Multicentre comparative study of Z-shape elevating-pulling reduction and skull traction reduction for treatment of lower cervical locked facets

Clinical Efficacy and Safety of Ibuprofen plus Traction, Reposition, and Hip Spica Cast in the Treatment of Developmental Dysplasia of the Hip

Objective. To assess the clinical efficacy and safety of ibuprofen plus traction, reposition, and hip spica cast in the treatment of developmental dysplasia of the hip (DDH). Methods. Between January 2019 and July 2020, 60 children with DDH treaded in department of orthopedics of our institution were assessed for eligibility and recruited. They were assigned at a ratio of 1 : 1 to receive either traction + reposition + hip spica cast plus analgesia pump (observation group) or traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen (control group). The outcome measures included clinical efficacy, pain scores, unexpected pain calls, the dosage of analgesia pump, and adverse events. Results. The two groups had similar clinical efficacy ( $P>0.05$ ). The patients given oral ibuprofen were associated with significantly lower pain scores at 24 h and 72 h postoperatively versus those without oral ibuprofen ( $P<0.05$ ). Analgesics with oral ibuprofen resulted in fewer unexpected pain calls versus analgesics without oral ibuprofen within 72 h postoperatively ( $P<0.05$ ). The application of oral ibuprofen in the analgesia pump showed great improvement in lowering the dosage of analgesia pump versus the absence of ibuprofen ( $P<0.05$ ). The incidence of adverse events was similar between the two groups of patients ( $P>0.05$ ). Conclusion. Traction + reposition + hip spica cast plus analgesia pump and oral ibuprofen effectively mitigated postoperative pain in children with DDH and reduces analgesic drug dosage with a high safety profile.

Early Management of Cervical Spine Trauma: WFNS Spine Committee Recommendations

Epidemiology, prevention, early management of cervical spine trauma and it's reduction are the objectives of this review paper. A PubMed and MEDLINE search between 2009 and 2019 were conducted using keywords. Case reports, experimental studies, papers other than English language and and unrelated studies were excluded. Up-to-date information on epidemiology of spine trauma, prevention, early emergency management, transportation, and closed reduction were reviewed and statements were produced to reach a consensus in 2 separate consensus meeting of World Federation of Neurosurgical Societies (WFNS) Spine Committee. The statements were voted and reached a positive or negative consensus using Delphi method. Global incidence of traumatic spinal injury is higher in low- and middle-income countries. The most frequent reasons are road traffic accidents and falls. The incidence from low falls in the elderly are increasing in high-income countries due to ageing populations. Prevention needs legislative, engineering, educational, and social efforts that need common efforts of all society. Emergency care of the trauma patient, transportation, and in-hospital acute management should be planned by implementing detailed protocols to prevent further damage to the spinal cord. This review summarizes the WFNS Spine Committee recommendations on epidemiology, prevention, and early management of cervical spine injuries.