Interlocking intramedullary nail for forearm diaphyseal fractures in adults-A systematic review and meta-analysis of outcomes and complications.

PURPOSE: The purpose of this systematic review is to examine the outcomes, complications, and potential advantages of using anatomical interlocking intramedullary nails (IMN) in the treatment of radius and ulnar shaft diaphyseal fractures in adults. METHODS: Medline, Embase, Web of Science, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were searched between January 2000 and January 2023. Studies meeting criteria were observational or randomized controlled trials evaluating outcomes in IMN for adult diaphyseal forearm fractures. Standardized data extraction was performed and a quality assessment tool was used to evaluate individual study methodology. Descriptive statistics for interventions, functional outcomes, and complications were reported. Meta-analysis was performed for patient-reported outcome measures and operative time. RESULTS: A total of 29 studies involving 1268 patients were included with 764 (60%) undergoing IMN, 21% open reduction and internal fixation (ORIF), and 9% hybrid fixation. There was no significant difference between groups in DASH and Grace-Eversmann scores. Operative time was significantly shorter in IMN compared with ORIF. The DASH scores were: 13.1 ± 6.04 for IMN, 10.17 ± 3.98 for ORIF, and 15.5 ± 0.63 in hybrids. Mean operative time was 65.3 ± 28.7 in ORIF and 50.8 ± 17.7 in IMN. Complication rates were 16.7% in the IMN group, 14.9% in ORIF, and 6.3% in hybrid constructs. There were 11 cases of extensor pollicis rupture in the IMN group. Average IMN pronation and supination were 78.3° ± 7.9° and 73° ± 5.0°, respectively. Average ORIF pronation and supination was 82.15° ± 1.9° and 79.7° ± 4.5°, respectively. CONCLUSIONS: Similar functional outcomes and complication rates along with shorter operative times can be achieved with IMN compared with ORIF. The use of IMN is promising, however, higher quality evidence is required to assess appropriate indications, subtle differences in range of motion, implant-related complications, and cost-effectiveness. Trail Registration PROSPERO (International Prospective Register of Systematic Reviews) (ID: CRD42022362353).

Retraction: Urinary Bladder Hernia: A Rare Cause of Urinary Frequency.

[This retracts the article DOI: 10.7759/cureus.20993.].

E-cigarettes and Vaping: A Smoking Cessation Method or Another Smoking Innovation?

The prevalence of using e-cigarettes (vaping) has risen rapidly since its introduction in 2007, mostly among male youth. Although research on the health risks of e-cigarettes is still limited, there is growing evidence of debilitating pulmonary conditions and general immune weakness from e-cigarettes, leading to various infections. Moreover, there are concerns that vaping could be used as a new model of cannabis consumption, increasing cannabis addiction among adolescents. With well-known health risks from traditional smoking, e-cigarettes are viewed as a safe way of smoking, appealing more to youth. Additionally, extensive e-cigarette marketing boosted by the internet and fame has resulted in worries that e-cigarettes can lead to a renormalization of cigarette smoking and can be used as a new method to consume vaporized drugs. Although the concern that e-cigarettes are as harmful as traditional smoking has been raised, youth and most healthcare providers remain relatively unaware. Therefore, this review explored the association between e-cigarettes and traditional smoking. With the introduction of e-cigarettes in the last two decades, the topic is still new and less studied. Therefore, this review will help us understand the topic to better care for e-cigarette smokers and reduce the increasing public health burden from vaping.

Urinary Bladder Hernia: A Rare Cause of Urinary Frequency.

Hernia repair is one of the most commonly performed surgical operations worldwide. Inguinal hernia is a common condition and has a high prevalence rate. Advanced age and male sex are the most important risk factors. Inguinal hernia usually presents with groin swelling with abdominal discomfort. We report the case of a 39-year-old man who presented to our urologic clinic with a complaint of urinary frequency for the last two months. This was associated with nocturia, feeling of incomplete emptying, and groin swelling. There was no history of hesitancy, intermittency, or weak stream. The patient was otherwise healthy with no significant previous medical or surgical history. Abdominal examination showed a right groin swelling with associated visible and palpable cough impulse in keeping with inguinal hernia. There was no abdominal guarding or rigidity, and the abdomen was non-tender. Examination of the genitalia was unremarkable. No abnormal findings were noted in the examination of other systems. Routine laboratory markers did not show any abnormalities. Urinalysis findings showed no leukocytes and had negative results for leukocyte esterase and nitrites. A computed tomography (CT) scan confirmed the presence of a right-sided inguinal hernia, with part of the urinary bladder seen herniating into the right inguinal canal. The patient underwent a laparoscopic surgery in which the herniated bladder was reduced and the defect was closed with a synthetic mesh. The patient recovered with no complications. Postoperatively, the patient reported significant improvement in his symptoms. Herniation of the bladder through the inguinal canal is an uncommon surgical condition. The case highlighted the importance of considering this diagnosis when they encounter a patient with unexplained lower urinary symptoms. Laparoscopic repair is a feasible and safe option if the surgical team was experienced with this approach.