The Experts below are selected from a list of 105 Experts worldwide ranked by ideXlab platform
Chungwei Christine Lin - One of the best experts on this subject based on the ideXlab platform.
-
surgical versus conservative treatment for high risk stress Fractures of the lower leg anterior tibial cortex Navicular and fifth metatarsal base a systematic review
British Journal of Sports Medicine, 2015Co-Authors: Wouter H Mallee, Hanneke Weel, Niek C Van Dijk, Maurits W Van Tulder, Gino M M J Kerkhoffs, Chungwei Christine LinAbstract:Aim To compare surgical and conservative treatment for high-risk stress Fractures of the anterior tibial cortex, Navicular and proximal fifth metatarsal. Methods Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective studies. Two reviewers independently extracted data and assessed methodological quality. Main outcomes were return to sport and complication rate. Results 18 studies were included (2 anterior tibia (N=31), 8 Navicular (N=200) and 8 fifth metatarsal (N=246)). For anterior tibial Fracture, no studies on initial surgery were eligible. Conservative treatment resulted in high complication rates and few cases returned to sport. For Navicular Fracture, a weighted mean return to sport of 22 for conservative and 16 weeks for surgical treatment was found. Six weeks of non-weightbearing cast was mostly used as conservative treatment. Surgical procedures varied widely. For the fifth metatarsal Fracture, weighted mean return to sport was 19 for conservative and 14 weeks for surgical treatment. Surgery consisted of intramedullary screw fixation or tension band wiring. For conservative methods, insufficient details were reported. Overall, there was a high risk of bias; sample sizes were small and GRADE level of evidence was low. Conclusions Strong conclusions for surgical or conservative therapy for these high-risk stress Fractures cannot be drawn; quality of evidence is low and subjected to a high risk of bias. However, there are unsatisfying outcomes of conservative therapy in the anterior tibia. The role of initial surgery is unknown. For the Navicular, surgery provided an earlier return to sport; and when treated conservatively, weightbearing should be avoided. For the fifth metatarsal, surgery provided the best results. Treatment decision-making would greatly benefit from further prospective research. Study registration number PROSPERO database of systematic reviews: CRD42013004201.
Wouter H Mallee - One of the best experts on this subject based on the ideXlab platform.
-
surgical versus conservative treatment for high risk stress Fractures of the lower leg anterior tibial cortex Navicular and fifth metatarsal base a systematic review
British Journal of Sports Medicine, 2015Co-Authors: Wouter H Mallee, Hanneke Weel, Niek C Van Dijk, Maurits W Van Tulder, Gino M M J Kerkhoffs, Chungwei Christine LinAbstract:Aim To compare surgical and conservative treatment for high-risk stress Fractures of the anterior tibial cortex, Navicular and proximal fifth metatarsal. Methods Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective studies. Two reviewers independently extracted data and assessed methodological quality. Main outcomes were return to sport and complication rate. Results 18 studies were included (2 anterior tibia (N=31), 8 Navicular (N=200) and 8 fifth metatarsal (N=246)). For anterior tibial Fracture, no studies on initial surgery were eligible. Conservative treatment resulted in high complication rates and few cases returned to sport. For Navicular Fracture, a weighted mean return to sport of 22 for conservative and 16 weeks for surgical treatment was found. Six weeks of non-weightbearing cast was mostly used as conservative treatment. Surgical procedures varied widely. For the fifth metatarsal Fracture, weighted mean return to sport was 19 for conservative and 14 weeks for surgical treatment. Surgery consisted of intramedullary screw fixation or tension band wiring. For conservative methods, insufficient details were reported. Overall, there was a high risk of bias; sample sizes were small and GRADE level of evidence was low. Conclusions Strong conclusions for surgical or conservative therapy for these high-risk stress Fractures cannot be drawn; quality of evidence is low and subjected to a high risk of bias. However, there are unsatisfying outcomes of conservative therapy in the anterior tibia. The role of initial surgery is unknown. For the Navicular, surgery provided an earlier return to sport; and when treated conservatively, weightbearing should be avoided. For the fifth metatarsal, surgery provided the best results. Treatment decision-making would greatly benefit from further prospective research. Study registration number PROSPERO database of systematic reviews: CRD42013004201.
Lyndon Mason - One of the best experts on this subject based on the ideXlab platform.
