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1.
Sylvain Mathieu Gabriel Baron Martin Soubrier Philippe Ravaud 《Joint, bone, spine : revue du rhumatisme》2018,85(1):109-114
Introduction
The EUropean League Against Rheumatism (EULAR) congress is an important meeting to present abstracts of research in rheumatology. However, information in these abstracts is insufficient and must be followed and developed in a published article. This study aims to assess to what extent abstracts presented in the EULAR Meeting are published in journals.Methods
We identified all abstracts of randomized controlled trials accepted for presentation at the EULAR annual meeting from 2002 to 2011. Using a standardized research, we used Pubmed to find the corresponding publication to each congress abstract. We assessed the cumulative percentage of published abstracts over time and compared the number of included patients, the outcome and the moment of outcome assessment between abstracts presented in congress and in published article.Results
A total of 1839 abstracts were analyzed. The cumulative probability of abstracts being published in journals was 16.9% (95% CI: 15.2% to 18.6%) at 12 months, 34.3% (95% CI: 32.2% to 36.5%) at 24 months, and 46.5% (95% CI: 44.2% to 48.8%) at 36 months. When evaluable, a difference between the congress and published abstracts was found in 29.0% (247/852). The most frequent difference was a different number of included patients (196/247: 79.4%).Conclusion
More than half of the abstracts of randomized trials were not published three years after they were presented in EULAR meeting. Thirty percent of abstracts were different between their presented and published version. 相似文献2.
Background
The aim of this study was to evaluate the current standards of Fellowship training in Foot and Ankle Surgery Fellowship in the UK.Methods
Thirteen UK post-FRCS (Tr&Orth) or equivalent Fellows completed a questionnaire detailing their outpatient, surgical, teaching and research experience, along with documenting their supervision and terms of employment.Results
A Fellow attended a mean of 2.5 (0.5–4) clinics and 3.84 (2–7) theatre sessions per week. 62% of Fellows had independent clinics. The three largest sub-specialty areas experienced were forefoot surgery, mid or/hindfoot arthritis and deformity correction. 82% of Fellows had a regular MDT meeting. All were involved in both teaching and research, but only 64% had timetabled research sessions. All Fellows were satisfied with their experience and would recommended the Fellowship.Conclusions
The current standard of a post FRCS (Tr&Orth) Fellowship in Foot & Ankle surgery in the UK has been defined. Further improvement will require all Fellows to be involved in a regular MDT meetings, work in an independent clinic, have guaranteed timetabled research time and a ring fenced study leave budget. 相似文献3.
C.J. Deutsch A. Tan S. Smailes P. Dziewulski 《Burns : journal of the International Society for Burn Injuries》2018,44(5):1040-1051
Introduction
Smoke inhalation injury (II) is an independent risk factor for mortality in burns and its management is inherently complex. We aim to make recommendations for best practice in managing II and its sequelae by reviewing all available current evidence in order to provide an evidence-based approach.Methods
We conducted a systematic search of the Cochrane database and Embase using PRISMA guidelines with no patient population exclusion criteria. Published work was reviewed and evidence levels graded.Results
We identified 521 abstracts for inclusion. Of the 84 articles identified for secondary review, 28 papers were excluded leaving 56 papers suitable for final inclusion.Conclusions
We are able to identify a number of strategies in both diagnosis and treatment of II that have support in the published literature, including the role of bronchoscopy, permissive hypercapnia, nebulized heparin and hydroxycobalamin. Other strategies have not been shown to be harmful, but their efficacy is also not firmly established, such as high frequency oscillatory ventilation and exogenous surfactant. Prophylactic antibiotics and corticosteroids are not recommended. In general, published evidence for II is mostly Level 3 or below, due to a noticeable lack of large-scale human studies. This represents a challenge for evidence-based burns practice as a whole. 相似文献4.
