bluuebunny/crossref_metadata_2025 huggingface dataset:
Biological features of  high altitude rare medicinal plant species Hedysarum theinum Krasnob. in Western Siberia cultivation
Authors: Zinner Nadezhda S. , Nekratova Anna N. , Shchukina Anastasia V. , Kovaleva Alina L.
Published: April 2021

The paper summarizes the results of a long-term introduction study of a rare alpine plant Hedysarum theinum Krasnob., which is widely used in medicine. We found that the species demonstrates sufficiently high seed productivity with adequate agrotechnical care under introduction conditions. Nevertheless, there were cases of a single lack of fruiting, which cannot be considered a reaction to different ecological conditions since these phenomena can also be observed in natural habitats; most likely, this is a feature of the reproductive biology of the species. The phenological characteristics, seed productivity, and seed germination of the species are given, and the range of variation in signs of the vegetative and generative spheres is established. The introduction assessment indicates high plasticity and a high degree of the species adaptation.
Patterns of richness, diversity and abundance of an odonate assemblage from a tropical dry forest in the Santiago Dominguillo Region, Oaxaca, México (Insecta: Odonata)
Authors: González-Soriano Enrique , Noguera Felipe , Pérez-Hernández Cisteil , Zaragoza-Caballero Santiago , González-Valencia Leonardo
Published: April 2021

A study on the patterns of richness, diversity and abundance of the Odonata from Santiago Dominguillo, Oaxaca is presented here. A total of 1601 specimens from six families, 26 genera and 50 species were obtained through monthly samplings of five days each. Libellulidae was the most diverse family (21 species), followed by Coenagrionidae (19), Gomphidae (4) and Calopterygidae (3). The Lestidae, Platystictidae and Aeshnidae families were the less diverse, with only one species each.Argiawas the most speciose genus with 11 species, followed byEnallagma,Hetaerina,ErythrodiplaxandMacrothemiswith three species each andPhyllogomphoides,Brechmorhoga,Dythemis,ErythemisandOrthemiswith two species each. The remaining 17 genera had one species each.Argia pipilaCalvert, 1907 andLeptobasis vacillansHagen in Selys, 1877 were recorded for the first time for the state of Oaxaca. We also analysed the temporal patterns of taxonomic and phylogenetic divergence for the Santiago Dominguillo Odonata assemblage: the Shannon diversity value throughout the year was 21.07 effective species, while the Simpson diversity was 13.17. In general, the monthly phylogenetic divergence was higher than expected for taxonomic distinctness, and lesser for average taxonomic distinctness. Monthly diversity, evenness and taxonomic divergence showed significant positive correlations (from moderate to strong) with monthly precipitation values. The analysis of our results, however, indicates that an increase in rainfall not only influences the temporal diversity of species, but also the identity of supraspecific taxa that constitute those temporal assemblages, i.e. there is an increase in temporal phylogenetic divergence.
Pythium huanghuaiense sp. nov. isolated from soybean: morphology, molecular phylogeny and pathogenicity
Authors: Chen Jia-Jia , Feng Hui , Yu Jian , Ye Wenwu , Zheng Xiaobo
Published: April 2021

Soybean (Glycine max) is a major source of edible oil and protein. A novel species of the genus Pythium, Pythium huanghuaiense, isolated from soybean seedlings in China, is described and illustrated on the basis of morphological characters and molecular evidence.

Pythium huanghuaiense sp. nov. is closely related to species of the genus Pythium in clade F, as evidenced by the presence of hyphal swellings and its relatively rapid morphological growth. However, it differs by having relatively small sporangia and plerotic or nearly plerotic and thin-walled oospores. A pathogenicity test confirmed the newly-identified species as a pathogen of soybean.
Morphological and genetic evidence supports the separation of two Tapinoma ants (Formicidae, Dolichoderinae) from the Atlantic Forest biome
Authors: Escárraga Mayron E. , Lattke John E. , Pie Marcio R. , Guerrero Roberto J.
Published: April 2021

The taxonomic boundaries of many Neotropical ant species of the genus Tapinoma are still unclear. Tapinoma atriceps and T. atriceps breviscapum are two morphologically similar taxa which occur sympatrically in the southern Atlantic Forest of Brazil. Some characters such as the scape length and head shape suggest that these taxa may be different species. We used DNA analysis and morphological evidence, including scanning electron microscopy, to evaluate the taxonomic validity of these taxa. We found distinct morphological characteristics that allow separating them as two different species, Tapinoma atriceps and Tapinoma breviscapumstatus novo, and this decision is supported by the DNA results, where Tapinoma atriceps was recovered as a lineage independent of T. breviscapum.
A new species of Hemiptarsenus Westwood (Hymenoptera, Eulophidae) from China, with a key to Chinese species
Authors: Tao Shu-xia , Huang Kun , Tian Jing , Ruan Chang-chun
Published: April 2021

A new species, Hemiptarsenus jilinus Tao, sp. nov., is described and illustrated. All the type specimens were reared from Chromatomyia horticola (Goureau) (Diptera: Agromyzidae), a leafminer attacking the plants Ixeris polycephala Cass. and Pterocypsela indica (L.) Shih, in Jilin Province, north-eastern China. A key to Chinese species of the genus is provided.
Continuing Education: How do you Build a Program?
Authors: Smallegan Marian
Published: April 2021

