bluuebunny/crossref_metadata_2025 huggingface dataset:
Response to Zamani et al. (2020): The omission of critical data in the pursuit of “revolutionary” methods to accelerate the description of species
Authors: Sharkey Michael , Brown Brian , Baker Austin , Mutanen Marko
Published: April 2021

Here we respond to the criticisms leveled against a proposal that suggested an efficient solution to the taxonomic impediment. We clarify some of our objectives and demonstrate that many of the criticisms apply more to traditional approaches to taxonomy rather than to our minimalist approach.
L'éthique en contexte info-communicationnel numérique
Authors: Cordier Anne , Capelle Camille , Lehmans Anne
Published: April 2021

L’introduction du numérique à l’école, qui correspond aussi à une intrusion du monde extérieur dans un espace relativement clos, pose de nouvelles et importantes questions, souvent perturbantes, parce qu’à travers le numérique dans ses potentialités informationnelles, l’intégrité, la santé, la liberté, l’autonomie individuelles sont susceptibles d’être menacées. Cette question concerne particulièrement les enseignants. À partir des données recueillies dans le cadre de deux projets de recherche collectifs, nous nous demanderons quelles conceptions de l’éthique dans l’éducation au numérique sont portées par les enseignants en début de carrière, et quelle place ils accordent à cette dimension dans les formations qu’ils mettent en place. Pour ce faire, nous présenterons tout d’abord les cadres théoriques et méthodologiques dans lesquels s’inscrivent nos réflexions croisées. Puis nous analyserons la façon dont les enseignants de nos études perçoivent la dimension éthique de l’éducation au numérique. Enfin nous tenterons de proposer des pistes éducatives et pédagogiques pour une appréhension ambitieuse et complexe de la dimension éthique de l’éducation au numérique.
Les pôles de compétitivité, territoires de l’innovation sociale
Authors: Peres Raphaële
Published: April 2021

Cette recherche explore l’innovation sociale dans les pôles de compétitivité. Notre analyse propose sept dimensions de l’innovation sociale, mises en évidence dans le fonctionnement de deux pôles de compétitivité de la Région Sud. Pour ce faire, nous mobilisons les outils de gestion inhérents à l’activité des pôles de compétitivité en termes de coordination, de régulation et de management des connaissances. Il en ressort que les pôles de compétitivité constituent des structures d’innovation sociale dont le fonctionnement est propice à la réalisation de l’innovation sociale. De plus, nous mettons en évidence que ce sont les projets portés par les membres des pôles de compétitivité qui répondent aux besoins sociaux territorialisés.
Comment peut-on améliorer la performance individuelle au travail ?
Authors: Nande Florence , Commeiras Nathalie
Published: April 2021

La performance individuelle au travail est au cœur des débats de toutes les organisations, relevant du secteur privé ou de la fonction publique. La littérature sur ses déterminants est foisonnante. Cependant, peu de travaux analysent les liens entre les identités multiples détenues par un individu (appelées ici ressources identitaires), les ressources contextuelles présentes dans son environnement de travail et sa performance individuelle au travail. L’objectif de cette recherche est de tester d’une part, les effets directs des ressources identitaires sur la performance au travail et d’autre part, l’effet médiateur des ressources contextuelles sur cette relation. Cette recherche suggère ainsi qu’en contexte de travail, les ressources contextuelles à la disposition des individus interagissent avec ses ressources identitaires et vont avoir des conséquences en termes de performance au travail. Pour mieux appréhender ces relations, la théorie de la conservation des ressources (Hobfoll, 1989; Hobfoll et al ., 2018) est mobilisée. Pour les tester, une étude empirique auprès de 400 enseignants-chercheurs français titulaires d’Universités Françaises a été menée. Les résultats de la recherche indiquent que les effets directs des ressources identitaires sur la performance sont peu nombreux. En revanche, les ressources contextuelles médiatisent la relation entre les ressources identitaires d’un individu et sa performance individuelle au travail, mettant en exergue l’importance dans une culture managériale d’un environnement de travail favorable à la préservation et l’acquisition des ressources des individus.
Voyage des ressources en organisation polaire : étude d’un « Caravan resources passageway » au sein d’un centre hospitalier
Authors: Alphonse-Tilloy Isabelle , Dubroeuq Anne-Fabienne , Scoyez-Van Poppel Sylvie
Published: April 2021