Background
There is an evident lack of research on timing of polydactyly surgery and its effects on treatment results.Methods
Retrospective comparative study on foot polydactyly patients treated at our department from 1995 to 2009. Patients were divided into 2 groups, group A – under the age of 5 at surgery, and group B – 5 years and older.Results
There were 24 patients (8 male, 16 female), 30 feet. Median age at surgery was 1 year (range, 9 months–4.5 years) for group A, and 8.5 years (range, 6–37 years) for group B. Median follow-up was 16.2 years (range, 7–21 years). There were 16 postaxial and 8 preaxial cases. At the last follow-up 12 patients’ feet were “excellent” and 12 “good”. No significant differences were identified between the two groups at final follow-up.Conclusions
Timing of surgery for foot polydactyly is not crucial for final results. 相似文献5.
N. Gutteck H. Martin T. Hanke J.B. Matthies A. Heilmann H. Kielstein G. Gradl K.S. Delank D. Wohlrab 《Foot and Ankle Surgery》2018,24(3):208-212
Background
A number of studies report on limitations of the screw arthrodesis in severe malalignment of the hindfoot, neuropathic deformity, poor bone quality and osteoporosis.Methods
Fourteen anatomically correct polyurethane foam models of the right leg (Sawbones Europe, Malmö, Sweden) and eighteen fresh-frozen human lower leg specimens (9 pairs) were used for the comparative biomechanical testing.Results
The statistical analysis of the stiffness of the fixation developed a significant difference in favor of the plate in all test directions.Conclusions
The excellent biomechanical results are very promising and we hope for a reduction of the pseudarthrosis rate and shorten the postoperative treatment phase. 相似文献6.
Sarthak Sinha Grace Yoon Wisoo Shin Jeff A. Biernaskie Duncan Nickerson Vincent A. Gabriel 《Burns : journal of the International Society for Burn Injuries》2018,44(2):263-271
Background
Randomized controlled clinical trials (CTs) are gold standard tools for assessing interventions. Although burn CTs have improved care, their status, publication frequency, and publication quality are not known.Objectives
(1) Characterize burn CTs by analyzing location, completion status, temporal trend, and funding sources. (2) Assess quality of trial reporting.Data sources
CT records were obtained from ClinicalTrials.gov and WHO’s CT Registry (searched May 2017). Publications were obtained from PubMed, Google Scholar, OVID MEDLINE, and ClinicalTrials.gov (searched June 2017).Publication appraisal
23-item rubric adapted from CONSORT and ICH E3 guidelines.Results
738 burn CTs were identified globally, of which majority were publically-funded (77%), ongoing (52%), and assessed behavioral, pharmacological, device-based, dietary-based, and biological/procedural interventions. Amongst the ended trials, 69 (28%) published their findings. Significantly fewer industry-funded trials published findings (14% vs 33% publically-funded). Quality of reporting was suboptimal, and most underreported categories were trial phase, severity, and sample size estimation.Limitations
Incomplete, outdated, and non-registered CTs which are difficult to track.Conclusions
Burn trials are proliferating in number, location, and interventions assessed. Only a small proportion are published and quality of reporting is suboptimal.Implications of key findings
Burn researchers should aim to register and report on all clinical trials regardless of outcome. Superior a priori design can reduce precocious termination and mandatory reporting of data fields can improve quality of reporting.Systematic review registration number: CRD42017068549. 相似文献7.
Introduction
Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition.Case report
We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18FDG PET scan helped to diagnose ALS. Further surgery was performed. At 3-year follow-up examination showed no recurrence of the infection.Discussion
ALS should be suspected during recurrent symptoms after spinal fusion surgery. Evaluation should be based on the results of 18FDG PET scan and surgery.Conclusion
Bacterial and histopathological analyses combined with an increase of spine fixation and adapted antimicrobial therapy are a safe management for ALS. 相似文献8.
