scholarly journals Ilioinguinal versus modified Stoppa approach for open reduction and internal fixation of displaced acetabular fractures: A Protocol for Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Amit Srivastava ◽  
Rajesh Kumar Rajnish ◽  
Prasoon Kumar ◽  
Rehan Ul Haq ◽  
Ish Kumar Dhammi
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Open Reduction ◽  
English Language ◽  
Case Reports ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Acetabular Fractures ◽  
Anatomical Reduction ◽  
Stoppa Approach

Background: The fracture of the acetabulum is one of the most challenging fractures to manage and operate for orthopaedic surgeons, to get a good surgical outcome, anatomical reduction of fractures and reconstruction of the joint is of utmost importance. To achieve a good postoperative outcome an appropriate surgical approach is necessary to achieve an anatomical reduction of fractures and fewer complications. Objective: The current review aims to compare the outcomes of the ilioinguinal versus modified Stoppa approach for open reduction and internal fixation (ORIF) of displaced acetabular fractures by analyzing the evidence from the current literature. Methods: A systematic review of the literature will be conducted in accordance with the PRISMA guidelines. The primary searches will be conducted on the Medline (PubMed), Embase, Scopus, and Cochrane Library databases, using a pre-defined search strategy. The studies of any design in the English language will be included which compared the outcomes of the ilioinguinal and modified Stoppa approach for ORIF of displaced acetabular fractures and reported at least one outcome of interest. Studies that do not compare the outcomes of the ilioinguinal and modified Stoppa approach for the treatment of displaced acetabular fractures in adults (>18 years of age), case reports, conference abstracts, posters, book chapters, review articles, biomechanical studies, technical tips, cadaveric studies, and articles not in the English language will be excluded. Both qualitative and quantitative analyses will be done. Qualitative analysis will be done using appropriate tables and diagrams. Wherever feasible, quantitative analysis to be done with the appropriate software. The risk-of-bias assessment will be done using the MINORS tool for the non-randomized comparative studies, and The Cochrane Collaboration risk-of-bias tool will be used for randomized control trials.

scholarly journals Retention period after treatment of posterior crossbite with maxillary expansion: a systematic review

2017 ◽  
Vol 22 (2) ◽  
pp. 35-44 ◽  
Author(s):  
Julia Garcia Costa ◽  
Thaís Magalhães Galindo ◽  
Claudia Trindade Mattos ◽  
Adriana de Alcantara Cury-Saramago
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Maxillary Expansion ◽  
Retention Period ◽  
Posterior Crossbite ◽  
Acrylic Plate ◽  
Removable Appliances ◽  
Quad Helix

ABSTRACT OBJECTIVE: The aim of this systematic review was to evaluate the duration of the retention period in growing patients undergoing maxillary expansion and its relation with posterior crossbite stability. METHODS: Search strategies were executed for electronic databases Cochrane Library, Web of Science, PubMed and Scopus, which were completed on January 15, 2016. The inclusion criteria included randomized, prospective or retrospective controlled trials in growing subjects with posterior crossbite; treated with maxillary expanders; retention phase after expansion; post-retention phase of at least 6 months. The exclusion criteria were anterior crossbite, craniofacial anomalies, surgery or another orthodontic intervention; case reports; author’s opinions articles, thesis, literature reviews and systematic reviews. The risk of bias of selected articles was assessed with Cochrane risk of bias tool for RCTs and Downs and Black checklist for non-RCTs. RESULTS: A total of 156 titles/abstracts was retrieved, 44 full-texts were examined, and 6 articles were selected and assessed for their methodological quality. The retention period after maxillary expansion ranged between 4 weeks and 16 months. Fixed (acrylic plate, Haas, Hyrax and quad-helix) or removable (Hawley and Hawley expander) appliances were used for retention. CONCLUSIONS: Six months of retention with either fixed or removable appliances seem to be enough to avoid relapse or to guarantee minimal changes in a short-term follow-up.

