bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of Preoperative Scoring System in Prediction of Postoperative Survival in Patients with Metastatic Bone Disease: A Systematic Review and Meta-Analysis
Authors: Mansour Ahmed Abdallah Abdelazim , Azmy Sherif Ishak , Mowafi Mohamed Ahmed El 
Published: November 2024

Abstract

Background
Management of patients with metastatic bone disease for which there is risk of pathological fracture remains a clinical challenge. Surgeries performed in cancer patients are procedures at a high risk of thromboembolic and infectious complications. Expected survival is the most important factor to determine the treatment modality. This study evaluated preoperative different survival scores in metastatic bone disease surgery.

Methods
An electronic search of medical literature was conducted through MEDLINE (accessed via Ovid), EMBASE (accessed via Ovid), and PubMed. We performed a systematic review for studies involving prognostic scores that assessed the survival rates of patients with bone metastases. Further, we conducted a meta-analysis including studies that measured the sensitivity and specificity of the Tokuhashi and Tomita score in predicting 6- month survival rates for spinal metastases.

Results
A total of 68 studies were included in our study; of them, 35 studies were included in the meta-analysis. Sensitivities ranged from 27 to 92% for the Tokuhashi score and from 76 to 99% for the Tomita score, and specificities ranged from 44 to 96% for the Tokuhashi score and from 1 to 44% for the Tomita score. The pooled DOR was 6.04 (95 % CI, 3.96– 9.21; Tau-squared= 0.90; I2= 86%) for the Tokuhashi score and 1.34 (95 % CI, 0.67–2.67; Tau-squared = 1.02; I2= 85%) for the Tomita score. The SORG Nomogram, developed in a large surgical cohort, showed good discrimination on 3-month and 1-year survival, good calibration and was superior in direct comparison with low risk of bias and low concern regarding applicability. PATHFx 3.0, 2013-SPRING and potentially Optimodel were found to be the best models in terms of performance in predicting survival for surgery for extremity metastasis.

Conclusion
Regarding spinal metastases, the SORG Nomogram and machine learning algorithms showed better performance in survival prediction for surgery. Regarding extremity metastases, we found PATHFx 3.0, 2013-SPRING and Optimodel to be the best models in terms of performance. Although Tokuhashi score was more accurate than Tomita score slightly, both showed low accuracy to predict 6 months residual survival.
Comparative Study between Dual Mobility Total Hip Replacement versus Bipolar Hemiarthroplasty in the Treatment of Displaced Femoral Neck Fractures in the Elderly
Authors: Mohamed Haytham Abdel-Azim , Sallam Ahmed Mohamed , Abdallah Ahmed Ali Ahmed 
Published: November 2024

Abstract

Background
Total hip arthroplasty (THA) or hemiarthroplasty are the most popular treatments for dislocated intracapsular hip fractures.

Objective
to compare dual mobility total hip arthroplasty and bipolar hemiarthroplasty as a management for the femoral neck fracture in elderly and evaluating the functional outcome. The objective is to perform a systematic review of the outcomes of use of the dual mobility total hip arthroplasty compared to bipolar hemiarthroplasty.

Patients and Methods
We included randomized controlled trials, including cluster RCTs, controlled (non-randomized) clinical trials or cluster trials, prospective and retrospective comparative cohort studies and case control or nested case-control studies.

Results
There was statistically significant decrease in the Harris Hip score in BA group (78.31±9.25) than THA group (82.72±7.53). There was statistically significant increase in the percentage of patients with dislocation in BA group (6.2%) than THA group (1.9%).

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2023.

Conclusion
dual mobility cup total hip arthroplasty offers for the patients many advantages such as stability, lower dislocation rates and longevity, all those pros make it a superior treatment choice that bipolar hemiarthroplasty.
Systematic Review and Meta-Analysis of Management of Failed Arthroscopic Bankart Repair
Authors: Abdelaal Ahmed Mahmoud , Khater Ahmed Hany , Abd Mostafa Aly El 
Published: November 2024

Abstract

Background
The shoulder joint has the largest range of motion of all joints with little inherent bony stability. As such, it is one of the most frequently dislocated joints in the body with an incidence of up to 47 per 100,000 person years.

