Efort Open Reviews最新文献

{"title":"Esophageal perforation more than 10 years after anterior cervical spine surgery: a case report and literature review.","authors":"Hua Luo, Zhangfu Wang, Shuang Mi, Wenjun Pan, Xingbing Feng, Zhenghua Hong","doi":"10.1530/EOR-24-0110","DOIUrl":"10.1530/EOR-24-0110","url":null,"abstract":"<p><p>Esophageal perforation is a rare but serious complication that can occur post-cervical spine surgery. This case report presents the clinical course, diagnostic challenges and management strategies of a patient who had a late-diagnosis esophageal perforation after anterior cervical spine surgery (ACSS). A woman in her 50s underwent ACSS for cervical spondylosis. Three months postoperatively, she experienced persistent right neck and shoulder pain. Despite multiple consultations, an esophageal perforation was only diagnosed 10 years later when a neck mass ruptured, discharging food debris. Surgical management included removing the anterior cervical plate and reconstruction with a sternocleidomastoid muscle flap. Postoperatively, she faced wound complications, and the perforation failed to heal despite multiple debridement and stent placements. Ultimately, complete excision of the diverticulum, repair of the perforation and muscle flap reconstruction led to her recovery, with no recurrence over an 8-year follow-up. We reviewed the literature on cases with esophageal perforation occurring more than 10 years after anterior cervical surgery and summarized the treatment experiences. This case underscores the diagnostic challenges and delayed presentation of esophageal perforation post-ACSS. Early recognition and multidisciplinary management are essential. In cases of late perforation, hardware removal, diverticulum excision and a muscle flap are critical to achieving successful closure of the esophageal lesion, preventing recurrence and ensuring comprehensive repair. Addressing esophageal diverticula during perforation treatment is crucial to prevent recurrence and ensure thorough repair. This highlights the need for high clinical suspicion and a coordinated surgical approach to improve patient outcomes.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"57-63"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and prognosis of children with culture-negative osteoarticular infections: a meta-analysis based on cohort studies.","authors":"Xingguang Chen, Jue Liu, Mingfeng Xue, Ting Zhuang, Feng Yao, Jialing Lu, Xiaodong Wang","doi":"10.1530/EOR-24-0048","DOIUrl":"10.1530/EOR-24-0048","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric osteoarticular infections (OAIs) are an orthopedic emergency that can lead to severe sequelae if not treated appropriately. Approximately half of the patients with OAIs in clinical practice fail to obtain microbiological results even after undergoing aspiration or surgery, which presents a significant challenge in clinical practice. The inability to identify pathogens can lead to incorrect antibiotic usage or under-treatment, increasing the risk of adverse outcomes. This study aims to investigate the clinical characteristics and prognosis of culture-negative OAIs compared to culture-positive OAIs through a meta-analysis, providing insights to optimize treatment strategies.</p><p><strong>Methods: </strong>A systematic search was conducted to identify cohort studies comparing the clinical characteristics and prognosis of children with culture-negative OAIs to those with culture-positive OAIs. The search encompassed the databases of Wanfang Data, China National Knowledge Infrastructure, China Biology Medicine disc, Excerpta Medica Database, PubMed and the Cochrane Library, with the literature review extending up to March 2024. Data were extracted from eligible articles and assessed using the Newcastle-Ottawa scale, and the articles were selected based on predefined inclusion and exclusion criteria.</p><p><strong>Results: </strong>Twelve literature reports covering 1630 patients were included in this meta-analysis. Publication bias did not significantly affect the results. The incidence of long-term sequelae, temperature before admission, baseline laboratory indicators and possibility of surgery in the culture-negative group of patients were significantly lower than those in the culture-positive group. In addition, there were no significant differences in gender, age, race, trauma history, patient delay, antibiotic usage before admission or clinical symptoms between the two groups.</p><p><strong>Conclusions: </strong>Children diagnosed with culture-negative OAIs generally demonstrated less severe systemic inflammatory responses, required shorter treatment durations, exhibited a reduced likelihood of requiring surgical intervention and were less prone to experience long-term functional impairments compared to children with culture-positive OAIs. However, no differences in patient characteristics and clinical symptoms were found between the two groups. Further large-scale studies are still required to validate these findings.</p><p><strong>Type of study: </strong>Meta-analysis.