scholarly journals Gastrointestinal manifestations of COVID-19 in children: a systematic review and meta-analysis

2020 ◽  
pp. flgastro-2020-101529 ◽  
Author(s):  
Anthony K Akobeng ◽  
Ciaran Grafton-Clarke ◽  
Ibtihal Abdelgadir ◽  
Erica Twum-Barimah ◽  
Morris Gordon
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Case Reports ◽  
Meta Analysis ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Risk Of Bias ◽  
Gastrointestinal Manifestations ◽  
Published Evidence ◽  
Pooled Prevalence

ObjectivesTo summarise the published evidence on the gastrointestinal manifestations of COVID-19 in children and to determine the prevalence of gastrointestinal symptoms.MethodsIn this systematic review and meta-analysis, we searched PubMed, Embase, CINAHL and the WHO’s database of publications on novel coronavirus. We included English language studies that had described original demographic and clinical characteristics of children diagnosed with COVID-19 and reported on the presence or absence of gastrointestinal symptoms. Meta-analysis was conducted using the random-effects model. The pooled prevalence of gastrointestinal symptoms was expressed as proportion and 95% CI.ResultsThe search identified 269 citations. Thirteen studies (nine case series and four case reports) comprising data for 284 patients were included. Overall, we rated four studies as having a low risk of bias, eight studies as moderate and one study as high risk of bias. In a meta-analysis of nine studies, comprising 280 patients, the pooled prevalence of all gastrointestinal symptoms was 22.8% (95% CI 13.1% to 35.2%; I2=54%). Diarrhoea was the most commonly reported gastrointestinal symptom followed by vomiting and abdominal pain.ConclusionsNearly a quarter of children with COVID-19 have gastrointestinal symptoms. It is important for clinicians to be aware of the gastrointestinal manifestation of COVID-19.PROSPERO registration numberCRD42020177569.

scholarly journals Minimally invasive reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra-articular calcaneal fractures

2018 ◽  
Vol 3 (7) ◽  
pp. 418-425 ◽  
Author(s):  
Haroon Majeed ◽  
James Barrie ◽  
Wendy Munro ◽  
Donald McBride
Keyword(s):  
High Risk ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Percutaneous Fixation ◽  
Calcaneal Fractures ◽  
Minimally Invasive Reduction

The aim of this article is to systematically identify and analyse research evidence available to compare the outcomes of minimally invasive reduction and percutaneous fixation (MIRPF) versus open reduction and internal fixation (ORIF) for displaced intra-articular calcaneal fractures. Articles from 2000 to 2016 were searched through MEDLINE (PubMed), Cochrane Library, Embase, ScienceDirect, Scopus and ISI Web of Knowledge using Boolean logic and text words. Of the 570 articles identified initially, nine were selected including three randomized controlled trials and six retrospective comparative studies. All nine studies had a total of 1031 patients with 1102 displaced intra-articular calcaneal fractures. Mean follow-up was 33 months. Of these, 602 (54.6%) were treated with MIRPF and 500 (45.4%) were treated with ORIF. Overall incidence of wound-related complications in patients treated with MIRPF was 4.3% (0% to 13%) compared with 21.2% (11.7% to 35%) in the ORIF group Functional outcomes were reported to be better in the minimally invasive group in all studies; however, the results did not reach statistical significance in some studies. All the studies had methodological flaws that put them at either ‘unclear’ or ‘high’ risk of bias for multiple domains. Overall quality of the available evidence is poor in support of either surgical technique due to small sample size, flaws in study designs and high risk of bias for various elements. Individual studies have reported minimally invasive techniques to be an effective alternative with lower risk of wound complications and better functional outcomes. Cite this article: EFORT Open Rev 2018;3:418-425. DOI: 10.1302/2058-5241.3.170043

scholarly journals Comparison of complications of early and delayed open reduction and internal fixation for treating pilon fracture: A protocol of systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258962
Author(s):  
Yang Chen ◽  
Xiaoyu Huang ◽  
Yili Chen ◽  
Changlong Shi ◽  
Hao Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Complications ◽  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Secondary Outcome ◽  
Statistical Heterogeneity ◽  
Pilon Fractures