Sherif Dabash Gautham Prabhakar Eric Potter Ahmed M. Thabet Amr Abdelgawad Stephen Heinrich 《Journal of Clinical Orthopaedics and Trauma》2018
Introduction
Premature growth arrest can pose a challenge to the orthopedic surgeon. Various options for treating physeal arrest exist.Methods
Systematic searches were conducted on PubMed/Medline, ScienceDirect, OVID, and Cochrane Library. Secondary searching was performed, where certain articles from reference lists of the selected studies were reviewed that were not found in the primary search.Results
This review article discusses the different methods of management for premature growth arrest.Conclusions
The use of mesenchymal stem cells provides a promising alternative treatment modality. 相似文献9.
João L. Ellera Gomes Arthur F. Soares Carlos E. Bastiani Jacqueline Vieira de Castro 《Foot and Ankle Surgery》2018,24(6):486-489
Background
The anterior drawer test is traditionally used to assess ankle instability, but we believe that there is room for a small but effective improvement by adding digital palpation of the talus. We aimed to determine the accuracy of anterolateral talar palpation (ATP) in the diagnosis of ankle instability by comparing it with the traditional anterior drawer test.Methods
Fourteen symptomatic and 10 asymptomatic patients were examined for excessive mobility through comparison of both ankles by two blinded orthopedic surgeons, each one using one of the above-mentioned tests. Symptomatic patients were also referred for stress radiography and magnetic resonance imaging (MRI).Results
ATP was the most sensitive test, but also the least specific, yielding more positive results than the other tests, including tests with negative MRI. ATP and radiography had the highest accuracy and highest level of agreement with MRI.Conclusions
ATP significantly improved diagnostic accuracy in detecting ankle instability.Level of evidence
IV: cross-sectional study. 相似文献10.
Background
Gustilo–Anderson grade 3B open ankle fracture-dislocations requiring stable fixation and soft tissue coverage are increasingly common in frail populations.Methods
We identified all patients with open ankle fracture-dislocations treated with a tibiotalocalcaneal nail and soft tissue coverage over a five-year period. We retrospectively recorded pre-morbid status, fracture and soft tissue injury pattern, surgical details, post-operative mobility, length of hospital stay, complication and re-operation rate and survival.Results
21 ankles (20 patients) are included, all grade 3B open fractures. All patients were permitted to mobilise by one to six weeks post-surgery. One patient required further soft tissue surgery. Six patients had superficial wound colonization/infection, none developed deep infections. None of the nails have required removal. We observed a 15% three-month mortality rate.Conclusion
Tibiotalocalcaneal nail fixation and soft tissue coverage of unstable open ankle fractures in frail patients facilitates early return to ambulation with a low complication and re-operation rate. 相似文献11.
Marcello Zappia Daniela Berritto Francesco Oliva Nicola Maffulli 《Foot and Ankle Surgery》2018,24(4):342-346
Background
Percutaneous Achilles tendon repair has been developed to minimise soft tissue complications following treatment of tendon ruptures. However, there are concerns because of the risk of sural nerve injury. Few studies have investigated the relationship between the Achilles tendon, the sural nerve and its several anatomical course variants.Methods
We studied 7 cadaveric limbs (7 Achilles tendons) in which a percutaneous repair of the Achilles tendon was performed. On each tendon, high resolution real time ultrasonography examination was performed by an experienced musculoskeletal radiologist before and after the procedure, with the surgeons blind to the results of the scan both before and after surgery.Results
In two instances, high resolution real time ultrasonography examination revealed nerve entrapment at the level of most proximal lateral suture.Conclusions
Since the sural nerve can be easily visualised using high-frequency high resolution real time ultrasonography, intraoperative ultrasound can be of assistance during percutaneous repair of Achilles tendon rupture.Clinical relevance
The sural nerve can be readily visualised by high-frequency high resolution real time ultrasonography probes. It could be beneficial to use high resolution real time ultrasonography intraoperatively or perioperatively to minimise the risks of sural nerve injury when undertaking percutaneous repair of Achilles tendon tears. 相似文献12.