La littérature décrit une intensification du travail des cadres paramédicaux (cadres de santé et cadres paramédicaux de pôle) exerçant dans les établissements hospitaliers qui est susceptible d’impacter la santé au travail. Des réorganisations structurelles ont par ailleurs modifié le contexte dans lequel cet encadrement opère. Dans quelle mesure ce contexte est-il créateur ou destructeur de ressources permettant à l’encadrement paramédical de faire face aux exigences ? Le traitement de cette problématique repose sur la mobilisation du concept de « Caravan Resources Passageways » (CRP) issu de la théorie de la conservation des ressources (Hobfoll, 1998, 2001 ; Halbesleben et al., 2014). L’apport théorique de l’article réside dans l’identification et la caractérisation de six mécanismes par lesquels un CRP agit, dans le cadre d’une étude de cas réalisée sur l’encadrement paramédical d’un établissement hospitalier : l’attribution de ressources, l’invalidation de ressources, la diffusion de signaux pour investir en ressources, le renforcement des gains et des pertes, le renforcement ou l’atténuation du besoin en ressources et la restauration de ressources. L’enjeu managérial consiste à identifier les leviers d’action permettant de retrouver des gisements de ressources et ainsi influer sur la qualité de vie au travail des personnels de cet encadrement.
Régulation des conflits interpersonnels : le rôle de l’objet-frontière
Authors: Ndiaye Adama
Published: April 2021

L’objet-frontière permet-il de réguler les conflits interpersonnels dans le secteur social et médico-social ? L’usage d’un objet frontière cadre le questionnement, et une démarche ethnographique de deux études de cas longitudinales dans le secteur social et médico-social est déployée. Les résultats montrent deux trajectoires contrastées : un premier cas (REPOSANCE) marqué par la persistance des conflits interpersonnels et la perte de sens, un second cas (RESTOS DU CŒUR) montrant une capacité de prise en charge effective des conflits interpersonnels. En proposant le concept d’objet-frontière, nous montrons leur rôle dans la prise en charge vertueuse et pérenne des conflits interpersonnels.
Maintenir l’ordre. De quel État notre police est-elle le nom ?
Authors: Guémas Marion , Taïbi Nadia
Published: April 2021

Il s’agit de plaider pour un service public qui se tourne vers la protection des citoyens, ce qui induit un changement d’approche fondamental. Au contraire, on a l’impression que certains syndicats de police sont assez frileux et ont des réflexes corporatistes, ce qui les conduit à minimiser le malaise qui existe actuellement entre forces de l’ordre et population et à rejeter toute remise en question. C’est par exemple le cas quand ils manifestent leur opposition à toute condamnation judiciaire contre un agent, quelle qu’ait été son action.
L’institut Luce sous la présidence Sardi 1928-1933
Authors: Copertino Giovanni
Published: April 2021

Penser la période fasciste, c’est se confronter à des images, des documentaires et des ciné-journaux, qui ont marqué une partie de l’histoire du xx e  siècle italien. Sans doute Benito Mussolini a été attiré par toutes les potentialités du nouveau moyen cinématographique pour acculturer les masses au nouveau régime fasciste.
Area Inservice Interest Group Ohio - Pennsylvania
Authors: Popa Helen
Published: April 2021

Another NfSE (Nursing Inservice Education) Group
Methods of Teaching - Revisited Displays and Exhibits
Authors: Cooper Signe S
Published: April 2021

This article, the seventeenth in this series, discusses two audiovisual resources that might be better designated learning aids than teaching methods. Readers are invited Io share lheir experiences with leaching methods.
The Professional Issues Forum for Primary Nurses: A Method for Professional Development
Authors: Ponte Patricia Reid , Barrett Carol
Published: April 2021

ABSTRACT

This article describes a formal mechanism for facilitating a theory-based practice through professional development of primary nurses in a large teaching hospital. The use of the theoretical concepts in clinical decision-making by primary nurses is illustrated by a case presentation. The continuing nurse educator's role in planning and conducting the forums is discussed.
The Effects of Continuing Education on Nursing Practice: A Meta-Analysis
Authors: Waddell Donna L
Published: April 2021