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"10 1","pages":"48-56"},"PeriodicalIF":4.3,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11728918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fixation of tibial plateau fracture - risk factors for developing infection: a narrative review.","authors":"Nicolas Franulic, Jose Tomas Muñoz, Tomas Pineda, Jose Laso, Rodrigo Olivieri, Steffen Schröter","doi":"10.1530/EOR-24-0058","DOIUrl":"10.1530/EOR-24-0058","url":null,"abstract":"<p><p>Fracture-related infection (FRI) after tibial plateau open reduction and fixation is a common complication that leads to catastrophic sequelae and substantial economic costs, making prevention paramount. To facilitate an appropriate approach, it is useful to classify risk factors based on patient-related factors, injury-related factors, and management-related factors. Patient-related factors like smoking have a great amount of evidence establishing their relation with FRI. Diabetes and obesity might be associated, but evidence is somewhat conflicting. Nevertheless, smoking cessation and a multidisciplinary approach for these pathologies are essential to prevent FRI. Injury-related factors like high-energy fractures and acute compartment syndrome have compelling evidence relating them to FRI and must be acknowledged as inherent factors. While the exposure of the fracture has been associated with infection, open fractures are yet to be confirmed as directly related to FRI in tibial plateau fractures. Likewise, early antibiotic prophylaxis and surgical debridement are mandatory. As for management-related factors, increased surgical time emerges as a strong predictor for FRI. Evidence regarding the number of surgical approaches and plates shows a trend toward an increase in FRI prevalence. With respect to external fixator installation and removal, pin-plate overlapping is yet to be confirmed or ruled out as risk factors.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1170-1178"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619731/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip preservation surgery for borderline and frank dysplasia: an overview of systematic reviews.","authors":"Pierre Martz, Jerome Magendie, Sonia Ramos-Pascual, Ankitha Kumble, Benoît Boutaud, Nicolas Verdier","doi":"10.1530/EOR-23-0152","DOIUrl":"10.1530/EOR-23-0152","url":null,"abstract":"<p><strong>Purpose: </strong>To identify, synthesise, and critically appraise findings of systematic reviews and/or meta-analyses on hip preservation surgeries for borderline and/or frank dysplasia with or without concomitant femoroacetabular impingement (FAI).</p><p><strong>Methods: </strong>A search, following the PRISMA guidelines, was conducted using Medline and Embase on 19/04/2023. Findings extracted from eligible studies were tabulated and synthesised.</p><p><strong>Results: </strong>The search identified 477 references. Nineteen were eligible for data extraction: nine reported on arthroscopy, five reported on periacetabular osteotomy (PAO), one reported on shelf acetabuloplasty, and one reported on Chiari osteotomy, while two compared arthroscopy versus PAO, and one compared PAO versus rotational acetabular osteotomy (RAO) versus eccentric acetabular osteotomy (ERAO). The nomenclature and lateral centre edge angle (LCEA) thresholds to define hip dysplasia varied widely across included studies. All hip preservation surgeries provided good outcomes, with the Harris hip score (HHS) being the most commonly reported clinical score. Using the AMSTAR checklist for risk of bias, no systematic reviews were rated as high quality; ten were rated as moderate quality; six were rated as low quality; and three were rated as critically low quality.</p><p><strong>Conclusions: </strong>Most published systematic reviews on hip preservation surgery are of moderate or low quality, and there is high heterogeneity among them regarding outcomes reported, follow-up periods, and definitions of dysplasia. The authors recommend the following thresholds and nomenclature for dysplasia: LCEA < 20° for frank dysplasia, 20°-25° for borderline dysplasia, and >25° for no dysplasia. Although all hip preservation surgeries can provide good outcomes, it is challenging to conclude which surgery provides the best outcomes and to determine if treatment options are dependent on LCEA.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1144-1155"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of miRNAs as biomarkers in heterotopic ossification.","authors":"Chen Xie, Xiao Liu, Wenbao Li, Zhaozhe Yao, Hongyue Men, Zongyu Li","doi":"10.1530/EOR-22-0100","DOIUrl":"10.1530/EOR-22-0100","url":null,"abstract":"<p><p>Fibrodysplasia ossificans progressiva and progressive osseous heteroplasia are genetic forms of heterotopic ossification (HO). Fibrodysplasia ossificans progressiva is caused by ACVR1 gene mutations, while progressive osseous heteroplasia is caused by GNAS gene mutations. Nongenetic HO typically occurs after trauma or surgery, with an occurrence rate of 20-60%. It can also be observed in conditions such as diffuse idiopathic skeletal hyperostosis, spinal ligament ossification, ankylosing spondylitis, and skeletal fluorosis. The exact cause of nongenetic HO is not entirely clear. More than 100 types of miRNAs have been identified as being linked to the development of HO. Some miRNAs are promising potential biomarkers for traumatic HO and ossification of the posterior longitudinal ligament. These findings further emphasize the significant role miRNAs play in the pathogenesis and progression of bone disorders. Repeated investigations into the function of a specific miRNA are infrequent and yield inconsistent results, possibly because of variable experimental conditions. It is hypothesized that miRNAs can enhance osteogenesis for the management of fractures and bone defects. However, further research is required to validate this hypothesis.