bluuebunny/crossref_metadata_2025 huggingface dataset:
COMBINED RADIOCARPAL INTERCARPAL ARTHRODESIS
Authors: Rayan Ghazi M , Clark Gaylord L
Published: April 2021

ABSTRACT: Nineteen patients with disabling radiocarpal arthritis were treated over a period of 10 years with wrist arthrodesis. Three patients died for reasons not related to their surgery, and two were lost to followup. Of the 14 patients studied, 10 were treated with a surgical technique, consisting of intercarpal fusion with cancellous bone grafts combined with inner iliac corticocancellous bone graft fixation using cancellous screws. All patients studied were evaluated using a 100 point scale evaluation system: 13 patients scored above 90 with excellent results, and the remaining one patient scored 70 with a fair result. The one patient's lower score was related to his preoperative reflex sympathetic dystrophy. All patients had solid fusion, postoperative functional improvement, and were satisfied. This combined technique also provides a short recuperation period.
EVALUATION OF THE PRITCHARD TOTAL ELBOW ARTHROPLASTY
Authors: Rosenfeld Samuel R , Anzel Sanford H
Published: April 2021

ABSTRACT: Total elbow arthroplasty is a valuable therapeutic modality in incapacitating degenerative joint disease from rheumatoid arthritis. This study is a retrospective analysis of 17 elbow arthroplasties in 13 patients with rheumatoid arthritis using the Pritchard elbow prosthesis. The Pritchard elbow prosthesis has several distinctive design features. This is a semiconstrained prosthesis that has abduction, adduction and rotational capabilities. The prosthesis requires minimal bone resection, providing significant inherent stability. Patient selection for this study has been limited to incapacitating degenerative joint disease from rheumatoid arthritis. The grading system of Pritchard has been adopted to evaluate the results of this study. Greater than 94% of the patients obtained excellent and good results. All of the patients were satisfied with their results. Complications included transient ulnar neuropathy, humerus fracture, and Mark I humeral component fracture. There were no infections and no loosening. The complications reflected technical problems and design limitations of the Mark I prosthesis only. Careful patient selection is the key factor in total elbow arthroplasty.
VERTEBRAL METASTATIC CHEMODECTOMA CAUSING PARAPLEGIA: A CASE REPORT WITH A REVIEW OF THE LITERATURE
Authors: Lee Casey K , Hubschmann Otakar R
Published: April 2021

ABSTRACT: This paper presents a report of a case with vertebral metastatic chemodectoma with neurological complication who was treated successfully. A review of the literature on vertebral metastatic chemodectoma is also presented.
A Retrospective Analysis of Severe Diaphyseal Tibial Fractures Treated With External Fixation
Authors: Emerson Roger H , Grabias Stanley L
Published: April 2021

ABSTRACT: This retrospective study examines consecutively treated tibial fractures managed with external fixation methods.
Bone Block Method of Triple Arthrodesis
Authors: McCall Richard E , Mondo Paul J , Jones Richard E
Published: April 2021

ABSTRACT: Triple arthrodesis has remained an excellent therapeutic modality for many disabling foot problems. Classical arthrodesis involves excision of significant amounts of the opposing tarsal joint surfaces, a procedure that may not be necessary in all cases. Tarsal fusion by means of iliac bone block inlay grafting provides an excellent alternative in selected cases, minimizing many of the problems associated with classical triple arthrodesis, such as postoperative edema, alteration of foot shape, and pseudarthrosis.
Long Term Results of Total Hip Arthroplasty in Younger Age Group: Comparative Analysis With Young Resurfacing Arthroplasty Patients
Authors: Gustilo Ramon B , Mendoza Rex M , Burnham Wesley H
Published: April 2021

ABSTRACT: Critical analysis of 87 total hip replacement patients with 116 hips, 60 years of age and under (16 to 60), followed for five to 10 years, resulted in 89% satisfactory results and an 11% revision rate. Complications requiring revision surgery were: loss of femoral component (five hips), broken femoral compartment (two hips), loosening of both acetabular component (two hips), and loosening of acetabular component alone (one hip). Revision rate in patients 40 years and under was 15.4%, compared to 6.7% of patients 41 to 60 years of age. Complication of loosening was directly related to activity level of patients. Comparing conventional total hip arthroplasty versus resurfacing arthroplasty, the revision rate was 11% and 21.3% respectively, with shorter followup in the latter group.
Hip Arthroplasty in Patients With Tabetic Charcot Joints
Authors: Gerhart Tobin N , Scott Richard D
Published: April 2021

ABSTRACT: The results of 10 hip procedures in seven patients with Charcot arthropathy secondary to tabes dorsalis were reviewed clinically and radiographically. Three total hip replacements, three cemented Moore prostheses, two cup arthroplasties, one girdlestone, and one fusion were performed. All patients except one had significant pain as a predominant preoperative symptom. Followup ranged from three to 10 years (average 5.3 years). All three total hip replacements remained dislocated after repeated closed reduction. One Moore prosthesis was chronically dislocated, one subluxed, and one loosened. Both cup arthroplasties dislocated, but one remained reduced after closed reduction. There was long term improvement in all hips only in the pain category. Function, walking, and motion were not improved. Despite overall hip ratings of poor or failure in nine of 10 hips, patients were satisfied in seven of 10 hips. Key words: hip arthroplasty, Charcot arthropathy, tabes dorsalis.
Secondary Infection of a Total Hip Replacement With Brucella Abortus
Authors: Jones Richard E , Berryhill William H , Smith James , Hofmann Aaron , Rogers David
Published: April 2021