Background Tibial Pilon fractures are severe fractures accompanied by soft tissue injury. Although open reduction and internal fixation (ORIF) are effective in treating Pilon fractures, there is a controversy over time to surgery due to reported postoperative complications. However, there is no systematic review evaluating the difference of postoperative complications between early and delayed ORIF for treating pilon fractures. Methods Relevant literature written in English will be searched through PubMed, Cochrane Library, Embase, MEDLINE, and Web of Science. The study aims to compare the effects and complications of early and delayed ORIF for treating fresh pilon fractures in adult patients. The primary outcome will be infection rate, fracture union time, nonunion and malunion rate. And the secondary outcome will be metalwork removal, amputation, and ankle function grade. Two reviewers will independently assess the eligibility of the studies according to the pre-defined inclusion and exclusion criteria. A meta-analysis for the available data will be conducted using Revman 5.3. To measure effect size, odds ratios (ORs) and mean difference will be used for dichotomous and continuous data, respectively. Statistical heterogeneity will be explored. And a random-effects model or a fixed-effects will be used in pooled data on the basis of the existence or absence of heterogeneity. Subgroup analysis will be conducted to identify sources of heterogeneity and sensitivity analysis to test the results’ robustness. We will assess the risk of bias by four different quality assessment tools according to the study design. Publication bias will be evaluated by funnel plot. The study data will be stored in the Open Science Framework website. PROSPERO registration number CRD42020207465

scholarly journals Open Reduction and Internal Fixation of Acetabular Fractures Using the Modified Stoppa Approach

2019 ◽  
Vol 9 (1) ◽  
pp. e3 ◽  
Author(s):  
Moritz Tannast ◽  
Marius J. B. Keel ◽  
Klaus-Arno Siebenrock ◽  
Johannes D. Bastian
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Acetabular Fractures ◽  
Stoppa Approach

scholarly journals Effectiveness of Traditional Chinese Exercise for Symptoms of Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 17 (21) ◽  
pp. 7873
Author(s):  
Ruojin Li ◽  
Hongwei Chen ◽  
Jiahao Feng ◽  
Ying Xiao ◽  
Haoyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Physical Function ◽  
Case Reports ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Statistical Heterogeneity

Background: Growing evidences have advocated the potential benefits of traditional Chinese exercise (TCE) on symptomatic improvement of knee osteoarthritis (KOA). However, most of them have been derived from cross-sectional studies or case reports; the effectiveness of TCE therapies has not been fully assessed with a randomized control trial (RCT). In order to evaluate the combined clinical effectiveness of TCE for KOA, we conducted a systematic review and meta-analysis on the existing RCTs on KOA. Methods: A systematic search was performed in four electronic databases: PubMed, Web of Science, Cochrane Library, and EMBASE from the time of their inception to February 2020. All eligible RCTs were included in which TCE was utilized for treating KOA as compared to a control group. Two reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCT. The symptoms of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) were regarded as the primary outcomes in this study. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random or fixed effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. In addition, subgroup analyses were used to investigate heterogeneity and sensitivity analysis was carried out for the results of the meta-analysis. Egger’s test and the funnel plots were used to examine the potential bias in the RCTs. Results: A total of 14 RCTs involving 815 patients with KOA were included. Compared with a control group; the synthesized data of TCE showed a significant improvement in WOMAC/KOOS pain score (SMD = −0.61; 95% CI: −0.86 to −0.37; p < 0.001), stiffness score (SMD = −0.75; 95% CI: −1.09 to −0.41; p < 0.001), and physical function score (SMD = −0.67; 95% CI: −0.82 to −0.53; p < 0.001). Conclusions: Our meta-analysis suggested that TCE may be effective in alleviating pain; relieving stiffness and improving the physical function for patients with KOA. Yet; given the methodological limitations of included RCTs in this meta-analysis; more high-quality RCTs with large sample size and long-term intervention are required to further confirm the effectiveness and underlying mechanisms of TCE for treating KOA.

