AIR trialBMJ (Clinical research ed.) 2021
Use of cast immobilisation versus removable brace in adults with an ankle fracture: multicentre randomised controlled trial.
There was no significant difference in ankle function at 16 weeks between cast and brace, and no clinically important differences at other time points; casting was not superior to functional bracing.
Randomised trialManagementLower limb trauma
HIP ATTACKLancet (London, England) 2020
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial.
Accelerated surgery did not significantly reduce either mortality or the composite of major complications at 90 days. Some secondary outcomes, such as delirium and time to mobilisation, favoured accelerated surgery.
Randomised trialManagementLower limb trauma
HEALTHThe New England journal of medicine 2019
Total Hip Arthroplasty or Hemiarthroplasty for Hip Fracture.
There was no significant difference in the rate of secondary procedures at 24 months. THA gave a small functional and quality-of-life advantage that was unlikely to be clinically important, while dislocation was more common after THA.
Randomised trialManagementLower limb trauma
WOLLFJAMA 2018
Effect of Negative Pressure Wound Therapy vs Standard Wound Management on 12-Month Disability Among Adults With Severe Open Fracture of the Lower Limb: The WOLLF Randomized Clinical Trial.
There was no significant difference in disability at 12 months, and no significant reduction in deep infection with negative pressure wound therapy.
Randomised trialManagementLower limb trauma
WHiTE 3: HEMIThe bone & joint journal 2018
A randomized controlled trial comparing the Thompson hemiarthroplasty with the Exeter polished tapered stem and Unitrax modular head in the treatment of displaced intracapsular fractures of the hip: the WHiTE 3: HEMI Trial.
Quality of life at four months did not differ significantly between implants, and any difference was below the minimum clinically important threshold. Mortality and mobility were also similar.
Randomised trialManagementLower limb trauma
FAITHLancet (London, England) 2017
Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial.
Reoperation at 24 months did not differ significantly between implants, but avascular necrosis was significantly more common with the sliding hip screw. Exploratory subgroups suggested possible benefit from the sliding hip screw in smokers and in displaced or basicervical fractures.
Randomised trialManagementLower limb trauma
SPRINTThe Journal of bone and joint surgery. American volume 2008
Randomized trial of reamed and unreamed intramedullary nailing of tibial shaft fractures.
Reamed nailing reduced events in closed fractures, an effect largely due to fewer autodynamisations, with no clear difference in open fractures. The trial also showed that delaying reoperation for nonunion for at least 6 months reduces unnecessary procedures.
Randomised trialManagementLower limb trauma