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1120-1133"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic value of neutrophil-to-lymphocyte ratio and albumin-to-globulin ratio for periprosthetic joint infections: a systematic review and meta-analysis.","authors":"Chun-Ching Chen, Yu-Pin Chen, Yi-Jie Kuo, Yu-Cheng Liu, Shu-Wei Huang","doi":"10.1530/EOR-23-0206","DOIUrl":"10.1530/EOR-23-0206","url":null,"abstract":"<p><strong>Purpose: </strong>Periprosthetic joint infection (PJI) is a serious complication after joint arthroplasty, resulting in high morbidity and mortality. The neutrophil-to-lymphocyte ratio (NLR) and albumin-to-globulin ratio (AGR) are novel diagnostic markers for PJI; however, their diagnostic value remains inconsistent.</p><p><strong>Methods: </strong>This meta-analysis was conducted using the PubMed, Embase, and MEDLINE databases to determine the diagnostic accuracy of NLR and AGR for PJI in the knee or hip. Data extraction and quality assessment were independently completed by two reviewers. The pooled sensitivity and specificity, diagnostic odds ratio (DOR), summary receiver operating characteristic curve (sROC), and area under the sROC curve (AUC) were assessed using the univariate meta-analysis framework.</p><p><strong>Results: </strong>Nineteen eligible studies were included in the quantitative analysis. The pooled sensitivity and specificity of NLR for the diagnosis of PJI were 0.73 (95% CI: 0.68-0.77) and 0.72 (95% CI: 0.66-0.77), respectively. Its pooled DOR was 6.89 (95% CI: 5.03-9.43), and AUC was 0.79 (95% CI: 0.75-0.82). The pooled sensitivity and specificity of AGR for the diagnosis of PJI were 0.80 (95% CI: 0.70-0.88) and 0.83 (95% CI: 0.79-0.87), respectively. Its DOR was 17.69 (95% CI: 10.76-29.07), and AUC was 0.88 (95% CI: 0.85-0.91).</p><p><strong>Conclusion: </strong>NLR and AGR can be individually used as reliable serum biomarkers for the detection of PJI. Future research is warranted to determine the diagnostic value of these markers in combination with C-reactive protein levels and erythrocyte sedimentation rates to improve diagnostic accuracy for PJI in clinical practice.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1134-1143"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological strategies in rotator cuff repair: a clinical application and molecular background.","authors":"Maciej Pawlak, Joanna Wałecka, Przemysław Lubiatowski","doi":"10.1530/EOR-24-0012","DOIUrl":"10.1530/EOR-24-0012","url":null,"abstract":"<p><p>Conventional repair of rotator cuff tears bears a variable but significant risk of incomplete healing. Biological therapies that accompany surgical rotator cuff repair include platelet-rich plasma, stem cells of different origins, and biological scaffolds. Biological therapies facilitate the regeneration of the correct microarchitecture of the tendon attachment to the bone and reduce failures after surgical rotator cuff repair.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1156-1169"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic antibiotic prophylaxis in arthroplasty - a narrative review of how many doses are optimal.","authors":"Peter Wahl, Philip Drennan, Michel Schläppi, Yvonne Achermann, Michael Leunig, Emanuel Gautier, Emanuel Benninger","doi":"10.1530/EOR-24-0022","DOIUrl":"10.1530/EOR-24-0022","url":null,"abstract":"<p><p>Systemic antibiotic prophylaxis (SAP) is well-established in arthroplasty to prevent periprosthetic joint infection. However, the optimal duration and dosing of SAP remain a matter of debate, as evidenced by ongoing discordance between recommendations and clinical practice, reflected in the heterogeneity and imprecision of national and societal guidelines. The evidence currently available regarding the duration of SAP is summarised and discussed, specifically the postoperative repeated administration of antimicrobials within the first 24 h. The evidence available suffers from limitations, specifically deficiencies in outcome assessments in the available randomised controlled trials. Observational studies suggest that a short postoperative prolongation (<24 h) of SAP in arthroplasty may result in superior long-term outcomes compared to a single dose, and that an optimal dosing strategy, which warrants further prospective evaluation, may involve 'stacked dosing' in the early postoperative period, with re-administration every two half-lives when using commonly recommended beta-lactam antibiotics, instead of repetition at usual dosing intervals over 24 h. A stacked approach would also cover recognised indications for repetition, such as major blood loss and increased duration of operation, potentially simplifying prescribing protocols. Pharmacokinetic simulations are provided to illustrate the distinct concentration-time profiles associated with different prophylaxis regimens. Prolonging SAP beyond 24 h is not recommended. This review concludes by providing recommendations for further research, particularly a call to document SAP regimens with sufficient detail (choice of drug, dose regimen, and duration of administration) into established national arthroplasty registries, which should rapidly enable a significantly more nuanced understanding of these critical issues than permitted by the current literature.