bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences Between Indiana Registered Nurse Attenders and Nonattenders in Continuing Education in Nursing Activities
Authors: Puetz Belinda E
Published: April 2021

Indiana registered nurses were surveyed on their participation in continuing education in nursing activities and their reasons for attending or not. Attendance differed with respect to age, marital status, basic educational preparation in nursing, employment position, area of practice, and employment history. Reasons are given far attending related to maintaining currency in nursing practice and reasons given for not attending related to personal inconvenience. Implications were made for program planners in continuing education and for legislation of a continuing education requirement for relicensure.
Evaluation of an Interactive Instructional Television Program in Hansen's Disease
Authors: O'Connor Richard J J
Published: April 2021

The use of instructional television (ITV) is becoming increasingly common in developing continuing education programs in Hansen's disease (leprosy). This study attempted to determine if it is educationally advantageous to develop ITV material that incorporates an active learner response as compared with a conventional view-only format among a group of forty-seven professional nurses employed at a public hospital. Results indicated a clear gain in the knowledge level of those nurses who actively assessed their own progress toward preestablished instructional goals. The study also reaffirms the need to conduct validation studies of mediabased instructional material in order to determine educational effectiveness.
An Alternative Learning Experience for Intensive Care Unit Nurses
Authors: Puntillo Kathleen , Duncan Joy
Published: April 2021

A group consisting of eight ICU nurses and two instructors was formed to provide the nurses with an alternative learning experience. The title of the course was "Assessment of Cardio-Pulmonary Interventions." Continuing education credit was allotted for one and one-half hours of independent study and a two-hour "problem-solving" seminar each week (total of 16 hours of continuing education credit). Students were responsible for designing their own learning program. They selected learning objectives from a leveled list; pursued independent study in order to meet these objectives; and actively participated in problem-solving seminars. A detailed evaluation of the course components and instructors indicated that this type of alternative learning experience was considered effective and acceptable by these intensive care nurses.
Evaluating a Continuing Education Program
Authors: Goodykoontz Lynne
Published: April 2021

An experience in evaluating a continuing education program for nurses substantiates what was offered and provides information for making revisions. The emphasis is on a positive approach to the process that includes collecting relevant information, drawing conclusions, and making recommendations. The evaluation was made using a pre- and post-test and a follow-up questionnaire answered by nurses attending the program.
Developing a Model for Implementation of an Evaluation Component in an Orientation Program
Authors: Kibbee Priscilla
Published: April 2021

Evaluation should be an ongoing activity that originates with identified educational needs. The author outlines a continuous model using a flow chart, which will re-evaluate those needs yearly from a variety of sources utilizing the Delphi technique.
Developing and Marketing Your Continuing Education Programs
Authors: Wise Pat S Yoder
Published: April 2021

This session focused on analyzing a needs assessment and using a format for brochure design, neither of which are described in this article. The content here, however, reflects the basis on which these assessments and brochures are used and describes an integrating approach for the educational and marketing components of continuing education courses.
Workshop Worries: Planning is the Answer
Authors: Asmussen Sandy , Ludowese Fran
Published: April 2021

For those agencies anticipating sponsoring workshops, sequential steps in planning are suggested. Certain "housekeeping tips" are emphasized to offset the often forgotten details that directly influence a successful workshop.
Is the Computer the Answer?
Authors: Marks Ruth J
Published: April 2021

Accurate records are essential for nursing education. However, the method of keeping records may present problems for those involved in staff development positions. The purpose of this article is to consider the use of a computer program for nursing education as one possibility.
Methods of Teaching - Revisited The Incident Process
Authors: Cooper Signe S
Published: April 2021

The twentieth in a series of articles describing methods of teaching, this article describes another technique for initiating discussion and analyzing problems. Readers are encouraged to share their experiences with successful teaching strategies.
Participatory Learning in Continuing Nursing Education: Soviet Edition of a Public Health and Medicine Trivia Game
Authors: Barber-Madden Rosemary , Glanz Karen
Published: April 2021

ABSTRACT

The challenge in designing professional continuing education programs lies in balancing the need to provide a new knowledge base with the need to engage the interest of the adult learner. This article reports on the use and evaluation of an experiential and innovative educational approach using adult learning techniques in a continuing education program for nurses in a cross-cultural setting.
What Happens to Learning When the Workshop Is Over?
Authors: Kiener Mary Elaine , Hentschel Doe
Published: April 2021

ABSTRACT

This article presents findings from a study conducted to identify factors that facilitate and hinder the process by which professionals incorporate learning into practice. While a majority of learners identified their new knowledge as a facilitative factor for the incorporation process, nearly a third acknowledged that a knowledge deficit or the task's complexity would hinder the incorporation process. References to administrative support more frequently identified hindrances rather than facilitators.
NCLEX-RN Preparation: Enabling Candidates to Pass
Authors: Colombraro Geraldine C
Published: April 2021

ABSTRACT

Today's NCLEX-RN candidates are potentially the RNs of tomorrow. It has become increasingly important and cost effective for hospitals to work with their NCLEX-RN candidates to enable them to pass the licensure exam the first time it is taken. Preparation of candidates may include review courses, review books, group work, and individual review materials. Building on the solid educational foundation each nurse brings to the hospital, the nurse educator can develop cost effective strategies to help their candidates pass the NCLEX-RN.
Recruitment and Retention of International Nurses Aided by Recognition of Phases of the Adjustment Process
Authors: Pilette Patricia Chehy
Published: April 2021

ABSTRACT

Spurred by the shortage of nurses, hospitals are turning to overseas recruitment. The success of such recruitment rests in large measure on an organization's address of an immensely and immediately practical consideration: What is the nature of the adjustment process for the international nurse, and what can a hospital do to facilitate this adjustment?

