Archives of Bone and Joint Surgery-ABJS最新文献

{"title":"The Impact of Preoperative Co-morbidities on Blood Transfusion Requirements Following Reverse Total Shoulder Arthroplasty.","authors":"Alexander C Turner, Hunter B Jones, Philip A Serbin, Senthil M Sambandam","doi":"10.22038/ABJS.2024.78961.3625","DOIUrl":"10.22038/ABJS.2024.78961.3625","url":null,"abstract":"<p><strong>Objectives: </strong>Reverse total shoulder arthroplasty (RTSA) continues to increase in popularity as a surgical operation in the United States. As indications for this procedure expand, more attention is needed to evaluate perioperative risk factors and patient characteristics. Postoperative anemia requiring blood transfusion (BT) is a well-documented risk factor for increased in-house mortality although little has been studied on the relationship between RTSA and postoperative BT. The purpose of this study was to identify comorbidities and patient characteristics as risk factors for BT in patient's undergoing RTSA.</p><p><strong>Methods: </strong>Using the Nationwide Inpatient Sample (NIS) database, 59,925 RTSA patients (2016-2019) were analyzed, with 1.96% requiring postoperative BT. Demographics, comorbidities, and preoperative factors were compared between BT and non-BT groups via univariate and multivariate analyses.</p><p><strong>Results: </strong>Overall prevalence of blood transfusion in all patients was 1.96%. Male sex (OR 1.75, p < 0.001), Asian ethnicity (OR 1.96, p = 0.012), age >80 (OR 1.51, p < 0.001), age >90 (OR 2.26, p < 0.001), CKD (OR 1.94, p < 0.001), and Parkinson's disease (OR 2.08, p < 0.001) were associated with increased BT odds. Cirrhosis exhibited the highest impact (OR 5.7, p < 0.001). Conversely, Caucasian ethnicity (OR 0.76, p = 0.023), uncomplicated DM (OR 0.73, p = 0.002), tobacco-related disorders (OR 0.43, p < 0.001), BMI >30 (OR 0.8, p = 0.011), and elective procedures (OR 0.16, p < 0.001) decreased BT odds.</p><p><strong>Conclusion: </strong>These results were useful with identifying several risk factors that predispose to a higher risk of postoperative BT in patients undergoing RTSA including male sex, people of Asian descent, age > 80, CKD, Parkinson's disease, and cirrhosis. These findings provide clinicians with information that may be helpful with preoperative planning and perioperative management of complex patient populations.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 7","pages":"487-493"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of Three-Dimensional Printing in Orthopaedics: a Systematic Review and Meta-analysis.","authors":"Olivia O'Connor, Reece Patel, Azeem Thahir, Jamie Sy, Eric Jou","doi":"10.22038/ABJS.2024.74117.3465","DOIUrl":"10.22038/ABJS.2024.74117.3465","url":null,"abstract":"<p><strong>Objectives: </strong>3D-printing is a rapidly developing technology with applications in orthopaedics including pre-operative planning, intraoperative guides, design of patient specific instruments and prosthetics, and education. Existing literature demonstrates that in the surgical treatment of a wide range of orthopaedic pathology, using 3D printing shows favourable outcomes. Despite this evidence 3D printing is not routinely used in orthopaedic practice. We aim to evaluate the advantages of 3D printing in orthopaedic surgery to demonstrate its widespread applications throughout the field.</p><p><strong>Methods: </strong>We performed a comprehensive systematic review and meta-analysis. AMED, EMBASE, EMCARE, HMIC, PsycINFO, PubMed, BNI, CINAHL and Medline databases were searched using Healthcare Databases Advanced Search (HDAS) platform. The search was conducted to include papers published before 8th November 2020. Clinical trials, journal articles, Randomised Control Trials and Case Series were included across any area of orthopaedic surgery. The primary outcomes measured were operation time, blood loss, fluoroscopy time, bone fusion time and length of hospital stay.</p><p><strong>Results: </strong>A total of 65 studies met the inclusion criteria and were reviewed, and 15 were suitable for the meta-analysis, producing a data set of 609 patients. The use of 3D printing in any of its recognised applications across orthopaedic surgery showed an overall reduction in operative time (SMD = -1.30; 95%CI: -1.73, -0.87), reduction in intraoperative blood loss (SMD = -1.58; 95%CI: -2.16, -1.00) and reduction in intraoperative fluoroscopy time (SMD = -1.86; 95%CI: -2.60, -1.12). There was no significant difference in length of hospital stay or in bone fusion time post-operatively.