bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing a Community-Wide HIV/AIDS Nurse Education Series: A Strategy for Success
Authors: Lachat Maryanne F , Cowen Edward R
Published: April 2021

ABSTRACT

The need for continuing nursing education in the area of HIV/AIDS care and prevention has intensified. Planning community-wide HIV/AIDS programs is a challenge. This article describes a strategy that was successful in consolidating multiagency expertise and in establishing a framework for subsequent continuing education programs.
Individualized Enhancement Programs for Nurses that Promote Competency
Authors: Rath Darlyne , Boblin-Cummings Sheryl , Baumann Andrea , Parrott Eric , Parsons Marilyn
Published: April 2021

ABSTRACT

Working in a cost-conscious health care environment changes the accessibility to conferences, workshops and other continuing education offerings. Educators, employers and individual nurses are compelled to be innovative in their approach to maintaining competency through continuing education (CE). Greater emphasis must be placed on effectively matching CE programs with carefully targeted learning needs. This article illustrates a four-phase approach to an individualized enhancement program that incorporates job expectations and competencies. The phases are: 1) completing a needs assessment, 2) defining learning objectives, 3) assessing available learning resources, and 4) evaluating the CE experience.
From RN to BSN: Seeing Familiar Situations in Different Ways
Authors: Callin Mona
Published: April 2021

ABSTRACT

Registered nurses enrolled in post-RN programs are a special group of students with unique learning needs. One important outcome of a successful post-RN program is the ability of its graduates to see familiar situations in different ways and to demonstrate these changes in new and different approaches to patient care. This shift in the way nurses see themselves and their worlds can be described and explained by Mezirow's Theory of Perspective Transformation. This article discusses perspective transformation related to post-RN students in nursing programs; describes teaching-learning models that assists perspective transformation to take place; identifies conditions that promote perspective transformation; and suggests some strategies to facilitate the process.
Taming the "No-Show" Tiger: Decreasing the Rate of Absenteeism at Educational Programs
Authors: Michal Diane M , Omer Laura P , O'Very Dorothy I , Leblanc Lynne , Chaffee Mary W , Delizo Caroline V
Published: April 2021

ABSTRACT

A multidisciplinary staff development department developed a continuous quality improvement project to study the consistently high absentee rate for scheduled training and its relationship to the class registration process. Data were collected using a 9-question survey of students who failed to attend scheduled training. Findings show that changes to the class registration process resulted in a decrease in the number of absentees under the control of the staff development department from an average of 43% to 6% by the end of the year-long review period. The overall absentee rate stabilized at 20% and has been established as the benchmark for this setting.
So You Want to Host a Nursing Conference?
Authors: Brady Margaret
Published: April 2021

ABSTRACT

The increasing prevalence of nursing certification has led to a corresponding demand for nursing contact hours. The experience of a pediatric department in hosting a nursing conference that offered contact hours may assist others in successfully hosting such a conference and avoiding pitfalls of program planning.
Reflective Learning: Work Groups as Learning Groups
Authors: Carkhuff Marjorie H
Published: April 2021

ABSTRACT

Staff development educators are challenged to develop additional learning strategies to meet the demands of the professional nurse in the changing healthcare environment today. Methodology for workplace learning is being developed to meet the critical thinking skills necessary for the professional nurse of the future. This article identifies the use of reflective learning in the workplace and reports outcomes from the implementation of the reflection-on-action technique. The implications for staff development educators are reviewed for the concept of work groups as learning groups.
Psychometric Evaluation of the Program Evaluation Instrument
Authors: Schneider Joanne Kraenzle , Connelly Lynne M , Martin Arneatha
Published: April 2021

ABSTRACT

Most continuing education program evaluations are developed informally with little attention paid to psychometric properties. Rigorous evaluation of continuing education programs should measure quality and allow valid comparisons across programs. The Program Evaluation Instrument (PEI), which evaluates continuing education programs, was tested in this study to further evaluate its psychometric properties. The 19-item instrument consists of four theoretical subscales: program objectives, learner objectives, teacher behavior, and program satisfaction. Participants (N=566) completed the instrument after a variety of hospital continuing education programs. Principal components factor analysis with Varimax rotation revealed two interpretable factors, Preparation and Presentation, and Usefulness. Coefficient alphas for the two factors were .94 and .70 respectively. The findings suggest item revision and further psychometric evaluation.
Changes in Leadership Styles as a Function of a Four-Day Leadership Training Institute for Nurse Managers: A Perspective on Continuing Education Program Evaluation
Authors: Wolf Margret S
Published: April 2021

ABSTRACT

This study measured changes in knowledge acquisition and application of the Hersey and Blanchard model of leadership styles and leadership style adaptability among 144 registered nurses who participated in a four-day management institute. A pre- and post-institute administration of the LEAD-Self instrument was conducted. Although the findings demonstrated a significant change in the participants' leadership styles, the data revealed that outcomes were not as positive as had been assumed based on participants' selfreports. The discussion of findings reveals the complexity and the necessity of measuring learning outcomes for continuing education program improvement.
Community-Based Educational Programs for Cancer Nursing
Authors: Grant Marcia M , Anderson Paula R , Ritchey Kathie Jo , Gold Sara
Published: April 2021

