Surgical site infection after wound closure with staples versus sutures in elective knee and hip arthroplasty: a systematic review and meta-analysis.

Purpose: This systematic review and meta-analysis aimed to study surgical site infection of wound closure using staples versus sutures in elective knee and hip arthroplasties.

Methods: A systematic literature review was performed to search for randomized controlled trials that compared surgical site infection after wound closure using staples versus sutures in elective knee and hip arthroplasties. The primary outcome was surgical site infection.

Adoption of direct discharge of simple stable injuries amongst (orthopaedic) trauma surgeons.

Introduction: The importance of routine follow-up of several relatively simple stable injuries (SSIs) is questionable. Multiple studies show that direct discharge (DD) of patients with SSIs from the Emergency Department results in patient outcomes and experiences comparable to 'standard care' with outpatient follow-up. The purpose of this study was to evaluate to which extent DD of SSIs has been adopted amongst trauma and orthopedic surgeons internationally, and to assess the variation in the management of these common injuries.

Wound complications after total hip arthroplasty: a prospective, randomised controlled trial comparing staples with sutures.

Objective: Does the use of staples or sutures for wound closure have a lower surgical site infection rate in patients receiving primary total hip arthroplasty (THA)?

Design: Prospective, randomised controlled multicentre trial.

Methods: 535 patients undergoing THA were included and randomised into 2 groups: 268 wounds were closed with staples, and 267 with sutures. Primary outcome was surgical site infection (SSI).

Detecting scaphoid fractures in wrist injury: a clinical decision rule.

Introduction: The aim of this study was to develop and validate an easy to use clinical decision rule, applicable in the ED that limits the number of unnecessary cast immobilizations and diagnostic follow-up in suspected scaphoid injury, without increasing the risk of missing fractures.

Methods: A prospective multicenter study was conducted that consisted of three components: (1) derivation of a clinical prediction model for detecting scaphoid fractures in adult patients following wrist trauma; (2) internal validation of the model; (3) design of a clinical decision rule. The predictors used were: sex, age, swelling of the anatomic snuffbox, tenderness in the anatomic snuffbox, scaphoid tubercle tenderness, painful ulnar deviation and painful axial thumb compression.

Accuracy of cup placement in total hip arthroplasty by means of a mechanical positioning device: a comprehensive cadaveric 3d analysis of 16 specimens.

Introduction: We tested whether a mechanical device (such as Hipsecure) to pinpoint the anterior pelvic plane (APP) as a guide can improve acetabular cup placement. To assess accuracy we asked: (1) is the APP an effective guide to position acetabular cup placement within acceptable ° of divergence from the optimal 40° inclination and 15° anteversion; (2) could a mechanical device increase the number of acetabular cup placements within Lewinnek's safe zone (i.e.

What Are the Applications and Limitations of Artificial Intelligence for Fracture Detection and Classification in Orthopaedic Trauma Imaging? A Systematic Review.

Background: Artificial-intelligence algorithms derive rules and patterns from large amounts of data to calculate the probabilities of various outcomes using new sets of similar data. In medicine, artificial intelligence (AI) has been applied primarily to image-recognition diagnostic tasks and evaluating the probabilities of particular outcomes after treatment. However, the performance and limitations of AI in the automated detection and classification of fractures has not been examined comprehensively.

Perioperative management of external fixation in staged protocols: an international survey.

Introduction: Despite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities.

Materials And Methods: A 26-question survey was sent to 170 members of the Traumaplatform.

Large variation in use of patient-reported outcome measures: A survey of 188 foot and ankle surgeons.

Background: There is an increasing interest in the use of patient reported outcome measures (PROMs). However, there is a large variety of PROMs and a lack of consensus regarding preference for their use. Aim of this study is to determine how often PROMS are used for foot and ankle disorders, for what purpose PROMs are used, and what the preferences of the foot and ankle surgeons are, when choosing a PROM to use.

Online Studies on Variation in Orthopedic Surgery: Computed Tomography in MPEG4 Versus DICOM Format.

The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms.