This article describes the four phases of the adjustment process that are generic to the first-year experience of the international nurse and offers suggestions for an assimilation program.
Personal and Work-Milieu Resources as Variables Associated With Role Mastery in the Novice Nurse
Authors: Dufault Marlene A
Published: April 2021

ABSTRACT

The purpose of this study was to explore the relative contribution of eight independent variables in explaining novices' perceived variation in role mastery 3 months following their appointment. The study sample included 75 novice graduate nurses in a large tertiary teaching hospital. A correlational design using the multivariate procedure of step-wise multiple regression was used.

On day one of orientation, the Schwerian Six-Dimensional Scale of Nursing Performance was administered to the novices, their preceptors, and head nurses. To obtain a measure of the nursing unit's collective expertise, its job satisfaction, and its role socialization, nurse educators rated their units using the Nursing Practice Group Role Mastery Assessment Scale. Participation in bicultural training was documented by attendance. Three months later, the novices were posttested using the Schwerian Scale as the criterion variable.

Of the eight potential explanatory variables, only four entered the regression equation, explaining 40% of the variance (p<.05). These were: entry-level role mastery, the nursing unit's collective expertise, its job satisfaction, and its role socialization. Interestingly, the head nurse's role mastery, and the three interventions used to address role transition problems were not predictors. Also, specific competency weaknesses in novices paralleled their experienced peers in the areas of assessing priorities, written communication, and skills salient to discharge planning.
Wanted: Nurses With Critical Thinking Skills
Authors: Schank Mary Jane
Published: April 2021

ABSTRACT

Knowing how to think, apply, analyze, synthesize, and evaluate are crucial skills for nursing professionals. Development of critical thinking skills requires educational involvement beyond the level of basic preparation. The diffusion of nursing knowledge afforded by continuing education in nursing makes it the perfect milieu for the enhancement and continuous development of critical thinking skills.
Productivity in Education: Facing Critical Options
Authors: Keely Beth , Davis Kay
Published: April 2021

ABSTRACT

Even though hospitals across the country are facing tremendous financial pressure, a change in educational focus can offer a positive and exciting outcome. In this climate, educational productivity demands a clear sense of the mission of education as well as the strategic plans of the organization. To survive, educators must be responsive to meeting goals for staff performance and envision themselves as change agents.
Nurses' Assessment of Patients' Spirituality: Continuing Education Implications
Authors: Boutell Karen A , Bozett Frederick W
Published: April 2021

ABSTRACT

This article reports the results of a study to determine the extent to which nurses assessed patients' spiritual needs, indicators of spirituality used in the assessments, data collection methods used, and nurses' demographic information related to assessment and methods of data collection. Boutell's Inventory for Identifying Nurses' Assessment of Patients' Spiritual Needs was developed. Test-retest indicated an acceptable level of reliability.

The Inventory was sent to a random sample of 817 nurses eligible to practice nursing in Oklahoma, yielding 238 (29%) usable questionnaires. Criteria for inclusion in the study were that the nurses needed to be employed and giving direct care to patients 18 years of age or older. Findings indicate that the majority of nurses assessed their patients' spiritual needs from a moderate to considerable extent. They most frequently assessed for fears, sources of strength, and feelings of hope. Least frequently assessed were integration, giving love to God, meaning in suffering, and transcendence. Moreover, nurses ages 50 to 59 and psychiatric nurses were more likely than other nurses to assess the spiritual realm. Availability of time and patient acuity were major factors that influenced assessment. Data were most frequently obtained through observation of patients and discussions with patients rather than from secondary sources, such as clergy or patient records. Also, the nurses' basic educational preparation was not found to influence assessment. Suggestions for continuing education and programs are made.
Psychomotor Skill Development
Authors: Oermann Marilyn H
Published: April 2021

ABSTRACT

Psychomotor skills represent those activities that are primarily movement-oriented. In teaching, emphasis is placed on this movement component, although ultimately in practice, performance requires an integration of related knowledges and values. This article examines the process of psychomotor skill development and provides guidelines for teaching motor skills.
The Generic Research Protocol: An Innovative Technique to Facilitate Research Skills Development and Protocol Preparation
Authors: Jairath Nalini , Fitch Margaret I
Published: April 2021

ABSTRACT

Hospitals are increasingly delegating responsibility for initiating nursing research to nursing staff whose knowledge of and experience in conducting research may be limited. As a result, nurses involved in continuing education and staff development are increasingly involved in helping staff develop their research skills and prepare research protocols. The generic research protocol (GRP) is a computerized learning package that assists nursing staff in preparing a scholarly research protocol through step-by-step instruction and guidance. When used in two unrelated nursing studies, research skills of participating nursing staff were developed and protocol preparation facilitated. The time and editorial effort required for protocol preparation were reduced, and novice researchers were familiarized with research terminology and issues related to study design.
Information Resources and Knowledge Needs of Rural Nurses Regarding Alzheimer's Disease
Authors: Bellaver Constance , Daly Jeanette M , Buckwalter Kathleen C
Published: April 2021

ABSTRACT

Background: The need for current information on Alzheimer's disease (AD) is apparent as medical research, diagnostic, and treatment guidelines are advancing at a rapid rate.

