bluuebunny/crossref_metadata_2025 huggingface dataset:
OPTIMISATION OF ULTRACLEAN AIR
Authors: Chosky S. A. , Modha D. , Taylor G. J. S.
Published: February 2018

The use of ultraclean air (UCA) in operating theatres reduces the infection rate after joint replacement but some cases of infection still occur. We investigated one possible source of contamination, namely the setting up of instruments in a conventional plenum-ventilated preparation room.

We measured bacterial fallout using agar settle plates and compared instruments set up in the preparation room with those set up in the UCA theatre, assessed the effect of covering instruments after preparation and compared fallout during their preparation with total fallout throughout the operation.

Our findings showed that covering the instruments reduced total bacterial fallout fourfold by reducing the exposure time, particularly during periods of increased activity and bacterial dispersal. Preparation in the UCA theatre and subsequent covering of the instruments reduced total fallout 28-fold. All measurable bacterial fallout occurred during the setting up and not during surgery.
GRAM STAIN DETECTION OF INFECTION DURING REVISION ARTHROPLASTY
Authors: Chimento G. F. , Finger S. , Barrack R. L.
Published: February 2018

We reviewed 194 revision arthroplasties of the hip and knee performed over a ten-year period. The results of intraoperative Gram staining were available in 169 (87%). Thirty-two were found to be infected (11 hips and 21 knees) and 137 had no evidence of infection.

Intraoperative Gram staining was negative in all 169 cases. The method therefore had a sensitivity of 0% for detecting infection. We conclude that the absence of organisms on intraoperative Gram staining during revision arthroplasty does not confirm the absence of infection.
Cemented total hip arthroplasty with acetabular bone graft for developmental dysplasia
Authors: Iida H. , Matsusue Y. , Kawanabe K. , Okumura H. , Yamamuro T. , Nakamura T.
Published: February 2018

Although the technique of autogenous acetabular bone grafting has been widely used to augment containment of the acetabulum in total hip arthroplasty (THA) for developmental dysplasia, the role of this technique in improving long-term results remains controversial.

We present the long-term results of cemented THA with acetabular bone grafting in 112 patients (133 hips) in order to clarify the factors which affect the outcome. The mean follow-up was for 12.3 years (8 to 24). Kaplan-Meier survivorship analysis predicted a rate of survival of the acetabular component at 15 years of 96% (95% confidence interval (CI) 92 to 99) with revision for aseptic loosening as the endpoint, and of 75% (95% CI 65 to 85) when radiological loosening was used. Parametric survivorship analysis using the Cox proportional-hazards model indicated that trochanteric nonunion, lateral placement of the socket, and delayed trabecular reorientation of the bone graft were risk factors for loosening of the acetabular component.

Our findings have shown that autologous acetabular bone grafting is of value for long-term success provided that the risk factors are reduced.
Treatment of the mobile, painful arthritic elbow by distraction interposition arthroplasty
Authors: Cheng S. L. , Morrey B. F.
Published: February 2018

Between 1986 and 1994, 13 patients with mobile painful arthritic elbows were treated by distraction interposition arthroplasty using fascia lata. The mean period of follow-up was 63 months. An elbow distractor/fixator was applied for three to four weeks to separate the articular surfaces and to protect the fascial graft.

Nine of the 13 patients (69%) had satisfactory relief from pain; eight (62%) had an excellent or good result by the objective criteria of the Mayo Elbow Performance score. Four have required revision to total elbow arthroplasty at a mean of 30 months with good results to date.

Instability of the elbow, both before and after surgery, was found to be associated with unsatisfactory results. The rate of success when the procedure was performed for inflammatory arthritis was similar to that for post-traumatic arthritis, about 67%. Eight complications occurred in six patients, all in the group with post-traumatic arthritis. Two of these required further surgical procedures such as transposition of the ulnar nerve or repair of hernia of the fascia lata.

Although less reliable than prosthetic replacement, distraction interposition arthroplasty is a useful option in the treatment of young, high-demand patients with arthritis of the elbow. It is rarely indicated in the presence of generalised inflammatory arthritis, but may be of value in those patients in whom the disease is limited primarily to the elbow.
The management of brachymetatarsia
Authors: Kim H. T. , Lee S. H. , Yoo C. I. , Kang J. H. , Suh J. T.
Published: February 2018

We treated 35 brachymetatarsal rays of 18 feet in 12 patients by one-stage lengthening with interpositional bone grafts or by gradual lengthening with callotasis combined with shortening of the adjacent metatarsals and phalanges. Definition of the two parabolas which connect the metatarsal heads and the tips of the toes, and recognition of three patterns of metatarsal length, were helpful guides in treatment. In total, 36 excisions of the phalanges and/or the metatarsals were undertaken. The mean shortening was 8 mm.

The radiological results were satisfactory. The mean values were as follows: one-stage lengthening, length gain, 1.3 cm; healing index, 1.3 months/cm; percentage increase, 30%; gradual lengthening, length gain, 2.0 cm; healing index, 2.0 months/cm; percentage increase, 50%.