</p><p><strong>Conclusion: </strong>The use of 3D printing in orthopaedics leads to an improvement in primary outcome measures showing reduced operative time, intraoperative blood loss and number of times fluoroscopy is used. With its wide-reaching applications and as the technology improves, 3D printing could become a valuable addition to an orthopaedic surgeon's toolbox.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 7","pages":"441-456"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11283294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kinematic Analysis of Pelvic and Lower Limb Joints during Stand-to-sit Movement in Individuals with Chronic Low Back Pain: A cross-sectional study.","authors":"Fatemeh Ghasemi Dehcheshmeh, Mohammad Reza Nourbakhsh, Zahra Amini Farsani, Babak Bazrgari, Amir Massoud Arab","doi":"10.22038/ABJS.2024.76840.3551","DOIUrl":"https://doi.org/10.22038/ABJS.2024.76840.3551","url":null,"abstract":"<p><strong>Objectives: </strong>It is crucial to investigate the daily functions commonly utilized by individuals with low back pain (LBP) due to their implications for recurrence and chronicity. Stand-to-sit (StTS) task is one of the more repetitive functions in human daily life. This study aims to evaluate pelvic and lower limb joint kinematics during the StTS task in individuals with Non-Specific Chronic Low Back Pain (NSCLBP) compared to a healthy control group.</p><p><strong>Methods: </strong>Pelvic and lower limb joint kinematic data in all three planes were recorded from 20 individuals with LBP and 20 healthy individuals using a Qualisys motion capture system during the StTS task. A Functional Data Analysis statistical approach was employed to compare the kinematic data between the two groups.</p><p><strong>Results: </strong>In the initial phase of the movement, we observed a greater anterior pelvic tilt (P=0.028) and an altered pelvic frontal plane motion pattern (P=0.029) in the LBP compared to the healthy group. The only significant differences between the lower limb joint kinematics of the two groups were a less hip external rotation position (P=0.025) and a more knee adduction pattern (P=0.002) on the right side in the LBP subjects compared to the healthy group.</p><p><strong>Conclusion: </strong>Considering a few differences noted between the two groups across various joints and planes evaluated, it appears that the kinematic pattern of the lower limbs does not significantly differ between the NSCLBP and healthy groups during the StTS task in most comparisons. However, distinct kinematic patterns have been observed in the pelvic region, particularly in the sagittal and frontal planes, between the two groups.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 8","pages":"587-596"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11353145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Value of Radiographic Singh Index Compared to Dual-Energy X-Ray Absorptiometry Scan in Diagnosing Osteoporosis: A Systematic Review.","authors":"Elham Ghalenavi, Zahra Mirfeizi, Kamila Hashemzadeh, Maryam Sahebari, Mohammad Hassan Joker","doi":"10.22038/ABJS.2023.70632.3309","DOIUrl":"10.22038/ABJS.2023.70632.3309","url":null,"abstract":"<p><strong>Objectives: </strong>Since various medications can control the rate of fractures and subsequent complications of osteoporosis, the early detection of the disease is crucial. This systematic study aimed to compare the diagnostic accuracy of Singh index (SI) with dual-energy X-ray absorptiometry (DEXA) as a benchmark standard for diagnosing osteoporosis.</p><p><strong>Methods: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) were utilized in the current study. A detailed search was carried out using PubMed and Scopus from inception to 30 May 2022. Examining quality of the studies was performed by the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).</p><p><strong>Results: </strong>A total of 22 studies were included. In general, 50% of the studies considered SI a poor screening tool for detecting osteoporosis due to a negligible inter-observer agreement between SI and DEXA or a poor correlation of SI with the bone mineral density (BMD) category or DEXA T-score. A moderate inter-observer agreement was reported for SI in 5 (55.6%) studies. Among the studies assessing the sensitivity and specificity of SI compared to DEXA (n=13), six studies estimated a low sensitivity for SI.