Method: A needs assessment survey determined what educational topics related to dementia nurses perceived they most need, would be most likely to attend, and what information they likely would solicit in a telephone consultation.

Results: Nurses in Iowa were interested in continuing education programming and teleconferences on major topics regarding AD provided through the state's fiberoptic system such as: (a) challenging behaviors over the course of illness; (b) family needs such as education, support, respite, referral, and safety; (c) case management services for patients and families; (d) long-term care services from adult care to hospice; and (e) new developments in AD.

Conclusion: Rural nurses experiencing professional isolation and lack of resources can access up-to-date information via continuing education programs transmitted by telecommunication strategies.
Improving Aged Care Education for Australian Rural Nurses Using Problem-Based Learning
Authors: Peterson Raymond , Hakendort Marcia , Guscott Tony
Published: April 2021

ABSTRACT

Background: A continuing education program in aged care was developed using the principles of problem-based learning (PBL) to improve the participating nurses' understanding of current government guidelines on aged care, to develop their ability to apply this information to their workplace situations, and to give them the confidence and strategies to initiate change in their workplaces. The use of a guided introduction to PBL and the use of journals were important components in the design of this program.

Method: Both quantitative and qualitative approaches were used to evaluate the program, and data collected through observation of the participants when working on case scenarios, journal writing, and pre-questionnaires and post-questionnaires were included. Fifteen nurses participated in the program.

Results: Participants developed a holistic approach to aged care, reflected on their practice in the journals, developed an understanding of the current aged care guidelines, and acquired the skills, strategies, and motivation to make changes in their workplaces.

Conclusion: PBL enabled the nurses to link theory with practice, not only through the case scenarios considered in the program, but also when reflecting on their work practices in their journals. The use of journals by participants and the guided introduction to the PBL approach were important factors in the Aged Care Program's success.
NOILES TOTAL KNEE REPLACEMENT PROCEDURE
Authors: Accardo Nick J , Noiles Douglas G , Pena Rudolph , Accardo Nick J
Published: April 2021

ABSTRACT: We report preliminarily on 32 Noiles total knee replacements performed during a 32month period, with a detailed account of those results, including 11 cases (9 patients) followed up for 24 to 32 months, and an illustrative case report. We had excellent results in 31 cases. The Noiles prosthesis function met the standards of function reported by Wilson and Venters,1 using a system developed at the University of North Carolina for evaluating the results of total knee replacement, and also passed the standards referred to by Kettlekamp and Nasca.2
COMPLICATIONS OF CLOSED SUCTION-IRRIGATION: A CASE REPORT
Authors: Fulkerson John P , Phillips Stuart B
Published: April 2021

ABSTRACT: Subcutaneous dissection of fluid and toxicity from the chosen antimicrobial agent may occur when using a closed suction-irrigation system. Continuous rather than intermittent suction, and frequent examination of the treated extremity should minimize the risk of subcutaneous fluid dissection. Nephrotoxic agents are dangerous in closed suctionirrigation and should be avoided whenever possible.
METAPHYSEAL CUPPING: A CASE REPORT
Authors: Wiss Donald A
Published: April 2021

ABSTRACT: A case of metaphyseal cupping of bone that probably occurred as the result of an impaired blood supply to the leg of an infant is reported. Avascularity and premature closure of the central segment of the growth plate is the proposed pathogenesis. The blood supply, growth and development of the ends of growing bones are discussed and the radiographie features of metaphyseal cupping are described.
Symptomatic Eosinophilic Granuloma of the Spine: Report of Two Cases and Review of the Literature
Authors: Sanchez Ramon L , Llovet Jose , Moreno Abelardo , Galito Emilio
Published: April 2021

ABSTRACT: We report two cases of eosinophilic granuloma of the spine in which the first manifestation of the disease was an associated neural deficit. In addition, we review the literature for cases of histiocytosis X in which the initial diagnosis was based only upon the discovery of spinal lesions. Thirty-nine reported cases of what we designated as "symptomatic eosinophilic granuloma of the spine" were found. A review of all 41 cases revealed that most patients present with pain, muscular stiffness and/or neurologic symptoms, the disorder most often affects the cervical vertebrae, and a high incidence of osteolytic lesions (as opposed to vertebral collapse) are found. These findings vary from those of radiologic and clinical evaluations of classical, multifocal, histiocytosis X that involves the spine.
ANSWER PLEASE
Authors: Yngve David A
Published: April 2021