Associated shortening of an adjacent bone can avoid the disadvantages of one-stage lengthening which may not achieve target length and can result in neurovascular complications. Reduction of the target length enables the surgeon to carry out one-stage instead of gradual lengthening. It also shortens the length of treatment in the group undergoing callotasis and improves cosmesis.
CANDIDA SEPTIC ARTHRITIS OF THE HIP IN A YOUNG PATIENT WITHOUT PREDISPOSING FACTORS
Authors: Kawanabe K. , Hayashi H. , Miyamoto M. , Tamura J. , Shimizu M. , Nakamura T.
Published: February 2018

We present a case of septic arthritis of the hip caused by Candida albicans in a 24-year-old woman. This is the first report of a Candida infection of the hip in a patient without any predisposing factors. She underwent a two-stage total hip arthroplasty three years after the onset of the infection. An elevated plasma level of β-D-glucan suggested Candida as the infecting organism and the diagnosis might have been made earlier if this test had been undertaken at presentation.
Direct access carpal tunnel surgery
Authors: Jarrett M. E. D. , Giddins G. E. B.
Published: February 2018

Carpal tunnel syndrome is a common condition and clinical diagnosis is often easily made. A system of direct referral for day-case carpal tunnel surgery was introduced. General practitioners, physicians and surgeons were advised of the service and the criteria for referral, which included female patients with bilateral symptoms and physical signs, and some response to conservative treatment. All patients were reviewed preoperatively by the senior author (GEBG). The service was an alternative to standard outpatient referral.

A total of 51 patients was seen. Two were refused surgery. In all those who underwent surgery, the symptoms either resolved or were improved. The service was well received, although some patients felt that they were poorly informed preoperatively. The mean waiting time for surgery was reduced by four months and the patients avoided an outpatient appointment.

Direct access day-case carpal tunnel surgery works well by reducing delays and the costs of treatment. Adequate patient information is important to make the best of the service.
Partial hemiarthroplasty for the treatment of osteonecrosis of the femoral head
Authors: Ushio K. , Oka† M. , Hyon S.-H. , Yura S. , Toguchida J. , Nakamura T.
Published: February 2018

The use of a composite osteochondral device for simulating partial hemiarthroplasty was examined. The device was composed of a polyvinyl alcohol hydrogel and a titanium fibre mesh, acting as artificial cartilage and as porous artificial bone, respectively. The titanium fibre mesh was designed to act as an interface material, allowing firm attachment to both the polyvinyl alcohol gel (through injection moulding) and the femoral joint surface (through bony ingrowth). We implanted 22 of these devices into canine femoral heads. Histological findings from the acetabular cartilage and synovial membrane, as well as the attachment of the prosthesis to bone, were examined up until one year after operation.

No marked pathological changes were found and firm attachment of the device to the underlying bone was confirmed. The main potential application for this device is for partial surface replacement of the femoral head after osteonecrosis. Other applications could include articular resurfacing and the replacement of intervertebral discs.
Extracorporeal shock-wave treatment for tennis elbow
Authors: Melikyan E. Y. , Shahin E. , Miles J. , Bainbridge L. C.
Published: February 2018

The efficacy of extracorporeal shock-wave therapy for tennis elbow was investigated using a single fractionated dosage in a randomised, double-blind study. Outcomes were assessed using the Disabilities of Arm, Shoulder and Hand questionnaire, measurements of grip strength, levels of pain, analgesic usage and the rate of progression to surgery. Informed consent was obtained before patients were randomised to either the treatment or placebo group. In the final assessment, 74 patients (31 men and 43 women) with a mean age of 43.4 years (35 to 71), were included.

None of the outcome measures showed a statistically significant difference between the treatment and control groups (p > 0.05). All patients improved significantly over time, regardless of treatment. Our study showed no evidence that extracorporeal shock-wave therapy for tennis elbow is better than placebo.
Biomechanical effects of dissecting flexor carpi ulnaris
Authors: Kreulen M. , Smeulders M. J. C. , Hage J. J. , Huijing P. A.
Published: February 2018

Our aim was to determine whether the length and function of the flexor carpi ulnaris muscle were affected by separating it from its soft tissue connections. We measured the length of flexor carpi ulnaris before and after its dissection in ten patients with cerebral palsy. After tenotomy, tetanic contraction shortened the muscle by a mean of 8 mm. Subsequent dissection to separate it from all soft tissue connections, resulted in a further mean shortening of 17 mm (p < 0.001). This indicated that the dissected connective tissue had been strong enough to maintain the length of the contracting muscle. Passive extension of the wrist still lengthened the muscle after tenotomy, whereas this excursion significantly decreased after subsequent dissection.

We conclude that the connective tissue envelope, which may be dissected during tendon transfer of flexor carpi ulnaris may act as a myofascial pathway for the transmission of force. This may have clinical implications for the outcome after tendon transfer.
Anterior acetabular head index of the hip on false-profile views
Authors: Chosa E. , Tajima N.
Published: February 2018

The vertical-centre-anterior margin (VCA) angle quantifies the anterior cover of the femoral head. However, when the femoral head is deformed it may be difficult to identify its centre. We have therefore created a new index, the anterior acetabular head index (AAHI) which is measured on the false-profile radiograph. We measured the VCA and AAHI angles in 312 hips in which the centre-edge angle was > 25°. There were 250 patients, 86 men and 164 women, whose ages ranged from 20 to 65 years. The mean AAHI was 84.1% (81.7% in women and 88.5% in men). There was a correlation between the AAHI and VCA angles. Our data suggest that the AAHI is useful in the evaluation of anterior acetabular cover and that it is higher in men than in women.
INTRAPELVIC DISLOCATION OF THE HEAD OF FEMUR THROUGH THE OBTURATOR FORAMEN ASSOCIATED WITH IPSILATERAL FRACTURE FEMUR
Authors: Farag A. W. , Shohayeb K. A.
Published: February 2018