Alignment of the hindfoot in total knee arthroplasty: a systematic review of clinical and radiological outcomes

2021 ◽  
Vol 103-B (1) ◽  
pp. 87-97
Author(s):  
Arne Burssens ◽  
Dries De Roos ◽  
Alexej Barg ◽  
Matt J. Welck ◽  
Nicola Krähenbühl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
English Language ◽  
Case Reports ◽  
Varus Deformity ◽  
Cochrane Library ◽  
Hindfoot Alignment ◽  
Total Knee ◽  
Hindfoot Deformity

Aims Patients with a deformity of the hindfoot present a particular challenge when performing total knee arthroplasty (TKA). The literature contains little information about the relationship between TKA and hindfoot alignment. This systematic review aimed to determine from both clinical and radiological studies whether TKA would alter a preoperative hindfoot deformity and whether the outcome of TKA is affected by the presence of a postoperative hindfoot deformity. Methods A systematic literature search was performed in the databases PubMed, EMBASE, Cochrane Library, and Web of Science. Search terms consisted of “total knee arthroplasty/replacement” combined with “hindfoot/ankle alignment”. Inclusion criteria were all English language studies analyzing the association between TKA and the alignment of the hindfoot, including the clinical or radiological outcomes. Exclusion criteria consisted of TKA performed with a concomitant extra-articular osteotomy and case reports or expert opinions. An assessment of quality was conducted using the modified Methodological Index for Non-Randomized Studies (MINORS). The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and registered in the PROSPERO database (CRD42019106980). Results A total of 17 studies were found to be eligible for review. They included six prospective and ten retrospective studies, and one case-control study. The effects of TKA showed a clinical improvement in the hindfoot deformity in three studies, but did not if there was osteoarthritis (OA) of the ankle (one study) or a persistent deformity of the knee (one study). The radiological alignment of the hindfoot corrected in 11 studies, but did not in the presence of a rigid hindfoot varus deformity (in two studies). The effects of a hindfoot deformity on TKA included a clinical association with instability of the knee in one study, and a shift in the radiological weightbearing axis in two studies. The mean MINORS score was 9.4 out of 16 (7 to 12). Conclusion TKA improves both the function and alignment of the hindfoot in patients with a preoperative deformity of the hindfoot. This may not apply if there is a persistent deformity of the knee, a rigid hindfoot varus deformity, or OA of the ankle. Moreover, a persistent deformity of the hindfoot may adversely affect the stability and longevity of a TKA. These findings should be interpreted with caution due to the moderate methodological quality of the studies which were included. Therefore, further prospective studies are needed in order to determine at which stage correction of a hindfoot deformity is required to optimize the outcome of a TKA. Cite this article: Bone Joint J 2021;103-B(1):87–97.

scholarly journals Open reduction and internal fixation of acetabular fractures in patients of old age

2020 ◽  
Vol 44 (10) ◽  
pp. 2123-2130 ◽  
Author(s):  
Pol Maria Rommens ◽  
Roland Schwab ◽  
Kristin Handrich ◽  
Charlotte Arand ◽  
Daniel Wagner ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Internal Fixation ◽  
Old Age ◽  
Predictive Factors ◽  
Open Reduction ◽  
Rating Scale ◽  
Acetabular Fractures ◽  
Anatomical Reduction