Knee Ligament Injury with Rim Compression Fracture
Static Load Response of the Heels of SACH Feet
Authors: Skinner Harry B , Abrahamson Mark A , Hung Raymond K , Wilson Leigh A , Effeney David J
Published: April 2021

ABSTRACT: Excessive heel hardness in the prosthetic foot is a frequent problem that may contribute to decreased function in the above knee and below knee amputee. Optimal mechanical characteristics of the SACH (solid ankle cushion heel) foot have not been defined. In an effort to characterize the mechanical properties of the heels of these feet, we performed static load-deformation tests on the heels of SACH feet at stimulated heelstrike. These data were interpreted using least squares fitting of the natural logarithms of the load-deformation data. Statistical comparison of these data revealed no significant difference in the static response of the "medium" and "regular" grades of foot. A difference at the 1% level of confidence was found between the "soft" grade and the two firmer grades. Consistency within a grade of foot was quite good. Comparison of feet from another manufacturer revealed no difference in static response, suggesting consistency in static performance among manufacturers. It was our clinical impression that all grades of SACH heels are too stiff.
The Mauch Hydraulic Knee Unit for Above Knee Amputation
Authors: Volatile Thomas B , Roberson James R , Whitesides Thomas E
Published: April 2021

ABSTRACT: Hydraulic knee units provide a mechanical means of simulating normal gait in the above knee amputee. Sixty-one above the knee amputees were fitted with 70 Mauch SNS hydraulic knee units. Four of 60 patients rejected or were unable to use the hydraulic knee. Only one patient rejected the hydraulic knee unit for another design. Therefore, the rate of acceptance of the prosthesis was 93%. If inappropriate prescriptions for two triple amputees are omitted, the acceptance rate rises to 97%. A significant majority of patients stated that the hydraulic knee unit gave them a smoother gait, ability to change cadence, Increased activity level, increased stability in stance phase, fewer falls, and less fatigue.
A Viscoelastic Knee Brace for Anterior Cruciate Ligament Deficient Patients
Authors: D'Ambrosia Robert , Solomonow Moshe
Published: April 2021

ABSTRACT: A biomechanical review of the anterior cruciate ligament deficient knee shows that the unbraced knee undergoes instability once its angular velocity exceeds normal cadence rate. It also shows that various braces that utilize extension limits for purposes of preventing subluxation and tibial rotation introduce abnormal gait and posture responses, which may impose on the patient's activities. A speed-regulated, viscoelastic knee brace has been designed, fabricated, and tested on two patients. The brace allows full range of knee motion and reduces the angular velocity of the tibia from near-full extension to neutral at normal, non-unstabilizing walking speeds. Capability is incorporated for adjusting the terminal angular velocity for each individual patient as well as for the same patient during the recovery period.
An Overriding Radius Fracture in a Child with an Intact Ulna: Management Considerations
Authors: Woodbury Derrik F , Fischer Bruce
Published: April 2021

ABSTRACT: The case history of a 7 year old female with a transverse, 100% dorsally displaced fracture of the radius and a torus fracture of the distal ulna is presented. Mechanism of injury and principles of evaluation and treatment are discussed.
Civilian Gunshot Wounds
Authors: Dugas Robert , D'Ambrosia Robert
Published: April 2021

ABSTRACT: A wide variety of injuries are encountered in civilian gunshot wounds with the severity directly related to the amount of kinetic energy imparted on the tissues. A surgeon should be aware of the different ballistic properties of the various firearms and be prepared to treat each patient as an individual. Furthermore, the physician should be attentive to severe complications that may occur even after appropriate treatment has been given.

During an 18 month period on the LSU Surgical Service, 431 patients were admitted for gunshot wounds of which 218 had extremity injuries. One hundred seventy of these patients were evaluated and surveyed for type of injury, surgical procedure, and complications relating to the velocity of the involved.
In Vitro Characteristics of Tobramycin-PMMA Beads: Compressive Strength and Leaching
Authors: Kirkpatrick D Kay , Trachtenberg Laura S , Mangino Paul D , Von Fraunhofer Joseph A , Seligson David
Published: April 2021

ABSTRACT: Antibiotic-impregnated polymethylmethacrylate (PMMA) bone cement beads have been used as a local drug delivery system for the treatment of bone and soft tissue infections. The beads deliver a high local level of antibiotic with a decreased risk of toxic systemic levels. This study was undertaken to determine the antibiotic release characteristics of tobramycin-impregnated beads over time and to determine the compressive strength of these beads.

Acrylic resin (PMMA) bone cement beads were prepared with three different concentrations of tobramycin. The beads were tested for compressive strength, and their antibiotic release characteristics were determined over a 21 day period by radioimmunoassay and by biological testing against a variety of bacteria.