We describe a case of traumatic anterior dislocation of the hip in a 14-year-old boy with associated intrapelvic displacement of the femoral head and ipsilateral fractures of the shaft of the femur and greater trochanter. There was a delay in presentation of eight days. At operation the femoral head was reduced into the acetabulum after enlarging the obturator foramen by performing an osteotomy of the superior pubic ramus.
Choline acetyltransferase activity and evoked spinal cord potentials for diagnosis of brachial plexus injury
Authors: Hattori Y. , Doi K. , Dhawan V. , Ikeda K. , Kaneko K. , Ohi R.
Published: February 2018

The purpose of this study is to investigate the diagnostic value of evoked spinal cord potentials (ESCPs) and choline acetyltransferase (CAT) activity during exploration of injuries to the brachial plexus. We assessed 25 spinal roots in 19 patients. The results of the two investigations were consistent in all except two roots. Although assessment of ESCPs is easy and quick, it mainly records the nerve potentials along the sensory pathway. Although measurement of CAT activity needs a specimen of the nerve and the availability of a radioisotope laboratory, it gives direct information regarding the motor function of ventral spinal roots. These two techniques should be complementary to each other in order to achieve a more accurate diagnosis.
The management of infection in arthroplasty of the shoulder
Authors: Coste J. S. , Reig S. , Trojani C. , Berg M. , Walch G. , Boileau P.
Published: February 2018

The management and outcome of treatment in 42 patients (49 shoulders) with an infected shoulder prosthesis was reviewed in a retrospective multicentre study of 2343 prostheses. The factors which were analysed included the primary diagnosis, the delay between the diagnosis of infection and treatment and the type of treatment. Treatment was considered to be successful in 30 patients (71%). Previous surgery and radiotherapy were identified as risk factors for the development of infection. All patients with an infected prosthesis had pain and limitation of movement and 88% showed radiological loosening. In 50% of the shoulders, the antibiotics chosen and the length of treatment were considered not to be optimal. The mean follow-up was 34 months. Antibiotics or debridement alone were ineffective. In acute infection, immediate revision with excision of all infected tissue and exchange of the prosthesis with appropriate antibiotic therapy gave the best results. Multidisciplinary collaboration is recommended.
Intra-operative findings in varus osteoarthritis of the knee
Authors: Ritter M. A. , Faris P. M. , Thong A. E. , Davis K. E. , Meding J. B. , Berend M. E.
Published: February 2018

Interest in unicompartmental knee arthroplasty (UKA) for the treatment of medial compartment osteoarthritis has increased in recent years with apparent improvement in the long-term results. This is a result of improved surgical technique, patient selection, and implant design. In an effort further to improve patient selection we analysed the relationship between the pre-operative alignment of the knee and the anatomical findings at the time of surgery. We compared these findings with the indications for UKA.

From 4021 total knee arthroplasties we compared intra-operative observations with the pre-operative clinical data in order to identify knees with isolated, medial, compartment changes, which would have been ideal candidates for UKA.

We found that only 247 of the knees (6.1%) met anatomical qualifications for isolated, medial, unicompartmental osteoarthritis, and of these, only 168 (4.3%) met clinical standards ideal for UKA. Pre-operative alignment showed a significant relationship with patterns of disease. Logistic regression revealed a relationship between pre-operative alignment and intra-operative findings resembling a Gaussian distribution. Patients with a pre-operative varus alignment of 7° were slightly more likely to be selected for UKA. But the further the anatomical alignment in either direction varies from 7° of varus, the more unlikely it is for the knee to exhibit a disease pattern of isolated, medial, unicompartmental osteoarthritis.
Osteochondral defects of the talus treated with autologous bone grafting
Authors: Kolker D. , Murray M. , Wilson M.
Published: February 2018

We reviewed, retrospectively, 13 patients who had undergone open anterograde autologous bone grafting of the talus for symptomatic osteochondral defects of the dome of the talus. The mean age of the seven men and six women was 38.4 years. The defects included the full thickness of articular cartilage, extended through the subchondral plate and were associated with subchondral cysts. Six patients (46%) were clinical failures requiring further surgery. Of the remaining seven, functional outcome results were obtained at a mean of 51.9 months after surgery. The mean outcome scores for the Musculoskeletal Outcomes Data Evaluation and Management System foot and ankle questionnaire and the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale were 87.0 and 84.3, respectively. There was an overall 46.2% patient satisfaction rate.

We believe that the technique of autologous bone grafting presented should be used with extreme caution, when considered as the primary treatment for the adult patient with a symptomatic advanced osteochondral defect of the talus.
Wear of the cup in the Charnley LFA in the young patient
Authors: Wroblewski B. M. , Siney P. B. , Fleming P. A.
Published: February 2018

Since wear and loosening of the ultra-high-molecular-weight polyethylene cup are factors which limit the life of an arthroplasty we have attempted to identify factors associated with either low wear (0.02 mm/year or less) or high wear (0.2 mm/year or more). In a series of 1434 Charnley low-friction arthroplasties (1092 patients) 190 (13.2%) showed low wear while 149 (10.4%) showed high wear. We used chi-squared test to assess the significance of various factors.