</p><p><strong>Conclusion: </strong>While there is supporting evidence indicating the potential usefulness of SI for predicting femoral neck fractures in individuals with suspected osteoporosis, numerous studies challenge its reliability and diagnostic value as a screening tool for identifying femoral neck osteoporosis. Further primary studies are required to verify the effectiveness of the SI index in identifying populations at risk of osteoporosis.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 1","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oswestry Disability Index, Roland-Morris Disability Questionnaire, and Quebec Back Pain Disability Scale: Responsiveness and Minimal Clinically Important Changes in Iranian People with Lumbar Disc Herniation Following Physiotherapy.","authors":"Hajar Ghaderi Niri, Tabassom Ghanavati, Neda Mostafaee, Zahra Salahzadeh, Akram Divandari, Hakimeh Adigozali, Jalal Ahadi","doi":"10.22038/ABJS.2023.72246.3366","DOIUrl":"10.22038/ABJS.2023.72246.3366","url":null,"abstract":"<p><strong>Objectives: </strong>The present study aimed to investigate the responsiveness of the Persian version of the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Quebec Back Pain Disability Scale (QBPDS) and detect minimal clinically important changes (MCICs) of these questionnaires in people with lumbar disc herniation.</p><p><strong>Methods: </strong>Ninety-two patients with lumbar herniated disc completed the Persianversion of the ODI, RMDQ, and QBPDS before and after the physiotherapy intervention. Additionally, they completed a global rating of change scale after the final physiotherapy session to give an account of non-improved and improved outcomes. The responsiveness of these three disability questionnaires was represented by Receiver Operating Characteristic (ROC) and correlation analyses. The MCIC was defined as the best cut-off when sensitivity and specificity were optimally balanced.</p><p><strong>Results: </strong>Area under the ROC curves are in the acceptable range for ODI and QBPDS (0.78 and 0.70, respectively). Moreover, ODI, RMDQ, and QBPDS have significant positive fair to moderate correlation with the external anchor (P<0.001). The MCIC values for ODI, RMDQ, and QBPDS were 13, 5.5, and 14.5 points, respectively.</p><p><strong>Conclusion: </strong>Our results revealed that the ODI and QBPDS questionnaires have adequate responsiveness to detect improvements in the functional status of lumbar herniated disc patients following a physiotherapy treatment. Therefore, the ODI and QBPDS seem to be superior to the RMDQ for use in randomized clinical trials and clinical settings in patients with herniated lumbar discs. The MCIC scores of 13 and 14.5 obtained for the ODI and QBPDS can help to identify important changes in the clinical status of an individual patient and treatment efficacy.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 1","pages":"58-65"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10838580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139693858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomic Reduction of Greater Tuberosity Fragment for Shoulder Hemiarthroplasty: a Predictor of Good Clinical Outcome.","authors":"Francesco Lazzarini, Marco Distefano, Tony Shen, Gregorio Secci, Michael Cresci, Raffaele Tucci, Luigi Zanna","doi":"10.22038/ABJS.2023.74441.3448","DOIUrl":"10.22038/ABJS.2023.74441.3448","url":null,"abstract":"<p><strong>Objectives: </strong>Proximal humerus fractures account for four-five % of all fractures. Shoulder hemiarthroplasty is indicated for complex fractures with high complication rates when treated with ORIF. This study aims to evaluate the correlation between the proper intraoperative tuberosity reduction, and the mid-to-long-term clinical outcome in a series of patients treated with hemiarthroplasty after proximal humerus fracture.