ABSTRACT

A United Way grant allowed the Department of Nursing Research and Education to make available its expertise in cancer nursing and establish itself as a resource for oncology. Community educational needs were assessed by a questionnaire sent to outside agencies prior to designing an oncology educational program. In a 9-month period, 57 classes at 21 different facilities representing 417 hours of instruction were provided. Nurses attending the classes totaled 1,175. Results showed an increase in scores from pre-test to post-test, indicating that participants demonstrated increased knowledge as a result of class participation. This funding provided the catalyst to prepare a large number of community hospital nurses in the complex care of oncology patients.
Nurses and Public Law 102-119: A Family-Centered Continuing Education Program
Authors: Winstead-Fry Patricia , Bishop Kathleen Kirk
Published: April 2021

ABSTRACT

The passage of Part H of the Education of the Handicapped Act, Public Law 99-457, and the reauthorization of the law in 1991, as Public Law 102-119, mandates a family-centered approach to the provision of services to infants and young children with handicaps. Nurses are named as providers in this federal legislation. The authors conducted a survey to assess the learning needs of nurses who may wish to serve as providers under the law. The survey results were used to develop a family-centered continuing education curriculum that pairs parents and nurse faculty as partners in delivering the curriculum.
The Enhancement of Writing Skills Among Post-RN Students
Authors: Thorpe Karran , Kulig Judith C
Published: April 2021

ABSTRACT

Nurses need to communicate in oral and written formats, but the emphasis on concise charting and multiple-choice examinations hinders the development of scholarly writing skills. A questionnaire completed by 97 students identified the areas within writing and formatting that needed strengthening. Three strategies, useful to continuing education programs for nurses, were incorporated in a post-RN program to enhance the students' writing abilities: a writing skills workshop, an in-class writing exercise and a draft paper assignment. Student evaluations have supported these strategies as well as guidance by faculty in assisting students to improve their writing.
Influence of Professional vs. Personal Role on Pain Assessment and Use of Opioids
Authors: McCaffery Margo , Ferrell Betty Rolling
Published: April 2021

ABSTRACT

Previous surveys have revealed that patient characteristics such as behavior may influence nurses' decisions about pain assessment and analgesic use. This survey suggested that the role assumed by the nurse, professional versus personal, also influences these decisions. The findings further suggested that continuing education aimed at improving pain management needs to include not only knowledge about pain assessment and safety in the use of opioid analgesics, but also teaching methods that increase empathy.
Application of Nursing Interventions Classification (NIC) in a Cardiovascular Critical Care Unit
Authors: Robbins Barbara T
Published: April 2021

ABSTRACT

The nursing profession is moving toward developing a standardized language. Benefits of such a language are outlined. Nursing Interventions Classification (NIC) (Iowa Intervention Project, 1992), a standardized language for nursing interventions, has been recently developed by the Iowa Intervention Project. This article describes how NIC was incorporated into a nursing care plan in a tertiary acute care facility. Teaching strategies, which include aspects of adult learning theory and motivational theory, are discussed, utilization of creativity and variability in the planning and implementation of a unit based inservice program were the most beneficial strategies used.
Thinking About Thinking
Authors: Ulsenheimer Jeanine H , Bailey Donna W , McCullough Elleton M , Thornton Susan E , Warden Elizabeth W
Published: April 2021

ABSTRACT

Background: The nursing leadership at a 900-bed tertiary-care facility in the southeast believed an opportunity existed to improve the critical thinking abilities of the professional nursing staff.

Method: A team, consisting of a diversified group of nurse educators and managers, had the opportunity to gain understanding of the critical thinking process of the nursing staff as well as to develop a plan designed to improve critical thinking skills.

Results: Outputs of the team included development of a critical thinking model and process as well as an action plan that specifically outlined how it would implement the model within the organization using a preceptor-based educational process.

Conclusion: Nursing leadership within this facility believes that nurturing critical thinking in the staff will have a positive impact on care delivery outcomes. Creating shared visions through the assumptions that the staff and organization hold is important to improving care provided. Assisting staff with using a critical thinking process in order to construct, tear down, and then reconstruct clinical incidents as encouraged by this model is one key to problem-solving.
Collaborative Research Among Clinical Nurse Specialists and Staff Nurses
Authors: Govoni Amy L , Pierce Linda L
Published: April 2021

ABSTRACT

Background: Conducting research in clinical settings can be problematic for many nurses in practice due to lack of experience and support.

Method: Research collaboration between clinical nurse specialists and staff nurses in clinical settings can promote development of their research process skills.

Results: Strategies identified can be applied by clinical nurse specialists involved in continuing education and staff development in clinical practice through further research development.

Conclusion: Collaboration among clinical nurse specialists and staff nurses provides a unique and strong link that transcends degrees and roles to make substantial contributions to professional nursing practice.
Identification, Intervention and Education: Essential Curriculum Components for Chemical Dependency in Nurses
Authors: Pullen Lisa M , Green Laura A
Published: April 2021

ABSTRACT

Background: A documented need exists for continuing education in the area of chemical dependency as it relates not only to patient care, but also to nurses who are susceptible to addiction. This is significant due to the fact that nurses are at risk for chemical dependency and many nurse peers are unable to recognize the signs of chemical dependency and therefore unable to actively intervene.

