RESUMO
BACKGROUND: The adoption of evidence-based practice is fundamental to good medical care; it ensures that intervention is clinically effective and safe. In a world of limited healthcare resources, consideration of cost-effectiveness must, unfortunately, restrict clinicians' choice. The National Institute for Health and Clinical Excellence has, for over 10 years, developed guidance to achieve a national consensus on best practice. OBJECTIVES: This review describes the Institute's methodology, examines guidance relevant to otolaryngology and presents more recent research to update the evidence.
Assuntos
Otolaringologia/normas , Guias de Prática Clínica como Assunto , Qualidade da Assistência à Saúde , Academias e Institutos , Adenoma/cirurgia , Anquiloglossia , Ablação por Cateter , Dacriocistorinostomia , Medicina Baseada em Evidências , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Hipertrofia/cirurgia , Anormalidades da Boca/cirurgia , Otite Média com Derrame/cirurgia , Neoplasias Hipofisárias/cirurgia , Conchas Nasais/cirurgia , Reino UnidoRESUMO
The radiographic and clinical records of 95 children with nondisplaced or minimally displaced fractures of the lateral humeral condyle treated on a nonoperative protocol were reviewed. Acute nondisplaced or minimally displaced fractures were defined as < 24 h old on initial evaluation and displaced < 2 mm in three radiographic planes (anteroposterior, lateral, and internal oblique). Closed treatment and close follow-up in a long-arm cast or splint resulted in a union rate of 98% in 3-7 weeks. Two of the fractures displaced required open reduction and internal fixation and then subsequently went on to union without complications.
