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Purpose: High-energy injuries to the knee may lead to extensive soft tissue loss, fractures, and potential loss of extensor function. The gastrocnemius flap is a prominent reconstructive option for patients with injuries involving the knee and proximal third of the lower extremity. To the best of our knowledge, there has not been an informative review that has evaluated outcomes of patients who have undergone post-traumatic knee reconstruction with a pedicled medial or lateral gastrocnemius flap. The goal of this study is to assess outcomes in patients who have undergone gastrocnemius flap reconstruction after traumatic injuries to the knee. Methods: The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology. Four databases were utilized including PubMed, Cochrane Reviews, Embase, and CINAHL. Our search criteria consisted of the following keywords: gastrocnemius, flap, knee, and traum*. Results: A total of 204 studies were imported for screening, from which five papers met our final inclusion/exclusion criteria. The most common studies utilized in this review were case series followed by retrospective chart reviews. In total, 43 patients with traumatic soft tissue knee defects were included with an average patient age of 27.28 years. All patients had successful and clinical viable flaps post-operatively, and there were a total of five patients who had complications. Conclusion: The gastrocnemius flap has demonstrated to be an effective option for individuals undergoing post-traumatic knee reconstruction. Infection rates, loss of mobility, and scarring represent a minority of complications that may be seen when this reconstructive technique is utilized. Still, additional randomized controlled trials and retrospective studies are required in order to further evaluate for other potential complications that may occur in this patient population. [ABSTRACT FROM AUTHOR]

Purpose: We assessed the accuracy of quotations in the published literature of the Wound Management of Open Lower Limb Fractures (WOLLF) Randomized Clinical Trial. Methods: A literature search was performed to identify all citations of WOLLF from 2018 to 2021. Duplicate papers, non-English language papers, textbooks, technical tip videos, Ph.D. theses, and other grey literature were excluded from analysis. Eligible publications had their full text assessed by 2 independent reviewers who used a validated framework of error classification. Results: We identified 62 original papers that met our eligibility criteria and referenced WOLLF. Of the 62 papers, 12 contained a quotation error (12/62, 19%). Errors were classified into major and minor. There were 7 major errors and 5 minor errors. The majority of quotation errors (7/12, 58%) occurred due to multi-referencing, where groups of references were used to support single assertions. There was substantial agreement between the two independent reviewers as determined by a Kappa coefficient of 0.761. Conclusion: Our study demonstrated a 19% quotation error rate in the literature regarding WOLLF. The majority were due to multi-referencing. We suggest that both authors and reviewers carefully check the source literature of key references. [ABSTRACT FROM AUTHOR]

The aim of this paper was to perform a systematic overview of secondary literature studies on care pathways (CPs) for hip fracture (HF). The online databases MEDLINE-PubMed, Ovid-EMBASE, CINAHL-EBSCO-host, and The Cochrane Library were searched. A total of six papers, corresponding to six secondary studies, were included but only four secondary studies were HF-specific and thus assessed. Secondary studies were evaluated for patients' clinical outcomes. There were wide differences among the studies that assessed the effects of CPs on HF patients, with some contrasting clinical outcomes reported. Secondary studies that were non-specific for CPs and included other multidisciplinary care approaches as well showed, in some cases, a shorter hospital length of stay (LOS) compared to usual care; studies that focused on promoting early mobilization showed better outcomes of mortality, morbidity, function, or service utilization; CPs mainly based on intensive occupational therapy and/or physical therapy exercises improved functional recovery and reduced LOS, with patients also discharged to a more favorable discharge destination; CPs principally focused on early mobilization improved functional recovery. A secondary study specifically designed for CPs showed lower odds of experiencing common complications of hospitalization after HF. In conclusion, although our overview suggests that CPs can reduce significantly LOS and can have a positive impact on different outcomes, data are insufficient for formal recommendations. To properly understand the effects of CPs for HF, a systematic review is needed of primary studies that specifically examined CPs for HF. [ABSTRACT FROM AUTHOR]

Background: de Quervain's tenosynovitis is a painful condition of the wrist which leads to difficulties in performing activities of daily living. Aims: This systematic review was conducted to examine the effectiveness of steroid injection therapy as compared to splinting for treatment of de Quervain's tenosynovitis in adults. Methods: The following databases were searched for relevant studies, MEDLINE, EMBASE, CINAHL, AMED and PsycINFO (via NHS Evidence), and Cochrane Library (via Cochrane Collaboration). Synonyms and free texts were used to locate studies. The reference lists of articles were checked for related papers. Hand searching was performed for important relevant journals. All searches found 89 studies, out of which 14 were relevant. Two studies were selected according to the inclusion criteria of the systematic review. Data were extracted and analysed for the two selected randomised trials using a fixed effect model at 95 % confidence intervals. Results: The meta-analysis demonstrated that the total effect estimate was 3 with a narrow 95 % confidence interval (1.89, 4.77). z score for overall effect was 4.66 which was highly significant ( p < 0.01). Moderate heterogeneity with I-square test was found to be 64 % but was not significant ( p > 0.05). Number needed to treat was 2, which showed that for every two persons treated with steroid injections, one person gets the benefit. Conclusion: Steroid injection is an effective form of conservative management for de Quervain's disease although more research is needed to establish the full benefits of the treatment. [ABSTRACT FROM AUTHOR]

Upper extremity deep venous thrombosis (DVT) is considered a rare phenomenon. Little is known as to what factors may contribute to the development of upper extremity DVT following trauma or elective orthopaedic surgery. The incidence of pulmonary embolism (PE) related to upper extremity thrombosis is reported as 12 to 36%, where up to 16% of cases are fatal. The purpose of this paper was to systematically review the literature to assess all cases of upper extremity DVT presented in the literature in order to determine epidemiology and outcome. A review of EMBASE, Medline, CINAHL and AMED from their inception to November 2009, sources of grey literature and a pertinent hand search of specialist orthopaedic journals was undertaken. A total of 38 cases of upper extremity DVT and 19 cases with PE were identified from 20 publications. The incidence of upper extremity DVT and PE was greatest in cases following shoulder surgery. There did not appear to be any greater risk in patients with diabetes or obesity. In total, one patient died after a PE following shoulder surgery. Although a relatively uncommon complication, the literature suggests that upper extremity DVT can lead to PE, which should be considered by orthopaedic clinicians in patients following upper extremity surgery or trauma. [ABSTRACT FROM AUTHOR]