Conclusion: According to the literature, which includes current research, nurses lack knowledge regarding specific risk factors, symptoms of chemical dependency in peers, and steps for intervention. In addition, the literature revealed that nursing curricula allot little time to chemical dependency issues. The results of a small-scale learning needs assessment support this literature finding. Continuing education courses can effectively educate nurses to be able to identify their own susceptibility and those of chemically dependent peers, intervene appropriately, and begin the healing process for the impaired nurse. This article outlines a curriculum and additional resources to address the learning needs of nurses related to chemical dependency.
Substance Abuse Education for Clinical Nurses: A Controlled Study
Authors: Graham Antonnette V , Christy Kathleen , Emmitt-Myers Stephanie , Zyzanski Stephen
Published: April 2021

ABSTRACT

Background: A study was conducted to evaluate a substance abuse component of a workshop for nurses being promoted to the position of Advanced Clinical Nurse.

Methods: We compared whether the 88 nurses who received the educational intervention increased their knowledge and enhanced their feelings of competence regarding the care of chemically dependent patients more than a control group of nurses who received the promotion workshop without the substance abuse component.

Results: The nurses in the intervention group had greater increases in knowledge and competence.

Conclusions: This study points out the importance of providing hospital nurses with continuing education on substance abuse to compensate for their educational deficiencies, to provide the information they need and desire, and to help them meet the ANA's practice standards.
Moving Forward Together: What Hope, Efficacy, Optimism, and Resilience Tell Us About Generation Z
Authors: Cartwright-Stroupe Lya M. , Shinners Jean
Published: April 2021

Generation Z is entering the workforce, requiring nursing professional development (NPD) practitioners to consider their unique characteristics when planning ongoing professional learning. They are also entering the profession at a time when concerns for well-being and resilience are at an all-time high. This article compares psychological capital scores between generational cohorts and provides strategies for the NPD practitioner with the development and education of Generation Z nurses.

[
J Contin Educ Nurs
. 2021;52(4):160–162.]
A Quality Improvement Education Pilot Project to Increase Recommendations for Physical Activity in Cancer Survivors
Authors: Lubejko Barbara , Struth Deborah , Bishop Rachel , Otte Diane
Published: April 2021

Physical activity can provide benefits for cancer survivors. A nurse-provided physical activity recommendation is strongly supported by evidence-based symptom interventions developed by the Oncology Nursing Society. This pilot project aimed to evaluate whether a focused quality improvement education (QIE) intervention could increase the frequency with which oncology nurses provide a physical activity recommendation to patients. Using The Expanded Learning Model for Systems to structure the project, the project team provided a multipronged educational approach with coaching through quality improvement activities to guide practice change. Oncology-focused clinical quality measures (CQMs) related to assessment for cancer-related fatigue and recommendation for physical activity provided the primary data used to evaluate the impact of the QIE intervention. CQM data demonstrated substantial increases in the frequency with which patients were assessed for fatigue and provided with a physical activity recommendation. This pilot project provides preliminary evidence that a QIE intervention supported by coaching can help facilitate evidence-based practice change.

[
J Contin Educ Nurs
. 2021;52(4):184–191.]
United States Suicide Rates, 1933-1968: An Analysis of Some Trends
Authors: Shneidman Edwin S
Published: April 2021

I: Demography of Suicide
Legal Aspects of Psychiatry in the Soviet Union
Authors: Babayan Eduard A
Published: April 2021

ETHICAL ASPECTS OF PSYCHIATRY: A SOVIET PSYCHIATRISTS VIEW
When Should Inpatients Who Exhibit Violent Behaviors Be Prosecuted?
Authors: Dinwiddie Stephen H.
Published: April 2021

Acts of physical violence perpetrated by inpatients on hospital staff are pervasive, erode staff morale, and consequently lead to burnout; these acts of physical violence are all too often ignored or minimized. The human costs of such violence are slowly being recognized, but systemic response lags. In this article, it is argued that under some circumstances criminal prosecution of patients who have exhibited assaultive behavior is an ethically and clinically appropriate response. Prosecution should be an option particularly when assaultive behavior on the part of the patient is clearly instrumental, planned, and believed to stem from antisocial attitudes rather than severe mental illness. Experience has shown that for this intervention to be effective, “stakeholders,” including local police, prosecutors, and hospital administration, must collaborate and agree upon a process whereby specific acts of violence can be addressed by the criminal justice system.

[
Psychiatr Ann
. 2021;51(3):123–126.]
KNOW YOUR COMMUNITY RESOURCES
Authors: Adkins Bertha S
Published: April 2021

Federal Council on the Aging
EXTRAOSSEOUS OSTEOGENIC SARCOMA: A CLINICAL ANALYSIS OF TEN CASES
Authors: Wu Kent K , Guise Edwin R
Published: April 2021

ABSTRACT: This article describes the clinical manifestations, roentgenographic appearance, microscopic features and short- and long-term prognosis of ten cases of extraosseous osteosarcoma. The surgical technique of wedge biopsy and en bloc excision with interlocking sutures has also been illustrated. We feel that en bloc excision is the treatment of choice, and that amputation should be reserved for large tumors with major neurovascular involvement and unresectable recurrence. The overall five-year survival rate was 42.9%.
THE CLINICAL USE OF CEPHAPIRIN SODIUM IN TOTAL HIP ARTHROPLASTY AND MEASUREMENT OF PLASMA AND BONE LEVELS
Authors: Murray William R , Jameson Elizabeth
Published: April 2021

