PurposeDisplaced femoral neck fractures in healthy elderly patients have traditionally been managed with hemiarthroplasty (HA). Recent data suggest that total hip arthroplasty (THA) may be a better alternative.MethodsA systematic review of the English literature was conducted. Randomized controlled trials comparing all forms of THA with HA were included. Three authors independently extracted articles and predefined data. Results were pooled using a random effects model.ResultsEight trials totalling 986 patients were retrieved. After THA 4 % underwent revision surgery versus 7 % after HA. The one-year mortality was equal in both groups: 13 % (THA) versus 15 % (HA). Dislocation rates were 9 % after THA versus 3 % after HA. Equal rates were found for major (25 % in THA versus 24 % in HA) and minor complications (13 % THA versus 14 % HA). The weighted mean of the Harris hip score was 81 points after THA versus 77 after HA. The subdomain pain of the HHS (weighted mean score after THA was 42 versus 39 points for HA), the rate of patients reporting mild to no pain (75 % after THA versus 56 % after HA) and the score of WOMAC (94 points for THA versus 78 for HA) all favored THA. Quality of life measured with the EQ-5D favored THA (0.69 versus 0.57).ConclusionsTotal hip arthroplasty for displaced femoral neck fractures in the fit elderly may lead to higher patient-based outcomes but has higher dislocation rates compared with hemiarthroplasty. Further high-quality randomized clinical trails are needed to provide robust evidence and to definitively answer this clinical question.

No abstract

BackgroundThe objective of this systematic review was to evaluate the reliability and reproducibility of measurements of shortening in midshaft clavicle fractures (MSCF) using any available imaging technique.MethodsElectronic databases (PubMed, EMBASE, and Cochrane) were searched. The 4-point-scale COSMIN checklist was used to evaluate the methodological quality of studies.ResultsFour studies on reliability of measurement of MSCF were identified. These studies were of fair and poor quality. The reported intrarater reliability varied between none to fair, and intrarater reliability was minimal.ConclusionNo definite conclusions could be drawn. In order to optimize future studies and the realization of comparable results, more research is necessary to identify a standardized method of imaging and measuring.Level of Evidence III.Electronic supplementary materialThe online version of this article (10.1186/s13643-017-0614-4) contains supplementary material, which is available to authorized users.

Traumatic anterior shoulder dislocation can be associated with anteroinferior glenoid bone loss causing potential recurrent instability. We report on a 62-year-old man with a first-time traumatic anterior dislocation of the right shoulder, resulting in both an infraglenoid tubercle triceps avulsion fracture and a greater tuberosity fracture. After reduction, nonsurgical management was chosen. No inferior-oriented apprehension was noticed during follow-up, which might necessitate surgical treatment of the inferior glenoid rim. At latest follow-up, the patient had recovered his shoulder function. Avulsion fractures of the infraglenoid tubercle are uncommon lesions after an anterior shoulder dislocation and, without signs of instability, can be treated conservatively.

No abstract