The significant factors of the low-wear group were female gender (p = 0.042), rheumatoid arthritis (p = 0.014), Charnley grade C (p = 0.03) and varus position of the stem (p = 0.003). The use of acetabular cement pressurisation (p = 0.07) and medialisation of the cup (p = 0.07) approached significance.

In the high-wear group there was a predominance of men (p = 0.042) with osteoarthritis (p = 0.006) as the underlying hip pathology, and the stem in a valgus position (p = 0.023). Support of the cup by the rim of the acetabulum approached significance (p = 0.07). There was no statistical significance between the two groups for revision for aseptic loosening of the stem or fracture of the stem (p = 0.49). There was a highly significant difference (p < 0.0001) between the two groups for revision for wear and aseptic loosening of the cup, 5.3% compared with 39%.

Changes in the cup geometry are probably sufficient to explain the increasing incidence of loosening and revisions with the increasing depth of penetration of the cup. There is much to be gained from the use of a low-wearing ceramic-ultra-high-molecular-weight combination. Tissue reaction to the polyethylene particles cannot be the cause of aseptic loosening of the stem.
Glenothoracic fusion
Authors: Clarke A. , Dewnany G. , Neumann L. , Wallace W. A.
Published: February 2018

We describe a surgical procedure used to achieve glenothoracic fusion after one-stage radical, near total scapulectomy for primary or secondary malignant lesions in six patients. The aim was complete excision of the lesion and preservation of the glenoid to provide a fulcrum for movement of the arm.

Post-operative assessment involved determination of the range of movement and the application of the Musculoskeletal Tumour Society score and the Constant score to evaluate function. The results showed that a functional range of movement was attainable despite such radical surgery, although there was a considerable reduction in power and ability to lift.
Congenital absence (ankylosis) of the knee
Authors: Yaniv M. , Ezra E. , Wientroub S. , Segev E.
Published: February 2018

A congenital, unilateral, fixed flexion deformity in a neonate was diagnosed as a congenital absence of the knee. A single cartilage mass, with fusion of the lower femoral and upper tibial ossification centres, was demonstrated by imaging studies. This condition has been reported in the literature only once before. Surgery on our patient, which was performed at the age of two years, consisted of separation of the fused cartilaginous anlage and gradual correction of the deformity using an Ilizarov frame.
Correction of Madelung’s deformity by the Ilizarov technique
Authors: Houshian S. , Schrøder H. , Weeth R.
Published: February 2018

We present our experience with correction of Madelung’s deformity by the Ilizarov technique. Seven patients (eight deformities) were treated by osteotomy of the radius with subsequent lengthening and angular correction. They were reviewed at a mean of 30 months (1.5 to 5.5 years). At the time of operation their mean age was 19 years (9 to 44).

At follow-up all were free from pain and supination had improved by a mean of 34° and pronation by 9°. Flexion had increased in most cases with a median increase of 15°, but only one patient gained further extension. Radial and ulnar deviation were increased by a mean of 6° and 9°, respectively. Radiographic measurements showed that the mean volar angulation had been reduced from 25° to 11°, ulnar inclination from 45° to 30° and carpal malalignment (volar translation) from 7 to 2 mm. The mean lengthening of the radius was 12 mm (6 to 25). All the patients were satisfied with the functional and cosmetic results.
Comparative analysis of risk factors for pathological fracture with femoral metastases
Authors: Van der Linden Y. M. , Dijkstra P. D. S. , Kroon H. M. , Lok J. J. , Noordijk E. M. , Leer J. W. H. , Marijnen C. A. M.
Published: February 2018

A number of risk factors based upon mostly retrospective surgical data, have been formulated in order to identify impending pathological fractures of the femur from low-risk metastases. We have followed up patients taking part in a randomised trial of radiotherapy, prospectively, in order to determine if these factors were effective in predicting fractures. In 102 patients with 110 femoral lesions, 14 fractures occurred during follow-up. The risk factors studied were increasing pain, the size of the lesion, radiographic appearance, localisation, transverse/axial/circumferential involvement of the cortex and the scoring system of Mirels. Only axial cortical involvement > 30 mm (p = 0.01), and circumferential cortical involvement > 50% (p = 0.03) were predictive of fracture. Mirels’ scoring system was insufficiently specific to predict a fracture (p = 0.36). Our results indicate that most conventional risk factors overestimate the actual occurrence of pathological fractures of the femur. The risk factor of axial cortical involvement provides a simple, objective tool in order to decide which treatment is appropriate.
Fluorosis-induced hyperparathyroidism mimicking a giant-cell tumour of the femur
Authors: Chadha M. , Kumar S.
Published: February 2018

We report the case of a young woman who, over a period of five years was diagnosed and treated for a giant-cell tumour of bone, osteomalacia and fluorosis. A review of the literature revealed a correlation between these three diagnoses, the primary pathology being fluorosis and the remaining symptoms being secondary manifestations. It is important to be aware of this association, especially in regions with endemic skeletal fluorosis.
Autologous chondrocyte implantation
Authors: Goldberg A. J. , Lee D. A. , Bader D. L. , Bentley G.
Published: February 2018

An increasing number of patients are treated by autologous chondrocyte implantation (ACI). This study tests the hypothesis that culture within a defined chondrogenic medium containing TGF-β enhances the reexpression of a chondrocytic phenotype and the subsequent production of cartilaginous extracellular matrix by human chondrocytes used in ACI. Chondrocytes surplus to clinical requirements for ACI from 24 patients were pelleted and cultured in either DMEM (Dulbecco’s modified eagles medium)/ITS+Premix/TGF-β1 or DMEM/10%FCS (fetal calf serum) and were subsequently analysed biochemically and morphologically.