ABSTRACT: A 54-year-old dairy farmer developed systemic manifestations of brucellosis five months following total hip replacement. Initial medical treatment with tetracycline relieved his systemic symptoms; however, hip symptoms persisted up to two years later. At surgery, a culture of the hip grew Brucella abortus. Subsequent treatment with parenteral antibiotics and a one-stage total hip revision utilizing streptomycin-impregnated cement was performed. The patient has remained symptom free at 36 months following the revision arthroplasty.
Arthroscopy and the Maquet Proximal Tibial Osteotomy
Authors: Tippett Joe W
Published: April 2021

ABSTRACT: This paper describes the techniques for combining arthroscopic treatment of unicompartmental osteoarthritic knees and proximal tibial osteotomy.
Failed Total Knee Prosthesis Secondary to Metal Hypersensitivity
Authors: Kumar Prem , Bryan Christopher E , Bowler James , D'Ambrosia Robert
Published: April 2021

ABSTRACT: A 56-year-old white man with metal hypersensitivity that led to failure of a total knee prosthesis is presented. History of rash from wearing jewelry should increase one's suspicion of a metal allergy. Laboratory tests to verify this allergy are presented. When considering revision surgery for a failed prosthesis, metal allergy should be included in the differential as a cause for failure.
A Computer Model of Slipped Capital Femoral Epiphysis: Causes of Fixation Error and Chondrolysis
Authors: Nuzzo Roy M
Published: April 2021

ABSTRACT: Penetration of the joint by metal pins can occur when treating slipped capital femoral epiphysis. Predisposing factors are present in the usual surgical methods. These include x-ray detail loss secondary to the pelvic projection and failure to obtain specific x-ray orientation to the axis of the capital epiphysis. One operative strategy to reduce these predispositions is presented. A probable mechanism of how chondrolysis can occur without joint penetration following extra capsular osteotomy is described with a theoretical remedy.

Computer disease modeling and treatment simulation are the basis of this study. The computer model, which closely simulates all degrees of the disease, suggests that SCFE deformation is caused by hip extension against anterior hip capsule contracture. The latter is also the proposed cause of chondrolysis following realignment procedures.
Immediate or Delayed Küntscher-Rodding of Femoral Shaft Fractures
Authors: Eriksson Ejnar , Wallin Claes
Published: April 2021

ABSTRACT: Early rodding of femoral fractures is preferable from an intensive care point of view. It has, however, been claimed that early rodding leads to impaired healing of the fractures, Healing time and complications in 20 fractures of the femur operated with Küntscher rods within 12 hours after injury were therefore compared with 47 fractures treated with traction for ten days and then Küntscher-rodding. No significant differences in results were found between the two groups concerning complications, but the acutely operated individuals returned to work on an average of two months earlier than the delayed group.

If proper shock treatment is given and concomitant injuries with higher priority are treated first, early Küntscherrodding does not seem to impair the healing of femoral fractures.
Bipolar Implant Shoulder Arthroplasty
Authors: Swanson Alfred B , Swanson Genevieve de Groot , Maupin B Kent , Wei Jar-Ning , Khalil Momtaz A
Published: April 2021

ABSTRACT: A bipolar implant was designed by the author in 1975 for reconstruction of the severely arthritic shoulder. It has the advantage of not requiring glenoidal component fixation, but still provides an artificial joint interface. The ball of the humeral intramedullary stemmed component articulates with a polyethylene bearing within the glenoid cup component. This bipolar prosthesis was implanted in 15 shoulders of patients who presented severe arthritic shoulder disabilities. The follow up period averaged 41 months. Nine patients had rheumatoid arthritis, and five had osteoarthritis; all presented with severe pain and joint crepitation with loss of motion. A "shoulder score" system, based on the rating of pain, activities of daily living and range ot motion, was devised to categorize the results obtained. Patients obtained greatly improved range of motion with good to excellent pain relief and very good functional restoration. Radiographically, the implant was well tolerated and there was no stem loosening. This procedure appears to be safe and efficacious for use in the severely arthritic shoulder.
Objective Anterior Cruciate Ligament Testing
Authors: Boniface Raymond J , Fu Freddie H , Ilkhanipour Kaveh
Published: April 2021

ABSTRACT: We examined subjects with the Stryker knee laxity tester as part of the clinical examination to determine its usefulness in evaluating the anterior cruciate ligament. We measured 123 athletes with no history of knee injury, as well as 30 patients with ACL injury proven by arthroscopy, and 11 injured patients with intact ACL at arthroscopy. We recorded anterior and posterior tibial displacement at 20° of knee flexion and 20 lbs force in each direction. Anterior laxity and side to side difference correlated with ACL injury; posterior and total AP laxity did not. In normal subjects, mean anterior laxity was 2.5 mm. Only 8% of normal knees had anterior laxity of 5 mm or more. Ten percent of normal subjects had a side to side difference of 2 mm or more. In ACL tears, mean laxity was 8.1 mm, with 94% measuring 5 mm or more. Of the subjects, 89% with unilateral ACL injury had an increase of 2 mm or more on the injured side. Ten of ten acute ACL tears were detected by these criteria, with no false positives. In injured knees with intact ACL, measurements did not differ significantly from normal. We found the objective knee laxity measurement to be a useful complement to clinical knee examination.
The Migration of a Broken Pin Following Fixation of the Acromioclavicular Joint: A Case Report and Review of the Literature
Authors: Lindsey Ronald W , Gutowski W Thomas
Published: April 2021