ABSTRACT

A meta-analysis of published and unpublished studies was conducted to reconcile the apparent conflicting results in the domain of research designed to determine the effects of continuing education on nursing practice. The overall mean effect size supported the hypothesis that continuing education positively affects nursing practice. Findings related to mediating effects were inconclusive. Suggestions for future research are given.
Nursing Internships: Taking a Second Look
Authors: Kotecki Catherine Nuss
Published: April 2021

ABSTRACT

Nursing internships are associated with recruitment and retention efforts of hospitals to gain new nursing employees. They are recognized as a benefit to new nursing staff and the hospital as well. Reported to bridge the gap and ease the transition to registered nurse, internships have been reported in the literature for over 30 years. But how effective are they? This article reviews the recent literature for evidence that internship programs improve recruitment and retention, have a positive cost benefit ratio, and ease the role transition of newly employed nurses.
Using a Game Format to Improve Compliance with Required Review of Hospital Standards and Policies
Authors: Felder Beverly J
Published: April 2021

ABSTRACT

Maintaining quality patient care requires frequent review of hospital standards and policies. This repetition, however, proves to be boring and not much fun, resulting in poor staff participation. The anticipation of a visit from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) provided the impetus for individual nursing units to develop a means of addressing this problem. Utilizing shared governance concepts, staff developed a game format to stimulate interest. This not only made learning and reviewing fun, but also empowered the staff to become accountable for the quality of their work. This article describes the development of the game format, its implementation, and evaluation of its effectiveness.
An Orientation Program for New Graduate Nurses: The Basis of Staff Development and Retention
Authors: Cooney Ann Taylor
Published: April 2021

ABSTRACT

The nursing shortage and an increased demand for obstetric nurses led a Central Texas hospital to hire new graduates for the Level Three obstetric unit. This change in hiring policy necessitated a reevaluation of the orientation program resulting in a new approach in staff development. A three-phase program was developed beginning with orientation and socialization of the new staff member, continuing with the development of advanced skills, and leading to assignments of complex cases after completing appropriate educational programs. The program has fostered autonomy in the experienced staff nurse and increased job satisfaction as measured by advancement in the career ladder and retention rate. The program is regularly monitored by chart and peer review audits, as well as by the orientees' six-week and six-month evaluations.
A 10-Year Follow-Up Study: Nurse Refresher Program
Authors: Ferris Laurice , Brown Linda B
Published: April 2021

ABSTRACT

A university-based school of nursing has provided a refresher course for inactive nurses since 1980. In 1985, the nursing shortage and declining enrollments in generic nursing schools emphasized the need to return inactive nurses to work. This article describes the 10-year follow-up evaluation of the course with attention to the long-term effectiveness in returning inactive registered nurses to the work force. This study also describes the employment profile of course graduates and the continuing education acquired by respondents since completing the course. Of the 71 respondents, 91% successfully reentered the work force and remained employed in nursing. Nearly half of these individuals were employed in acute care settings. Further, the employment profile of the working graduates showed that 74% had obtained an initial nursing position and remained in it until the time of the follow-up evaluation. Implications of the study and changes planned for the course are also described.
Retention of Continuing Education Participants
Authors: Gillies Dee Ann , Pettengill Marian
Published: April 2021

ABSTRACT

The Midwest Alliance in Nursing (MAIN) used a multidirectional approach to recruit long-term care nurses to a three-year, federally funded continuing education (CE) program in geriatric nursing. Program staff used a project logo, frequent mailings, bimonthly telephone calls, a series of diverse educational offerings, and scattered social meetings to strengthen participants' identification with the project's purpose and activities. Nevertheless, several nurse dyads failed to complete the program, citing excessive workload and lack of agency support as principal reasons for withdrawal. Program staff concluded that, without strong and continuing support from their employer, even highly motivated nurses will not maintain commitment to an extended-time CE program.
Juggling Performance Checklist
Authors: Mooney Nancy E
Published: April 2021

ABSTRACT

Teaching psychomotor skills to nurses presents challenges to nurse preceptors. The Juggling Performance Checklist, used by The Presbyterian Hospital in New York City, presents a humorous way of teaching nurses how to teach psychomotor skills. Humor can have both a physical and psychological benefit. Please note the directions on the performance checklist-washing your hands is optional; having fun is not!
How to Outsmart "Murphy"
Authors: Romer Charlene M
Published: April 2021