Abstract Material and methods There is an ongoing debate on which treatment for acetabular fractures in elderly patients is the most appropriate. This study was set up to identify the role of open reduction and internal fixation of acetabular fractures in persons of old age. We retrospectively reviewed the medical charts and radiological data of all patients older than 65 years, who suffered an isolated acetabular fracture and were admitted in our Department between 2010 and 2014 (5-year period). Complications, outcome and mortality were recorded. Of all surviving patients, quality of life (QoL), mobility and independence were graded with European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L), European Quality of Life 5 Dimensions Visual Analogue Scale (EQ-5D-VAS), Numeric Rating Scale (NRS), Elderly Mobility Scale (EMS) and Tinetti Mobility Test (TMT). Results Seventy patients could be identified. There were 52 men (74%) and 18 women (26%) with a median age of 79.0 years (range: 65–104 years). Forty-six patients (66%) had been treated with open reduction and internal fixation (ORIF), 24 (34%) conservatively. There were negative predictive factors—subchondral impaction, damage to the femoral head and multiple fragments—in 54% of the operative group. With ORIF, an anatomical reduction could be achieved in 27 patients (59%), an acceptable in 18 (39%) and a poor in one (2%). At follow-up, 18 patients (26%) had died and 23 (33%) were not able to participate. The follow-up rate of the surviving operatively treated patients was 77%. Eleven of 46 operated patients (24%) needed a conversion to a total hip arthroplasty (THA). All patients undergoing conversion had imperfect reduction after surgery. No patient in the non-operative group underwent conversion to THA during follow-up. The median follow-up time of operatively treated patients without conversion (n = 17) was 30 months (range, 16–73 months), of patients with THA (n = 9) 30 months after conversion (range, 17–55 months). Quality of reduction correlated to QoL, mobility and independence in all recorded parameters. Patients with secondary THA had similar good outcomes as patients after ORIF without later conversion. Men had better outcome than women. Conclusion ORIF of acetabular fractures in patients of old age results in excellent outcomes at short-term follow-up when anatomical reduction can be achieved. In case of negative predictive factors, ORIF cannot be regarded as a definitive solution, rather as the construction of a stable socket for secondary THA. The decision of therapy should be made dependent on pre-operative radiographic parameters.

scholarly journals Open Reduction with Internal Fixation (ORIF) versus Hybrid Circular External Fixator (HCEF) as the Treatment of Choice for Bicondylar Tibial Plateau Fractures : A Systematic Review and Meta-Analysis

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0004
Author(s):  
I Made Arya Susila ◽  
Sherly Desnita Savio ◽  
Cokorda Gde Oka Dharmayuda
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Blood Loss ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Similar Operation

Bicondylar Tibial Plateu Fractures (BTPF) present a challenge in management due to the involvement of articular surface, resulting in high complication rate. This study aims to compare two treatments, Open Reduction with Internal Fixation (ORIF) and Hybrid Circular External Fixation (HCEF) as the choice of surgical procedure for BTPF that still controversial until now. Discussion: BTPF is a complex and challenging injury associated with severe bone and soft tissue damage which may result in severe morbidity and chronic complications. The minimally invasive procedure offered by HCEF preserves soft tissue and offers lower rate of deep infection. Furthermore, HCEF should be more considered as the treatment of choice for BTPF due to its shorter hospital LoS which may minimalize nosocomial infection risks and costs. Materials and Methods: A systematic review using Cochrane Library, PubMed, and Google Scholar was conducted based on PRISMA guideline. Inclusion criteria were studies comparing HCEF and ORIF of BTPF. Studies of only one surgical technique modality, Schatzker types I-IV Tibial Plateu Fractures, and case reports were excluded, resulting in six included studies. For the meta-analysis of hospital length of stay (LoS), random effect model was used for continuous outcomes using Review Manager 5.3. Results: Most common complications are nerve injuries, infection, and non/delayed union. Blood loss was higher in ORIF group, while both procedures have similar operation time and functional outcome. The mean hospital LoS for ORIF (n = 60) was 18.45, as for HCEF (n =63) was 8.325. There was significant difference in terms of hospital LoS between ORIF and HCEF (P =0.003). Conclusion: ORIF and HCEF carry similar operation time, functional outcome, union rate, and complication, though HCEF is more beneficial in terms of blood loss and hospital LoS.

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