ABSTRACT: The use of smooth and threaded pins for internal fixation is often complicated by component migration, especially when employed about the acromioclavicular joint. A case report of pin breakage with subsequent migration is presented. This phenomenon occurred despite efforts to stabilize the pin corroborating the potential hazards and unpredictability of these implants. A protocol for the management of these devices, before and aftercomponent failure, is presented.
Modified Latissimus Dorsi and Teres Major Transfer for External Rotation Deficit of the Shoulder
Authors: Freund Ronald K , Terzis Julia K , Jordan Louis , Taylor Gervas
Published: April 2021

ABSTRACT: Variable impairment occurs following birth associated brachial plexus injury. Muscle transpositions have evolved in response to patient need for functional reconstruction. Loss of external rotation limits the ability to perform activities with the arm in an overhead position. A modification of the combined latissimus dorsi and teres major transfer is described by means of which increased excursion of the transfer may be achieved.
Treatment of Multiple Enchondromatosis (Ollier's Disease) of the Hand
Authors: Fatti John F , Mosher John F
Published: April 2021

ABSTRACT: The clinical treatment and results for three hands in two patients with multiple enchondromatosis Ollier's disease) are presented. Diaphyseal resection (total or subtotal) in 27 phalanges and metacarpals preceded autogenous fibular bone grafting to the defects. All bone grafts subsequently healed and were well incorporated. Hand function and cosmesis were restored satisfactorily in each case. There were no infections or recurrences.
External Fixation as a Test for Instability After Spinal Fusion L 4-S 1: A Case Report
Authors: Olerud Sven , Hamberg Mats
Published: April 2021

ABSTRACT: A case presented with severe backache after fusion of the L 4-S 1 levels; the patient became immediately painfree after external transpedicular fixation between L 4 and the sacrum. The device was kept in place for 10 weeks. After an additional 4 weeks the patient was able to return to his work after several years of sickleave. The case indicates instability as a cause of backache. Painful nonunion of a fusion can be present in spite of signs of healing on radiographs and CT-scan. External transpedicular fixation may be a good tool in assessing instability of the lower lumbar spine.
The Effect of Hydration Water Temperature on Orthopedic Plaster Cast Strength
Authors: Callahan Dennis J , Carney David J , Daddario Nicholas , Walter Norman E
Published: April 2021

ABSTRACT: The effect of hydration water temperature (dip water) on the strength of orthopedic casts is discussed. Three methods of testing are used in an attempt to detect any differences and also to assess their clinical relevance.

It was found that warmer water produced stronger casts, however, the differences were not found to be clinically relevant. It is suggested that water temperature be chosen on the basis of considerations other than strength.
Primary Rhabdomyosarcoma of Long Bone: A Case Report
Authors: Hsueh Swei , Hsih Shin-Nong , Kuo Tseng-tong
Published: April 2021

ABSTRACT: A case of embryonal rhabdomyosarcoma of the femur observed in an 11-year-old boy is reported, which simulated an osteosarcoma clinically and radiographically. To our knowledge, this is a second documented case of rhabdomyosarcoma of the long bone.
Solitary Osseous Myeloma With Polyneuropathy: Case Report and Review of the Literature
Authors: Stricker Stephen R , Mnaymneh Walid
Published: April 2021

ABSTRACT: Solitary osseous myeloma is an uncommon malignancy of bone which is distinguished from multiple myeloma by being localized and without associated monoclonal gammopathy or Bence-Jones proteinuria. This disease may present with a progressive symmetrical sensorimotor neuropathy. A recent case of localized myeloma with polyneuropathy is presented along with a review of the literature pertinent to orthopedic surgeons.
CLOSURE OF THE PHYSIS AFTER PINNING OF SLIPPED CAPITAL FEMORAL EPIPHYSIS
Authors: Stanton Robert P , Shelton Yvonne A
Published: April 2021

ABSTRACT

A study was conducted to detennine what effect pinning in situ for slipped capital femoral epiphysis (SCFE) had on the timing of subsequent closure of the growth plate. Eighty-nine patients with a SCFE were reviewed- Twenty-six patients with a unilateral SCFE were treated with closed pinning in situ; no manipulative reductions were performed. The timing of physeal closure was assessed using postoperative radiographs of both pinned and non-pinned sides. The average time until physeal closure was 12.0 months for the pinned physis and 22.2 months for the non-pinned physis. In two cases, the physes closed simultaneously, and in no patient did the non-pinned physis close earlier than the pinned physis. The pinned physes closed an average of 10.2 months (range: 0 to 22) earlier than the unpinned physes. No difference was noted in the rates of closure with different types of internal fixation. This study supports the theory that pinning SCFE in situ causes early closure of the physis.
Fibular Nonunion in Combination With Fractures of the Tibia
Authors: Ebraheim Nabil A , Savolaine Edward R , Skie Martin C , Jackson W Thomas
Published: April 2021