Context
Pelvic organ prolapse is a common condition affecting at least a half of adult women. Most women are asymptomatic, but a significant proportion of women choose to have an operation.Objective
The aim of this paper is to review the various surgical procedures for the correction of pelvic organ prolapse.Evidence acquisition
Guidelines from professional organizations, meta-analysis, reviews, and high-quality studies were referred to collect the evidence for the various surgical techniques.Evidence synthesis
Management of pelvic organ prolapse is considered under anterior vaginal wall prolapse, apical prolapse, and posterior vaginal wall prolapse to help the reader organize the information to counsel women in a systematic way.Conclusions
Surgical management of prolapse can be challenging, and various factors affect the procedure of choice and the outcomes. Providing information, careful counseling, and informed choice are crucial to deliver patient expectations. All these factors should be considered when deciding on the surgical procedure. 相似文献13.
Thibaut Noailles Ronny Lopes Giovanni Padiolleau François Gouin Jean Brilhault 《Foot and Ankle Surgery》2018,24(2):80-85
Introduction
A lateral ankle sprain is one of the most frequent reasons for consultation at the emergency trauma unit. Numerous surgical procedures have been described with long-term outcomes that differ.Hypothesis
The long-term results of anatomical repair of the anterior talofibular ligament (ATFL) and the calcaneofibular (CFL) ligament are better, with less secondary radiological osteoarthritis than non-anatomical repair.Materials and methods
A review of the literature after a minimum follow-up of 10 years was performed to analyze the clinical and radiological results of direct anatomical repair (Broström, Duquennoy) and non-anatomical repair (Watson Jones, Evans, Castaing). Thirteen articles were selected.Results
Eight hundred and one ankles were evaluated after a mean follow-up of 15.3 years. The functional outcome was better after anatomical repair but with recurrent instability. Loss of range of motion and secondary osteoarthritis was more frequent after non-anatomical repair.Conclusion
Anatomical repair of the lateral collateral ligament of the ankle resulted in a better functional outcome and less secondary osteoarthritis than non-anatomical repair.Study design
Review of the literature; level of proof IV. 相似文献14.
Background
The purpose of this retrospective study was to evaluate the clinical and radiological results of hallux valgus surgery using a plantar locking plate.Methods
Proximal oblique metatarsal osteotomy combined with distal soft tissue treatment was performed in 59 adult patients (68 feet) with hallux valgus, using an anatomically pre-contoured plantar locking plate for fixation of the osteotomy. The median age was 64.0 years and the median follow-up period was 16.5 months.Results
The mean JSSF scale improved significantly from 56.0 points preoperatively to 95.8 points postoperatively. The mean intermetatarsal angle and hallux valgus angle decreased from 16.4° and 41.8° preoperatively to 4.2° and 10.8° postoperatively, respectively. The mean inclination angle was 19.9° preoperatively and 20.5° postoperatively. Removal of hardware was needed in 2 feet (2.9%).Conclusions
Proximal oblique metatarsal osteotomy is an effective method for relief of pain and improvement of function in correction of hallux valgus deformity. Use of a plantar locking plate provides sufficient maintenance of the correction, and complications associated with the hardware are rare. 相似文献15.
Background
Soft tissue release for hallux valgus correction is traditionally performed through a dorsal first web space incision. We performed a single surgeon series review of hallux valgus correction with Scarf ± Akin osteotomy and lateral release using a single medial incision.Methods
192 feet were included. Patient satisfaction survey was conducted at the time of study. Pre-operative and final post-operative radiographic data obtained.Results
All radiological parameters had statistically significant improvement [p < 0.05 for each variable]. Response rate was 71% (completely satisfied 69%, satisfied with minor reservation 14%, satisfied with major reservation 11%, dissatisfied 6%). There was no correlation of any preoperative or postoperative radiographic measure with satisfaction grade. No patient required revision procedure.Conclusions
Single medial incision surgery for hallux valgus correction is a simple, safe and effective technique with very high satisfaction. The results are comparable to traditional two-incision surgery. 相似文献16.