This article looks at the variety of methods used by a Continuing Education program to obtain and develop ideas for course offerings. The use of a variety of methods was intentional so that the resources available would be well utilized. The methods are discussed in the context of methods indicated in the literature.
Notes on Continuing Education
Authors: Murphy Julianne
Published: April 2021

The Faculty of Continuing Education in Nursing from The University of Wisconsin-Extension discuss various aspects of continuing education in this bimonthly feature. Your reactions and suggestions for topics are welcome.
Teaching a New Approach to Quality Improvement
Authors: Green Ellie
Published: April 2021

ABSTRACT

Whatever the educator's role in teaching quality methods, rapid, industry-wide changes in quality practices are having a profound impact on the education department Familiar, comfortable teaching methods for monitoring and evaluation have disappeared. Clinical practice models, long the mainstay of nursing education, have become obsolete in today's multidisciplined environment. This article describes a new approach to quality improvement that utilizes a model expanded beyond clinical practice: a tri-focus of patient, staff, and system, integrated with the four broad-based categories of standards (structure, outcome, process, and evaluation) to achieve quality improvement within the organization.
Generic Orientation for Agency Nurses
Authors: Bliss Julie Beshore , Alsdort Phyllis
Published: April 2021

ABSTRACT

The nurse shortage in hospitals has brought increased entry routes to RNs. One is the employment agency. This pool of nurses has facilitated staffing, but concerned administrators struggle to meet accreditation criteria for orientation of these employees while containing costs. One method is a generic orientation program. The result is a cost savings for hospital administrators, a successful continuing education program, and an assurance of the education/training of employees hired through outside agencies.
Copyright-What's Right?
Authors: Garrett Barbara , Hawkes Warren G
Published: April 2021

ABSTRACT

As information and its methods of storage and transmission continue to expand dramatically, it becomes more important than ever to understand copyright law. Since continuing education means providing current knowledge, educators are in a position to find copyright law the means to that end or the grounds for legal action against them.
A Collaborative Effort in Using Telecommunications to Enhance Learning
Authors: Phillips Carol Y , Hagenbuch Elaine Gallaspy , Baldwin Patricia J
Published: April 2021

ABSTRACT

A consortium of three educational institutions was developed to respond to a possible need for educational programs in the workplace through teleconferencing technology. Based on survey findings, a pilot project of three educational programs was presented. Evaluation of the adequacy of such programming indicated its success in the use of such technology. The effort was unique because there was unprecedented collaboration among nurse executives, nurse educators, the Pennsylvania Nurses Association, the Hospital Association of Pennsylvania, and WITF, the publicly owned telecommunications center.
Nurses and Adult Educational Philosophy: A Comparison of Nurses and Non-Nurses in a Graduate Adult Education Program
Authors: Rachal John R , Pierce W Lee , Leonard Rex , DeCoux Valerie
Published: April 2021

ABSTRACT

A sample of 90 students enrolled in a graduate program in adult education completed three instruments examining adult education philosophies during a related course. There were no significant differences between the nurse educators and the non-nurses on any of the three instruments or on any of their components. This finding contradicts previous research suggesting that nurse educators do not generally incorporate adult learning methods into their courses. Intercorrelations were computed among all the variables. One unanticipated finding was the significant relationship between age and congruence with adult learning principles.
Institute for Nursing Excellence: A Retention Model
Authors: Shay Saundra , Stallings Karen
Published: April 2021

ABSTRACT

In 1989, the General Assembly funded initiatives for the recruitment and retention of nurses, including two pilot "Institutes for Nursing Excellence" designed to develop, recognize, and reward excellent staff nurses. The Wake Area Health Education Center (AHEC) implemented the pilot projects.

In 1991, additional funding was obtained to replicate the pilot projects. The grant was awarded to the Wake AHEC from the General Assembly, through the newly established Center for Nursing. This cooperative effort between the legislature and nursing is considered a model of its kind in this state and possibly the nation.

The purpose of the Institute was to develop mentoring, role-modeling, change, and lifelong learning skills in an atmosphere of renewal, rejuvenation, and trust.
The Multicultural Workplace: Preparing Preceptors
Authors: Williams Jane , Rogers Susan
Published: April 2021

ABSTRACT

As we approach the 21st century, the workforce in the United States is becoming more culturally diverse. This is evident in many of our hospitals across the nation. Preceptors, who are trained as role models, communicators, and teachers, are poorly prepared to deal with the cultural diversity of nurses and their clients. The Texas Medical Center Collaborative Preceptor Program uses several methods to explore cultural differences and increase preceptors' sensitivity to people from other cultures. The course assists preceptors in identifying potential conflicts of value systems and cultural differences and enables them to identify methods of facilitating cultural adjustment. Preceptors are given the opportunity to identify their own cultural values and communication techniques and to experience cultural differences firsthand. The class includes lecture/ discussion, gaming, role-play, and video. Experiential learning is used to identify cultural differences without being culturally offensive or stereotypical.
A Qualitative Analysis of Factors in the Work Environment That Influence Nurses' Use of Knowledge Gained from CE Programs
Authors: Scheller Mary Kay Suitor
Published: April 2021

ABSTRACT

Continuing education (CE) programs for nurses often result in improved quality of patient care and personal and professional growth of participants. These outcomes are not achieved when nurses perceive barriers to putting knowledge from CE programs into practice.