Abstract

Seventeen cases of fibular nonunion or delayed union were seen in our institution from 1985 to 1990. All but one of these cases were associated with nonunion of the tibia which was diagnosed radiologically and/or surgically. The fíbula characteristically heals before the tibia; therefore, if the fibula is slow in healing or showing nonunion, more intensive investigation of the tibia for occult nonunion, or delayed union, should be done to determine whether early surgical intervention would be necessary to avoid prolonging the course of treatment. Nonunion of the fibula may indicate instability of the fractured tibia. The authors have examined the relationship of this mutual nonunion and recommend careful observation of the fibular healing in associated fractures of the tibia and fibula.
The Thoracic Outlet Syndrome
Authors: Fechter Joel D , Kuschner Stuart H
Published: April 2021

Abstract

The thoracic outlet syndrome is a compressive neurovascular condition of the upper extremity. The neurologic, arterial, and venous structures may be affected individually or in combination in any given patient. Multiple surgical and medical subspecialists may be involved in the care of these patients, including orthopedic, vascular, and thoracic surgeons, neurosurgeons, and neurologists. The topic is extremely controversial; some authors believe that this is a very common condition, while others question the existence of the syndrome. There is disagreement concerning the diagnosis, workup, and proper therapeutic management. The purpose of this article is to critically review and analyze the literature on this subject.
THE TREATMENT OF OLECRANON FRACTURES BY EXCISION OF FRAGMENTS AND REPAIR OF THE EXTENSOR MECHANISM: HISTORICAL REVIEW AND REPORT OF 12 FRACTURES
Authors: Inhofe Perry D , Howard Thomas C
Published: April 2021

ABSTRACT

The operative treatment of olecranon fractures is controversial. Proponents of open reduction and internal fixation cite restoration of anatomy and rigid fixation, while proponents of excision of fracture fragments with repair of the extensor mechanism cite few complications and a rapid return of motion and function. An extensive review of the literature is presented, outlining the arguments in favor of each procedure. A series of cases is also presented. We report the results after excision of fragments and repair of the extensor mechanism for all 17 patients who underwent this procedure during the past 10 years at our hospitals. Evaluation included subjective, clinical, and radiographic assessment to provide a clinical score. Among the 12 patients with sufficient follow up to be rated, there were 7 excellent results, 4 good results, and 1 poor result. There were no complications. Our patients had a rapid return of motion and function with a rapid return to the preinjury level of activity. We believe the indications for this procedure may be even broader than suggested in the literature.
MODIFIED EXPOSURE FOR PRONATOR SYNDROME DECOMPRESSION: A PRELIMINARY EXPERIENCE
Authors: Gainor Barry J
Published: April 2021

ABSTRACT

Because hypertrophic and symptomatic scarring is not infrequent from a lazy S incision across the antecubital fossa, a new surgical approach to the pronator tunnel has been developed. Preliminary experience with this modified incision has proven to be encouraging in seven cases (five patients). The exposure is composed of two off-set linear incisions which allow visualization of the median nerve and brachial artery distal and proximal to the lacertus fibrosis. An intact bridge of skin at the antecubital fossa protects the medial cutaneous nerves of the arm and forearm from injury. The median nerve is exposed by splitting the pronator teres along its length, and fractional step cutting of the pronator aponeurosis relaxes the muscle. Postoperative scar management with a compressive wrap and elastomer insert is helpful for cosmetic healing of the incisions.
Tourniquet Pressures on Pediatric Patients: A Clinical Study
Authors: Lieberman James R , Staheli Lynn T , Dales Mark C
Published: April 2021

ABSTRACT

A clinical study was undertaken to evaluate pneumatic tourniquet pressures required for hemostasis in extremity surgery of pediatric patients. Occlusion pressures were measured by Doppler, and tourniquet pressures were set 50 mm above this value. Of 29 cases, 86% were determined to provide adequate hemostasis throughout the procedure. Maximum mean pressures used in the upper and lower extremity groups were 173.4 ± 11.6 mm Hg (range: 155 to 190 mm Hg) and 176.7 ± 28.7 mm Hg (range: 140 to 250 mm Hg), respectively, accounting for adjustments made to inadequate initial settings. This study suggests that lower tourniquet pressures than previously used may be needed to maintain adequate hemostasis in pediatric patients.
The Effect of Femoral Component Rotation and Asymmetry in Total Knee Replacements
Authors: Worland Richard L , Jessup Douglas E , Johnson Gonzalo Vazquez-Vela , Alemparte Jose Antonio , Tanaka Sakae , Rex Francisco Soza , Keenan Jonathan
Published: April 2021

Abstract

Between April 1999 and February 2000, femoral component rotation and asymmetry (universal versus anatomic) were studied in a prospective randomized control trial in 101 consecutive patients undergoing total knee replacement. Patients were randomly assigned to four groups. The same surgical technique was used in all patients except for femoral component symmetry and rotational alignment.