Francesc Malagelada Miki Dalmau-Pastor Betlem Fargues Maria Cristina Manzanares-Céspedes Fernando Peña Jordi Vega 《Foot and Ankle Surgery》2018,24(1):40-44
Background
The purpose of this study is to describe a simple and reproducible method to localize the neurological structures at risk and to describe a safe zone for hallux minimally invasive surgery (MIS) procedures.Methods
Ten fresh-frozen cadaveric feet were dissected to identify the dorsomedial digital nerve (DMDN) and the dorsolateral digital nerve (DLDN) of the first toe. Axial sections were performed at the sites of metatarsal osteotomies. We documented the position of the nerves with respect to the extensor hallucis longus (EHL) tendon using a clock method superimposed on the axial sectionResults
The DMDN was found at an average of 26.2° medial to the medial border of the EHL tendon. (SD 11.26, range 14.5–45.5), whereas the average distance of the DLDN was 32.3° lateral to the medial border of the EHL tendon. (SD 6.29, range 13.5–40).Conclusions
Using the clock method the DMDN and DLDN were found consistently between 10 o’clock and 2 o’clock in either right and left feet. The clock method may facilitate avoiding the area where these nerves are located serving as a valuable tool in minimally invasive foot surgery. 相似文献17.
Background
The incidence of Disc herniation is about 2–3% of population. Each year 300,000 procedures performed in USA. The aim of this paper is to describe the utility of endoscopic procedure in treatment of lumbar disc herniation.Methods
We operated 359 patients from September 2013 to December 2016 for lumbar disk herniation by Endoscopic DESTANDAU method (EDM). The average length of surgery was 47 min. We operated 211 male and 148 female patients. In average, patients had pain for 4.3 months before surgery.Results
310 patients became pain free in six weeks and 332 after 3 months. We had 7 recurrent herniation. Among these patients 4 have been operated for the second time with success. Three patients refused to be operated. And had infiltration. We had 1 deep infection and 3 cutaneous infections. We have 7 two SCF fluid leak. Among them 3 needed second operation.Conclusions
The patients are admitted the day of surgery and are discharged the day after surgery. EDM is a good alternative surgery for lumbar disk herniation in comparison with classical surgery. The duration of hospitalization is shorter and recovery is faster. 相似文献18.
Yukiko Yoshino Ken Kubomura Hyakuzoh Ueda Takuya Tsuge Rei Ogawa 《Burns : journal of the International Society for Burn Injuries》2018,44(3):683-691
Objective
The choice between local flap designs for burn reconstruction is largely shaped by aesthetic, vascularity, procedural complexity, and wound-closure considerations. However, another key consideration is how well specific local flap designs release post-burn scar contractures. This is because constant tension on wound edges can generate pathological scarring. However, the ability of specific local flap to release post-burn scar contractures is poorly understood. This question was addressed by this study of patients who underwent local flap surgery to release post-burn scar contractures.Methods
The flap type, its original size, and the degree to which the flap extended 6 months after surgery were recorded.Results
Of the 40 patients enrolled, 20 received an island flap and 20 received a skin-pedicled flap. The scars were most commonly located on the anterior chest, axilla, and cubital fossa, followed by the lateral chest, abdomen, thigh, and popliteal fossa. Six months after surgery, the skin-pedicled and island flaps had extended on average by 1.53- and 1.28-fold, respectively.Conclusions
While it was technically easier to transfer island flaps to the recipient site, they released contractures less effectively than skin-pedicled flaps. The postoperative extensibility of flaps should be considered when determining which flap design is optimal for the individual patient. 相似文献19.
Mohammad Abufaraj Guido Dalbagni Siamak Daneshmand Simon Horenblas Ashish M. Kamat Ryu Kanzaki Alexandre R. Zlotta Shahrokh F. Shariat 《European urology》2018,73(4):543-557