This qualitative study examined nurses' perceptions of factors in the work environment that influence the use of knowledge gained from CE programs. Fourteen themes were identified from analysis of in-depth interviews of eight RNs and observations of their work environment, a 40-bed general medical unit. Factors identified by the nurses were rated on a Likert-type scale and these factors were represented in diagrammatic form, consistent with Lewin's (1951) Field Theory analysis. An in-depth analysis of two qualitative themes is presented here. This analysis suggests three important implications for educators and reemphasizes the need for participant involvement in the planning phase of continuing education programs.
Teaching Infant CPR to Mothers of Cocaine-Positive Infants
Authors: Messmer Patricia , Meehan Renée , Gilliam Nancy , White Susan , Donaldson Pamela
Published: April 2021

ABSTRACT

Cocaine abuse, a major problem in our society, has increased in women of childbearing age. Because cocaine-positive infants are at greater risk for apnea/sudden infant death syndrome (SIDS), their mothers need to be instructed in infant CPR. This study compared the use of a computerized interactive video learning system to the traditional infant CPR teaching method (lecture, video, and return demonstration) to determine the most effective method. This study indicated that mothers of cocaine-exposed infants can learn infant CPR in the immediate postpartum period and that the traditional method was found to be more effective. One unexpected positive outcome was the increase in these mothers' self-esteem.
A Systematic Evaluation of a Poster Presentation
Authors: Horn Phyllis B , Kopser Kathleen G , Carpenter Alicia D
Published: April 2021

ABSTRACT

The purpose of this study was to describe an alternative approach to educating nurses and comparing attendance rates between traditional and alternative programs. In these times of scarce nursing resources, traditional methods of staff development have been found to be ineffective. Frequently, nurses are unwilling to leave their patient care responsibilities to attend even short presentations at a given place and time. A poster presentation designed for oncology nurses attracted 65% of all possible participants.
Continuing Education for Advanced Nurse Practitioners: Preparing Nurse-Midwives as Clinical Preceptors
Authors: Meng Anne , Morris Donna
Published: April 2021

ABSTRACT

Nurses in advanced practice roles are increasingly being sought as clinical preceptors for master's students. These nurses have variable experience as clinical teachers. A program was designed to prepare Certified Nurse-Midwives as clinical preceptors for students enrolled in a masters-level nurse-midwifery program. The program focused on techniques to foster clinical decision making, feedback, evaluation, and learning styles. Evaluations were positive and reflected that preceptors benefited from filmed modeling simulations and case study analyses.
the group therapy MOVEMENT
Authors: Durkin Helen E
Published: April 2021

Current Trends In Historical Context
techniques to raise intensity
Authors: Aronson Marvin L
Published: April 2021

INTENSIFYING THE GROUP PROCESS
INDICATIONS FOR A LONG STEM FEMORAL COMPONENT IN TOTAL HIP REPLACEMENT
Authors: Edwards Walter C , Bethea Stephen J , Fleming Lamar L
Published: April 2021

ABSTRACT: A series of 11 patients who underwent total hip arthroplasty with a long stem femoral component was reviewed. The longest period of followup was five years, average three years. Patients included two women and eight men whose ages ranged from 41 to 67 years. The indications for a long stem femoral component resulted from motor vehicle trauma in three patients, iatrogenic trauma in two patients, neoplastic involvement of the femoral shaft in two patients, and weakened bony stock in four patients. Average hospital stay was five weeks. There were no early deep infections, no postoperative dislocations, and no neurovascular complications. One patient sustained a nonfatal pulmonary embolus. One patient died from overwhelming femoral osteomyelitis three years after surgery. One patient underwent hemipelvecromy for recurrent neoplastic disease three years after surgery. One patient died from pulmonary metastasis two years after surgery.
LONG-TERM FOLLOW-UP STUDY: SEMI-CONSTRAINED ELBOW PROSTHESIS
Authors: Pritchard Rowland W
Published: April 2021

ABSTRACT: Two-hundred and sixty nine cases of elbow replacements employing a semi-constrained hinge prosthesis (Pritchard Mark I and Mark II types) were reviewed by the author. Information was gathered using a standard information sheet sent out to orthopedic surgeons known to have used the prosthesis. Responses from 100 orthopedic surgeons reviewed by the author reflected a significant lowering of long-term loosening as a complication of this type of surgery. This study suggests that careful patient selection, improved techniques for inserting methymethacrylate cement into the medullary canals of long bones, and the improved design of the semiconstrained hinge prosthesis are all important factors relating to long-term loosening.
SUPRAPATELLAR PLICA: A STUDY OF THEIR OCCURRENCE AND ROLE IN INTERNAL DERANGEMENT OF THE KNEE IN ACTIVE DUTY PERSONNEL
Authors: Blatz Douglas J , Fleming Richard , McCarroll John
Published: April 2021

ABSTRACT: Over the past two years, 380 knee procedures have been reviewed to determine the number of suprapatellar plicas that were observed as contributing factors in the patello-femoral derangement problems of active duty personnel seen at the Naval Regional Medical Center in Charleston. Fiftyeight cases with a follow-up of greater than six months were found in which a suprapatellar plica was considered to be pathological, and was removed. The surgical cases involving a plicectomy, a plicectomy and partial chondrectomy of the patella, a plicectomy and menisectomy, or a plicectomy and extensor reconstruction of the patella were followed to determine whether the patients with these conditions returned to full active duty. It was felt that because of the rigors required for shipboard activities, a return to full active duty was considered a good result. One hundred percent of the cases treated by plicectomy and menisectomy were able to return to full active duty after six months. Eighty percent of the cases treated by plicectomy, extensor reconstruction, and partial chondrectomy of the patella were able to return to full shipboard activities.

