surgical strategies for metastatic proximal femoral fractures: endoprosthetic reconstruction, intramedullary nailing, and open reduction internal fixation (ORIF).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

42.

Close Contact Casting vs Surgery for Initial Treatment of Unstable Ankle Fractures in Older Adults: A Randomized Clinical Trial.

Author: WillettKeith, KeeneDavid J, MistryDipesh, NamJulian, TuttonElizabeth, HandleyRobert, MorganLesley, RobertsEmma, BriggsAndrew, LallRanjit, ChesserTimothy J S, PallisterIan, LambSarah E,

Less operating room time
Similar functional outcomes
Radiologic malunion

Close contact casting was equivalent to surgery in terms of ankle function at 6 months in older adults with unstable ankle fracture. Casting had fewer complications (infection and wound breakdown) than surgery, but radiologic malunion was more common.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Pragmatic Clinical TrialA trial conducted in a real-world clinical setting. It evaluates the effectiveness of interventions in everyday healthcare environments.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

43.

Medium-sized posterior fragments in AO Weber-B fractures, does open reduction and fixation improve outcome? the POSTFIX-trial protocol, a multicenter randomized clinical trial.

Author: VerhageSander, van der ZwaalPeer, BronkhorstMaarten, van der MeulenHuub, KleinveldSanne, MeylaertsSven, RhemrevSteven, KrijnenPieta, SchipperInger, HoogendoornJochem

Trimalleolar fracture treatment

This study discusses the lack of consistent guidelines for treating the posterior fracture fragment in trimalleolar fractures, calling for further research to establish optimal treatment strategies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

44.

Treatment of Displaced Midshaft Clavicle Fractures: Figure-of-Eight Harness Versus Anterior Plate Osteosynthesis: A Randomized Controlled Trial.

Author: TamaokiMarcel Jun Sugawara, MatsunagaFabio Teruo, CostaAdelmo Rezende Ferreira da, NettoNicola Archetti, MatsumotoMarcelo Hide, BellotiJoao Carlos

Improved function
Reduced nonunion
Paresthesia
Shortening

Surgical treatment for dislocated midshaft clavicle fractures decreased the likelihood of nonunion, but there was no difference in limb function compared to nonsurgical treatment.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

45.

Effect of Locking Plate Fixation vs Intramedullary Nail Fixation on 6-Month Disability Among Adults With Displaced Fracture of the Distal Tibia: The UK FixDT Randomized Clinical Trial.

Author: CostaMatthew L, AchtenJuul, GriffinJames, PetrouStavros, PallisterIan, LambSarah E, ParsonsNick R,

Nail fixation
Plate fixation
No superior disability

Intramedullary nail fixation and locking plate fixation are equally effective in treating displaced distal tibia fractures in patients 16 years or older. In a randomized controlled trial, there was no statistically significant difference in disability status at 6 months between the two groups. However, nail fixation was associated with better outcomes at 3 months, and fewer patients required further surgery at 12 months.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

46.

Complications in the treatment of mandibular condylar fractures: Surgical versus conservative treatment.

Author: García-GuerreroIván, RamírezJuan M, Gómez de DiegoRafael, Martínez-GonzálezJosé M, PobladorMaría S, LanchoJosé L

Mandibular Fracture Treatment
Facial Nerve Damage

Conservative treatment (CTR) and surgical treatment (ORIF) for mandibular condylar fractures have minimal complications. CTR is associated with functional limitations from delayed mobilization, while ORIF is associated with facial nerve damage.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

47.

Intramedullary nail fixation versus locking plate fixation for adults with a fracture of the distal tibia: the UK FixDT RCT.

Author: CostaMatthew L, AchtenJuul, HenningsSusie, BootaNafisa, GriffinJames, PetrouStavros, MaredzaMandy, DritsakiMelina, WoodThomas, MastersJames, PallisterIan, LambSarah E, ParsonsNick R

Faster recovery
Lower cost

This multicenter randomized trial compared intramedullary (IM) nail fixation and locking plate fixation for fractures of the distal tibia. While disability ratings were similar at 6 months, recovery across all outcomes was faster and costs were lower in the IM nail fixation group. These results suggest that IM nail fixation may be a more effective and cost-efficient treatment option for distal tibia fractures.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English