Pellets cultured in DMEM/ITS+/TGF-β1 stained positively for type-II collagen, while those maintained in DMEM/10%FCS expressed type-I collagen. The pellets cultured in DMEM/ITS+/TGF-β1 were larger and contained significantly greater amounts of DNA and glycosaminoglycans. This study suggests that the use of a defined medium containing TGF-β is necessary to induce the re-expression of a differentiated chondrocytic phenotype and the subsequent stimulation of glycosaminoglycan and type-II collagen production by human monolayer expanded chondrocytes.
Total elbow arthroplasty after previous resection of the radial head and synovectomy
Authors: Whaley A. , Morrey B. F. , Adams R.
Published: February 2018

We examined the effects of previous resection of the radial head and synovectomy on the outcome of subsequent total elbow arthroplasty in patients with rheumatoid arthritis.

Fifteen elbows with a history of resection and synovectomy were compared with a control group of patients who had elbow arthroplasty with an implant of the same design. The mean age in both groups was 63 years. In the study group, resection of the radial head and synovectomy had been undertaken at a mean of 8.9 years before arthroplasty. The mean radiological follow-up for the 13 available patients in the study group was 5.89 years (0.3 to 11.0) and in the control group was 6.6 years (2.2 to 12.6). There were no revisions in either group. The mean Mayo elbow performance score improved from 29 to 96 in the study group, with similar improvement in the control group (28 to 87). The study group had excellent results in 13 elbows and good results in two. The control group had excellent results in seven and good results in six.

Our experience indicates that previous resection of the radial head and synovectomy are not associated with an increased rate of revision following subsequent arthroplasty of the elbow. However, there was a higher rate of complication in the study group compared with the control group.
Open reduction, ulnar osteotomy and external fixation for chronic anterior dislocation of the head of the radius
Authors: Hasler C. C. , Von Laer L. , Hell A. K.
Published: February 2018

We reviewed 15 patients, nine girls and six boys, with chronic anterior dislocation of the radial head which was treated by ulnar osteotomy, external fixation and open reconstruction of the elbow joint but without repair of the annular ligament. Their mean age was 9.5 years (5 to 15) and the mean interval between the injury and reconstruction was 22 months (2 months to 7 years).

All radial heads remained reduced at a mean follow-up of 20 months (6 months to 5 years). Normal ranges of movement for flexion, extension, pronation and supination were unchanged in 96.1% (49/51) and worse in 3.9% (2/51). Limited ranges of movement were improved in 77.8% (7/9), unchanged in 11% (1/9) and further decreased in 11% (1/9).There were two superficial pin-track infections and two cases of delayed union but with no serious complications. Reconstruction of the radiocapitellar joint is easier using external fixation since accurate correction of the ulna can be determined empirically and active functional exercises started immediately. Only patients with a radial head of normal shape were selected for treatment by this method.
Prospective study on diagnostic strategies in osteochondral lesions of the talus
Authors: Verhagen R. A. W. , Maas M. , Dijkgraaf M. G. W. , Tol J. L. , Krips R. , van Dijk C. Niek
Published: February 2018

Our aim in this prospective study was to determine the best diagnostic method for discriminating between patients with and without osteochondral lesions of the talus, with special relevance to the value of MRI compared with the new technique of multidetector helical CT. We compared the diagnostic value of history, physical examination and standard radiography, a 4 cm heel-rise view, helical CT, MRI, and diagnostic arthroscopy for simultaneous detection or exclusion of osteochondral lesions of the talus. A consecutive series of 103 patients (104 ankles) with chronic ankle pain was included in this study. Of these, 29 with 35 osteochondral lesions were identified. Twenty-seven lesions were located in the talus.

Our findings showed that helical CT, MRI and diagnostic arthroscopy were significantly better than history, physical examination and standard radiography for detecting or excluding an osteochondral lesion. Also, MRI and diagnostic arthroscopy performed better than a mortise view with a 4 cm heel-rise. We did not find a statistically significant difference between helical CT and MRI. Diagnostic arthroscopy did not perform better than helical CT and MRI for detecting or excluding an osteochondral lesion.
Ligamentous repair and reconstruction for posterolateral rotatory instability of the elbow
Authors: Sanchez-Sotelo J. , Morrey B. F. , O’Driscoll S. W.
Published: February 2018

We describe the intermediate results of lateral ligamentous repair or reconstruction for posterolateral rotatory instability of the elbow. Between 1986 and 1999, we performed 12 direct repairs and 33 ligament reconstructions with a tendon autograft. One patient was lost to follow-up and 44 were retrospectively studied at a mean of six years (2 to 15).