A more detailed look at the knees that had a plicectomy alone, with a pathologic plica as its only internal derangement, showed that 40% had an excellent result with a return to full active duty and unlimited sports activities. Another 44% had a good result with a return to their full shipboard responsibilities.
THE HERSHEY HALO JIG
Authors: Schwentker Edwards P , Skinner Stephen R , Bowman Larry S
Published: April 2021

ABSTRACT: The Hershey Halo Jig is a device for simplifying the application of the cranial halo ring. Secured by the patient's own body weight, the jig safely supports both the patient's head and the halo ring, leaving the surgeon's hands free for skull pin insertion. The head support is adjustable allowing cervical spine flexion or extension according to stability requirements. The halo jig significantly increases the speed, accuracy, and safety of halo application.
TUBERCULOUS ARTHRITIS OF THE WRIST: DIFFERENTIAL DIAGNOSIS AND CASE REPORT
Authors: Pinstein Martin L , Scott Randall L , Sebes Jeno I
Published: April 2021

ABSTRACT: Tuberculous arthritis usually occurs in the spine, hip, or knee. Tuberculosis is not usually considered early in the evaluation of monoarticular arthritis of a non- weight-bearing joint. We wish to présent a case in which progressive destruction of the wrist occurred in a patient with minimal symptoms and no systemic complaints, thus emphasizing the insidious nature of the disease. A high index of suspicion is necessary if proper diagnosis and medical management are to be instituted.
Gait and Functional Analysis of Patients Following Patellectomy
Authors: Hill James A , Moynes Diane R , Yocum Lewis A , Perry Jacquelin , Jobe Frank W
Published: April 2021

ABSTRACT: Twelve patients who had undergone unilateral total patellectomies were subjected to a thorough evaluation which included questionnaire, physical examination, isometric and isokinetic muscle testing and gait analysis. There were seven excellent results, one good, and four fair results. Patients with excellent and good results had a 45% loss of their quadriceps power compared with the fair group which had a 60% loss of quadriceps power. The patients with an excellent and good result had a velocity of 75.9 m/min compared with the fair result group which averaged 54.3 m/min. There was also a significant difference between the si ng Ie I im b support time in the excel lent and good groups compared with the fair group. Eighty per cent of the patients demonstrated early soleus firing prior to heel contact which is hypothesized to decrease the quadriceps demands at heel strike. Gait analysis revealed direct correlation with functional results, with patients with an excellent or good result having almost a normal gait pattern, compared with the fair group's having marked abnormalities of gait.
Laceration of the Ulnar Nerve With a Closed Fracture of the Distal Radius and Ulna: A Case Report
Authors: Kornberg M , Aulicino P L , DuPuy T E
Published: April 2021

ABSTRACT: Injury to the ulnar nerve with closed fractures at the wrist are rare. A case of an ulnar nerve laceration as a result of a closed Colles' fracture is presented. Rationale for early exploration of the ulnar nerve due to persistent palsy following fracture reduction is discussed.
Cephalosporin Prophylaxis for Total Hip Replacement
Authors: Ritter Merrill A , Conway Mark F , Stringer Elizabeth A , Williams James G
Published: April 2021

ABSTRACT: A randomized, double-blind study of 110 subjects was undertaken to determine the adequacy of recommended antibiotic prophylaxis regimens for total hip replacement. Patients received either cephalothin or cefamandole preoperatively at anesthesia induction, and every four hours for 48 hours postoperatively. Samples of eight tissue types, excised in surgery, and serum and wound drainage were assayed for antibiotic levels. These levels were averaged for each drug group and time interval taken and compared with the MICs for Staphylococcus aureus and S. epidermidis. Cefamandole maintained consistently higher levels in all tissues, and penetrated bone and deep tissues better than cephalothin (P < .001). Our study supports the following recommendations for total hip replacement prophylaxis: the initial dose should be given 15 minutes prior to incision; a second dose should be given one hour after the first dose; and cephalothin, if used for prophylaxis, should be given in the maximum recommended dosage due to its poor tissue penetration.
Hydrofluoric Acid Burns of the Hand
Authors: Straub Ronald R
Published: April 2021

ABSTRACT: Hydrofluoride burns of the hand are evaluated from physiologic and treatment aspects, and two case reports are presented. An uncommon complication of hydrofluoric acid burns of the hand is presented as reflex sympathetic dystrophy. Initial treatment of hydrofluoric acid burns of the hand involves debridement of the burn and calcium gluconate injections locally into the area. Burns involving the nail bed frequently necessitate removal of the nail for proper treatment.
Wound Sepsis Due to Postoperative Gauze Packing
Authors: Green Stuart A , Garland Douglas E
Published: April 2021

ABSTRACT: Two cases of sepsis due to postoperative gauze pads left in wounds during the course of daily wound packing are reported. We recommend that only continuous gauze rolls be used for such procedures.
The Principles of the Treatment of Tibial Shaft Fractures: A Review of 10,146 Cases From the Literature
Authors: Keller Cary S
Published: April 2021

