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Erichsen JL, Andersen PI, Viberg B, Jensen C, Damborg F, Froberg L. A systematic review and meta-analysis of functional outcomes and complications following external fixation or open reduction internal fixation for distal intra-articular tibial fractures: an update. Eur J Orthop Surg Traumatol 2019; 29:907-917. [PMID: 30739163 DOI: 10.1007/s00590-019-02368-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/03/2019] [Indexed: 01/30/2023]
Abstract
PURPOSE To conduct a systematic review and meta-analysis comparing physical function and complications following DIATF surgery with external fixation (EF) or open reduction internal fixation (ORIF). METHOD A search was conducted using PubMed, Embase, Cochrane CENTRAL, Open Grey and Orthopaedic Proceedings. Studies with a level of evidence of I-III on patients (≥ 18 years) with DIATFs operated on with either EF or ORIF were included. A total of 3814 studies were identified. The Cochrane Risk of Bias Tool for randomised controlled trials and the ROBINS-I tool for nonrandomised studies were used to assess risk of bias. RESULTS Nine studies with 478 patients, 271 ORIF and 197 EF met the inclusion criteria. The mean follow-up ranged from 12 to 38 months. The meta-analysis showed a higher incidence of superficial wound infections (RR = 2.94, 95% CI 1.62-5.34, p = 0.0004) and malunions (RR = 2.62, 95% CI 1.27-5.43, p = 0.009) in the EF group compared to the ORIF group. Also worse physical function was associated with the EF group. However, the overall evidence was low. CONCLUSION This systematic review is the first to report on physical function following DIATF surgery. In general, decreased physical function was reported. The meta-analysis showed lower incidence of superficial wound infection and malunion rates in the ORIF group. Heterogeneity was low. In conclusion, this review reports lower complication rates following ORIF for DIATF. The overall evidence was limited, and therefore, the authors cannot recommend ORIF to be superior to EF treatment for DIATF. More multi-centre studies with larger sample sizes are needed to assess long-term physical function and complications following DIATF surgery. LEVEL OF EVIDENCE Level 1.
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Affiliation(s)
- J L Erichsen
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital a Part of Hospital Lillebaelt, Sygehusvej 24, 6000, Kolding, Denmark. .,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
| | - P I Andersen
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital a Part of Hospital Lillebaelt, Sygehusvej 24, 6000, Kolding, Denmark
| | - B Viberg
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital a Part of Hospital Lillebaelt, Sygehusvej 24, 6000, Kolding, Denmark.,Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - C Jensen
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital a Part of Hospital Lillebaelt, Sygehusvej 24, 6000, Kolding, Denmark.,Institute for Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - F Damborg
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital a Part of Hospital Lillebaelt, Sygehusvej 24, 6000, Kolding, Denmark
| | - L Froberg
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Christensen B, Klaaborg KE, Andersen PI. [A centrifugal pump used as a support of left ventricular pumping function after extracorporeal circulation]. Ugeskr Laeger 1991; 153:1427-8. [PMID: 2028553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The first Danish employment of a centrifugal pump for relief of the left ventricle after open heart surgery is presented. A man aged 72 years with three-vessel coronary arteriosclerosis was submitted to a coronary by-pass operation. At the conclusion of the operation, the pumping capacity of the heart was found to be so reduced that it was not possible to maintain an adequate minute-volume without support from a mechanical pump. The circulation in this patient was supported for four hours by means of an outflow catheter from the left atrium and an inflow catheter in the ascending aorta. After this, the patient's own heart could achieve the necessary minute-volume. The remainder of the postoperative course was uncomplicated.
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Affiliation(s)
- B Christensen
- Odense Sygehus, thoraxkirurgisk afdeling og anaestesiologisk afdeling
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Heslet L, Lybecker H, Andersen PI. [Rational hemotherapy. Indications, complications and practical performance]. Ugeskr Laeger 1990; 152:2635-9. [PMID: 2219485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Employment of allogenic blood products involves the risk of a series of complications in the recipient: transfusion-transmitted disease, immune suppression, immunological transfusion reactions and coagulopathy. Hepatitis C is the most common transfusion-transmitted infection with a post-transfusion incidence of 2-4%. Transfusion-transmitted AIDS plays a quantitatively lesser role but the course of the condition is frequently fatal. The duration of the period during which a HIV-sero-negative individual is potentially infectious is uncertain. After blood transfusion, the immune apparatus is suppressed, probably on account of the leukocyte content of the blood transfusion. These disturbances in immune function increase the risk of infection and possibly the frequency of recurrence of cancer after operative treatment of a series of neoplastic diseases. Coagulopathy after blood transfusion may be related primarily to the number of transfusions and can be counteracted by administration of the relevant coagulation factors. Rational hemotherapy aims at minimizing these transfusion-related complications by restricting the indications for blood transfusion, blood component therapy, peroperative normovolaemic haemodilution, preoperative deposition of autologous blood and/or peroperative collection of blood and re-infusion. Employing rational hemotherapy, it becomes possible to reduce the need for transfusion by 20-90% and hence the morbidity and the mortality connected with blood transfusion.
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Affiliation(s)
- L Heslet
- Anaestesi- og intensivafdelingen, Odense Sygehus
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