ABSTRACT: Cephapirin sodium, a new parenteral cephalosporin antibiotic recommended for use perioperatively, was administered to 50 consecutive patients undergoing total hip arthroplasty. Blood and bone concentrations extracted simultaneously were measured, and excellent penetration of cephapirin into bone was demonstrated. No infection was observed in any patient after surgery. Few instances of adverse reactions were noted. Although some patients developed phlebitis, no case was severe.
PREVENTIVE PEDIATRIC ORTHOPEDICS
Authors: Thompson George H , Rang Mercer
Published: April 2021

ABSTRACT: Prevention programs for pediatric orthopedic disorders are deficient in the United States today primarily due to a lack of knowledge about their incidence and ultimate disability. Open neural tube defects, Duchenne muscular dystrophy, cerebral palsy, spastic dislocation of the hip, congenital dislocation of the hip, and idiopathic scoliosis are common problems with preventable aspects. These facts should be known by all physicians involved in the care of children.
BILATERAL TOTAL HIP REPLACEMENT IN A DIASTROPHIC DWARF
Authors: Bell Robert S , Rosenthal Ronald E
Published: April 2021

ABSTRACT: This article reports a case of bilateral total hip replacement in a diastrophic dwarf. We were unable to find reports of any similar cases in the world literature, although we do know that Hungerford performed a total hip replacement in a diastrophic dwarf in 1974 (personal communication). In addition to the case report, this article reviews some of the salient characteristics that set diastrophic dwarfism apart from other chondrodystrophies.
DISTAL RADIOULNAR JOINT SUBLUXATION SECONDARY TO EXCISION OF THE RADIAL HEAD
Authors: Hergenroeder Patrick T , Gelberman Richard H
Published: April 2021

ABSTRACT: Subluxation of the distal radioulnar joint, degenerative arthritis, and wrist pain are recognized sequelae of radial head excision. Recently we treated a patient who developed symptoms of wrist pain 20 years after radial head resection. Thirty years after excision the symptoms were severe, and subluxation of the joint was greater (6mm) than in any case reported previously. The long asymptomatic interval associated with marked subluxation and severe symptoms suggests that long term followup is required to determine the incidence of this complication.
POROUS-COATED ENDOPROSTHESIS IN TREATMENT OF SUBCAPITAL FRACTURES
Authors: Rayan Ghazi M , Brooker Andy F
Published: April 2021

ABSTRACT: Excision of the femoral head and replacement with a non-cemented porous-coated Austin Moore prosthesis was performed on 13 patients with subcapital fractures. These fractures represented a small cross-section of problems, including simple trauma, pathologic lesions, and fractures in patients with chronic renal failure and receiving long-term steroid therapy. Followup ranged from 13 to 28 months, during which all patients were interviewed and examined clinically and roentgenographically. One patient was lost to followup. Our results were satisfactory, permitting essentially normal daily activity in all but two patients. One female hemiplegic, confined to a wheelchair prior to surgery, developed considerable ectopic bone limiting hip motion, while a second patient had loosening of his prosthesis after several falls related to his uncontrolled diabetes and hypoglycemic episodes.
PIGMENTED VILLONODULAR SYNOVITIS: A CLINICAL ANALYSIS OF TWENTY-FOUR CASES TREATED AT HENRY FORD HOSPITAL
Authors: Wu Kent K , Ross Paul M , Guise Edwin R
Published: April 2021

ABSTRACT: This article describes the clinical findings, roentgenographic manifestations, gross and microscopic pathology, treatment, and results of 24 cases of pigmented villonodular synovitis treated at Henry Ford Hospital over a period of 25 years. We conclude that synovectomy is the treatment of choice, and we have experienced a 16.7% recurrence rate.
LEGAL LIABILITY AND ORTHOPEDIC SURGERY
Authors: Clarke Ian C
Published: April 2021

The Legal and Engineering Interfaces of Orthopedic Surgery
Mechanical Factors in the Etiology of Low Back Pain
Authors: Adams M A , Hutton W C
Published: April 2021

ABSTRACT: Mechanical experiments were performed on cadaveric lumbar intervertebral joints in order to outline the etiology of common back injuries and low back pain. The results suggest that the osteo-ligamentous lumbar spine is most at risk in the lordotic posture and when bending forward. Sustained lordotic posture can produce abnormal loading of the apophyseal joints. Bending forward wedges the lumbar discs, rendering them vulnerable to fatigue injuries if heavy labor is performed in this posture. Excessive flexion at some spinal level will cause posterior ligament damage, and a strong contraction of the back muscles can then cause prolapsed intervertebral disc. Key words: Lumbar spine, lordotic posture, prolapsed disc.
Cortical Evoked Potentials in Spinal Surgery
Authors: Faust Donald , Happel Leo T
Published: April 2021

ABSTRACT: Few complications of surgery are as devastating as paraplegia in a patient who has been operated on for correction of a spinal abnormality. Early warning of potential damage to the spinal cord is highly desirable. This is possible with cortical evoked potentials. It measures electroencephalographic activity after peripheral nerve stimulation, and may be used during surgery without interrupting the procedure.

In this report, 42 patients were studied by means of cortical evoked potentials. Findings in 35 patients were unremarkable. Six showed changes that made the test valuable; four of these six patients had changes that were ominous. In three of the four, the changes were appreciated and corrections were made to avoid paralysis. In one, changes were not appreciated and the patient became paralyzed. In one case, improvement in conduction was evident when the deformity of the spine was corrected. In another case, the latency was momentarily prolonged when a feeder artery to the cord was ligated.