</p><p><strong>Methods: </strong>Forty-one patients with proximal humerus fractures who underwent hemiarthroplasty surgery between July 2009 and December 2019 were retrospectively reviewed. Quantitative analysis of the reduction of the tuberosities was performed on postoperative X-rays focusing on the distance between reconstructed greater tuberosity and the apex of the head of the prosthesis, (head-tuberosity distance), and contact between tuberosity and humerus diaphysis. The University of California Los Angeles Score (UCLA) was calculated for each patient.</p><p><strong>Results: </strong>The mean time to surgery was 6.29 ± 2.8 days (range 2-18 days). Nine patients out of 41 (22%) had non anatomic tuberosity, and 32 (78%) were anatomic reduced. The UCLA score at the final follow-up was good and excellent (≥27) in 27 patients (66%), and poor (<27) in 14 (34%). A significant correlation was observed between proper tuberosity reduction and good/excellent UCLA scores (P<0.001).</p><p><strong>Conclusion: </strong>Hemiarthroplasty is a valid and reliable technique for the treatment of proximal humerus fracture not eligible for internal fixation, with high risk of failure. The proper tuberosity reconstruction, paying special attention to the HTD and the contact between the cortical of the humeral diaphysis and the reconstructed tuberosity, is essential to reach a good clinical outcome.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 2","pages":"108-115"},"PeriodicalIF":1.3,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10898802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical Diagnoses to Consider in the Assessment of Pediatric Patients Presenting with Limp in the Rheumatology Ward: A Cross-Sectional Study.","authors":"Abdolreza Malek, Atefeh Esmati, Abdolkarim Hamedi, Mahdieh Vahedi","doi":"10.22038/ABJS.2024.79948.3652","DOIUrl":"10.22038/ABJS.2024.79948.3652","url":null,"abstract":"<p><strong>Objectives: </strong>Limping is a frequent reason for visits to emergency departments. The causes of limping in children are various, ranging from benign musculoskeletal problems to serious etiologies, such as malignancy and infections.</p><p><strong>Methods: </strong>In this recent cross-sectional study, we evaluated the causes of limps in children referred to the pediatric rheumatology ward in northeast Iran. We collected clinical characteristics and demo-graphic data of patients with musculoskeletal limping and documented laboratory tests and other para-clinical findings. Statistical analysis was performed in SPSS software (version 23). A P-value < 0.05 was concluded to be statistically significant.</p><p><strong>Results: </strong>Our study investigated 95 pediatric patients with limping referred to the rheumatology department, the majority of whom exhibited acute-onset limping (≤2 days). The most common reason for hospitalization in the rheumatology ward was transient synovitis (43.1%), followed by other causes of reactive arthritis (15.7%). Acute lymphocytic leukemia (ALL) accounted for limping in 6% of the patients, while benign and malignant bone tumors, including osteoid osteoma, osteosarcoma, and Ewing sarcoma, contributed to limping in 4.2% of cases.</p><p><strong>Conclusion: </strong>While the cause of limping in children is mostly benign, it is crucial to recognize that the causes may not solely stem from musculoskeletal problems. In instances where the musculoskeletal sys-tem is involved, infections of the joints and bones should also be considered.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 12","pages":"854-858"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Traumatic Anterior Shoulder Instability: A Systematic Review and Proposed Modern Classification System.","authors":"Al-Achraf Khoriati, Zien A Fozo, Tony Antonios, Richard Dimock, Mohamed Imam, Ali Narvani","doi":"10.22038/ABJS.2024.78466.3617","DOIUrl":"10.22038/ABJS.2024.78466.3617","url":null,"abstract":"<p><p>Numerous surgical techniques have been developed to address recurrent anterior shoulder instability, with the Bankart repair and the Latarjet procedure emerging as dominant. With recent advancements in keyhole surgery, there's been a surge in popularity for all-arthroscopic procedures. Our systematic review aims to determine if there's justification for incorporating these techniques into a classification system for guiding treatment of traumatic anterior recurrent instability. We identified and analysed a variety of key studies, including 12 systematic reviews, three prospective studies, seven non-randomized prospective and retrospective studies, along with one biomechanical study. Our study sheds light on the wide range of procedures available to shoulder surgeons dealing with traumatic anterior recurrent instability. We introduce a novel classification system (BoTH) designed to simplify the decision-making process in this context.