Surgery restored stability in all except five patients. In two the elbow became stable after a second procedure. The mean post-operative Mayo elbow performance score was 85 points (60 to 100). The result was classified as excellent in 19, good in 13, fair in seven and poor in five patients. Thirty-eight patients (86%) were subjectively satisfied with the outcome of the operation. Better results were obtained in patients with a post-traumatic aetiology (p = 0.03), those with subjective symptoms of instability at presentation (p = 0.006) and those who had an augmented reconstruction using a tendon graft (p = 0.04).

Reconstruction using a tendon graft seems to provide better results than ligament repair and the results do not seem to deteriorate with time. The outcome of this procedure is less predictable in patients with no subjective instability.
Intertrochanteric osteotomy combined with acetabular shelfplasty in young patients with severe deformity of the femoral head and secondary osteoarthritis
Authors: Haverkamp D. , Marti R. K.
Published: February 2018

Intertrochanteric osteotomy may postpone the need for total hip replacement (THR). In young patients with an acquired deformity of the femoral head and secondary osteoarthritis, a valgus intertrochanteric osteotomy may allow better congruency but the acetabular cover may become insufficient because of subluxation of the femoral head. In patients with a spherical femoral head and acetabular dysplasia, cover can still remain insufficient after varus displacement osteotomy. We present the long-term results of intertrochanteric osteotomy combined with an acetabular shelfplasty in both these circumstances.

Sixteen hips (15 patients) with a deformed femoral head, and ten (seven patients) with a spherical femoral head, underwent an intertrochanteric osteotomy and acetabular shelfplasty. The mean age at the time of surgery was 30 and 37 years and the mean final follow-up was 15 and 19 years, respectively. Six patients in the deformed group, but only one in the spherical group, had required a THR by the time of their final follow-up. In both groups, those who had not undergone a THR had a good result.

Acetabular shelfplasty is an excellent addition to an intertrochanteric osteotomy and gives full cover of the femoral head in patients with a deformity of the head and secondary osteoarthritis.
Prevention of dislocation of the hip in children with cerebral palsy
Authors: Hägglund G. , Andersson S. , Düppe H. , Lauge-Pedersen H. , Nordmark E. , Westbom L.
Published: February 2018

In 1994, a register for cerebral palsy and a health-care programme were started in southern Sweden with the aim of preventing dislocation of the hip in children with cerebral palsy. It involved all children with cerebral palsy born in 1992 or later.

None of the 206 affected children born between 1992 and 1997 has developed a dislocation following the introduction of the prevention programme. Another 48 children moved into the area and none developed any further dislocation. Of the 251 children with cerebral palsy, aged between five and 11 years, living in the area on January 1, 2003, only two had a dislocated hip. One boy had moved into the area at age of nine with a dislocation and a girl whose parents chose not to participate in the programme developed bilateral dislocation. One boy, whose condition was considered to be too poor for preventative surgery, developed a painful dislocation of the hip at the age of five years and died three years later.

Eight of 103 children in a control group, consisting of all children with cerebral palsy living in the area between 1994 and 2002, and born between 1990 and 1991, developed a dislocation of the hip before the age of six years.

The decreased incidence of dislocation after the introduction of the prevention programme was significant (p < 0.001). Dislocation of the hip in cerebral palsy remains a serious problem, and prevention is important. Our screening programme and early intervention when lateral displacement of the femoral head was detected appear to be successful.
A variant of mirror hand
Authors: Jafari D. , Sharifi B.
Published: February 2018

We describe a rare variant of mirror hand in a 20-year-old man who presented with multiple fingers. Radiographs revealed two ulnae (one vestigial) and a radius. There was duplication of the humeral head. The unique features of this case are the age of patient before the start of treatment and extension of the duplication proximal to the elbow.
How Patterns of Learning About Sexual Information Among Adolescents Are Related to Sexual Behaviors
Authors: Bleakley Amy , Khurana Atika , Hennessy Michael , Ellithorpe Morgan
Published: February 2018

CONTEXT

Parents, peers and media are informal sources of sexual information for adolescents. Although the content of sexual information communicated by these sources is known to vary, little is known about what adolescents report actually learning from each source.

METHODS

Data from 1,990 U.S.14–17‐year‐olds who participated in an online survey in 2015 were used to assess learning about four topics (sex, condoms, hormonal birth control and romantic relationships) from three informal sources (parents, peers, and television and movies). Gender and race differences in learning by source and topic were assessed using t tests. Following a factor analysis, learning about all topics was grouped by source, and regression analyses were conducted to examine associations between learning from each source and three outcomes: sexual activity, condom use and hormonal birth control use. Models included interactions between information sources and race and gender.

RESULTS

White adolescents reported learning more from parents and less from media than black adolescents. Compared with males, females learned more about hormonal birth control and less about condoms from their parents, and more about relationships from peers and media. Learning from parents and from peers were positively associated with adolescents’ sexual activity (unstandardized coefficients, 0.26 and 0.52, respectively). Learning from parents was positively associated with condom use (odds ratio, 1.5).