ABSTRACT: The tibial shaft is a common site of long bone fracture, and both nonoperative and operative treatment methods have been developed in an effort to speed union while minimizing complications. To compare the recent results of present treatment alternatives and to identify those factors of prognostic significance, a review of the 1976-1981 English literature was performed, representing a review of 10, 146 fractures. Comminution, displacement, bone loss, distraction, soft tissue injury, infection, polytrauma, and patient personality were found to be factors that place the patient with a tibial shaft fracture at risk for local and systemic complications. Fracture location, fracture configuration, and concomitant fibula fracture were found to be of no prognostic significance. The advantages and disadvantages of casts, traction, plates, intramedullary rods, and external fixation are discussed. The principles of treatment of soft tissue injury, transverse and short oblique fractures, spiral fractures, single butterfly comminution, segmental fractures, comminuted fractures, bone loss, "floating knee" injuries, bilateral tibial fractures, and brain injured patients are detailed.
A Histopathologic Comparison of the Tissue Reaction to Prosthetic Materials in the Knee Joint of Rats
Authors: Uchida Shoji
Published: April 2021

ABSTRACT: The five kinds of prosthetic materials: powders of cobalt alloy, stainless steel, alumina ceramic, HDP plastic and bone cement, were injected into the knee joints of 16 rats for each material. Two controls were used, one with saline solution and the other untreated. Some of the rats were sacrificed at one week, being left untreated. Some of the rats were sacrificed at one, four, 12 and 25 weeks after injection. The knee joints of these rats were taken out for a histopathologic study. The main changes were fibrosis and granulation due to foreign bodies, but no remarkable change in the degree of tissue reactions was observed within each material group, nor did the length of period have any effect thereon. Comparing the degree of the above changes caused by each material in the tissue, ceramic powder showed the most significant change, followed by bone cement, HDP, stainless steel and cobalt alloy powder, in that order. No tumorous condition was observed.
Treatment of Fractures of the Femur with the Grosse-Kempf Rod
Authors: Acker James H , Murphy Charles , D'Ambrosia Robert
Published: April 2021

ABSTRACT: Intramedullary rod placement provides excellent fixation for many fractures of the femur. It also carries a high union rate, a low infection rate, and a shortened hospital stay for the patient. Certain fractures of the femur are not suitable for fixation with a standard intramedullary rod alone. Use of the Grosse-Kempf rod, with interlocking screws, allows for stable fixation for long oblique fractures, spiral fractures, comminuted fractures, segmental fractures, fractures with a butterfly fragment, and fractures located in the proximal or distal shaft of the femur.

The Louisiana State University (LSU) Orthopedic experience in the use of the Grosse-Kempf rod is presented in this article. We have treated a total of 60 fractures of the femur in 58 patients with this fixation system. This series consists of 58 acute fractures, one established nonunion, and one established infected nonunion. All patients in the group of acute fractures and who have had adequate follow up and time have healed. This group consists of 29 healed fractures and four fractures which are healing, but have recently had the static screw removed. Eight patients were lost to follow up, two died of causes unrelated to the treatment, and 17 have been placed recently and have not had time to healThere was one instance of wound infection in the acute fracture group, associated with the distal screws, but this has not required rod removal.

The Grosse-Kempf rod provides the treating physician with another option in the treatment of fractures of the femur not suitable for use by the standard intramedullary rod. The procedure is difficult, but we have found it to be reliable in treatment of difficult fractures.
Controlled Mobilization of Patients Undergoing Reconstructive Spinal Surgery: Preliminary Comparison of the Kinetic Therapy Table vs the Foster Frame
Authors: Trammell Terry R , Reed Dianne B , Goodwin Charles B
Published: April 2021

ABSTRACT: Controlled mobilization is necessary in certain situations during the management of patients undergoing reconstructive spinal surgery. Chart review of 39 patients (20 maintained on the Roto-rest bed, 19 maintained on the Foster frame) was undertaken. Both beds protected spinal stability and no delays occurred in any staged surgical procedure. Patients maintained on the Roto-rest bed did have a significantly higher incidence of skin problems (p<.05), but had no pulmonary emboli. Pulmonary emboli occurred in two of the 19 patients maintained on the Foster frame. Successful use of the Roto-rest bed was dependent upon skilled nursing personnel who were knowledgeable in the mechanical aspects of the bed and could provide a sense of security for the patient. No evidence was found that the Roto-rest bed affected the patients' use of postoperative anaigesics. Both beds provided adequate controlled mobilization. Consideration of the patients' total medical profile would determine the choice of bed.
Thumb Reconstruction-An Algorithm
Authors: Koman L Andrew , Poehling Gary G , Price James L
Published: April 2021

ABSTRACT: A patient-oriented treatment algorithm was developed to place in perspective the multiple treatment options available for thumb reconstruction. This algorithm was derived from our experience with 52 patients with congenital thumb hypoplasia or aplasia (n = 10) or traumatic amputations (n = 42). The available options for reconstructive treatment include replantation and revascularization, pollicization, microvascular transfer, lengthening, and web space deepening/lengthening. Using this algorithm, a rational decision can be made on the basis of the length of the remaining digit and the associated injuries. Often, patients with as much as 1 cm of proximal phalanx remaining may have good function and sensibility without reconstruction.
A Case Report of a Compressive Neuropathy of the Radial Sensory Nerve Caused by a Ganglion Cyst at the Elbow
Authors: Hermansdorfer John D , Greider Jack L , Dell Paul C
Published: April 2021

