Whatʼs New in Orthopaedic Trauma

Abstract

The goal of this Subspecialty Update in orthopaedic trauma is to familiarize the orthopaedic general and specialist surgeon alike on the most relevant published literature from the past year. Only clinical articles are reviewed in this essay. We will continue to place cited articles in an evidence-based context for the reader, with the understanding that a “level of evidence” for a single study cannot be the same as a recommendation for a specific treatment or diagnostic strategy for a health-care question. Many factors must be taken into consideration before such a leap of recommendation could occur, not the least of which are the quality of the particular evidence designation and the circumstances that an individual surgeon and health system bring to bear for that patient. We have expanded our search from last year to include more journals, choosing those that we believed to be most relevant to orthopaedic trauma. Our approach is strengthened by the large sample of journals that were reviewed, but it does not include all of the possible articles published globally in the field of orthopaedic trauma. We did not translate non-English-language articles, and we could feasibly review only 8814 abstracts for inclusion. Specifically, we searched the Cochrane Database, seven orthopaedic journals, one general-trauma journal, and four high-impact medical journals. We identified 318 potentially eligible studies. The complete abstracts of these 318 studies were reviewed by one of us (P.A.C.) for final inclusion. After a review of the abstracts, we summarized the salient findings of sixty-one studies (not including the 2004 Orthopaedic Trauma Association highlight papers), including seventeen Level-I studies, thirteen Level-II studies, six Level-III studies, twenty-five Level-IV studies, and zero Level-V studies. Of these, forty-one represented studies of therapy, seventeen involved prognosis, and three evaluated diagnostic tests (see Appendix). In addition to this systematic review, we …