CONCLUSION

Adolescents’ learning about sex from informal sources varies by race and gender. Future research should examine whether sexual health interventions and message development can capitalize on these differences.
Struktur Komunitas Semut (Hymenoptera : Formicidae) di Lahan Pertanian Organik dan Anorganik Desa Batur, Kecamatan Getasan, Kabupaten Semarang
Authors: Putra Ivan Mahadika , Hadi Mochamad , Rahadian Rully
Published: February 2018

Ants play an important role in terrestrial ecosystems, including in organic and inorganic farmland, as predators, scavengers, and their interaction with other organism. The objectives of this study were to compare the community structure and the role of the ant in organic and inorganic farmland, and also to determine soil abiotic factors in both farmland. The study was conducted in organic and inorganic chili crop land at Batur village, Getasan, Semarang. The sampling of ants was performed using pitfall traps and bait traps, and then the ants were identified. Data analysis used is an abundance index, diversity index, evenness index, Hutchinson test and similarity index. The results showed that the number of species and the number of individual of ants in organic farm were higher (45 individuals, 8 species) than inorganic farm (35 individuals, 6 species). Diversity index of ant species in both farmlands were categorized moderate with the index value of 1.92 and 1.42. Statistically, there were no significant differences in species diversity of ants in organic and inorganic farmland. There were five dominant species in organic field and three dominant species in inorganic field. Ants that predominate in both farmlands were Iridomyrmexsp, Tetramorium sp, Solenopsisgeminata, Odontoponeradenticulata and Diacammasp. The similarity of ant communities between organic and inorganic farmland showed high value of similarity index (IS) which was 85.7%. Statistically, abiotic factors showed that there were significantly different of some abiotic factors in both farmlands, the content of carbon, phospor, organic matter and c / n ratio. Keywords: community structure of ants, agricultural ecosystems
Identifikasi Jenis Pigmen Dan Uji Potensi Antioksidan Ekstrak Pigmen Bakteri Serratia marcescens Hasil Isolasi Dari Sedimen Sumber Air Panas Gedong Songo
Authors: Naufal Adhitya , Kusdiyantini Endang , Raharjo Budi
Published: February 2018

Pigments can be produced by plants, animals, and microbes, including the bacteria Serratia marcescens. Pigments are believed to be used as antibacterial, anticancer, antibiotic and antioxidant. The quality of the pigment is greatly determined by its type. The aim of this study was to identify the type of pigment produced by S. marcescens resulting from the sediment of Gedong Songo hot spring, and testing its antioxidant activity. S. marcescens was grown on Nutrient Broth (NB) medium for 96 hours at room temperature and sampled once every 6 hours for growth measurement and pigment measurement. Cell dry weight was used to measure the growth of S. marcescens, while the measurement of pigment production was done using spectrophotometer with 535 nm wavelength for red pigment and identification of pigment with Thin Layer Chromatography and UV-Vis and testing of antioxidant activity using carotene bleaching method. The results showed the measurement of pigment production has optimal point at 48 hours at 1,319 mg/L. Identification of pigment type S. marcescens using TLC obtained value of  0,8 with spectrophotometer wavelength at 536 nm. The value of antioxidant activity Pigment S. marcescens obtained at 13%. Keywords: Serratia marcescens, prodigiosin, KLT, antioxidant
PENGARUH ATRAKTOR CUMI TERHADAP HASIL TANGKAPAN ALAT TANGKAP BAGAN TANCAP DI PERAIRAN JEPARA Effect of Squid Atractor for Liftnet Fishing Production at Jepara Seawaters
Authors: Jayanto Bogi Budi , Boesono Herry , Fitri Aristi Dian Purnama , Asriyanto Asriyanto , Kurohman Faik
Published: February 2018

ABSTRAK   Alat tangkap Bagan digunakan untuk menangkap ikan phototaxis positif. Lampu sebagai alat bantu pengumpul ikan pada bagan dianggap tidak efektif dan efisien karena membutuhkan waktu yang cukup lama untuk mengumpulkan ikan. Apabila masalah tersebut dibiarkan maka dapat berdampak terhadap peningkatan kebutuhan bahan bakar minyak (BBM) sebagai sumber energi lampu. Penambahan atraktor cumi (fish aggregating device) pada bagan merupakan solusi dalam operasi penangkapan. Tujuan penelitian adalah mengetahui dan menganalisis pengaruh penggunaan atraktor cumi terhadap hasil tangkapan Bagan tancap (lift net) diperairan Jepara. Metode yang digunakan pada penelitian ini adalah metode eksperimen dengan pengulangan sebanyak 16 kali. Jumlah hasil tangkapan Bagan tancap yang tanpa menggunakan atraktor cumi adalah Cumi (38,55 kg), Ikan Teri (22,55 kg), Kepiting (2,3 kg) dan Udang (2,03 kg). Sedangkan pada Bagan tancap yang menggunakan atraktor cumi hasil tangkapannya adalah Cumi (46,62 kg), Teri (40,82 kg), Kepiting (4,5 kg) dan Udang (1,2 kg).   Kata kunci: Bagan, atraktor cumi, perairan Jepara     ABSTRACT Common fishing gear who uses to catch positive phototaxis fish is Lift Net. The lamp was no longer used as the fish aggregating device for lift net because it was ineffective and inefficient to gathered fish target. If the problem still continued it can increased fuels consumption for lamp attractor. Another fish aggregating device “Squid Attractor” was a solution for lift net operation. The objective of this research was to analyze Squid Attractor's effect of Lift Net catch in Jepara seawaters. The Method used in this research is experimental fishing with 16 repetitions. This research showed Lift Nets catch without  Squid Attractors is less than Lift Nets with Squid Attractor's, there is 38.55 kg of squid, 22.55 kg of anchovies, 2.3 kg of crabs and 2.03 of shrimps. Whereas Lift Net with squid attractor got bigger catch such as 46.62 kg of squid, 40.82 kg of anchovie,s 4.5 kg of crabs and 1.2 kg of shrimps.  Keywords: Lift net, squid attractor, Jepara Seawaters
DAMPAK IMPLEMENTASI PERMEN KP No. 1 TAHUN 2015 TERHADAP KONDISI SOSIAL EKONOMI NELAYAN DI JAWA TENGAH Impacts of Implementation PERMEN KP No. 1 Tahun 2015 to Social Economic Fisher Condition in Central Java
Authors: Triarso Imam , Wibowo Bambang Argo
Published: February 2018