The compressive strength of the beads was found to be adequate to avoid fragmentation during their clinical use. There was gradual release of tobramycin from the beads over the entire 21 days, but the release was most marked during the first 48 hours. There was antibiotic activity against both gram-negative and gram-positive organisms, except Enterococcus, for the entire 21 day period. The release of tobramycin followed a curvilinear relationship and was directly related to the initial antibiotic concentration of the bead. Tobramycin-impregnated polymethylmethacrylate beads may represent a reliable method of local antibiotic delivery with sustained activity against a broad spectrum of organisms.
Anterior Dislocation of the Shoulder in Patients Over 50 Years of Age
Authors: Wenner Steven M
Published: April 2021

ABSTRACT: Six patients over 50 years of age were treated and followed for traumatic, first-time anterior dislocation of the shoulder. Early post injury examination following the subsidence of acute pain due to the injury demonstrated passive motion that exceeded active motion. Later follow up, however, revealed that active motion was equal to passive motion. The author concludes that these patients injured their rotator cuffs at the time of the shoulder dislocation and that such rotator cuff injuries healed satisfactorily without surgical repair.
Correlations Between Objective Measures of Function and a Clinical Knee Rating Scale Following Total Knee Replacement
Authors: Gore Donald R , Murray M Patricia , Sepic Susan B , Gardner Gena M
Published: April 2021

ABSTRACT: Few objective measurements of function, other than range of motion, have been reported for patients with total condylar knee replacement. Moreover, to our knowledge, no studies have been reported which assess the degree of relationship between clinical ratings and measurements of function in these patients. Kinesiology tests of function and the Hospital for Special Surgery (HSS) Knee Rating Form were used to evaluate 34 patients before and 2 years after 39 total condylar knee replacements. Prosthetic alignment was also evaluated postoperatively. The kinesiologic studies showed postoperative improvement in muscle strength, weight-bearing ability, and use of assistive devices, and in velocity, knee flexion-extension, and lateral head motion during walking. A moderate but significant degree of improvement was measured by the HSS score. Correlation coefficients showed that the postoperative knee rating score was significantly related to almost all of the postoperative objective measurements of function. Correlation coefficients between the prosthetic alignment scores and measurements of function were not statistically significant. The study strengthens the validity of use of the HSS Knee Rating Form as a tool for evaluating functional performance, particularly during the postoperative period.
Irrigating Solutions Used in Arthroscopy and Their Effect on Articular Cartilage: An In Vivo Study
Authors: Arciero Robert A , Little James S , Liebenberg Stanley P , Parr Thomas J
Published: April 2021

ABSTRACT: The effect of arthroscopic irrigating solutions on articular cartilage was determined by the use of an animal model. Rabbit knee joints were irrigated continuously for two hours with either normal saline, Ringer's lactate, or sterile water. Subsequently, the rate of incorporation of 35SO4 by articular cartilage was used to measure the effect of the irrigants on chondrocyte metabolism. In addition, the irrigated groups were compared to an unirrigated control group. There was no significant difference in 35SO4 incorporation between the groups. This suggested that none of the irrigating solutions used in this study adversely affected articular cartilage function. On the basis of these findings, it appears that normal saline, Ringer's lactate, and sterile water can be safely used as irrigating solutions during most arthroscopic procedures.
Comparison of Neurosonography and Contrast Myelography
Authors: Gree Jacob , Reilly Allen , Schnitzlein Norman , Clewell William
Published: April 2021

ABSTRACT: Eighty consecutive patients who first had an electronic infrared thermogram (neurothermogram) and a subsequent oil myelogram were studied retrospectively. All patients had cervical and/or lumbosacral radiculopathy for 90 days. Negative neurothermograms were predictive of negative myelograms in 93% of our series. Positive neurothermograms were predictive of positive myelograms in 71% of the patients. The neurothermogram is not a specific test for intraspinal axis lesions as a cause of radiculopathy. Proximal neuropathic lesions of other causes will also produce abnormalities of the sympathetic autonomic (peripheral) nervous system. The major pathophysiologic findings detected by neurothermograms are complimentary to the EMG, NCVS, and late response techniques. Neurothermography was successful in predicting the outcome of myelography in 82% of patients in this study.
A Standard for Dorsal-Plantar and Lateral Radiographic Projections of the Feet
Authors: Brand Paul W , Coleman William C
Published: April 2021

ABSTRACT: Several attempts have been made to persuade physicians to establish standardized projections of foot radiographs. However, standards have not been widely accepted. Further advancement toward quantification of deformity and surgical criteria is delayed due to a tack of universally accepted technique. Procedures for obtaining two precise projections of the foot are described.
The Direct Lateral Approach to the Hip for Arthroplasty: Advantages and Complications
Authors: Foster Dennis E , Hunter John R
Published: April 2021

ABSTRACT: The direct lateral approach to the hip as described by Hardinge in 1982 was used in the performance of 83 hip arthroplasties. This approach was found to give excellent visualization of the proximal femur and acetabulum and was found to have comparable operative time, blood loss, time to ambulation, and range of motion to other approaches. The postoperative dislocation rate was very low (2.5%) and redislocations have not occurred. The incidence of heterotopic ossification was high (61%) and this may limit the use of this approach in some cases.
Internal Hemipelvectomy and Reconstruction for Malignant Primary Acetabular Tumors: A Report of Five Cases
Authors: Dodge Larry D , Johnston James O
Published: April 2021

