A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL)

BACKGROUND The efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest has not been studied specifically. We hypothesized that SSRF improves outcomes among patients with displaced rib fractures in the absence of flail chest. METHODS Multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours to medical management. Inclusion criteria were three or more ipsilateral, severely displaced rib fractures without flail chest. The trial involved both randomized and observational arms at patient discretion. The primary outcome was the numeric pain score (NPS) at 2-week follow-up. Narcotic consumption, spirometry, pulmonary function tests, pleural space complications (tube thoracostomy or surgery for retained hemothorax or empyema>24 hours from admission) and both overall and respiratory disability-related quality of life (RD-QoL) were also compared. RESULTS One hundred ten subjects were enrolled. There were no significant differences between subjects who selected randomization (n = 23) versus observation (n = 87); these groups were combined for all analyses. Of the 110 subjects, 51 (46.4%) underwent SSRF. There were no significant baseline differences between the operative and nonoperative groups. At 2-week follow-up, the NPS was significantly lower in the operative, as compared with the nonoperative group (2.9 vs. 4.5, p
Source: Journal of Trauma and Acute Care Surgery - Category: Surgery Tags: CWIS 2019 SUMMIT ARTICLE Source Type: research

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Conclusion: It appears that the knee OA pain and disability can be decreased after a dual-frequency LLLT applied to acupoints (SP9, SP10, and EX-LE2). The clinical efficacy of LLLT is highly related to the therapeutic settings of the laser apparatus; hence, more clinical trials with diffident parameter settings are needed to be further clarified. PMID: 33029170 [PubMed]
Source: Evidence-based Complementary and Alternative Medicine - Category: Complementary Medicine Tags: Evid Based Complement Alternat Med Source Type: research
Study Design. A prospective study of patients originally randomized to total disc replacement (TDR) or multidisciplinary rehabilitation. Objective. To assess the long-term development of facet arthropathy (FA) after TDR versus nonoperative treatment, and to analyze the association between FA and clinical outcome. Summary of Background Data. FA may appear or increase following TDR, but the natural course of FA is unclear, and no previous study has evaluated the long-term development of FA following TDR compared with nonoperative treatment. Methods. The study included 126 patients with chronic low back pain and de...
Source: Spine - Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research
Study Design. Retrospective cohort study. Objective. The goal of the present study was to determine whether neck pain responds differently to anterior cervical discectomy and fusion (ACDF) between patients with cervical radiculopathy and/or cervical myelopathy. Summary of Background Data. Many patients who undergo ACDF because of radiculopathy/myelopathy also complain of neck pain. However, no studies have compared the response of significant neck pain to ACDF. Methods. Patients undergoing one to three-level primary ACDF for radiculopathy and/or myelopathy with significant (Visual Analogue Scale [VAS] ≥ 3) ne...
Source: Spine - Category: Orthopaedics Tags: CERVICAL SPINE Source Type: research
Study Design. A registry-based comparative cohort study with 2-year follow-up. Objective. To assess whether Modic changes (MCs) are associated with health-related quality of life, long-term physical disability, back- or leg pain after discectomy. Summary of Background Data. Previous studies have failed to show a clinically significant association between MCs and patient-reported outcomes (PROs) after discectomy. Methods. Data from the Danish National Spine Registry on patients undergoing first-time lumbar discectomy at a single institution from 2014 to 2017 with an accessible preoperative lumbar magnetic resonan...
Source: Spine - Category: Orthopaedics Tags: CLINICAL CASE SERIES Source Type: research
Conclusion. A review of 25 placebo-controlled trials provides moderate-quality evidence that epidural corticosteroid injections are effective, although the effects are small and short-term. There is uncertainty on safety due to very low-quality evidence. Level of Evidence: 1
Source: Spine - Category: Orthopaedics Tags: COCHRANE COLLABORATION Source Type: research
Conclusion. Approximately one in three patients with LSS experience a poor clinical outcome consistent with surgical non-response. Demographic, health, and clinical factors were more predictive of clinical outcome than surgery-related factors. These predictors may assist surgeons with patient selection and inform shared decision-making for patients with symptomatic LSS. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
AbstractPurpose of ReviewThis paper seeks to review the important musculoskeletal issues that arise for pregnant and postpartum women. It outlines the background, diagnosis, and management of these musculoskeletal issues; reviews the existing and recent literature; and offers clinical opinions from the perspective of women ’s health PM&R physicians.Recent FindingsExisting and recent literature on pelvic girdle pain, lumbosacral back pain, pubic symphysis separation, transient osteoporosis, rectus diastasis, and postpartum neuropathy offer some new insights on management, which is often context-dependent. Management r...
Source: Current Physical Medicine and Rehabilitation Reports - Category: Rehabilitation Source Type: research
ConclusionsWomen with non-dominant BC use their involved limb similar to healthy controls but less than their dominant limb.
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: crFMF, MKD/HIDS and TRAPS negatively affected the quality of life (QoL) of adult and paediatric patients, including their physical, mental, psychosocial health, and social functioning. There remains, however, a high number of unmet needs for these patients to reduce their disease burden. PMID: 33025894 [PubMed - as supplied by publisher]
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Radiographic parameters are commonly used to determine the need for surgical supracondylar humeral (SCH) fracture reduction and the postoperative quality of reduction. We studied whether such parameters are correlated with mid-term patient-reported outcome (PRO) scores in pediatric patients. We retrospectively reviewed data from 213 patients (104 girls) treated surgically for Gartland type-II (n = 84) or type-III (n = 129) SCH fractures from 2008–2016. Mean (± standard deviation) age at surgery was 5.1 ± 2.1 years. Mean time from initial treatment to outcome survey completion was 5.0 &plu...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
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