6-week radiographs unsuitable for diagnosis of suspected scaphoid fractures.

Introduction: Six week follow-up radiographs are a common reference standard for the diagnosis of suspected scaphoid fractures. The main purpose of this study was to evaluate the interobserver reliability and diagnostic performance characteristics of 6-weeks radiographs for the detection of scaphoid fractures. In addition, two online techniques for evaluating radiographs were compared.

Reliability of classification for post-traumatic ankle osteoarthritis.

Purpose: The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis.

Methods: A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura. Reliability was evaluated with the use of the Siegel and Castellan's multirater kappa measure.

The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial.

Background: Fifth metatarsal (MT-V) stress fractures often exhibit delayed union and are high-risk fractures for non-union. Surgical treatment, currently considered as the gold standard, does not give optimal results, with a mean time to fracture union of 12-18 weeks. In recent studies, the use of bone marrow cells has been introduced to accelerate healing of fractures with union problems.

Guesstimation of posterior malleolar fractures on lateral plain radiographs.

Background: Accurate assessment of articular involvement of the posterior malleolar fracture fragments in ankle fractures is essential, as this is the leading argument for internal fixation. The purpose of this study is to assess diagnostic accuracy of measurements on plain lateral radiographs.

Methods: Quantification of three-dimensional computed tomography (Q-3D-CT) was used as a reference standard for true articular involvement (mm(2)) of posterior malleolar fractures.

Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs.

Background: In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy (BS) are widely used to establish a definitive diagnosis, but there is uncertainty about the most appropriate method.

Surgical versus conservative treatment for high-risk stress fractures of the lower leg (anterior tibial cortex, navicular and fifth metatarsal base): a systematic review.

Aim: To compare surgical and conservative treatment for high-risk stress fractures of the anterior tibial cortex, navicular and proximal fifth metatarsal.

Methods: Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective studies. Two reviewers independently extracted data and assessed methodological quality.

Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis.

Purpose: To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies.

Methods: PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane, and CINAHL databases. Only studies on clinical testing prior to radiographic evaluation and with acceptable reference standard for occult fractures were included.

Computed tomography for suspected scaphoid fractures: comparison of reformations in the plane of the wrist versus the long axis of the scaphoid.

Background: Definitive diagnosis of occult scaphoid fractures remains difficult. We tested the null hypothesis that, for diagnosis of true fractures among suspected scaphoid fractures, computed tomography (CT) reformations along the long axis of the scaphoid have the same accuracy as reformations made relative to the anatomical planes of the wrist.

Methods: In a prospective trial, 34 patients with a suspected scaphoid fracture underwent CT scanning within 10 days after trauma.

[Variations in management of suspected scaphoid fractures].

Objective: This study evaluated the daily clinical practice for management of patients with suspected scaphoid fractures in hospitals in the Netherlands and compared it with recommendations from the current literature.

Design: Questionnaire-based investigation.

Method: Doctors working in emergency departments in hospitals in the Netherlands were asked to complete an 8-question survey including questions on diagnostic strategies, treatment type and the time between different steps in the management policy.

Diagnostic performance tests for suspected scaphoid fractures differ with conventional and latent class analysis.

Background: Evaluation of the diagnostic performance characteristics of radiographic tests for diagnosing a true fracture among suspected scaphoid fractures is hindered by the lack of a consensus reference standard. Latent class analysis is a statistical method that takes advantage of unobserved, or latent, classes in the data that can be used to determine diagnostic performance characteristics when there is no consensus reference (gold) standard.

Purposes: We therefore compared the diagnostic performance characteristics of MRI, CT, bone scintigraphy, and physical examination to identify true fractures among suspected scaphoid fractures.

Comparison of CT and MRI for diagnosis of suspected scaphoid fractures.

Background: There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same diagnostic performance characteristics for the diagnosis of scaphoid fractures.

Methods: Thirty-four consecutive patients with a suspected scaphoid fracture (tenderness of the scaphoid and normal radiographic findings after a fall on the outstretched hand) underwent CT and MRI within ten days after a wrist injury.