ABSTRACT

Critical thinking and creativity are two of the many skills that nursing educators try to develop in their students. Assessing a problem, planning possible solutions, and then creatively using the resources available to implement the solution take practice. As nurse educators, we must not become "rusty" in these highly valued skills. The article is this author's humorous account of using these skills.
Continuing Education for Advanced Oncology Nurses
Authors: Lathrop Nancy , Otte Diane M
Published: April 2021

ABSTRACT

Continuing education (CE) opportunities for oncology nurses practicing at an advanced level are difficult to access. This article describes an ongoing educational effort to meet the needs of this target group in a midwestern state. Details of conference planning, implementation, and evaluation are included. A description of the screening process and program content is emphasized. This approach is applicable to a variety of specialty practice areas.
"Essential Americans": A Poster Session for Essential Education
Authors: Sedory Michelle A , Campeau Cheryl A
Published: April 2021

ABSTRACT

The Joint Commission on Accreditation of Healthcare Organizations requires that all member hospitals provide information to the nursing staff on safety practices at least every other a year. Hospital policy requires that this information be provided once yearly. The Staff Education Department at a large teaching hospital used posters to disseminate this required information, known as "Essential Education." The posters, which matched topic areas with famous Americans, presented the necessary content in a clear, concise manner. The nursing staff found the posters to be less time-consuming and more interesting than previous essential education programs. A cost analysis demonstrated a significant savings for the hospital.
Revisiting CPR Knowledge and Skills Among Registered Nurses
Authors: Lewis Frances H , Kee Carolyn C , Minick M Ptlene
Published: April 2021

ABSTRACT

The purpose of this investigation was to explore facets involved in the retention of the cognitive knowledge and psychomotor skills of cardiopulmonary resuscitation (CPR) by 73 RNs from three general hospitals. Data analysis indicated that cognitive knowledge was adequately retained but that skills were not. Product-moment correlation coefficients showed that the number of CPR courses taken, certification as a CPR instructor, the number of years certified, and time since last certification were significantly related to skill scores. Findings prompt questions of appropriateness of the usual certification procedures for hospital-based RNs.
How Nurses React to and Cope With the Uncertainty of Unfamiliar Technology: Validation for Continuing Education
Authors: Wichowski Harriet Conley , Kubsch Sylvia
Published: April 2021

ABSTRACT

Technological developments in healthcare continue, and nurses working in acute health care settings are assailed with new techniques. The focus of this qualitative study is methods nurses employ to stay current with new technological procedures. This article features nurses' verbatim responses regarding their use of technology and the facilitative role of continuing education.
Erroneous Beliefs About Research Held by Staff Nurses
Authors: Morrison Eileen F
Published: April 2021

ABSTRACT

Background: Experiences in working with nurses conducting research in clinical settings have uncovered a number of beliefs that may create unnecessary obstacles and limit research efforts. This article discusses these beliefs and provides examples.

Method: Although this article was not conceptualized as a research study, the information was gleaned through working with nurses on a day-to-day basis as a researcher.

Results: Eleven beliefs were identified and discussed.

Conclusion: These beliefs have implications for nurses who are attempting to conduct clinical research. The intent of the article is to educate nurses regarding the philosophy of science and research methods in this context.
PSYCHIATRY AND THE LAW
Authors: Stone Alan A
Published: April 2021

The case law which Judge Bazelon produced is the first substantial legal scholarship in an area which has for decades suffered from benign neglect. Psychiatrists need to understand the importance of case law and written opinion for judges, lawyers, law professors, and law students.
MEET YOUR LEADERS
Authors: Anonymous
Published: April 2021

Meet Your USPHS Leaders
TOTAL JOINT REPLACEMENT IN BUNION SURGERY
Authors: Kampner Stanley L
Published: April 2021

ABSTRACT: A preliminary report is given for total joint replacement arthroplasty utilizing a siliconepolyester prosthesis, in selected cases of destroyed metatarsophalangeal joints of the great toe. Fiftythree prostheses were implanted over a period from March 1971 to March 1977, with a minimum followup of one year. Overall results were good, from the standpoint of pain relief and cosmetic correction, in severely destroyed and deformed joints. The essential aspects for successful prosthetic arthroplasty include proper seating of the prosthesis and complete realignment of the first ray, paralleling the adjacent metatarsals. On the basis of these preliminary results, it is concluded that there is a place for total joint prosthetic replacement in the surgical reconstruction of the painful, destroyed metatarsophalangeal joint of the great toe.
FAILURE OF FEMORAL COMPONENT IN TOTAL HIP ARTHROPLASTY: A CASE STUDY - FAILURE ANALYSIS
Authors: Zeide Michael S , Pugh James , Jaffe William L
Published: April 2021

