RESUMEN
PURPOSE: The aim of this review was to compare the clinical outcomes between operative and conservative management for primary patella dislocation (PPD). METHODS: PubMed Medline, EMBASE, Google scholar, and the Cochrane Library were systematically searched for randomized controlled trials that compared operative technique versus conservative technique for PPD. The results of eligible studies were independently extracted and analyzed according to the following: patient's satisfaction, Kujala score, Tegner score, and redislocation rate. Random-effect and fixed-effect models were adopted to calculate the weight mean difference and the odds ratio for continuous and dichotomous variables with 95 % confidence interval. RESULTS: Seven studies met the inclusion criteria, resulting in 402 (216 surgery and 186 conservation) patients available for the present study. A meta-analysis showed no significant differences between the two treatment groups in terms of patient's satisfaction and Kujala score. However, significant differences in Tegner score (P < 0.00001) and redislocation rate (P = 0.002) were observed in favor of surgical treatment. In the subgroup analysis, surgical intervention achieved higher (P = 0.002) Kujala score in short term (<5 years), while conservation gained advantage (P = 0.003) in long term (>5 years). There was no significant difference in dislocation rate in long term. CONCLUSIONS: Surgical treatment might provide better clinical results in short term. More persuasive evidence is still needed to proof the effect of surgical management in long time.
Asunto(s)
Luxación de la Rótula/terapia , Adulto , Tirantes , Moldes Quirúrgicos , Evaluación de la Discapacidad , Femenino , Humanos , Inmovilización/métodos , Masculino , Satisfacción del Paciente , Ensayos Clínicos Controlados Aleatorios como Asunto , Recurrencia , Adulto JovenRESUMEN
Objective To investigate the microsurgery and management of postoperative complications in pediatric patients with intrinsic third ventricular craniopharyngiomas. Methods From July 2005 to May 2011, 18 pediatric patients with intrinsic third ventricular craniopharyngiomas were treated by microsurgery via the transcallosal-interseptal-interfomix approach. The microsurgical procedures and management of postoperative complications were analyzed retrospectively. Results The tumors were totally resected in 13 cases, subtotally resected in 3 and partially resected in 2. The symptoms and signs of the patients were improved in varying degrees. The major postoperative complications included diabetes insipidus (15/18),electrolyte disturbance (12/18),central hyperthermia (5/18) and epilepsy (4/18). The complications all responded to active managements. The global therapeutic outcomes were fine. Conclusions The resection via the transcal-losal-interseptal-interfomix approach is an ideal treatment of the pediatric intrinsic third ventricular craniopharyngiomas. Active management of postoperative complications is essential to a good prognosis of the patients.
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Catalysed by bromobenzene, alkali metals including Li, Na, and K can mediate the reductive coupling of carbonyl compounds under mild, solventless conditions to furnish the corresponding pinacol products.