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 9","pages":"669-673"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142577051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Poller Screw in Improving Radiological Outcomes after Intra-Medullary Nailing for Distal Tibia Fractures; A Retrospective Cohort Study.","authors":"Akeel Ahmed, Moiz Ali, Muhammad Omer Farooq, Muhammad Ahsan Sulaiman, Haroon Rashid, Tashfeen Ahmad","doi":"10.22038/ABJS.2024.79504.3639","DOIUrl":"10.22038/ABJS.2024.79504.3639","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the radiological outcomes after fixation of distal tibia fractures with IM nail between patients in whom poller screw was used vs those in whom it was not used.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted between 1st January 2009 to 31st June 2019 including patients treated with IM nail for distal tibial metaphyseal fractures. Patients were divided into 2 groups based on whether a poller screw was placed during surgery or not. The exposed group consisted of patients who underwent augmentation of IM nail with a poller screw, while control group included patients who underwent fixation with nail alone. All adult patients aged ≥18 years were included and patients with pathological fractures, known metabolic bone disease were excluded from the study. Follow-up x-rays were viewed through our hospital database and fracture healing was classified as either union, malunion or non-union based on radiographic parameters. A Radiographic Union Score in Tibia (RUST) score was calculated and a score of ≥9 was considered conclusive for complete union.</p><p><strong>Results: </strong>93 patients were included in the study with 21 patients in the exposed and 72 in the control group. According to the analysis, there were no significant differences in baseline characteristics of the study participants. The exposed group was found to be associated with increased rates of union and decreased non-union and mal-union rates compared to control group (P-value = 0.003). Mean RUST score was also noted to be significantly higher in exposed group compared to control group with a P-value of 0.025.</p><p><strong>Conclusion: </strong>Use of poller screw with IM nail in treatment of distal tibial fractures is important in improving post-operative outcomes and decreasing mal-union and non-union.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"701-705"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre-Operative Traction in Femoral Fractures for Pain Management: A Meta-Analysis of Comparative Studies.","authors":"Jean Tarchichi, Mohammad Daher, Ali Ghoul, Michel Estephan, Jad Mansour","doi":"10.22038/ABJS.2024.78869.3622","DOIUrl":"10.22038/ABJS.2024.78869.3622","url":null,"abstract":"<p><strong>Objectives: </strong>This meta-analysis studies and assesses the pain relief effect of different pre-operative traction systems in proximal and femoral shaft fractures as this subject is still debated and no clear guidelines are established.</p><p><strong>Methods: </strong>PubMed, Cochrane, Embase and Google Scholar (page 1-20) were searched until January 2024. The clinical outcomes collected consisted of pain scales following traction.</p><p><strong>Results: </strong>Two randomized clinical trials were included to compare skeletal (72 patients) to skin traction (80 patients) and eight randomized clinical trials with one prospective study were included to compare traction (457 patients) versus no traction (439 patients). Our results revealed no differences in terms of post-operative pain VAS between both the skeletal and skin traction as well as between traction and no traction.</p><p><strong>Conclusion: </strong>No added benefit of traction was observed when pain relief is the main consideration. Furthermore, with their different potential complications, systematic pre-operative traction should not be implemented in all femoral fractures.</p>","PeriodicalId":46704,"journal":{"name":"Archives of Bone and Joint Surgery-ABJS","volume":"12 10","pages":"683-689"},"PeriodicalIF":1.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}