ABSTRACT: Marked bending prior to fatigue failure of the femoral component of a total hip arthroplasty points out the necessity for proper valgus placement of the prosthesis in the femoral shaft, especially in large active patients. This failure also indicates the need for limiting activities in such a patient.
RECURRENT POSTERIOR DISLOCATION OF THE SHOULDER: A METHOD OF RECONSTRUCTION
Authors: Beller Rick D , Grana William A , O'Donoghue Don H
Published: April 2021

ABSTRACT: A method of reconstruction for recurrent posterior dislocation of the shoulder is presented, as well as the results of soft tissue repair in nine patients. There were no recurrences. There was one unsatisfactory result with restriction of activity and motion. Because of eight satisfactory results and no recurrences, we recommend soft tissue reconstruction for this entity.
ABERRANT LUMBRICAL MUSCLES CAUSING CARPAL TUNNEL SYNDROME
Authors: Wiss Donald , Weinert Carl R , Imbriglia Joseph E
Published: April 2021

ABSTRACT: Two cases of carpal tunnel syndrome secondary to an abnormally proximal origin of the lumbrical muscles are presented. Division of the transverse carpal ligament and neurolysis of the median nerve was performed in both cases, resulting in complete relief of symptoms. The anomalous lumbrical muscle bellies were not resected.
TRAUMATIC FEMORAL NERVE NEUROPATHY TREATED BY INTERFASCICULAR NERVE GRAFTING: A CASE REPORT AND LITERATURE REVIEW
Authors: Menon Jayasanker , House Homer C
Published: April 2021

ABSTRACT: A case of traumatic femoral nerve neuropathy secondary to a close range shotgun wound in the groin is described. Spontaneous recovery did not occur because of the segmental defect in the nerve and extensive scarring over the groin. Reinnervation of the quadriceps mechanism was achieved by interfascicular nerve grafting. Interfascicular nerve grafting is a useful technique in lower extremity nerve injuries.
LOWER EXTREMITY RECONSTRUCTION USING MYOCUTANEOUS FLAPS
Authors: Janecka Ivo P
Published: April 2021

ABSTRACT: This report describes a group of 57 myocutaneous flaps utilized in reconstruction of lower extremities. Myocutaneous flaps were selected in our cases to provide the necessary soft tissue coverage for exposed bones following trauma or surgery. No other local flaps could have been substituted. Cross-leg pedicle flaps, with their known disadvantages, were thus avoided. Successful transfer of myocutaneous flaps can be anticipated in over 90% of cases.
LOCALIZED NODULAR SYNOVITIS OF THE KNEE: A CASE REPORT
Authors: MacCarter Daryl J , Williams H James , Samuelson Kent M , Samuelson Cecil O
Published: April 2021

ABSTRACT: A 25-year-old man with chronic swelling of the right knee had a mass that was eventually palpated in the suprapatellar pouch. Arthrotomy and biopsy revealed localized nodular synovitis. Since surgical excision of the mass the patient has been asymptomatic. While localized nodular synovitis generally appears as an internal derangement of the joint, this patient had signs and symptoms of chronic monoarthritis.
MAYO CLINIC TUMOR ROUNDS
Authors: Eckardt Jeffrey J , Cooper Kay L , Unni Krishnan K , Sim Franklin H
Published: April 2021

Benign Giant Cell Tumor of Bone
QUADRICEPS RUPTURE IN ASSOCIATION WITH THE ROENTGENOGRAPHIC "TOOTH" SIGN: A CASE REPORT
Authors: Kelly Douglas W , Godfrey Kevin D , Johanson Paul H , Whiting Mikel
Published: April 2021