ABSTRACT: Five patients underwent hemipelvectomy and reconstruction for the treatment of a primary malignant tumor involving the acetabulum. There were no intraoperative complications and only one postoperative complication. All patients were ambulating within one week of surgery. During the follow up period which averaged 4 years, all patients remained ambulatory and pain-free, and none showed radiographic evidence of loosening or subsidence of the prosthesis or pins.
Symptomatic Relief Following Carpal Tunnel Decompression With Normal Electroneuromyographic Studies
Authors: Louis Dean S , Hankin Fred M
Published: April 2021

ABSTRACT: Carpal tunnel syndrome is a frequently encountered clinical entity. A retrospective study of a selected patient population revealed 12% of patients to have normal electrodiagnostic studies. Operative release of the transverse carpal ligament in these patients alleviated median nerve entrapment symptoms. Entrapment neuropathy of the median nerve remains a clinical diagnosis, and absolute reliance on electrodiagnostic studies is unwarranted when making a decision to surgically treat a patient with a suspected carpal tunnel syndrome.
Morphology of Scoliosis: Three-Dimensional Evolution
Authors: Perdriolle Rene , Vidal Jacques
Published: April 2021

ABSTRACT: The clinical examination of the scoliotic child's profile shows that it does not correspond to the physiological curvatures. This three-dimensional study of scoliosis shows evidence of the existence of three components, frontal, sagittal, and axial. Each generates a pathological displacement of the vertebrae maximal at the apical vertebral level. Because of rotation, in order to analyze each of the components, radiographs must be taken along the frontal or sagittal plane of the vertebrae. A comparative study of the sagittal and frontal components during progression of scoliosis indicates that the apical vertebrae are displaced not only laterally but also forward and then backward. The apical vertebrae are situated anteriorly with respect to the end vertebrae. If the scoliotic curves progress, the apical vertebrae eventually become displaced backward. During this displacement at a given moment they are situated in the frontal plane of the child at the same level as the upper end vertebra; then they come to lie behind this if the scoliosis continues to progress. This explains why, when observed from the side, the appearance changes and passes through three successive stages, lordosis, flat back, and kyphosis.
Salter-Harris Tppe II Stress Fracture in a Young Athlete: A Case Report
Authors: Weber Peter C
Published: April 2021

ABSTRACT: A Salter-Harris type II stress fracture of the distal femoral epiphysis is reported in a skeletally immature athlete.
Pubic Ramus Fatigue Fractures After Total Knee Arthroplasty: A Case Report
Authors: Smith Michael D , Henke John A
Published: April 2021

ABSTRACT; Fatigue fractures in the rheumatoid population are infrequent but well described clinical and radiographic entities, and rarely occur within the pelvis. These fractures often are difficult to diagnose. Pelvic fatigue fractures are much less commonly detected and reported after total joint arthroplasties. This article reports the sequential appearance of fatigue fractures of the superior portions of both pubic rami after total knee replacement arthroplasties which were not suspected on historical review, physical examination, nor well visualized on initial plain radiographs and technetium bone scanning.
A Chronically Dislocating Prosthetic Patella: A Case Report
Authors: Flandry Fred , Harding Amanda F , Kester Mark A , Cook Stephen D , Haddad Ray J
Published: April 2021

ABSTRACT: A 63-year-old white woman was evaluated for a chronically dislocating right patella 6 months following total knee arthroplasty. At the time of our initial evaluation, her knee would not extend beyond 35° and her patella was dislocated and irreducible. At arthrotomy, when the patella was everted, the patellar component was oriented with the facet ridge rotated 90° to the trochlear groove of the femoral component. The patellar template guide indicated that the fixation pegs had been drilled properly, and thus, the patellar component had been assembled improperly during manufacturing. After dome-type patellar prosthesis replacement and proximal and distal extensor realignments were performed, 2 months postrevision the patient had a range of motion from 5° to 95° and ambulated with no patellar instability or pain.
Isolated Rupture of the Subscapularis Tendon in an Arm Wrestler
Authors: Biondi John , Bear Thomas F
Published: April 2021

ABSTRACT: Rotator cuff injuries, especially in athletes, can be very disabling. A case of an isolated rupture of the subscapulars tendon in an arm wrestler is reported. Preoperative arthrogram and CT scan with intraoperative pictures are used to illustrate the pathology. Recommendation for treatment is surgical repair.
The Use of the Probe in Arthroscopic Examination of the Knee
Authors: Noble Jonathan , Elsworth C F , Hodson M , Drabu K
Published: April 2021

ABSTRACT: Careful examination of the results of 500 arthroscopic examinations of the knee showed that significant diagnostic information was gained by use of the probe in 52 knees. However, survey results show that in northwest England only 67% of surgeons always perform an arthroscopy prior to meniscectomy and only 41% of surgeons used a probe at every examination. Failure to use the probe at every examination may result in missed pathology.
The Use of Cement Forms to Control Methylmethacrylate in Immediate Posterior Stabilization of the Cervical Spine: A Technical Note
Authors: Dugdale Thomas W , Raycroft John F
Published: April 2021