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 12","pages":"1106-1119"},"PeriodicalIF":4.3,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose tissue-derived injectable products combined with platelet-rich plasma for the treatment of osteoarthritis: the promising preclinical results are not confirmed by the clinical evidence.","authors":"Simone Orazi, Angelo Boffa, Manuela Salerno, Lucia Angelelli, Stefano Zaffagnini, Giuseppe Filardo","doi":"10.1530/EOR-24-0050","DOIUrl":"10.1530/EOR-24-0050","url":null,"abstract":"<p><strong>Purpose: </strong>The association of adipose tissue-derived injectable products with platelet-rich plasma (PRP) has been promoted for osteoarthritis (OA) treatment. The aim of this study was to investigate the preclinical and clinical evidence supporting the potential of this combined approach to treat OA.</p><p><strong>Methods: </strong>A systematic review was performed in January 2024 on five databases (PubMed, Embase, Scopus, Cochrane, and Web-of-Science) to identify preclinical in vivo and clinical studies. Safety, OA biomarker changes, and outcomes in terms of clinical and imaging results were analyzed. The quality of studies was assessed with the SYRCLE's tool for preclinical studies and the Downs and Black checklist for clinical studies.</p><p><strong>Results: </strong>Ten preclinical studies (223 animals) and 14 clinical studies (594 patients) were included. Preclinical results documented improvements at the cartilage histological and immunohistochemical evaluation and at the biomarkers level. Clinical studies confirmed the procedure's safety, and the case series suggested satisfactory results in different joints in terms of symptoms and function improvement, with positive findings at the biomarker level. However, the randomized controlled trials did not document any clinical benefit, nor any changes in the imaging analysis. A large heterogeneity and overall poor quality were documented in both preclinical and clinical studies.</p><p><strong>Conclusions: </strong>There is an increasing interest in the use of adipose tissue-derived injectable products associated with PRP for the treatment of OA joints, with preclinical studies showing promising results with this combined approach. However, clinical studies did not confirm the benefits offered by PRP augmentation to adipose tissue-derived injectable products in patients affected by OA.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 11","pages":"1023-1033"},"PeriodicalIF":4.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between distal radius fracture malunion and patient-reported disability: a systematic review and meta-analysis.","authors":"Muhanned Ali, Roberto S Rosales, Elisabeth Brogren, Markus Waldén, Jesper Nordenskjöld, Isam Atroshi","doi":"10.1530/EOR-23-0212","DOIUrl":"10.1530/EOR-23-0212","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether distal radius fracture (DRF) malunion is associated with greater patient-reported disability.</p><p><strong>Methods: </strong>We searched PubMed, EMBASE, and Cochrane databases up to 21 May 2023. Two reviewers independently screened retrieved titles/abstracts and assessed the full text of potentially eligible articles to identify cohort studies and randomized controlled trials reporting outcomes of DRF in adults at least 12 months after fracture, confirmed radiologically 3 months or longer after fracture. We excluded studies not reporting patient-reported outcomes according to malunion and studies judged to have a high risk of bias, as assessed independently by two reviewers using the Quality In Prognosis Studies tool. To express the overall effect of malunion on patient-reported disability, we calculated the standardized mean difference (SMD) with a 95% CI.</p><p><strong>Results: </strong>Six studies with 898 patients (77% women) were included; five involved adults of all ages, and one restricted to patients aged 65 years and older. In the meta-analysis including the five studies with adults of all ages (1047 observations), the SMD was 0.58 (95% CI: 0.42-0.74; P < 0.001), favoring no malunion, with no statistically significant heterogeneity or publication bias. In the meta-analysis including all six studies (1193 observations), the SMD was 0.51 (95% CI: 0.35-0.67; P < 0.001), favoring no malunion, with moderate but significant heterogeneity.</p><p><strong>Conclusion: </strong>Malunion of distal radius fracture is associated with significantly greater patient-reported disability with a moderate magnitude in terms of clinical importance. The study does not address the possible influence of age or treatment methods.</p>","PeriodicalId":48598,"journal":{"name":"Efort Open Reviews","volume":"9 11","pages":"1097-1105"},"PeriodicalIF":4.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142606943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}