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Surgical versus non-surgical interventions for treating humeral shaft fractures in adults

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There is no evidence available from randomised controlled trials to ascertain whether surgical intervention of humeral shaft fractures gives a better or worse outcome than no surgery.
Fractures of the shaft of the humerus account for 1% to 3% of all fractures in …

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Intramedullary nailing for tibial shaft fractures in adults

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There are a variety of intramedullary nails and associated techniques available and widely used, but it is not clear which is the best method since there is insufficient evidence to draw definitive conclusions.
Fractures of the tibial shaft (breaks in the bone situated …

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Antibiotic prophylaxis for surgery for proximal femoral and other closed long bone fractures

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Antibiotic prophylaxis for closed fracture surgery is an effective intervention. Single dose intravenous prophylaxis is effective if the agent used provides tissue levels exceeding the minimum inhibitory concentration over a 12-hour period. If the antibiotic chosen has a short half-life which may …

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Conservative interventions for treating distal radial fractures in adults

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There remains insufficient evidence from randomised controlled trials to determine which methods of conservative treatment are the most appropriate for the more common types of distal radial fractures in adults. Therefore, at present, practitioners applying conservative management should use an accepted technique …

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Conservative versus operative treatment for hip fractures in adults

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Conservative treatment will be acceptable where modern surgical facilities are unavailable, and will result in a reduction in complications associated with surgery, but rehabilitation is likely to be slower and limb deformity more common.
Until operative treatment involving the use of various implants …

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External fixation versus conservative treatment for distal radial fractures in adults

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There is some evidence to support the use of external fixation for dorsally displaced fractures of the distal radius in adults. Though there is insufficient evidence to confirm a better functional outcome, external fixation reduces redisplacement, gives improved anatomical results and most …

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Interventions for isolated diaphyseal fractures of the ulna in adults

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Overall, there is insufficient evidence to determine which method of treatment (randomised trials assessed four treatment options) is the most appropriate for the treatment of isolated fractures of the ulnar shaft in adults. However, there is weak evidence (all trials were methodologically …

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Percutaneous pinning for treating distal radial fractures in adults

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There is some evidence to support the use of percutaneous pinning, its precise role and methods are not established. The higher rates of complications with Kapandji pinning and biodegradable materials casts some doubt on their general use.
A key method of surgical fixation …

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Pre-operative traction for hip fractures in adults

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From the evidence available, the routine use of traction (either skin or skeletal) prior to surgery for a hip fracture does not appear to have any benefit. However, the evidence is also insufficient to rule out the potential advantages for traction, in …

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Bone grafts and bone substitutes for treating distal radial fractures in adults

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Bone scaffolding may improve anatomical outcome compared with plaster cast alone but there is insufficient evidence to conclude on functional outcome and safety; or for other comparisons.
Surgical treatment of fractures of the distal radius can involve the implantation of bone scaffolding materials …

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