-
a review of the management and outcomes of tarsal Navicular Fracture
Foot and Ankle Surgery, 2020Co-Authors: Daniel Marshall, Robert J Macfarlane, Andrew Molloy, Lyndon MasonAbstract:Fractures of the Navicular are uncommon. This review focusses on the anatomy, classification, surgical management, post-operative rehabilitation, and outcomes of tarsal Navicular Fractures, to better inform decision making for clinicians managing these injuries. This review does not discuss Navicular stress Fractures because of the differing aetiology compared to other Fractures of the Navicular.
Maurits W Van Tulder - One of the best experts on this subject based on the ideXlab platform.
-
surgical versus conservative treatment for high risk stress Fractures of the lower leg anterior tibial cortex Navicular and fifth metatarsal base a systematic review
British Journal of Sports Medicine, 2015Co-Authors: Wouter H Mallee, Hanneke Weel, Niek C Van Dijk, Maurits W Van Tulder, Gino M M J Kerkhoffs, Chungwei Christine LinAbstract:Aim To compare surgical and conservative treatment for high-risk stress Fractures of the anterior tibial cortex, Navicular and proximal fifth metatarsal. Methods Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective studies. Two reviewers independently extracted data and assessed methodological quality. Main outcomes were return to sport and complication rate. Results 18 studies were included (2 anterior tibia (N=31), 8 Navicular (N=200) and 8 fifth metatarsal (N=246)). For anterior tibial Fracture, no studies on initial surgery were eligible. Conservative treatment resulted in high complication rates and few cases returned to sport. For Navicular Fracture, a weighted mean return to sport of 22 for conservative and 16 weeks for surgical treatment was found. Six weeks of non-weightbearing cast was mostly used as conservative treatment. Surgical procedures varied widely. For the fifth metatarsal Fracture, weighted mean return to sport was 19 for conservative and 14 weeks for surgical treatment. Surgery consisted of intramedullary screw fixation or tension band wiring. For conservative methods, insufficient details were reported. Overall, there was a high risk of bias; sample sizes were small and GRADE level of evidence was low. Conclusions Strong conclusions for surgical or conservative therapy for these high-risk stress Fractures cannot be drawn; quality of evidence is low and subjected to a high risk of bias. However, there are unsatisfying outcomes of conservative therapy in the anterior tibia. The role of initial surgery is unknown. For the Navicular, surgery provided an earlier return to sport; and when treated conservatively, weightbearing should be avoided. For the fifth metatarsal, surgery provided the best results. Treatment decision-making would greatly benefit from further prospective research. Study registration number PROSPERO database of systematic reviews: CRD42013004201.
Gino M M J Kerkhoffs - One of the best experts on this subject based on the ideXlab platform.
-
surgical versus conservative treatment for high risk stress Fractures of the lower leg anterior tibial cortex Navicular and fifth metatarsal base a systematic review
British Journal of Sports Medicine, 2015Co-Authors: Wouter H Mallee, Hanneke Weel, Niek C Van Dijk, Maurits W Van Tulder, Gino M M J Kerkhoffs, Chungwei Christine LinAbstract:Aim To compare surgical and conservative treatment for high-risk stress Fractures of the anterior tibial cortex, Navicular and proximal fifth metatarsal. Methods Systematic searches of CENTRAL, MEDLINE, EMBASE, CINAHL, SPORTDiscus and PEDro were performed to identify relevant prospective and retrospective studies. Two reviewers independently extracted data and assessed methodological quality. Main outcomes were return to sport and complication rate. Results 18 studies were included (2 anterior tibia (N=31), 8 Navicular (N=200) and 8 fifth metatarsal (N=246)). For anterior tibial Fracture, no studies on initial surgery were eligible. Conservative treatment resulted in high complication rates and few cases returned to sport. For Navicular Fracture, a weighted mean return to sport of 22 for conservative and 16 weeks for surgical treatment was found. Six weeks of non-weightbearing cast was mostly used as conservative treatment. Surgical procedures varied widely. For the fifth metatarsal Fracture, weighted mean return to sport was 19 for conservative and 14 weeks for surgical treatment. Surgery consisted of intramedullary screw fixation or tension band wiring. For conservative methods, insufficient details were reported. Overall, there was a high risk of bias; sample sizes were small and GRADE level of evidence was low. Conclusions Strong conclusions for surgical or conservative therapy for these high-risk stress Fractures cannot be drawn; quality of evidence is low and subjected to a high risk of bias. However, there are unsatisfying outcomes of conservative therapy in the anterior tibia. The role of initial surgery is unknown. For the Navicular, surgery provided an earlier return to sport; and when treated conservatively, weightbearing should be avoided. For the fifth metatarsal, surgery provided the best results. Treatment decision-making would greatly benefit from further prospective research. Study registration number PROSPERO database of systematic reviews: CRD42013004201.