ABSTRACT: This article reports a case of quadriceps tendon rupture in association with the roentgenographic "tooth" sign. This sign has not been reported previously in association with quadriceps tendon rupture, but may be helpful in assisting in the early diagnosis of this injury.
LOOSENING OF THE COMPRESSION SCREW IN SLIDING SCREW PLATE DEVICES
Authors: Weber Peter C
Published: April 2021

ABSTRACT: This article describes two cases in which the compression screws became loose after healing of intertrochanteric fractures that had been repaired with sliding screw plate devices. Although recent reports have emphasized the importance of retaining these compression screws, loosening of the screws may cause problems for some patients.
LEGAL LIABILITY AND ORTHOPEDIC SURGERY
Authors: Zweng Mark S
Published: April 2021

Civil Liability and the Investigational Device Exemptions
INTRAPELVIC MIGRATION OF THREADED PINS FOLLOWING OPEN REDUCTION AND INTERNAL FIXATION OF THE ACETABULAR FRACTURE
Authors: Popovic N A , Moehring D , Hankin F
Published: April 2021

ABSTRACT: The subject of this article is intrapelvic migration of threaded pins used in fixation of fracture. A case report is presented along with suggested treatment. A discussion of pin migration follows.
FEMORAL FRACTURE BELOW AN AUSTIN MOORE PROSTHESIS: A SIMPLE METHOD OF TREATMENT
Authors: Shelbourne K Donald , Hutson Richard A
Published: April 2021

ABSTRACT: Femur fractures below endoprostheses can be a catastrophic occurrence. Insertion of a long stem prosthesis, or bedrest with traction can both present problems in elderly patients. A simple method of treatment using Rush pins and cerclage wires is described along with a case presentation.
DeQUERVAIN'S TENOSYNOVITIS DIAGNOSTIC AND OPERATIVE COMPLICATIONS
Authors: Belsole Robert J
Published: April 2021

ABSTRACT: This study reviews 36 complications in 19 patients with DeQuervain's disease to emphasize specific diagnostic and therapeutic directives.
CUPPING OF THE LATERAL TIBIAL PLATEAU ASSOCIATED WITH A DISCOID MENISCUS
Authors: Engber William D , Mickelson M R
Published: April 2021

ABSTRACT: This report of a patient with a discoid lateral meniscus is of interest due to its association with a deep distinct cupping of the underlying lateral tibial plateau. This radiographic finding, if present on plain roentgenograms, should alert one to the possibility of a discoid meniscus.
FOREFOOT ARTHROPLASTY IN RHEUMATOID ARTHRITIS: CLINICAL APPRAISAL AND FORCE PLATE ANALYSIS
Authors: Fu Freddie H , Scranton Pierce E
Published: April 2021

ABSTRACT: Nineteen metatarsal head resections are evaluated at an average followup of 18 months. A subjective patient questionnaire and objective clinical evaluation reveal that in the rheumatoid patient with severe foot involvement, this operation is quite successful. The cholesterol-crystal force plate is shown to be helpful in pre- and postoperative evaluation of these patients.
Wrist Arthrography in Acute Carpal Injuries
Authors: Moneim Moheb S , Omer George E
Published: April 2021

ABSTRACT: A prospective study of 10 patients with acute complex carpal dislocations was undertaken. Preoperative wrist arthrograms were done in these patients. We then observed the ligamentous tear through both volar and dorsal approaches at the time of open reduction. Perilunate dislocation was always an integral part of the pathology in all patients, except in one patient with radiocarpal dislocation. Communication between the radiocarpal and midcarpal joint was found in all patients, except in one patient with radiocarpal fracture-dislocation. Volar extrusion of the contrast material occurred in all patients except one. Dorsal extrusion occurred only in three patients. The arthrography findings correlated well with the pathology at surgery, as far as indicating the level of the ligamentous disruption. Volar tears were much more common than dorsal tears.
RADIOLOGIC CASE STUDY
Authors: Schwartz Charles M , Demos Terrence C
Published: April 2021

DIAGNOSIS: Simple Bone Cyst
The Jeweller's Thumb: An Occupational Neuroma A Case Report
Authors: Thirupathi Ramaya , Forman Donald
Published: April 2021