ABSTRACT: A case of an elbow ganglion cyst with compression of the radial sensory nerve is presented. The mass was noted on the anterior-radial aspect of the elbow after exertional trauma. Symptoms resolved following surgical excision. There has been no recurrence at one year.
Medial Meniscal Cysts: Case Report and Review of the Literature
Authors: Spence Kenneth F , Robertson Roger J
Published: April 2021

ABSTRACT: Cysts of the medial meniscus are rare. They may present as a local tumor or may mimic signs of an internal derangement. The pathology may be treated by arthroscopic subtotal meniscectomy alone if the meniscal tear and cyst communicate, by local cyst excision and reattachment of the meniscus, or total meniscectomy. Two cases are presented with a review of the literature.
Fatigue Fracture of a Tibial Interlocking Nail
Authors: Cohn Bruce T , Bilfield Laurence
Published: April 2021

ABSTRACT: The interlocking system has recently become a popular mode of treatment for unstable fractures of the tibia. Metal fatigue is an extremely rare complication of the system; this article presents a case of metal failure, and the possible mechanisms.
Frostbite and Bone Scanning: The Use of 99m-Labeled Phosphates in Demarcating the Line of Viability in Frostbite Victims
Authors: Ikawa Glenn , dos Santos Paulo A L , Yamaguchi Kent T , Stroh-Recor Carol , Ibello Rick
Published: April 2021

ABSTRACT: Early diagnosis of the extent of bone and soft tissue damage is a very important step in treating a frostbite victim. The diagnostic use of Tc-99m-phosphates in assessing the viability of soft tissue and bone in frostbite was evaluated in the early post-thaw period. Four patients were treated with a combination of warm baths, rehydration, vasodilators, epidural block, fasciotomy, and debridement. Six scans were done to stage involvement. In three of the four cases, final involvement could be determined as early as the third day. When a specific level of soft tissue or bone uptake was determined, future scanning showed either improvement, or no change in three of the four patients. In our experience, Tc-99m-phosphate scans represent an improvement over other diagnostic tests for viability of tissues.
Changes in the Mechanical and Electrical Environment and the Effect on Bone
Authors: Kennedy Michael Anthony
Published: April 2021

ABSTRACT: The mechanical and electrical environment has been shown to influence the growth and development of bone. The research provided in this review of the literature, is that presented to the Department of Orthopedic Surgery at Stony Brook University Hospital, Long Island, New York. Bone development is influenced by the normal growth process, level of exercise intensity, and surgical procedures. An altered structure leads to an altered function. Clinical application of direct electrical stimulation has been shown to induce osteogenesis in nonunion fractures.
ANSWER PLEASE
Authors: Gruel John , Newman P James
Published: April 2021

Distal Clavicle Osteolysis
Malignant Rhabdoid Tumor of the Thoracic Spine
Authors: Tantana Supranee , Sotelo-Avila C , Pilla Thomas J , Sundaram Murali
Published: April 2021

ABSTRACT: A case of malignant rhabdoid tumor of the spine and a description of its CT findings are presented. The CT demonstrated a heterogenous contrast enhancing epidural mass associated with severe bony destruction of the adjacent vertebra and cord compression.
Compression Capability of Cerclage Fixation Systems: A Biomechanical Study
Authors: Shaw James A , Daubert Harlan B
Published: April 2021

ABSTRACT: Cerclage wire or tension band techniques are frequently complicated by broken wires or inadequate bony stabilization. The fixation capabilities of various cerclage systems were defined in this study by measuring the maximum compression forces generated by the different methods as well as their ultimate strengths. Parham bands and swage-lock titanium cables were found to exhibit the greatest fixation potential and highest ultimate strengths. Cerclage fixation using stainless steel wire was found to be enhanced by using a modified square knot. Mersilene tape was found to have fixation capabilities of similar magnitude to 20 gauge stainless wire secured with a twist knot The polypropylene and nylon cable ties tested showed no advantage when compared to the other systems.
Synovial Chondromatosis
Authors: Wilson William J , Parr Thomas J
Published: April 2021

ABSTRACT: Two patients were evaluated for a complaint of long-standing hip pain. No etiology of their progressively disabling symptoms was found by routine diagnostic studies. Hip arthrography and arthrotomography in each case, however, demonstrated multiple intraarticular filling defects consistent with nonradiopaque loose bodies. These were subsequently confirmed at arthrotomy.