Universal femoral components provide a cheaper and equally reliable solution compared to anatomic components. External rotation of the femoral component or using an anatomic femoral component did not statistically reduce the need for lateral release or improve patellar tracking.
Social and Economic Benefits of Flexible Intramedullary Nails in the Treatment of Pediatric Femoral Shaft Fractures
Authors: Greisberg Justin , Bliss Mary J , Eberson Craig P , Solga Patricia , d'Amato Charles
Published: April 2021

Abstract

All patients between the ages of 5 and 15 years with isolated femoral shaft fractures treated at our institution with flexible intramedullary nails between 1996 and 1998 were examined and compared to an age-matched group of patients treated with spica casting. All fractures healed well with no significant complications. Patients treated with flexible intramedullary nails achieved earlier independent ambulation, at an average of 19 days, compared to 106 in the control group (P<.0001). They also attained earlier independent bathroom use (21 versus 79 days, P<.0001). Hospital stays were significantly shorter as well (6 versus 29 days, P<.0001). These patients also returned to school earlier, at 28 days postinjury, compared to 120 days for patients in spica casts (P<.0001).

The use of flexible intramedullary nails allowed patients and their families to achieve independence months earlier than the spica cast patients. Earlier return to school, independent ambulation, and independent bathroom use are advantages of this treatment modality.
Musculoskeletal Trauma in Four-Wheeled All-Terrain Vehicles
Authors: Rios-Reboyras Luis A , Grovis Jorge E , Ramirez Norman , Zierenberg Charles , Otero Antonio , Vilella Fernando E
Published: April 2021

Abstract

A longitudinal study of four-wheeled all-terrain vehicle-related musculoskeletal injuries requiring orthopedic surgery was performed. Avoidable risk factors such as alcohol intake, lack of helmets, inexperience, and excess speed were identified. This study also shows that the quantity, severity, cost, and frequency of preventable accidents while riding continue to be the same as prior to a Consent Decrees issued by the Consumer Products Safety Commission >10 years ago.
Spinal Applications of Bioabsorbable Implants
Authors: Vaccaro Alexander R , Madigan Luke
Published: April 2021

Abstract

With the increasing use of bioabsorbable implants in a variety of clinical conditions, potential advantages in select spinal applications are now being realized. Newer polymers with biomechanical properties relevant to the requirements of specific spinal implants and resorption rates appropriate for specific spinal applications are being developed. These new materials offer the necessary biomechanical stability of conventional spinal implants without the sequelae associated with metallic implants such as long-term loosening, implant migration, and imaging interference. At this time, the majority of clinical applications for these new polymers have involved tension band plating in the lumbar and anterior cervical spine, anterior spinal interbody reconstruction, posterior bone graft containment, and bone graft harvest site reconstruction.
Feasibility of a Resorbable Anterior Cervical Graft Containment Plate
Authors: Ames Christopher P , Crawford Neil R , Chamberlain Robert H , Cornwall G Bryan , Nottmeier Eric , Sonntag Volker K H
Published: April 2021

Abstract

In this article we review the background of anterior cervical plating for one- and two-level diskectomy for degenerative disease and provide background justification for the design and testing of a cervical plate composed of a resorbable material. The design of the plate is discussed with special reference to modifications of implant design and implant tools compared with metallic plates that are necessary because of the different mechanical properties of the less rigid material. Our cadaveric and animal in vivo testing methodologies are described and a novel testing method for reliably quantifying graft containment is also described. Data from a representative sample are presented. Advantages and disadvantages of resorbable plating are discussed.
Bioresorbable Polymer Implants in the Unilateral Transforaminal Lumbar Interbody Fusion Procedure
Authors: Lowe Thomas G , Coe Jeffrey D
Published: April 2021

Abstract

Sixty patients from two centers have undergone instrumented transforaminal posterior lumbar interbody fusion (TLIF) with bioresorbable polymer cages and autograft bone for degenerative indications. This article discusses the technique of TLIF and its early outcomes. Although follow-up is short and results are preliminary, no adverse events or complications may be attributed to the bioresorbable polymer. Further multicenter clinical studies are underway with a minimum of 2 years of follow-up chosen as an endpoint to provide insight as to the future of biodegradable polymers as spinal interbody devices.
Update on Cartilage Repair
Authors: O'Driscoll Shawn
Published: April 2021

Orthopedics recently had an opportunity to speak with Dr Shawn O'Driscoll, President of the International Cartilage Repair Society, on the current status of cartilage repair.
Minimal Incision Acromioplasty
Authors: Cabot Anthony , Cabot Jennifer C
Published: April 2021

Minimal incision acromioplasty is a minimally invasive approach that uses an interscalene block and allows patients to return home the same day. The rapid rehabilitation, cost-effectiveness, and technical simplicity of minimal incision acromioplasty make it an attractive and effective alternative to arthroscopic acromioplasty and rotator cuff repair.
The Effect of Implant Constraint on Results of Conversion of Unicompartmental Knee Arthroplasty to Total Knee Arthroplasty
Authors: Miller Michael , Benjamin James B , Marson Blake , Hollstien Steve
Published: April 2021