ABSTRACT: Under certain clinical conditions, posterior stabilization of the cervical spine, supplemented with polymethylmethacrylate (PMMA), is an accepted method of achieving stability. A technique is described in which "cement forms" are used to limit the spread of PMMA and to allow bone graft placement in the lateral paraspinous gutters.
The Posterior Medial Complex Disruption
Authors: Stone Robert G , Barber F Alan
Published: April 2021

ABSTRACT: Seventy-five patients with 86 complex tears of the medial meniscus posterior horn (posterior medial complex disruptions) treated by arthroscopic partial meniscectomy were contacted for evaluation of their functional results. Forty-five patients returned for physical and radiographic examination 1 to 6 years after surgery. Condylar chondromalacia was significantly higher in patients waiting to undergo surgery over 6 months from the onset of their symptoms (94%) than those waiting less than 6 months (40%) (P=. 0001). Patients were classified into phases based on preoperative x-rays and the operative presence of condylar chondromalacia. Satisfactory resufts were seen in 87% of phase 0 and phase 1 patients, 50% of phase 2 patients, and 32% of phase 3 patients. Phase classification provided significant data for prognostication of satisfactory results (P=. 0001). With advancing age, presence of preoperative xray changes, the articular cartilage damage may compromise the results. Most patients in this study exhibited clinical improvement suggesting some benefit from the mechanical washout, if not the meniscectomy.
Ankle Arthroscopy: A Method of Distraction
Authors: Trager Stuart , Frederick Laurence Davis , Seligson David
Published: April 2021

ABSTRACT: Although ankle arthroscopy has been limited by the restricted available joint space, the use of distraction in addition to joint distention has permitted improved surgical and diagnostic examination of the ankle. In contrast to previously described methods of distraction, a simple, effective, and noninvasive method of distracting the ankle joint is proposed. This method requires no special equipment; a standard fracture table, adhesive tape, and sterile self-adherent bandages are used to provide successful joint distraction as demonstrated radiographically.
Compression Arthrodesis of the Ankle by Triangular External Fixation: An Improved Technique
Authors: Berman Arnold T , Bosacco Stephen J , Yanicko Daniel R , Raisis Leo W
Published: April 2021

ABSTRACT: In this preliminary report, the authors present a new application of an external tubular fixation system for compression arthrodesis of the ankle. A triangular ankle fusion frame was designed that provides rigid immobilization of the tibiotalar joint, with midfoot control provided by a metatarsal pin. Over the past 3 years, the authors have used this device to achieve solid tibiotalar arthrodesis in 12 of 14 patients. The surgical method, including step-bystep construction and application of the triangular ankle fusion frame, is presented. Early results suggest a nearly 90% union rate, including reoperative cases for failed primary fusion.
FACTORS AFFECTING POSTOPERATIVE FLEXION IN TOTAL KNEE ARTHROPLASTY
Authors: Shoji Hiromu , Solomonow Moshe , Yoshino Shinichi , D'Ambrosia Robert , Dabezies Eugene
Published: April 2021

ABSTRACT

In the review of 67 cases with total condylar (TC) prostheses, 59 with TC posterior stabilizers, 70 with TC prostheses modified with flat posterior tibial plateau, and 35 with porous-coated arthroplasty (PCA) prostheses, multiple crossexaminations of various factors for postoperative flexion were performed. Follow up was 2 to 9 years. In nearly all cases, no further improvement of flexion was noted after 1 year following surgery. The most influential factor for good postoperative flexion was intense physical therapy, leading to good suprapatellar pouch reconstitution. Residual flexion contracture was more frequent when the posterior cruciate ligament (PCL) was retained in the cases with significant preoperative flexion contracture. However, retention of PCL or preoperative ACL condition did not bear any significance to the ultimate flexion.
FOUR-YEAR AVERAGE FOLLOW UP OF CEMENTED PCA TOTAL KNEES: CLINICAL AND ROENTGENOGRAPHIC ANALYSIS
Authors: Brinker Mark R , Haddad Ray J , Cook Stephen D , Cash James D , James Plas T , Tan Edward H
Published: April 2021

ABSTRACT

Twenty patients with 25 consecutive primary-cemented Howmedica PCA total knee prostheses were clinically and roentgenographically reviewed. Twenty implants were placed in 16 women and five in four men. The average patient age at surgery was 68.0 years (range, 53 to 82), and average follow up was 51 months. Total knee replacement indication was degenerative joint disease in 21 knees and rheumatoid arthritis in four. Excellent or good results were seen in 22 of 25 knees (88%) at the early follow up examination and 18 of 25 knees (72%) at the most recent follow up examination.
TOTAL ANKLE JOINT REPLACEMENT: A CLINICAL FOLLOW UP
Authors: Jensen Niels Chr , Krøner Karsten
Published: April 2021

Abstract

The TPR total ankle joint replacement system (Smith & Nephew Richards) was implanted in 30 ankles in 25 patients. Twentythree ankles in 18 patients were followed; 21 had rheumatoid arthritis and two had osteoarthritis. The average age at surgery was 62 years (range: 37 to 77), and the average follow up was 59 months (range: 37 to 89). The improvement was especially obvious with respect to pain and function. The average walking distance improved from 260 m preoperatively to 975 m postoperatively. Even though there was some improvement with respect to pain and function, the results of the study are disappointing in comparison to .studies of ankle arthrodesis.
FLEXION DISTRACTION INJURIES OF THE THORACOLUMBAR SPINE: A REVIEW
Authors: Triantafyllou Steven J , Gertzbein Stanley D
Published: April 2021