Although this technique requires special training and equipment, its value justifies the trouble and expense. Certainly its common use in spinal surgery is inevitable.
A Study of Collared Prostheses and Proximal Femoral Dimensions
Authors: Nicholls Paul J , Beard Craig A , Jarecky Thomas
Published: April 2021

ABSTRACT: Difficulty has been encounterd in placing traditional collared total hips so the stem is in a valgus position and the collar is covering the cut portion of the femoral neck. We reviewed the data of Oh and Harris, which was used in designing the HD2 device, and compared these with actual specimens of 21 cadavers and x-rays of 104 Kentucky patients who received total hips. We found that the sizes of hips in Kentucky patients were exactly the same as those on patients in Boston, Massachusetts. We feel that valgus is perhaps overemphasized, and a nonvarus is more appropriate with the collar on the cut portion of the femoral neck.
Fatigue Fracture of the Femoral Neck After Total Knee Arthroplasty A Case Report
Authors: Henke John A , Herbertson F James , Gibson Mark D
Published: April 2021

ABSTRACT: Prolonged immobility predisposes to a multitude of medical problems. In the rheumatoid patient, immobility contributes to a preexisting problem of osteoporosis. Our patient with longstanding rheumatoid arthritis underwent total knee arthroplasty and subsequently developed a fatigue fracture of the ipsilateral femoral neck. To our knowledge, this is the first such case to be reported in a patient with rheumatoid arthritis.
RADIOLOGIC CASE STUDY
Authors: Ray Marilyn J , Bassett Robert L
Published: April 2021

Myositis Ossificans
Maximum Torque at the Time of Retrieval (MTR)
Authors: Burny F , Domb M , Donkerwolcke M , Andrianne Y
Published: April 2021

ABSTRACT: The MTR can be considered as representative of the quality of the anchorage of a cylindrical implant. We present preliminary investigations in the patients of our "External Fixation Clinic." The quality of the anchorage of the pins may decrease according to the duration of implantation. Appreciation of clinical loosening is valuable and can be used to roughly assess the quality of the anchorage.
New Biomechanics Study of Hoffmann® External Fixation
Authors: Vidal J , Nakach G , Orst G
Published: April 2021

ABSTRACT: While remaining faithful to the Hoffmann Vidal external fixator, the authors have been trying for the past 15 years to improve both the stiffness and versatility of the double frame device. Taking into account the different btomechanical studies about the double frame made by different research laboratories, the authors have improved the double frame device by certain modifications in the pins and rods configuration. They have thus obtained the quadrangular triple frame mounting and the triangulate triple frame. The latter device is comparable to a "chalet," being very rigid under any demands but also very versatile due to its smaller dimensions.
Use of External Fixation in Treatment of Primary Bone Tumors
Authors: Peruzzini V , Mainella G , Rolla A
Published: April 2021

ABSTRACT: Two cases of neoplastic affections of the femur are presented, in which external fixation has been used to maintain bone alignment and limb length during the whole treatment period. Advantages and indications of the external fixation in tumors are discussed.
External Fixator Management of Unstable Colles' Fractures: An Alternative Method
Authors: D'Anca Alfred F , Sternlieb Sanford B , Byron Thomas W , Feinstein Peter A
Published: April 2021

ABSTRACT: Eighty-seven comminuted Colles' fractures of the Frykman III-VIII variety have been treated with the Medium-C-Hoffmann® external fixator, as an alternative to pins in plaster management, over a three-year period, with an average length of followup of 19 months. A standard technique had been used. The results were assessed on the basis of subjective, objective, and roentgenographic findings. The overall goal of a painless wrist with excellent motion, good strength, and satisfactory cosmesis appears to have been achieved by this method of management.
A Medical Evaluation of the Effects of Computer Assisted Muscle Stimulation in Paraplegic Patients
Authors: Fournier Arthur , Goldberg Myron , Green Barth , Brucker Bernard , Petrofsky Jerrold , Eismont Frank , Quencer Robert , Sosenko Jay , Pina Ileana , Shebert Robert , Kessler Kenneth , MacDonald Anne , Fiore Paul , Burnett Betsy
Published: April 2021

ABSTRACT: An examination of the medical and physiological effects of functional electrical stimulation (FES) applied to the quadriceps muscle of five paraplegic male volunteers with complete spinal cord injuries was performed. FES training was provided three days a week over a 12-week period using a progressive resistive exercise protocol. Stimulation was applied through use of a closed-loop microprocessor-based FES system. Prior to the start of and immediately following the 12-week training period, subjects were assessed on several measures, including quadriceps muscle bulk and histochemistry, laboratory studies, echocardiography, and arm ergometry exercise. Results of the study indicated substantial increases in muscle strength and muscle bulk. At the outset of the study one patient suffered a patellar fracture. No significant changes in pretraining and posttraining general examinations, laboratory studies, echocardiography, or arm ergometry exercise testing were noted.
RADIOLOGIC CASE STUDY
Authors: Livingston Robert Dale , Khuri Suheil H
Published: April 2021

Osteochondroma
Isolated Rupture of the Tibialis Anterior Tendon Associated With a Fracture of the Tibial Shaft: A Case Report
Authors: Mirza M Ather , Korber Kenneth E
Published: April 2021