Aim of the Work
This review will focus on the etiology, evaluation, and management of patients after a failed primary arthroscopic Bankart repair.

Patients and Methods
Search strategy will be designed to include both manual and electronic data available. Electronic searches will involve searching databases of PubMed (from Jan. 2000 till July 2022), EMbase, CINAHL and Cochrane database searching keywords and terms listed below: “Bankart, Shoulder instability arthroscopic repair, open repair, revision, failure, and salvage”. Moreover, a manual search of the reference lists of the included studies will be searched for additional eligible articles.

Results
The main result of our study is that the Revision arthroscopic bankart repair in the setting of even below critical bone loss likely results in higher recurrent instability as compared to open bankart repair and laterjet procedure. The findings in the current study suggest that in the revision setting, open bankart repair offers the lowest recurrent instability rate (5.4%) compared to laterjet rate (8.8%) and revision arthroscopic bankart (23.8%). The first purpose of this review was to gather data from multiple studies to analyze the reasons of Failure of arthroscopic bankart repair.

Conclusion
We found that open bankart repair is superior to laterjet and arthroscopic bankart repair for failed arthroscopic bankart repair with acceptable recurrence rates of instability. Further comparative studies are needed to gain better understanding the possible solutions to the failure.
Physeal Growth Arrest after Traumatic Injury of Distal Tibial Physis A Systematic Review and Meta-Analysis
Authors: Ebrahim Ali Ebrahim Salah , Hefny Hany Mamdouh , Aly Ahmed Saeed 
Published: November 2024

Abstract

Background
Injury to the physis of the distal tibia in children can lead to subsequent growth arrest. This can result in physeal bars, leg-length discrepancies and angular deformities.

Aim of the Work
Is to review & meta-analysis the distal tibia physeal injury, treatment & how to decrease complications e.g premature physeal closure (PPC), angular deformity & leg length discrepancy.

Patients and Methods
We considered randomized controlled trials, prospective or retrospective cohort studies and case–control studies that directly compared ORIF to closed treatment of distal tibia physeal fractures in children and reported the rate of PPC. PPC was defined on radiographs by the presence of a bony bar in the distal tibia physis of the injured limb. Participants were young patients below 18 years old who have distal tibial physis fractures treated by closed reduction & internal fixation (CRIF), open reduction & internal fixation (ORIF).

Results
this systematic review we found that the degree of initial displacement was significant risk factor for growth arrest after physeal fracture of the distal tibia. Therefore, physicians should consider the possibility of growth arrest in patients with severely displaced physeal fractures of the distal tibia. The displaced S-H II distal tibia physeal fractures have a high risk of periosteal entrapment. ORIF is an effective choice of treatment to obtain an anatomical reduction for patients with &gt; 3 mm of initial displacement. However, PPC is a common complication following ORIF. The presence of associated fibula fracture plays an important role in the fracture outcome.

Conclusion
the degree of initial displacement was significant risk factor for growth arrest after physeal fracture of the distal tibia. Therefore, physicians should consider the possibility of growth arrest in patients with severely displaced physeal fractures of the distal tibia. The displaced S-H II distal tibia physeal fractures have a high risk of periosteal entrapment. ORIF is an effective choice of treatment to obtain an anatomical reduction for patients with &gt; 3 mm of initial displacement. However, PPC is a common complication following ORIF. The presence of associated fibula fracture plays an important role in the fracture outcome.
Total Elbow Arthroplasty Follow Up 10 Years in Rheumatoid Arthritis, A Systematic Review/Meta-Analysis
Authors: Atiyya Ahmed Naeem , Fathy Mounir Ayman , Touni Hani Nagati 
Published: November 2024

Abstract

Background
Rheumatoid arthritis is the most common form of chronic inflammatory arthritis and affects about 1% of adults. It is characterized by progressive, symmetrical arthritis involving many joints, most commonly the knee, wrist and interphalangeal joints. The elbow is affected in between 20% and 65% of patients, often causing severe painful disability. In patients with severe arthritis, many forms of treatment are available to relieve pain and improve function. Total elbow arthroplasty is commonly performed for end-stage arthritis. However, Total elbow arthroplasty has inferior implant survival and higher complication rates compared with arthroplasties of other major joints. This is usually thought to be due to the high risks associated with Rheumatoid arthritis and the complex anatomy of the elbow joint.

