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Fractures (breaks) of the thigh bone can be very painful, particularly when a child arrives in a stressful emergency environment and is undergoing assessment. Moving the child to get X‐rays or transferring the child to a special bed to support the leg in traction (keeping the leg straight) can cause additional pain, as can placing traction (a pulling force) on the broken thigh. This means that prompt provision of pain relief is an essential part of initial emergency management. This review investigated whether a nerve block, involving the injection of a freezing/numbing medication at the top of the thigh, would provide more effective pain relief than pain medicine given by mouth or into a vein (intravenously, e.g. morphine).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

A 'broken wrist' (from a fracture at the lower end of the two forearm bones) often results from a fall onto an outstretched hand in older adults and from high‐energy trauma, such as a road traffic accident, in young adults. Surgery may be considered for more seriously displaced fractures. Surgical treatment can involve the implantation of bone scaffolding materials (bone grafts and substitutes) into bony defects that may affect the stability of the fracture fragments after they have been put back into place.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Infection of bone and soft tissues can result after bone fractures. Fractures which penetrate the skin are called 'open' or 'compound'. If the skin remains intact despite the fracture, it is called 'simple' or 'closed'. If a closed fracture is treated by a surgical operation, bacteria can contaminate the wound, and cause surgical site infection. This, and other hospital‐acquired infections, can be life threatening in people following surgery for thigh and other closed long bone fractures. Antibiotics have been given routinely since the 1970s in an effort to reduce infections from bacteria such as staphylococcus. This review included 23 trials, involving a total of 8447 participants. The review found that antibiotics are effective in reducing the incidence of infection, both at the surgical‐wound site and in the chest and urinary tract. The effect of a single dose of antibiotic is similar to that from multiple doses if the antibiotic chosen is active through the period from the beginning of surgery until the wound is sealed. There were too few data available to confirm the expected tendency for increased adverse drug‐related events such as gut problems and skin reactions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Breaks in the lower (distal) end of the shin bone (or tibia) are mostly caused by high‐energy trauma, such as motor vehicle accidents. We set out to compare surgical treatment (such as putting the broken parts back into position and fixing these either by inserting a metal nail into the central cavity of the bone (nailing) or with a metal plate and securing it to the bone using screws (plating)) with non‐surgical treatment (plaster cast immobilisation). We also set out to compare different methods of surgery such as nailing versus plating.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

The bony tip of the elbow is called the olecranon. It is shaped to allow bending and straightening of the arm at the elbow. The olecranon sits directly under the skin of the elbow, which makes it vulnerable to injury and fracture (break) following a fall. When this happens, people are sometimes unable to straighten their arms. Treating this fracture usually involves an operation to re‐position the broken parts of the bone and then fix them in place using wires, pins, plates, screws and other devices.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Although uncommon, fractures of the femoral shaft (thigh bone) in children may require prolonged treatment in hospital and sometimes surgery. This can cause significant discomfort and can disrupt the lives of the children and their familles. This review compared different methods of treating these fractures. Surgical treatment comprises different methods of fixing the broken bones, such as internally‐placed nails, or pins incorporated into an external frame (external fixation). Non‐surgical or conservative treatment usually involves different types of plaster casts with or without traction (where a pulling force is applied to the leg).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

When considering that other therapies have been shown to reduce vertebral fracture rates, fluoride may not be the first choice of therapy for the treatment and prevention of osteoporotic fractures. The evidence showed an increase risk of gastrointestinal side effects and non vertebral fractures with fluoride.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Metal pins are sometimes used to apply traction or to attach other external fixation devices into broken arms or legs. These pins pierce through the skin. The way they are cared for may affect the frequency of infection. Different solutions are used for cleaning around pins, different dressings can be used, scabs may or may not be removed and massage might be used to drain fluids around them. Few clinical trials have investigated this area, and they were of poor quality. As a result, this review found no strong evidence that one pin care technique was better than any other for reducing the chance of infection and other complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Broken bones (fractures) are a major cause of disability in adults. The time taken for a bone to heal (achieve "union") is an important factor in determining recovery after an injury. A minority of fractures fail to heal at all or in an appropriate period of time. This review set out to find out whether treatment with platelet rich therapy (PRT) accelerates bone healing and reduces complications. Typically, platelet treatment involves the donation of a single venous blood sample from which the active, platelet‐rich, fraction is extracted usually by a process of centrifugation. Additional chemicals may be added to the active fraction to alter its biological and material handling properties.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