ABSTRACT: Perineural fibrosis and scarring of superficial nerves can occu r secondary to chronic frictional forces. This results in a tender lump in the nerve and hyperesthesia of the area of its distribution. Bowler's thumb is a well known entity which involves the ulna side digital nerve of the thumb at the level of the MP joint. This article describes a perineural fibrosis of the digital branch of the thumb in a jeweller who presented with pain and swelling at the center interphalangeal joint. Surgical excision of the fibrous mass and neurolysis has relieved the symptoms.
Slipped Capital Femoral Epiphysis: Complications Related to Internal Fixation
Authors: Swiontkowski Marc F
Published: April 2021

ABSTRACT: In situ pinning and subtrochanteric osteotomy have been widely used in the operative treatment of slipped capital femoral epiphyses. A review of all operative procedures performed at Children's Orthopedic Hospital in Seattle, Washington from 1960 to 1982 was performed. In the 85 consecutive cases, there were 66 pinning procedures with a 30% incidence of pin penetration. In 18 cases of attempted pin removal, there was major difficulty in 11 (61%). In 1 3 cases of subtrochanteric osteotomy, there was a significant incidence of infection, chondrolysis, and implant complication with fair to good clinical results in 11 cases. From this series the author concludes that in situ pinning is technically difficult and that two pins are adequate. Hagie or Moore pins should not be used, because of difficult pin removal. Anterior bone graft epiphysiodesis may be the procedure of choice for slips of more than 35° to 40°. Key indexing terms: slipped capital femoral epiphysis, slipped epiphysis, internal fixation, in situ pinning, subtrochanteric osteotomy.
Treatment of Posttraumatic Elbows With a New Hinge-Distractor
Authors: Deland J T , Walker P S , Sledge C B , Farberov Anatoly
Published: April 2021

ABSTRACT: A simple design of elbow hinge distractor for the restoration of joint function in contractures, ankyloses, persistent dislocations, and nonunions is presented. Soft tissue releases and reshaping of joint surfaces is carried out surgically as required. Obtaining motion and stability is achieved with side plates attached to external fixation pins, one of which passes through the axis of rotation of the joint and about which flexion takes place. Distraction is obtained by a screw that separates the ulnar side plates from the humeral side plates. To aid in accurately placing the axis of rotation pin at surgery, a study was done to determine the best fit axis of rotation and how it relates to boney landmarks. One case of an ankylosed elbow is presented in detail, including the surgical technique. This and other previous cases have shown that good clinical results can be achieved in these otherwise poorly functioning elbows. Key index words: Elbow, Biomechanics.
Surgical Treatment in Patients With Myelodysplasia Before Using the LSU Reciprocation-Gait System
Authors: McCall Richard E , Douglas Roy , Rightor Nicholas
Published: April 2021

ABSTRACT: Surgical procedures for myelodysplastic patients being prepared for treatment with the LSU reciprocation-gait system should correct any contractures or deformities of the lower extremities that are severe enough to prevent brace fitting. Most of these procedures should be done when the patient is between six and nine months, to enable the lower extremities to be in braceable position by the age of nine to twelve months.
Reconstruction of Acetabular Deficiency Utilizing Iliac Bone Graft
Authors: Eaton Richard , Capello William N
Published: April 2021

ABSTRACT; Acetabular reconstructions were performed on 12 hips possessing deficient acetabuli. Eleven required total hip arthroplasties for relief of pain; seven of which were surface replacements. The one remaining h ip had erosion of the posterior wall, secondary to spastic paraparesis, and the posterior wall was reconstructed. The etiologies of the deficient acetabuli included five secondary to fracture/dislocation, four with acetabular dysplasias, and three related to failed acetabular components from conventional total hip arthroplasties. There were six posterior Hp deficiencies, five superior rim deficiencies, and one central deficiency. The iliac crest provided the graft material utilized in 11 of 12 cases; in one case the femoral head was used for reconstruction. All peripheral defects, however, were handled similarly regardless of the source of graft material, in that all grafts were secured with at least two cortical cancellous screws lagged for compression. Central defects utilized single cortex grafts keyed into the defect upon a bed of cancellous graft and rimmed with methyl methacrylate. All patients were followed at routine intervals; the shortest followup was 14 months, and the longest 32 months. All grafts showed radiographic evidence of union by one year. Three-phase bone scans were routinely done in patients undergoing surface replacement by one year. The scan appearance of the femoral head was identical to other uncomplicated surface replacements. The grafted area showed increased uptake.