Aim of the Work
The aims of this study were to report on the long term outcome of total elbow arthroplasty in patients with rheumatoid arthritis, and to identify factors that affect the outcome patients satisfaction.

Patients and Methods
We searched PubMed, MEDLINE, Cochrane Reviews, and Embase from between January 2005 and March 2020. The primary aim was to determine the implant failure rate, the mode of failure, and risk factors predisposing to failure. A secondary aim is to identify the overall complication rate, associated risk factors and clinical performance. A meta- regression analysis completed to identify the association between each parameter with the outcome. The initial literature search resulted in 4776 studies, with 4665 duplicates subsequently removed. The remaining 111 studies were screened using our exclusion criteria. Following application of our exclusion criteria, the full texts of 111 studies were thereafter evaluated with our inclusion criteria to screen for eligibility. Overall, 13 clinical studies including 349 elbows were included in this study

Results
According to the movement degree, flexion was recorded in 5 studies with 229 elbows and it was found that there was a significant difference in pre and post-operative groups (p &lt; 0.001, I2 = 90%). Extension was recorded in 5 articles with 229 elbows. It was found that there was no significant difference in pre and post-operative groups (p = 0.12, I2 = 53%). Supination was recorded in 5 articles with 229 elbows. It was found that there was a significant difference in pre and post-operative groups (p = 0.008, I2 = 79%). Pronation was recorded in 5 papers with 209 elbows. It was found that there was a significant difference in pre and post-operative groups (p = 0.003, I2 = 83%).

Conclusion
Although elbow replacement is performed far less frequently than hip, knee, or shoulder replacement, its use is increasing and information for patients and clinicians on the longevity of implants and impact on quality of life is vital. Patients experienced a sustained improvement in pain and function for the 10 years following surgery.
Efficacy of Teriparatide in Improving Fractures Union and Healing: A Systematic Review and Meta-Analysis
Authors: Khalil Ibrahem Yasser Ibrahem , Salem Ahmed , Kotb Ahmed Sayed 
Published: November 2024

Abstract

Background
Fractures often contribute to high mortality and adverse outcomes in the geriatric population. During recovery from fracture, most patients experience fracture reduced mobility and impaired ability to perform routine daily activities, with a large proportion failing to regain their refracture functional level after 1 year.

Aim of the Work
This systematic review and meta-analysis study aimed to determine the role of teriparatide (recombinant human parathyroid hormone) for bone fracture healing in adults by comparing the different effects between PTH analogues and any other treatments (e.g. anti-osteoporosis drugs, placebo, standard care….etc.), regarding functional recovery, fracture union, and adverse events.

Methods
Searching process was performed using advanced search strategy on scientific databases. Inclusion criteria were adult patients administrated teriparatide after surgical fixation of fractures. We included all types of study design except case report and case series. The searching and identification process resulted in 16 papers which included in this study.

Results
Time to union were lower in TPTD group than non-TPTD group. The rates of fracture union after 3 and 6 months were similar in both groups. There were a significant improvement in bone mineral density when using teriparatide more than 6 months after surgical intervention for treatment of fracture. Varus collapse were lower in TPTD group than non-TPTD group. There were a significant improvement in functional outcome when using teriparatide post-operatively. HHS were higher in teriparatide (TPTD) group than non-TPTD group. Incidence of mal- union/nonunion and subsequent fracture were lower in TPTD group than non-TPTD group. Mortality rate were lower in TPTD group than non-TPTD group. Reoperation rate, complications’ rate and deformity rate were similar in TPTD group and non-TPTD group.