Abstract

A series of unicompartmental knee arthroplasty (UKA) revision to total knee arthroplasty (TKA) was compared to a group of primary TKAs performed at the same institution. The UKA revision group had a higher incidence of local wound complications and inferior clinical results as measured by Knee Society scores. When the revisions were stratified by the degree of interface constraint, knees revised with posterior cruciate ligament (PCL) substituting designs had superior knee scores that were comparable to the primary group. The use of a PCL-substituting knee design is recommended when converting a UKA to TKA.
Medial Clavicle Physis Fracture With Posterior Displacement and Vascular Compromise: The Value of Three-Dimensional Computed Tomography and Duplex Ultrasound
Authors: Hanby Charles K , Pasque Charles B , Sullivan J Andy
Published: April 2021

Fractures of the medial clavicle are rare, and most usually displace anterior or superior. Due to the structures in the mediastinum, accurate diagnosis of posterior fractures or dislocations is vital, but diagnosis can be difficult and delayed. Duplex ultrasound and three-dimensional computed tomography can be helpful in making the diagnosis.
Acute Displaced Femoral Shaft Fracture in a Football Player
Authors: Richter Howard , Temple H Thomas
Published: April 2021

Stress fractures occur when an imbalance between bone injury and bone remodeling is present If not treated with stress unloading, an acute fracture can occur.
Biomechanical Stability of Different Fixation Constructs for ORIF of Radial Neck Fractures
Authors: Capo John T. , Svach David , Ahsgar John , Orillaza Nathaniel S. , Sabatino Christopher T.
Published: April 2021

Radial head and neck fractures are common and at times require operative fixation. There is no consensus on the ideal fixation construct for unstable radial neck fractures. Using 7 fresh frozen cadaveric radii, fractures of the radial neck were created 2 cm from the articular surface. The fractures were stabilized with 5 different commonly used constructs: crossed K-wires; a 2.4-mm T-plate using screws in the head (T-plate and nonlocked screw construct); a T-plate using a screw and locked buttress pin in the head (T-plate and locked buttress pin construct); a T-plate with an interfragmentary screw from the shaft retrograde, through the plate into the head (retrograde interfragmentary screw construct); and a T-plate with an interfragmentary screw from a nonarticular portion of the head antegrade into the shaft (antegrade interfragmentary screw construct). All constructs were tested for bending and torsional rigidity using an Instron mechanical testing machine (Model 306; MTS Systems, Eden Prairie, Minnesota). The highest rigidity in both bending and torsion was the antegrade interfragmentary screw construct. During bending, the antegrade interfragmentary screw construct was significantly stronger than a T-plate and nonlocked screw construct. In torsion, the retrograde interfragmentary screw construct was significantly stiffer than K-wires and approached significance over a T-plate and locked buttress pin construct. Locking bolts vs screws into the head did not significantly increase rigidity in torsion or bending. In this model, plating showed an increase in stiffness in torsional loading as compared to K-wires. The addition of a lag screw across the neck fracture consistently showed an increase in torsional and bending stiffness of the constructs. These data may assist orthopedic surgeons in determining the best fixation for radial neck fractures.
Interreader Agreement on Comprehensive Essay Examinations
Authors: Nichols Elizabeth G , Miller Georgia K
Published: April 2021

ABSTRACT

Examination of faculty interreader reliability on essaytype comprehensive examinations revealed an overall agreement rate of 85.6%. No significant differences in agreement were found between departments. Examination of reader characteristics for those exams with 100 points variation between readers revealed no consistent differences. The findings support the use of one format with a structured scoring protocol for evaluating diverse clinical specialties.
Clinical Competencies of Baccalaureate Students
Authors: Field William E , Gallman LaVerne , Nicholson Ruth , Dreher Mitzi
Published: April 2021

ABSTRACT

Clinical Competencies of new graduates from baccalaureate programs have periodically been criticized by employers of new graduates. In an effort to understand the levels of clinical preparation for new baccalaureate graduates, three hypotheses dealing with the cognitive, affective, and psychomotor domains were tested. A review of the literature reveals that most exploration and work has been done relative to the cognitive domain.

Sixty-four NLN accredited baccalaureate programs responded to a request that they provide all of the clinical objectives used in their program. Findings revealed that there were clinical evaluation criteria written at all levels of the three domains; however, most schools did not have objectives at each of the levels of the three domains. A disproportionately large number of clinical objectives are written at the cognitive domain. The study raises the question as to the abilities of students to be clinically proficient upon graduation when there are relatively few evaluation criteria written in the psychomotor domain.
Combining Community Health and Psychosocial Nursing: A Clinical Experience With the Homeless for Generic Baccalaureate Students
Authors: Anderson Judith A , Martaus Therese M
Published: April 2021

ABSTRACT

A report is made of a teaching approach which combined community health and psychosocial nursing clinical experiences for senior level, generic, baccalaureate nursing students over a period of two academic quarters. An urban community center and shelter for the homeless was the setting for this unique clinical approach. Areas on which the evaluation of the clinical experience focused included the clinical design, student activities, types of clients seen, and student and faculty views. Strengths and limitations of the experience were identified. The progression of the student group in adapting to the homeless population was described in detail. Faculty concluded that by sharing their clinical expertise in this combination clinical setting with the homeless, generic students were able to maximize and coordinate their academic and clinical activities. The homeless setting is demonstrated to be an excellent arena for student learning when faculty provide structure, support, and guidance.
Developing an Evening Clinical Experience for Baccalaureate Community Health Nursing Students
Authors: Rajek Nancy J
Published: April 2021