ABSTRACT: A case is presented wherein a 19-yearold woman sustained a spontaneous rupture of the tibialis anterior tendon following the fracture of her distal tibia in a motorcycle accident. The details of the operative procedure are described, as well as a discussion of the historic and contemporary treatment modalities for this injury. Subsequent to the tendon reconstruction, the patient underwent a vigorous physical therapy program to correct the dorsiflexion deficit. This effort resulted in the patient walking and running without discomfort, and the achievement of excellent range of motion and dorsiflexion of the injured leg.
Acute Osteomyelitis Overview
Authors: Cole W G
Published: April 2021

ABSTRACT: The presentations and treatments of acute osteomyelitis are surveyed from the perspective of early, late, and subacute manifestations.
Management of Infected Prostheses
Authors: Buchholz H W , von Foerster G , Heinert K
Published: April 2021

ABSTRACT: A retrospective actuarial analysis of 825 onestage reimplantations using antibiotic-loaded acrylic cement for infected total hip replacements is presented. Staphylococcus aureus was the most commonly encountered organism. Failure rates of prostheses infected by S. aureus, Staphylococcus species, and anaerobic Corynebacteria did not differ statistically. A factor that significantly contributed to failure of this method of treatment was Pseudomonas infection. By actuarial analysis (with a twoyear minimum followup) at five years after operation 23% of the implants had failed, and at 11 years, 50%. This compares to a 77% success rate implied by conventional arithmetic.
AML Bipolar Arthroplasty for Degenerative Hip Arthritis
Authors: Shaw James A , Greer Robert B , Kollas Chad D
Published: April 2021

ABSTRACT: Primary total hip arthroplasty using an uncemented AML porous coated femoral component and a bipolar acetabular component was performed on 50 consecutive patients with degenerative arthritis. Of the 50 patients, 43 (48 hips) were available for review at 2 to 3 years follow up. The data obtained in this review suggest that total hip arthroplasty using this prosthesis provides a consistently reliable hip replacement with few related complications and a high patient satisfaction rate. A stable radiographic appearance of both the femoral and acetabular components can be expected.
Sacral Ribs: A Case Report
Authors: Heligman David , Sullivan Robert C , Millar Edward A
Published: April 2021

ABSTRACT: Supernumerary ribs are a rare anatomic curiosity usually discovered as an incidental finding on routine radiographs. The occurrence of sacrococcygeal ribs are extremely rare. Sacral ribs develop as a consequence of the failure of the rib anlage to fuse with the vertebral centers. The present case is unique from previous reports because of the associated scoliosis and hypoplasia of the ipsilateral gluteal musculature and foramina within the accessory rib.
ASSESSMENT OF BONE MINERAL DENSITY IN POSTMENOPAUSAL AND SENILE OSTEOPOROSIS USING QUANTITATIVE CT
Authors: Jahng Jun Seop , Kang Koon Soon , Park Hui Wan , Han Myoung Hoon
Published: April 2021

ABSTRACT

The authors analyzed bone mineral density in 213 patients from January 1988 to September 1989. Bone mineral density of the vertebral body in the osteoporosis group of patients was compared with that in the normal group to investigate the correlation between bone mineral density and age distribution, and to estimate fracture threshold in the osteoporosis group. It was fonnd that men, by linear regression, lose an average of 0.91 % of bone per year, and women, by cubic regression, lose an average of 1.14% per year, accelerating at menopause. In the osteoporotic group, bone mineral density of men decreased an average of 29.7% compared with the nonosteoporotic gronp; that of women decreased an average of 29.9%. There was no difference between sexes. The fracture threshold of the osteoporotic patient was estimated to be about 90 mg/cm
p 3
.
EFFECT OF TREATMENT AND NONCOMPLIANCE ON POST-POLIO SEQUELAE
Authors: Peach Paul E , Olejnik Stephen
Published: April 2021

ABSTRACT

In this study of 77 patients with post-polio sequelae (PPS), symptoms and manual test scores on initial evaluation were compared with those at subsequent follow-up evaluations. Patients were divided into three groups based on the degree to which they had complied with clinically recommended interventions: compilers, partial compilers, and noncompliers. At the end of the follow-up period (2.2 ± 1.2 years), the mean muscle function scores of the entire study group had declined - 1.5%, which represented a decline of -0.7% annually. On follow-up evaluations, the compiler group had realized an improvement or resolution of post-polio symptoms, and also an improvement in muscle function of +0.6% annually. The partial compiler group had realized either no improvement, or improvement in post-polio symptoms, but showed a further decline in muscle function of -3.0%, or an annual decline of -13%. The noncomplier group showed either no change, or a worsening of post-polio symptoms, and also showed a further decline in muscle function of -4.1%, which represented an annual decline of -2.0%.
SUBTROCHANTERIC FRACTURES FOLLOWING OSTEOSYNTHESIS OF FEMORAL NECK FRACTURES WITH THE VLC-FEMORAL SYSTEM
Authors: Blyme Peter J H , Kristensen Gert , Jensen Claus Hjorth , Tørholm Carsten
Published: April 2021