Conclusion
The using of teriparatide after fractures’ surgical fixation improve functional and radiological outcome and reduce time to union, rate of femoral shortening, degree of varus collapse and mortality rate especially in osteoporotic patients.
Causes of Failure of Subtrochanteric Fracture Fixation, Systematic Review and Meta-Analysis
Authors: Mahran Mahmoud Ali Salaheldin , Abdellatif Mohammed Ali Ibrahim , Desoky Ibrahim Mohamed Ismail 
Published: November 2024

Abstract

Background
Subtrochanteric (ST) femoral fractures is defined as fractures of proximal femoral shaft that is located within 5 cm of the lesser trochanter. Any internal fixation device for trochanteric fractures is subject to significant concentrated bending stresses, leading to implant fatigue and fixation failure. Fixation of sub-trochanteric femoral fracture is considered a critical challenge.

Objective
To assess causes of failure of sub-trochanteric fracture fixation.

Methods
This meta-analysis study included 12 papers which included 999 patients, fixation failed in 163 patients. The included studies mentioned approximately 7 causes for fixation failure which included deep infection (in 2 studies), delayed union (in 2 studies), non-union (in 6 studies), screw cut-out (in 3 studies), Poor reduction (in 3 studies), implant breakage (in 4 studies) and varsus deformity /malrotation (in 3 studies).

Results
This study included 12 studies recruited 999 patients with sub- trochanteric femoral fracture, fixation was failed in 163 patients. The incidence of sub-trochanteric fixation failure was 17% in all included studies 62% of patients with fixation failure were smokers The incidence of fixation failure after intramedullary fixation was lower than after extra-medullary fixation. The incidence of fixation failure after open surgery increases 2.41 times compared with closed surgery. The incidence of fixation failure was higher in patients with post- operative hip varus compared with patients without post-operative hip varus.

Conclusion
The incidence of sub-trochanteric fixation failure was 17%. The causes for fixation failure included smoking, poor reduction, nonunion, implant breakage, screw cutout, varus deformity, extra-medullary nailing.
A Systematic Review of Fixation Modalities in Supracondylar Fracture Femur in Geriatric Age Patients
Authors: Mohamed Ali Islam Ahmed , Abd-elaziz Basiony Ayman , El-khateeb Tameem Mohamed 
Published: November 2024

Abstract

Background
Surgical management has become the preferred treatment strategy for distal femur fractures due to improvements in alignment and functional outcomes over nonsurgical management, although bracing may be sufficient in stable, non-displaced fractures or for patients who are non-ambulatory or of high surgical risk

Aim and Objectives
The aim of this study was to systematically review the literature regarding Fixation modalities in supracondylar fracture femur in geriatric age patients with an emphasis on recent advances.

Subjects and Methods
In this systematic review, we searched Medline (Ovid), PubMed, Cochrane library, and EMBASE from Jan 2000 to July 2020. The search retrieved 779 unique records. We then retained 13 potentially eligible records for full-texts screening. Finally, 10 studies were included

Results
Mean Modifed RUST score pre − 3 changes to 10.1 post operation, mean Lysholm knee score post was 65.3, mean Knee society score was 83.5 and mean HSS knee score was 85.1 as shown in table8

Conclusion
The current systematic review suggested that the surgical fixations with different fixation techniques were all safe and effective in the treatment of supracondylar fracture femur in geriatric age patients, however minimally invasive treatments were recommended among this age group.
Dorso Lumbar Fractures Type A1 Treated by Segmental Fixation versus Conservative Treatment
Authors: Badrawy Ahmed Mohamed El , Fahmy Fady Micheal , Abdelradi Abdelradi Mahmoud , Mazeed Magdy Gamil 
Published: November 2024

Abstract

Background
Thoracolumbar fractures types A1 of AO classification are very common spine injuries. However, its management is usually without operative intervention especially if its patients are neurologically intact.