Synovial chondromatosis is a rare disease in which intrasynovial cartilage metaplasia results in multiple intracapsular loose bodies. Its presence in plain radiographs is uncommon, but has been previously documented. This can account for frequent long delays in accurate diagnosis. Arthrography and/or arthrotomography, however, can be key diagnostic tools. They are recommended in the evaluation of patients whose relatively normal initial clinical examination, laboratory, and roentgenographic studies fail to adequately explain the presence of genuinely disabling symptoms.
Thoracolumbar Needle Biopsy
Authors: Alexander A Herbert
Published: April 2021

ABSTRACT: Utilizing radiologic C-arm control, percutaneous needle biopsy of the spine may be performed safely at the T11 through L5 levels. Its main advantage is the avoidance of performing an open surgical biopsy; however, it is an exacting technique and, even when done properly, the procedure may result in nondiagnostic tissue.
Neuropathic Sternoclavicular Joint Secondary to Syringomyelia: A Case Report
Authors: Chidgey Larry K , Szabo Robert M , Benson Daniel R
Published: April 2021

ABSTRACT: A 14-year-old boy is presented with syringomyelia and a neuropathic sternoclavicular joint. Recognition of neuropathic arthropathy of the upper extremity is important when a massive, destructive joint lesion exists in a patient with syringomyelia.
Stabilization of Atlantoaxial Instability
Authors: Aprin Hormozan , Harf Robert
Published: April 2021

ABSTRACT: Eight patients with atlantoaxial instability were treated by arthrodesis oí the first and second cervical spine. Internal fixation was achieved by passing two 18 gauge stainless steel wires beneath the posterior arch of the atlas and around a threaded Steinmann pin which was drilled through the base of the spinous process of the axis. The wires were tightened over a preshaped iliac bone graft. A solid fusion was achieved in all patients. The risk of compression of the cord is decreased with this technique because the wires are not passed under the lamina of the axis. The lateral placement of the wires provides an excellent internal fixation and control of the forward flexion and rotation.
Angiomyoma in the Hand
Authors: Shapiro Jeffrey D , Froimson Avrum I
Published: April 2021

ABSTRACT: Angiomyoma of the upper extremities is not commonly encountered by the orthopedic surgeon. A case of a vascular leiomyoma developing in a 79-year-old woman is discussed along with a review of the literature.
Open Reduction and Internal Fixation of Three-Part Fractures of the Proximal Humerus
Authors: Savoie F H , Geissler W B , Vander Griend R A
Published: April 2021

ABSTRACT: Eleven patients with 12 threepart fractures of the proximal humerus were treated by open reduction and internal fixation using AO/ASIF buttress plating. All of the fractures healed. There were no failures of fixation. Nine of these patients returned for a follow up of more than 2 years and had a satisfactory rating using Neer's shoulder rating system. Five patients who had an acromloplasty at the time of their initial surgery had slightly better function and range of motion than the remaining patients. Successful operative treatment requires accurate definition of the fracture pattern, careful attention to the details of internal fixation, and supervised postoperative rehabilitation.
Bone Strength of the Radius and Ulna in the Non-Human Primate
Authors: Mennen Ulrich
Published: April 2021

ABSTRACT: The technique and measurement of the bone strength of the radius and ulna in the non-human primate are presented. The aim of this study was to find a relationship between the mechanical strength of an intact radius and ulna forearm and its collateral isolated radius and isolated ulna which would be of assistance in the studies on mechanical bone strength and bone healing. The findings include: (1) bone strength is significantly influenced by factors such as age, sex, and body weight; (2) wide variation in normal bone-tissue strength exists among similar individuáis; (3) there are differences in bone strength in the same individual if contralateral sides are compared; (4) growing bones are very elastic and are able to bend to an angle of up to 90° before a fracture occurs; (5) soft tissue structures (such as muscle, interosseous membrane, and tendons) do not contribute to the strength of a diaphysis in low velocity injuries; and (6) the midshaft area of the radius is approximately 10% stronger than that of the ulna in the adult.
The Charnley Total Hip Arthroplasty in Juvenile Rheumatoid Arthritis Patients
Authors: Gudmundsson G H , Harving S , Pilgaard S
Published: April 2021

ABSTRACT: A follow up of 27 consecutive total hip arthroplasties in 16 patients with juvenile rheumatoid arthritis was performed. The mean age at surgery was 18 years, and the average follow-up period was 64 months. No serious early complications were recorded, but three deep infections developed from 6 to 18 months after the arthroplasty, all requiring revision. The clinical results were good at follow up, as 20 hips were free of pain and 7 had only slight pain. Most of the patients had improved their walking ability and the range of motion in the hip as well. A poor correlation was, however, shown between the clinical and the roentgenographical results, as there was one femoral implant that was definitely loose and four more hips that had components which were probably loose.

The frequency of infections might have been reduced by using antibiotic prophylaxis during surgery in all the cases; the frequency of aseptic loosening might also have been reduced by improved cementing techniques. Because of high loosening rate without clinical symptoms, it is recommended to follow the patients roentgenographicaily to make revision surgery possible while the bone stock still is sufficient.
Correction of Hallux Valgus and Metatarsus Primus Varus Using the Cedell Technique
Authors: Jensen Niels Christian , Søballe Kjeld , Christiansen Svend Erik
Published: April 2021

ABSTRACT: The Cedell procedure consists of: a proximal valgus osteotomy of the first metatarsal bone to correct the metatarsus primus varus, a soft tissue plasty at the first metatarsophalangeal joint with lateral release, and tightening of the medial capsule to correct the hallux valgus. A total of 45 operations in 31 patients (2 men and 29 women) were performed. Forty-one of these operations were followed. The average age at surgery was 24 years (range 16 to 43 years), and the average follow-up time was 23 months (range 8 to 56 months). The postoperative decrease in the intermetatarsal angle averaged 10°, and the average decrease in the metatarsophalangeal angle was 26°. Only a few postoperative complications were observed. At the time of follow up, 75% of the patients had no pain, 23% had only slight pain, and 2% had severe pain. Ninety -five percent were cosmetically satisfied with the operation. The Cedell operative technique has proved to be an effective procedure to correct the combined hallux valgus and metatarsus primus varus in younger patients.
Measurement of Effective Pedicle Diameter in the Human Spine
Authors: Banta Charles J , King Andrew G , Dabezies Eugene J , Liljeberg Robert L
Published: April 2021