ABSTRACT

Twenty-two patients with femoral neck fracture were treated with the VLC (Variable Length Cannulated)-femoral screw system. In four patients, the osteosynthesis had complications with ipsilateral subtrochanteric femoral fractures in relation to the screw holes in the lateral cortex. The problem seemed to be excessive stress on the lateral cortex during insertion of the screws. The method has been abandoned in our department.
OXYGEN SATURATION DURING REAMING AND INTRAMEDULLARY NAILING OF THE FEMUR
Authors: Blitzer Charles M , Hamilton Lawrence
Published: April 2021

ABSTRACT

Oxygen saturation was monitored during the reaming and intramedullary nailing of 15 femoral fractures (three impending) to assess the relationship between intramedullary reaming and nailing and the production of hypoxemia. There were no statistically significant drops in oxygen saturation during this procedure in either the fractured or intact (impending fractures) femora.
CHANGING PATTERNS OF PROPHYLAXIS FOR DEEP VENOUS THROMBOSIS FOLLOWING ELECTIVE HIP REPLACEMENT
Authors: Grossman Robert S
Published: April 2021

ABSTRACT

The author audited the charts of elective hip replacements at a community hospital over an 18 month period. Initially, aspirin was the most commonly ordered prophylactic agent (31%). Only 15% of patients received an ideal or probably effective prophylactic regimen. After feedback was received by the orthopedists, another audit was performed. Warfarin was the most commonly used agent and 54% of patients received an ideal or probably effective regimen in the follow-up period (P<.0001 compared to initial survey). Although there is still room for further improvement, orthopedists in this community are using more effective regimens to prevent thromboembolism following elective hip surgery.
PEDIATRIC FEMUR FRACTURES: AN OVERVIEW OF TREATMENT
Authors: Levy Jon , Ward W Timothy
Published: April 2021

ABSTRACT

Femur fractures in the pediatric population are common injuries which may be either isolated or associated with polytrauma. The orthopedist is faced with treatment options ranging from skin traction to more aggressive methods, including internal or external fixation. We review the pros and cons of current treatment options. A simple treatment algorithm based on age of the patient, other associated injuries, and open vs closed injury is presented.
INTERLOCKING INTRAMEDULLARY FIXATION OF HAND FRACTURES
Authors: Dabezies E Jean , Faust Donald C
Published: April 2021

Abstract

Reduction and stabilization can be especially difficult in treating comminuted hand fractures with bone loss or nonunion. Two cases are presented to illustrate a method of intramedullary fixation using an AO mini fragment reconstruction plate, which allows interlocking fixation proximally and distali). Any defect can be Filled with corticocancellous bone graft. When necessary, this graft can be fixed to the metal plate that acts as a strut.

The fixation obtained is stable against rotational, angular, and compressive forces, making it a useful adjunct to the hand surgeon's armamentarium.
STABILITY IN RELATION TO HUMERAL HEAD RETROVERSION AFTER SURGICAL TREATMENT OF RECURRENT ANTERIOR SHOULDER DISLOCATIONS
Authors: Kronberg Margareta , Broström Lars-Åke , Posch Elisabeth
Published: April 2021

ABSTRACT

This study reports the influence of the retroversion angle on the postoperative stability in 50 patients operated on for recurrent shoulder dislocations. Fifty-two shoulders were reviewed by radiographic and clinical examinations. Particular attention was focused on humeral head retroversion, shoulder stability, and range of motion in relation to surgical technique. The retroversion angle was significantly reduced in 30 of 47 shoulders, for which satisfiactory radiographs could be achieved. Mean humeral head retroversion was 24° for both dominant and nondominant shoulders. Forty-eight of 52 reexamined shoulders became stable. Four had remaining instability following a Putti-Platt procedure, with a mean retroversion angle of 18°. A reduced humeral head retroversion is therefore proposed as an important factor in creating instability, and may be one explanation for failed stability after soft tissue repair. Irrespective of the type of surgical procedure (Bristow or Putti-Platt), there was a significant decrease in range of shoulder rotation in the operated shoulder compared to the contralateral stable shoulder and to reference values for normal controls. However, decreased rotation was not found to impair shoulder function, and 48 of the 50 reexamined patients generally improved after surgery.
A LITERATURE REVIEW OF LASERS AND ARTICULAR CARTILAGE
Authors: Vangsness C Thomas , Ghaderi Bahram
Published: April 2021

ABSTRACT

Articles from the English literature concerning lasers and articular cartilage were reviewed. Different experimental methods and laser systems were analyzed. Many studies lacked scientific validity. Future investigations with sound biologic foundations are recommended.
REFLEX SYMPATHETIC DYSTROPHY IN CHILDREN: AN ORTHOPEDIC PERSPECTIVE
Authors: Stanton Robert P , Malcolm James R , Wesdock Kimberly A , Singsen Bernhard H
Published: April 2021