ABSTRACT

With the ever-changing directions in health care delivery, baccalaureate nursing instructors are being challenged with the task of seeking out innovative approaches to community health nursing clinical experiences. With the focus on "community as client," an evening clinical program was designed and piloted for nontraditional nursing students who, because of daytime employment, were in need of evening courses to further their nursing education. The pilot project incorporated family nursing care, community-centered practice, and observational experiences. The evening community health nursing clinical experience was found to be mutually beneficial to clients and students and served to fill a gap in health teaching within the community.
Oral Health Care for Hospitalized Patients: The Nurse's Role
Authors: Miller Rosalie , Rubinstein Linda
Published: April 2021

ABSTRACT

Oral health care is an essential component of daily hygiene for hospitalized patients, and nurses have an important role in helping patients maintain an acceptable level of oral health. This study tested the hypothesis that nursing students are graduating with an insufficient knowledge of oral health care for hospitalized patients. Four groups of senior nursing students comprised the study sample. Study data reveal gaps in the subjects' knowledge of and rationale for oral health care procedures for hospitalized patients. However, the subjects also indicated a high level of interest in improving their ability to offer appropriate oral care services. In addition to study findings, an oral health care instructional unit outline for nursing students is presented.
Development and Evaluation of Classroom Tests: A Practical Application
Authors: Flynn Mary Kay , Reese Jean L
Published: April 2021

ABSTRACT

This manuscript describes the concerns of a 15-member faculty group in a team-taught undergraduate nursing course regarding the quality of its classroom tests. A process of systematic evaluation spanning several semesters resulted in changes both in testing and, subsequently, in the grading policy. The primary goal of the changes was to strengthen the validity and reliability of tests which, in turn, would increase test fairness for the students. Discussion areas include 1) reliability and validity; 2) difficulty and discrimination indices; 3) effects of poor-item elimination; and 4) determination of cut scores. Explanations of how testing and measurement principles were applied occurs in each area.
A Lack of Autonomy in the Contemporary Nursing Student: A Comparative Study
Authors: Boughn Susan
Published: April 2021

ABSTRACT

The purpose of this study is to determine whether or not female nursing students are as autonomous as female students in both traditional female occupations and nontraditional occupations. The population included 1,046 undergraduate, female students enrolled in bachelor's degree programs at a state college. Students who participated in the study were from the schools of nursing, education, business and arts and sciences. The two instruments used to measure the characteristics of autonomy, masculinity, and femininity, were the Krutines Autonomy Scale and a modified Bern Sex-Role Inventory Scale.

Students from the schools of nursing and education received the lowest scores on autonomy and masculinity and the highest scores on femininity. Students in the school of nursing scored significantly lower in autonomy and masculinity and significantly higher in femininity than the students from the School of Business and the School of Arts and Sciences. There was no significant difference between the scores of students in the School of Nursing and the School of Education. No significant correlation was found between the variables of parent's occupation. Grade Point Average (GPA), Scholastic Aptitude Test (SAT) scores or feminine scores and the autonomy scores. However, there was a strong correlation between masculinity and autonomy scores.
Using Microcounseling to Teach RN Nursing Students Skills of Therapeutic Communication
Authors: Daniels Thomas G , Denny Annette , Andrews Dorothy
Published: April 2021

ABSTRACT

This study assessed the degree to which nursing students acquired and retained six generic skills of communication. Fifty-three second year female RN students were randomly assigned to either an experimental group (E-group) which received microtraining, or a nonattention control group (C-group). All subjects completed both the Carkhuff Indices of Communication and Discrimination as pretests. The E-group then had approximately 25 hours of microtraining in six basic communication skills. Following training, each subject completed the Carkhuff Indices again, the Empathy Construct Rating Scale, and a 10- to 15minute audiotaped interview in which she assumed the role of a helping nurse.

Multivariate analysis of covariance indicated a significant main effect suggesting that the ?-group performed better than the C-group when all the measures were combined together. As well, the experimental trainees performed significantly better than the control trainees on empathy, reflection of feeling, and summarizing. The Egroup made fewer communication errors, asked fewer closed-questions, made more Good responses, and showed a significant increase in empathy over training.

At the nine-month follow-up, while there were no statistically significant differences between the groups on any dependent measure, the ?-group outperformed the C-group on all dependent measures.
The Development and Validation of a Scale Measuring Effective Clinical Teaching Behaviors
Authors: Zimmerman Lani , Westfall Joan
Published: April 2021

ABSTRACT

The purpose of this methodological study was to describe the development and validation of an instrument that would measure effective clinical teaching behaviors of nursing faculty. Two hundred eighty-one nursing students evaluated their clinical instructors using a 43-item Likert scale entitled "Effective Teaching Clinical Behaviors" (ETCB), and data were used to test the validity and reliability of the instrument. Content validity of the scale is adequately documented, and factor analysis suggests that the tool is measuring one major factor, "effective clinical teaching behaviors." Internal consistency and test-retest reliability coefficients achieved satisfactory standards for reliability. Alternate scales reliability coefficient was also satisfactory. The ETCB fills a void in the instrumentation available for clinical instructors. Since students are the direct recipients of instruction, it seems imperative that a valid and reliable scale be available for them to evaluate their instruction.
Effect of a CVIS Instructional Program Regarding Therapeutic Communication on Student Learning and Anxiety
Authors: Rickelman Bonnie , Thylor-Fox Jan , Reisch Joan , Payne Patricia , Jelemensky Linda
Published: April 2021