ABSTRACT: Effective pedicle diameter (EPD), the maximal cancellous diameter of the spinal pedicle, demonstrates the maximal diameter available for transpedicular screw placement. The pedicles of 16 spines from T6 to L5 were measured directly with a graduated mean increase in the EPD ranging from 4.8 mm at T6 to 5.9 mm at L5. This direct pedicle measurement was significantly smaller than that of previously reported studies, which directly and radiographically measured pedicle outside width rather than inner diameter. Three specimens had little, if any, pedicular medullary cavity on direct measurement, although radiographic appearance of a medullary cavity existed. If EPD is significantly smaller than radiographic pedicle width measurements, safe transpedicular screw fixation may not be achieved. Preoperative planning must account for this so that transpedicular screws of correct diameter may be used and the complications of pedicular blowout fracture and neurologic impairment may be avoided.
Urinary Tract Catheterization Protocols Following Total Joint Arthroplasty
Authors: Ritter Merrill A , Faris Philip M , Keating E Michael
Published: April 2021

ABSTRACT: Six hundred one consecutive total joint arthroplasty patients were divided into three groups using three different catheterization protocols. Each group was evaluated for preoperative and postoperative urinary tract infections, number of catheterizations, and number of subsequent urinary tract manipulations. Group 1 (165 patients) was treated with "as needed" intermittent catheterization. One hundred six of these patients (64%) required a minimum of one catheterization with a total of 265 (mean 2.4 per patient) catheterizations. One postoperative urinary tract infection was recorded. Group 2 (295 patients) was treated with in-and-out catheterization on one occasion followed by anchoring of a closed drainage system if needed. One hundred eighty-one patients (61%) required catheterization, 124 (69%) of these patients required anchoring of a closed system. Two (0.69%) of these patients developed postoperative urinary tract infections. Group 3 (140 patients) were treated with intraoperative sterile anchoring of a closed drainage system which was maintained for 48 hours or less. Ten patients required in-and-out catheterizations (maximum one per patient) after system discontinuance. No urinary tract infections developed. Using Fisher's Exact test, no statistical difference in infection rates was found between the three groups. The group 3 protocol was felt to offer several patient conveniences.
The Anaform Endoprosthesis: A Proplast-Coated Femoral Endoprosthesis
Authors: Keet George G M , Runne Wouter C
Published: April 2021

ABSTRACT: The Anaform® endoprosthesis study is a prospective trial by 12 orthopedic surgeons from six different hospitals in the Netherlands begun September 1984. As of March 1, 1988, 510 prostheses had been implanted, 60 with a follow up of more than 3 years. Of the 181 patients with a follow up of more than 2 years, 92% had a Harris hip score of more than 80 points. Apart from the main series, the prosthesis was used in 35 patients for revision of a cemented prosthesis, of whom 13 had a follow up of more than 2 years. Of these, ten patients (73%) had a Harris hip score of more than 80 points. Most patients studied were more than 65 years old. Fixation by ingrowth of fibrous tissue in a 2 mm thick, soft, flexible, lowmodulus stem coating can provide painless function, clinical stabilization, and normal gait. The Anaform femoral endoprosthesis seems to be of advantage in the young patient as a method of cementless fixation. When necessary, removal without bone destruction is easy.
Adaptive Bone Remodeling and Biomechanical Design Considerations for Noncemented Total Hip Arthroplasty
Authors: Huiskes Rik , Weinans Harrie , Dalstra Michel
Published: April 2021

ABSTRACT: Clinical problems with noncemented total hip arthroplasty (THA) stems, directly or indirectly related to load transfer, include mid-thigh pain due to relative (micro) motions or excessive endosteal interface stresses, subsidence and loosening due to inadequate primary stability and fit, and proximal femoral bone atrophy due to stress shielding. In this article, the load-transfer mechanisms associated with noncemented THA stems and their resulting stress patterns are discussed in relation to design features, bonding characteristics, and materials choice. Nonlinear finite-element models and computer simulation programs for strain-adaptive bone remodeling have been used for this study. Canalfilling, fully bonded metal stems have been found likely to cause proximal bone atrophy, possibly leading to long-term failure of the implant/bone composite. The use of flexible (isoelastic) materials and/ or press-fit fixation reduces stress shielding, but also reduces the potential for interface stability. The stem material, the stem shape, and the coating geometry interact in relation to the load-transfer mechanism, and it is suggested that optimal combinations of these characteristics can be determined through the computer simulation methods presented.
Correction of Rotary Malunion of the Fingers by Metacarpal Rotational Osteotomy
Authors: Menon Jayasanker
Published: April 2021

ABSTRACT: Metacarpal rotational osteotomy was performed in 12 patients to correct rotary malunion following fractures of the phalanges and metacarpals. All but one patient obtained excellent correction of their preoperative deformities. The procedure is simple and gives predictable results.