ABSTRACT

To design diagnostic criteria for reflex sympathetic dystrophy (RSD) and to initiate a prospective treatment protocol, we reviewed our experience with 49 episodes of RSD in 36 children. There were 24 females and 12 males; mean age at diagnosis was 13.4 years (range: 8 to 19); mean time from pain onset to correct diagnosis was 9.2 months (range: 1 to 53). Lower extremity involvement predominated. Pain was "severe" in 61%, and skin color changes, swelling, hyperesthesia, abnormal skin temperatures, muscle weakness, and decreased range of motion were all present in at least 75% of cases. Osteopenia was observed in 15 of 38 radiographs; of 24 bone scans, 7 were normal, 11 showed increased uptake, and 6 demonstrated decreased uptake. Of the 23 children who had psychological evaluations, 83% revealed some type of significant emotional dysfunction. Analgesic and antiinflammatory medications were not helpful, nor were local injections or regional blockades effective. An inpatient diagnostic and rehabilitation program for treating chronic pain, including orthopedics, rheumatology, psychology, and twice-daily physical therapy was most likely to lead to resumption of age-appropriate activities. Despite extensive physiological testing, physician, parent, and/or patient reluctance to accept absence of a primary organic disease was common. We present diagnostic criteria for pediatric RSD.
COMPLICATIONS IN ARTHROSCOPIC SURGERY OF THE KNEE AND SHOULDER
Authors: Small Neal C
Published: April 2021

ABSTRACT

Arthroscopy is a valuable technique used by the majority of orthopedic surgeons in practice. Complications in arthroscopy have been compiled on a formal basis since 1983. Several studies on complications are reviewed and summarized. A recent prospective study on complications is reviewed in detail. The most frequent type of complication encountered in arthroscopic surgery is hemarthrosis. The procedure with the highest complication rate is the lateral retinacular release. Technical considerations are discussed which would be useful in lessening the incidence of complications in arthroscopy.
CURRENT CONCEPTS IN ANKLE ARTHROSCOPY
Authors: Baker Champ L , Graham John M
Published: April 2021

ABSTRACT

Ankle arthroscopy has rapidly become an important diagnostic and therapeutic procedure. Currently, indications for operative arthroscopy include transchondral talar dome fractures, acute articular fractures with hemarthrosis, posttraumatic synovitis, loose bodies, inflammatory synovitis, degenerative joint disease, and soft tissue impingement. Diagnostic arthroscopy is indicated for the patient with a chronically painful, symptomatic ankle when nonoperative treatment has failed and other measures have failed to produce a diagnosis. Three standard portals are used for routine ankle arthroscopy and allow a systematic examination of the joint. Mechanical distraction may be required to visualize the entire joint, the tight ankle, the ankle with posterior lésions, or to allow operative instruments to be introduced. The use of lasers in arthroscopy has yet to be clearly defined. The small size of the laser is an advantage in the ankle, but cost remains a disadvantage. Advances in technique and equipment will continue to expand the indications for this procedure.
RECENT ADVANCES IN THE USE OF LOW MOLECULAR WEIGHT HEPARINS AS PROPHYLAXIS FOR DEEP VEIN THROMBOSIS
Authors: Colwell Clifford W
Published: April 2021

ABSTRACT

Low molecular weight heparins are providing a new prophylactic option for preventing deep vein thrombosis (DVT) in patients undergoing joint replacement surgery. Fragmentation of heparin in laboratory studies revealed differences in coagulation and bleeding factors. This unexpected finding led to clinical trials, starting in 1985 in Europe and the United States. By late 1993, more than 10 000 patients had been admitted to clinical trials of low molecular weight heparins (LMWH) for prevention of DVT. Results of these trials indicated that LMWHs were more effective than unfractionated heparins or warfarin in preventing DVT with no significant increase in bleeding noted.
IMPACTION GRAFTING: PRELIMINARY REPORT OF A NEW METHOD FOR EXCHANGE FEMORAL ARTHROPLASTY
Authors: Elting James J , Zicat Bernard A , Mikhail W E Michael , Hubbell John C , House Barbara S
Published: April 2021

ABSTRACT

Gie et al described a method for femoral component revision using compressed morselized cancellous allograft and a cemented collarless polished taper stem. We have reviewed our first 37 exchanges performed in this manner. Results after 2 to 5 years have reflected few complications, a majority of satisfactory results, evidence of graft incorporation, and no mechanical loosening. Further study is necessary; however, these preliminary findings give rise to cautious optimism.
DIGITAL LENGTHENING USING THE CALLOTASIS TECHNIQUE
Authors: Seitz William H , Froimson Avrum I
Published: April 2021

Abstract

A series of 14 lengthenings for congenital and posttraumatic digital deficiency has been carried out in a single stage utilizing individual, half-frame design, digital lengthening devices. These devices have afforded individual digital stability without need for additional external support and have provided between 2.0 cm and 3.5 cm lengthening per digit. In only one case was additional bone grafting necessary and in all cases the projected goal of lengthening was achieved. A slow rate of lengthening (0.25 mm in four daily increments) was associated with a minimal amount of pain, patients were able to utilize their hand for function during the lengthening period, and, in cases where physeal plates have remained open, continued growth has been experienced in the follow-up period.
THE USE OF A FOAM ANESTHESIA DONUT FOR THE POSITIONING OF A PATIENT IN THE BARBER CHAIR POSITION
Authors: Dvorkin Michael L , Bradley William
Published: April 2021

ABSTRACT

The foam anesthesia donut proves quite useful in the positioning of the patient in the barber chair position. By placing the donut on top of the patient's face, it protects the patient's eyes from trauma by the assistants holding retractors. The endotracheal tube also can be secured to the ring, protecting it from disconnection during surgery. The inner foam of the donut, which is removed when applying to the face, also can be used to pad the ulnar nerve at the elbow.
RADIOLOGIC CASE STUDY
Authors: Gilbert Thomas J , Goswitz Joseph J , Griffiths Harry
Published: April 2021

CLEAR-CELL CHONDROSARCOMA