Evidence
Alert

Functional braces are effective alternatives to plaster casts for ruptured Achilles tendons

Early weight-bearing in a below-knee rigid boot, a functional brace, following ruptured Achilles tendon can achieve similar results to traditional plaster casting. This NIHR-funded trial included 540 people, and after nine months there appeared to be no difference between the two treatments in terms of how well patients recovered from their injury. The functional brace …

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Plasma and blood cell injections have not shown a benefit for Achilles tendon injury

Injecting a ruptured Achilles tendon with a small sample of a person’s own plasma, without the red blood cells, has no functional or other benefit. Plasma rich in platelets and white blood cells for the acute injury was compared with placebo. The NIHR-funded trial involved 230 adults with acute Achilles tendon rupture (the tendon which …

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Using wires to fix wrist fracture has good long-term outcome

Fixing a displaced broken wrist with wires is as effective as fixation with locking plates in the long term. Wrist function and pain continue to improve in the five years following either operation, with no evidence of a difference between the two treatments. In 2014, a trial comparing the use of Kirschner wires and locking plates …

Collection

My Signals – Occupational Therapy

In My Signals, health and social care staff and service users tell us what research is important to them and why they feel others need to know about it. In this collection, we asked seven occupational therapists to tell us which Signals have interested them most and explain why they feel the findings are worth …

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Torn Achilles tendons have similar outcomes if treated with or without surgery

Outcomes for ruptured Achilles tendons appear similar irrespective of the choice of intervention. This systematic review and meta-analysis found that while the risk of re-rupture with corrective surgery was small at 2.3%, with conservative management (immobilisation in a cast), the rate was only 3.9%. The complication rate at 4.9% was three times higher in those …

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Paracetamol and alcohol are the most common substances taken by young people and rates of poisoning are increasing

The rates of the five most common types of poisoning in young people have increased three to five-fold from 1998 to 2014 and is cause for concern. A study including more than 1.7 million young people aged 10 to 24 in the UK found records of 31,509 people who had been treated for poisoning (2% of the …

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Negative pressure dressings are no better than standard dressings for open fractures

Negative pressure wound dressings are neither more nor less effective than standard wound dressings for severe open fractures of the lower leg. Any difference between groups was neither clinically important nor statistically significant. The outcomes included self-rated disability at one year, quality of life and deep surgical site infections at one month which occurred in …

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Early use of tranexamic acid reduces bleeding more effectively

In people bleeding after trauma or giving birth, tranexamic acid within an hour of the start of bleeding increases the chances of survival by 72% compared with a placebo. Overall the trial data showed that at least six deaths from bleeding complications were prevented for every 1,000 people treated and potentially more if treatment is …

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Two common operations to fix a broken tibia have similar outcomes

In people who had broken the lower part of their tibia (shin bone), fixation using a metal rod nailed to the inside of the bone was compared with a locking plate screwed onto the surface of the bone. There was no difference in the quality of life, disability or pain at 12 months for people who …

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Simple preventive actions by parents linked to fewer child injuries

Education is promoted as a way to tackle the scale of avoidable injuries to young children. Children have two to five times the risk of an accident leading to injury if a parent leaves them on a raised surface, places hot drinks within reach, or does not put medicines away straight after use. For example, …

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