Objective
Dorsolumbar fractures are treated either with operative (posterior fixation) or conservative. The aim of this study is to compare the results of conservative versus operative treatment in a certain type of fracture (type A1 dorsolumbar fracture) regarding fracture and radiological parameters.

Patients and Methods
60 patients were enrolled in the current study, 29 were males and 31 were females with a mean age of 31.300 years old in non operative patients and 33.867 years old in operative patients at time of surgery.

Results
Regarding radiological parameters, this study included measurements of local kyphosis angle, and vertebral body wedging. The results showed statistically significant differences between preoperative values in comparison to both postoperative and follow up values. Regarding the functional assessment scores, the mean VAS was 1.125 in non operative patients and the mean VAS was 1.040 in operative patients. The mean ODI was 10.633 % in non operative patients and about 8.700% in operative patients at the last follow up visit. There is no great difference between operative and non operative patients in VAS and ODI but there is more satisfaction in operative patients. The degree of kyphosis is more in non operative patients which made few of them in mild pain in the last follow up. The complications encountered were very few, not including any major or neurological complications.

Conclusion
The only purpose to do fixation on those patients of type A1 fracture is to permit early ambulation and to protect them from kyphosis. but VAS and ODI have no big difference between the two groups but more in non operative in cases suffering from post traumatic kyphosis.
Charcot Ankle Treatment with Ilizarov versus Intramedullary Nail Systematic Review and Metaanalysis
Authors: Fayed Mahmoud , Kotb Ahmed Mostafa , El-Sharkawy Mohamed Hassan Abd-Elhamid 
Published: November 2024

Abstract

Background
Charcot neuropathic osteoarthropathy or neuroarthropathy (CNO) of the foot and ankle constitutes a great clinical challenge for a poorly understood destructive process. The CNO is due to sensory and motor neuropathies which lead to a chronic and progressive destruction of the foot architecture involving bones, joints, and soft tissues. Secondary fractures and dislocations predispose to deformity and ulceration with a great decrease of the gait-related quality of life and an increasing potential for major amputation.

Objective
The aims of the arthrodesis reconstructive procedure are realignment and stabilization of the severely deformed ankle in order to avoid ulcers and amputation. Retrograde intramedullary nails (IMN) and ilizarov. are two of the most common fixation techniques used for arthrodesis in CNO.

Materials and Methods
This review seeks to collate evidence from comparative studies to look for significant differences in terms of fusion rate, salvage rate, and complications following ilizarov. and IMN techniques for tibiotalo-calcaneal arthrodesis. Recent clinical trials or cluster trials, prospective and retrospective comparative cohort studies. Search results will be uploaded to systematic review management software and manually screened for eligibility to be included. PRISMA flowchart will be introduced on the search results and the inclusion/exclusion criteria.

Results
As regard the American Academy of Orthopedic Surgeons Foot and Ankle score (AAOS- FAO), comparison between the two treatment groups was statistically insignificant preoperatively and postoperatively. Intergroup study, Ilizarov and IMN showed statistically highly significant difference between preoperative and postoperative scores (p &lt; 0.01).

Conclusion
Charcot arthropathy of the foot and ankle is a difficult problem that significantly affects the diabetic population. Operative correction of Charcot deformity involving the ankle joint was associated with a high complication rate and risk for failure. The lessons learned from this highly comorbid patient population with complex deformities can be used as a benchmark for applying modern surgical techniques. Use of a retrograde intramedullary nail or ring fixator resulted in high rates of successful limb salvage when used for ankle arthrodesis in patients with Charcot arthropathy. In conclusion, retrograde IMN and the Ilizarov external fixator both yielded better union for tibiotalar arthrodesis in Charcot neuroarthropathy. Comparison between Ilizarov and IMN showed statistically non-significant difference regarding union. Also, Comparison showed that Ilizarov technique had higher rate of complications than IMN, However, the need for revision surgery was more frequent in the retrograde nail group compared to the ring fixator group. The added stability offered by external fixation may benefit patients who are at high risk for complications or require extended arthrodesis.