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Surgical versus conservative interventions for displaced intra-articular calcaneal fractures

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There is insufficient high quality evidence to establish whether surgical or conservative treatment is better for adults with displaced intra-articular calcaneal (heel bone) fracture.
Fractures of the calcaneus (heel bone) comprise up to 2% of all fractures, and are mostly caused by a …

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Surgical versus conservative interventions for treating ankle fractures in adults

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There is insufficient evidence to conclude whether surgical or conservative treatment produces superior long-term outcomes for ankle fractures in adults.
Ankle fractures usually affect young men and older women and the question of whether surgery or conservative treatment should be used for ankle …

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Ultrasound and shockwave therapy for acute fractures in adults

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This review highlights the limitations of the available evidence on therapeutic ultrasound for acute fractures in adults. Currently, the best assessment of the clinical effectiveness of low intensity ultrasound (LIPUS) for complete or stress fractures in adults does not support the …

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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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