ABSTRACT

Flexion-distraction injuries of the thoracolumbar spine and the "seat belt syndrome" are reviewed. The incidence, pathogenesis, classification, diagnosis, and treatment of these injuries are discussed.
PATHOLOGIC FRACTURES OF THE ACETABULUM AND THE PELVIS
Authors: Rock Michael G , Harrington Kevin
Published: April 2021

ABSTRACT

Metastatic involvement of the pelvis, and in particular the acetabulum, is a common finding among patients with metastatic osseous disease. With involvement of the joint surfaces, specifically the hip and sacroiliac joints, marked compromise of function can occur. With advances in imaging and the evolution of surgical reconstructive alternatives, most of these patients can be rendered pain-free and functional by transferring weight distribution onto more stable elements of the hemipelvis. Reconstruction must be feasible and in the best interests of the patient. The decision to proceed represents a collective opinion of the patient, oncologist, and surgeon.
MECHANICAL PROPERTIES OF SM STAPLES IN BONE BLOCK MODELS
Authors: Freeland Alan E , Zardiackas Lyle D , Terral Gregg T , Blickentaff Kyle R
Published: April 2021

ABSTRACT

The use of power driven staples is an accepted method of fixation for small bones of the hand and wrist and of the foot and ankle. The staples must be applied to flat or nearly flat surfaces. A synthetic model was developed to evaluate the ability of the 3M power driven staple system to resist failure due to pulling out of the staples in cantilever bending, tension, and torsion. Three different staple configurations and two leg lengths were evaluated in each of the test modes. Results indicated statistically significant differences between one and two staple configurations and between longer and shorter leg lengths. There was clear superiority of the two staple configurations and of longer leg lengths.
COMPLICATIONS OF SEIDEL INTRAMEDULLARY NAILING OF NARROW DIAMETER HUMERAL DIAPHYSEAL FRACTURES
Authors: Riemer Barry L , Foglesong Math E , Burke Charles J , Butterfield Spencer L
Published: April 2021

ABSTRACT

Forty acute blunt fractures of the humeral diaphysis were treated with Seidel nails (9mm diameter) between April 1988 and August 1992. Follow up was available for 36 patients. Average Injury Severity Score (ISS) was 22. Forty-eight pelvic and lower extremity fractures necessitated humeral weight bearing in 23 patients. Patients were grouped by canal diameter measured at the point of distal humeral fixation: ≤9 mm or ≥10 mm. Data were analyzed with regard to complications, fracture pattern, and time to union. Due to difficulties reaming the humeral canal, five different reaming systems were used. In the ≤9 mm group (N = 12), there were seven complications (58%). Two patients had iatrogenic comminution distal to the nail. The two open fractures in this group (II, IIIA) developed wound infections, and one, osteomyelitis. Three patients had nonunions: one was lost to follow up at 6 months, and two united at 41 and 74 weeks after exchange nailing and bone grafting. Average time to union was 21 weeks. Six of the seven complications occurred in patients who required reaming of a long, tight segment of distal canal. In the ≥10 mm group (N = 24), there was one complication of iatrogenic comminution (4%). There were four open fractures (three, grade II; one, 111B) with no infections. All fractures united (average = 10 weeks). The differences in complications (P=.001) and union (P=.04) between groups were significant. Other complications were not associated with canal diameter or union. There were seven radiographic failures of the distal locking device (19%). Four nails (11%) were left prominent in the shoulder due to technical or equipment failures, and were eventually removed. Four patients (11%) had residual shoulder stiffness (three due to neurologic injury). These primary data suggest use of the Seidel nail is associated with a higher complication rate in humeri with canal diameters ≤9 mm.
THE ROLE OF A COMPOSITE, DEMINERALIZED BONE MATRIX AND BONE MARROW IN THE TREATMENT OF OSSEOUS DEFECTS
Authors: Tiedeman Jeffrey J , Garvin Kevin L , Kile Todd A , Connolly John F
Published: April 2021

ABSTRACT

The efficacy of demineralized bone matrix (DBM) used alone and with bone marrow as a graft material in the treatment of osseous defects was evaluated in 48 patients. Of these 48 patients, 39 were available to follow up and review. Follow up averaged 19 months for all patients. In the entire series, 30 of 39 patients demonstrated osseous union for a 77% success rate. Patients with fracture nonunion represented the most recalcitrant group clinically, with union achieved in only 61 % of these cases. Overall, the 39 patients grafted with DBM demonstrated healing that was comparable to results achieved with standard iliac crest bone graft. The results indicate the DBM and marrow composite grafting is a suitable alternative to autologous iliac crest bone graft for use in certain clinical situations, such as bone defects in children, comminuted fractures with associated bone loss, nonunited fractures, or to augment an intended arthrodesis site.