This summary of a Cochrane review presents what we know from research about the accuracy of imaging tests to detect true scaphoid fractures among suspected fractures.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Breaks (fractures) of the lower part of the thigh bone (distal femur) are debilitating and painful injuries. The reduced mobility after these injuries is also an important cause of ill‐health. Sometimes these fractures happen in people who have previously had a knee replacement; this can make treatment of the fracture more complicated.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Stress fractures are a type of overuse injury. They can be very painful and debilitating. Lower limb stress fractures are common in people undergoing military training and in athletes, particularly long distance runners. Measures to prevent stress fractures include modifications to footwear and changes to training schedules. We found some evidence that shock absorbing boot inserts help prevent stress fractures during military training. It is not clear what is the best design to use. Treatment of stress fractures generally involves a long period of activity restriction. We found some evidence that pneumatic braces may speed recovery of tibial stress fracture.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

This summary presents what we know from research about the effects of surgery compared with non‐surgical (conservative) treatments such as wearing a sling or a figure‐of‐eight bandage for two to six weeks to treat a fractured (broken) collarbone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Fractures (breaks) of the humerus are commonly treated without an operation. The indications for surgery are not completely clear, but often include open fractures (fractures exposed to contamination through the skin) or unstable fractures such as segmental fractures (where there are two or more fractures in the same bone with a free fragment in between).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

A broken collarbone (clavicle fracture) is a common injury, particularly in adolescents, and accounts for up to 4% of all fractures. Most collarbone fractures occur in the middle‐third section. These fractures are frequently treated with conservative treatments that do not involve surgery. Common conservative treatments are arm slings, strapping and figure‐of‐eight bandages.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Broken bones (fractures) are a major cause of disability in adults. The time taken for a bone to heal (achieve "union") is an important factor in determining recovery after an injury. A minority of fractures fail to heal at all or their healing takes considerably longer than expected. This review set out to find out whether treatment with ultrasound, in a variety of forms, accelerates fracture healing and reduces complications associated with new (acute) fractures. A related intervention, shockwave therapy, was also examined. Typically, ultrasound treatment involves placing a special device in contact with the skin overlying the fracture site for around 20 minutes on a daily basis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Broken kneecaps (patella fractures) account for 1% of all fractures. There are many treatments for these fractures and they can be treated with surgery or conservatively (any treatment where surgery is not used). Conservative interventions can be cast immobilisation, brace, immobilisation by traction and others. Surgery can be open or percutaneous (through a needle), can use metallic or non‐metallic implants, and the implants can be wires, screws or plates.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Fractures of the tibial plateau are injuries affecting the top end of the tibia (shin bone), which forms the lower bone surface in the knee joint. These fractures are often associated with a large amount of damage to the skin and muscle and may cause voids or defects in the bone.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Particularly in older women, a broken wrist (comprising a fracture at the lower end of the radius, one of the two forearm bones) can result from a fall onto an outstretched hand. Treatment usually includes putting the bone fragments back in place, if badly displaced, and immobilising the wrist in a plaster cast. Surgery may be considered for more seriously displaced fractures. Rehabilitation with interventions such as exercises and other physical interventions is used to help prevent complications, such as stiffness and aching, restore function and speed up recovery.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Broken bones (fractures) are very common and sometimes may take a long time to heal or in some cases may fail to heal. The resulting non‐union can result in long‐term pain and loss of function. The use of hyperbaric oxygen therapy (HBOT) has been suggested as a way to enhance healing and treat non‐union. Hyperbaric oxygen therapy involves the delivery of oxygen at high pressure to patients in a specially designed chamber (like those used for deep sea divers suffering pressure problems after resurfacing). The aim is to increase the supply of oxygen to the fracture site, which theoretically should improve healing. It should be noted that hyperbaric oxygen therapy may, albeit rarely, result in serious long‐term adverse effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

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