ABSTRACT

This quasiexperimental, pretest-posttest design study explored the effect of a computer video-interactive system (CVIS) instructional program regarding therapeutic communication on senior baccalaureate nursing students' learning and anxiety as they anticipated interaction with patients in psychiatric settings. The 75 subjects were randomly divided into two groups. Group I received a basic lecture and a supplementary CVIS instructional program on therapeutic communication, while Group II received the same lecture discussion on therapeutic communication and a videotape. Two hypotheses were tested, using analyses of covariance. Hypothesis I, that Group I would score significantly higher on a therapeutic communication posttest than would Group II, was supported (P<.001). This finding validates previous observations that computer-video interaction programs do enhance learners' application of knowledge. Hypothesis II, that Group I would evidence significantly less state anxiety at posttest than would Group II, was not supported. Although there were no significant differences for state anxiety scores between the groups at either pretest or posttest, these scores remained higher than reported normative state anxiety scores. This finding suggests that anticipated interaction with psychiatric patients is an anxiety-inducing situation for nursing students.
Nursing Students' Attitudes Toward AIDS
Authors: Lester Lula B , Beard Betty J
Published: April 2021

ABSTRACT

A study of 177 baccalaureate nursing students was conducted to explore their knowledge, fears, beliefs and other attitudes regarding AIDS. Lazarus' theory related to coping with threatening events provided the theoretical framework.

Students with a high fear score were less willing to care for AIDS patients, had higher knowledge scores, and were more homophobic. While 96.6% of the students felt that AIDS patients are entitled to the same care as any other patient, 49% preferred not to care for AIDS patients. Thirty-six percent thought nursing students should not be assigned to care for AIDS patients. Most of the students (70.6%) got their information about AIDS from the media.

Nursing faculty must respond by including current, correct information when instructing students about AIDS. Faculty also need to provide opportunities for students to ask questions and share their fears regarding AIDS.
Computer Anxiety in Nursing Students
Authors: Wilson Billie Ann
Published: April 2021

ABSTRACT

The purpose of the study was to estimate the prevalence and severity of computer anxiety in beginning AD and BS nursing students and to determine the effect of hands-on computer experience on computer anxiety. The sample consisted of 272 volunteer subjects from five schools of nursing in a central southern state. Computer anxiety was measured using the Computer Anxiety Index by Maurer and Simonson. Factor analysis of the index was carried out to provide construct validity for the tool. Twenty-one percent of the subjects were found to have high computer anxiety. No significant difference in computer anxiety was demonstrated between associate degree (AD) and baccalaureate (BS) students. However, subjects with more hands-on computer experience had significantly less computer anxiety.
Nursing Education, Practice, and Professional Identity: A Transcultural Course in England
Authors: Beeman Pamela B
Published: April 2021

ABSTRACT

Students from a baccalaureate program at the University of Delaware participated in a 4-week course in England, exploring nursing's role in the health care system of that country. Students observed and interacted with a variety of clients and nurses in diverse settings; they observed similarities and differences in nursing education, practice, and professional identity between nurses in England and in the United States. The course was timely and valuable - it provided students with the opportunity to enhance their awareness of another culture and it allowed them to recognize nursing's importance in global health concerns.
The Effects of a Synthesis of Nursing Practice Course on Senior Nursing Students' Self-Concept and Role Perception
Authors: Hughes Oneida , Wade Betty , Peters Margaret
Published: April 2021

ABSTRACT

This study investigated the effects of a Synthesis of Nursing Practice course on senior nursing students' self concept and perception of role competencies. Seventy senior baccalaureate nursing students enrolled in the Synthesis of Nursing Practice course participated in the study during their last semester in the program. The Tennessee SelfConcept Scale was used to measure self concept and the Slater Nursing Competencies Rating Scale was used to measure perception of role competencies. These instruments were administered at the beginning of the Synthesis of Nursing Practice course and immediately following completion of the course. A i-test was used to assess the differences between pre- and posttest group means.

The study findings indicated a significant increase in the students' self-concept (p = .10) and perceived role competencies (p = .001). Implications of the findings for nursing education are discussed.
A Systems Model Approach to Increasing Faculty Productivity
Authors: Anema Marion G , Byrd Gloria L
Published: April 2021

ABSTRACT

Faculty involvement in scholarly activities is essential for success and status of both the faculty member and the institution. This article describes the results of a 4-year project to increase scholarly productivity at Texas Woman's University College of Nursing, Dallas Center. Andreoli and Musser's (1984) systems model is the organizing framework. The process and outcomes for achieving greater productivity are described.

An essential component of determining the changes in faculty productivity was the initiation of a database system. The database provides a comprehensive list of faculty achievements. The benefits of an achievement database are described. As a result of the 4-year effort, faculty members are goal directed. They are meeting their own - and the institution's - expectations for scholarly productivity. The increases in productivity are a motivating factor from one year to the next.