ABSTRAK Diberlakukannya Permen KP No. 1 Tahun 2015 tentang Penangkapan Lobster (Panulirus spp),  Kepiting (Scylla spp) dan Rajungan (Portunus pelagicus) dengan tujuan untuk mengelola potensi sumberdaya Crustacea, disebabkan adanya fenomena semakin turunnya produksi Crustacea dan semakin kecilnya ukuran yang ditangkap. Tujuan penelitian ini adalah  untuk mengetahui dampak implementasi Permen KP No. 1/2015 tersebut terhadap kondisi sosial ekonomi nelayan di sentra penangkapan Lobster di Kabupaten Kebumen dan sentra penangkapan Rajungan di Kabupaten Demak dengan menggunakan metoda skoring. Hasil penelitian menunjukkan bahwa implementasi Permen KP No. 1/2015 ternyata berdampak positif terhadap nelayan Lobster di Kabupaten Kebumen dilihat dari segi nilai ekonomi nilai sosial. Namun, berbeda halnya dengan nelayan Rajungan di Kabupaten Demak, dimana kurang berdampak positif, baik nilai ekonomi maupun nilai sosial. Kondisi yang terjadi di Kabupaten Demak tersebut dikarenakan oleh ulah para bakul pengumpul/pengepul yang masih tetap membeli Rajungan, meskipun kondisinya bertelur dan ukurannya kecil. Selain itu, tidak diimbanginya pengawasan atau tindakan hukum bagi para pelanggar Permen KP No. 1/2015 tersebut sehingga telah menimbulkan adanya kecemburuan sosial antar nelayan setempat dan luar daerah. Kata kunci: Dampak, Permen KP No. 1/2015, Nelayan Lobster dan Rajungan  ABSTRACT The implementation of the PERMEN KP No. 1 Tahun 2015 with the aim to review manage resource potential Crustaceans, due to the phenomenon of the decline in production Crustaceans and captured the increasingly smaller sizes. Research objectives to know impact of  implementation Permen KP No. 1/2015 to Socio-Economic Fisher Conditions in Central of Java, especially at the center catching Lobster fishers in Kebumen District and center catching Crab in Demak District with using scoring method. The results showed that the implementatioo of Permen KP No. 1/2015 turned positive impact Lobster fishers in Kebumen District, seen view of economic value and social value. However,with different well asCrab in Demak District, that negaitive impact. In Demak District is caused by that remains buying Crabs, although the condition is laying andsmall size. Keywords: Impacts, Permen KP No. 1/2015, Crustaceans Fishers
ANALISIS MUTU SEDIMEN HABITAT KERANG DARAH (Anadara granosa L) DENGAN REBURIAL TEST (Sediment Quality Analysis for Habitat of Blood Cockle (Anadara granosa L) by Reburial Test)
Authors: Haeruddin Haeruddin , Suprapto Djoko , Rudiyanti Siti
Published: February 2018

ABSTRAKPenelitian dilakukan untuk mengkaji mutu sedimen habitat kerang darah (Anadara granosa L) berdasarkan preferensi reburial. Uji dilakukan terhadap sedimen yang berasal dari Estuari Wakak-Plumbon di Kabupaten Kendal dan sedimen dari Pulau Panjang, Kabupaten Jepara, Jawa Tengah.Hasil pengujian menunjukkan bahwa kerang darah yang dipapar dalam sedimen dari estuari Wakak-Plumbon dan Pulau Panjang tidak menunjukkan kegagalan dalam upaya membenamkan diri (reburial failured) setelah dipapar selama 48 jam. Perbedaan hanya terjadi dalam waktu adaptasi sebelum membenamkan diri. Kerang darah umumnya membutuhkan waktu yang lebih lama untuk adaptasi sebelum membenamkan diri pada sedimen yang berasal dari Estuari Wakak-Plumbon dibanding dari Pulau Panjang.Kata kunci: Habitat, kerang darah, reburialABSTRACTThis research conducted to determine quality of sediment for habitat of blood cockle based on reburial reference. Test done to sediment from Wakak-Plumbon estuary on Kabupaten Kendal and from Panjang Island, Kabupaten Jepara, Central Java. The results showed that blood cockle exposed to sediment from two location are not different in reburial failured, but different in time needed for adaptation before reburial. Anadara granosa needed more time to adapted, before reburial in Wakak-Plumbon sediment.Keywords: habitat, blood cockle, reburial