The purpose of this report is twofold: to present iliac crest as a graft material from which deficient acetabuli can be reconstructed when autogenous femoral head is not available, and to offer a fixation technique potentially less demanding and yet no less secure than those previously suggested. The results of this study indicate that, in selected situations, iliac crest graft acetabuloplasty can be successfully employed so that the total hip arthroplasties may be performed reducing fear of premature acetabular loosening related to insufficient bony coverage of the acetabular component.
Arthroscopy and Arthroscopic Surgery of the Elbow
Authors: Guhl James F
Published: April 2021

ABSTRACT: Arthroscopy and arthroscopic surgery of the elbow were performed in 45 cases of 3,300 arthroscopic procedures between 1974 through 1984. The indications established are: loose body removal, treatment of osteochondritis dissecans, synovectomy for non-specific and rheumatoid synovitis, treatment of some selected fractures, debridement of specific cases of degenerative arthritis, excision of osteophytes and for evaluation and treatment of the undiagnosed painful elbow. The choice of two different methods is described; one with the arm on an arm table as for hand surgery, and the other with the arm suspended overhead for easier access to the medial side. Normal arthroscopic anatomy of the elbow joint is described. The instruments have been classified as those most commonly used, those of special use, those instruments rarely or never used, and some special instruments introduced more recently. Eight approaches to the elbow joint for viewing and instrumentation are illustrated. The technique for entering the joint, distending and placing the scope, establishing drainage, probing and instrumentation is shown and illustrated. Immediate postoperative care and complications are shown. Seven representative cases are presented. Results of this small number of cases clearly indicate that there is a need for diagnostic and operative arthroscopy of the elbow.
Femoral Artery Laceration Complicating an Intertrochanteric Hip Fracture: A Multi-Disciplinary Therapeutic Problem
Authors: Moss Gregory David , Chmell Samuel , Pillars James R , Haid Sidney , Milewski Stanley
Published: April 2021

ABSTRACT: Major arterial injuries are uncommon complications of intertrochanteric hip fractures. Described is transcatheter embolization of a lacerated femoral artery complicated by a large hematoma, discovered following surgical repair of an eight day old intertrochanteric fracture. The case was complicated due to a history of aspirin usage, marked obesity, and thrombocytopenia. Interventional radiology techniques may provide an alternative to surgery in selected cases.
Delayed Tarsometatarsal Joint Dislocation Following Forefoot Injury
Authors: Wynne Austen T , Southgate George W
Published: April 2021

ABSTRACT; Presented is a case of a delayed dislocation of the tarsometatarsal joints following an apparent simple strain with no displacement. Open reduction was successfully performed five weeks following the injury. The difficulties assessing these potentially unstable injuries are discussed.
Total Knee Arthroplasty in Chronic Hemophilic Arthropathy
Authors: Magone Jerry B , Dennis Douglas A , Weis Lawrence D
Published: April 2021

ABSTRACT: Nine total knee arthroplasties were performed in seven patients with either Hemophilia A (factor VIII deficiency) or Hemophilia B (factor IX deficiency) and followed for an average of 52 months. A total condylar prosthesis was used in eight virgin knees and a stemmed variable axis prosthesis was used in one revision case. All knees demonstrated the severe joint destruction and cartilage erosion characteristic of chronic hemophilic arthropathy. The average age at operation was 32 years.

All patients were evaluated using the knee disability assessment of The Hospital for Special Surgery. All knees were postoperatively rated as either excellent or good. Pain, function, and range of motion were markedly improved. Postoperative radiographic alignment averaged 4° of valgus with half of the virgin knees demonstrating 1 mm or less of non-progressive tibial radiolucency without clinical loosening. The only complication was hemarthrosis from 37 to 59 months postoperatively. This was thought to be secondary to trauma to residual synovium.

Total knee arthroplasty in the hemophiliac is a viable alternative to conventional methods of treatment for chronic arthropathy and expectations for pain relief and functional gain can be high.
Free Vascularized Bone Transfers for Nonunions, Segmental Gaps, and Following Tumor Resection
Authors: Wood Michael B
Published: April 2021

ABSTRACT: Free vascularized bone transfer is recognized as a valuable technique for skeletal reconstruction and salvage with certain nonunions, skeletal defects, and following tumor resection. This procedure is most often indicated for reconstruction of lengthy skeletal defects or under circumstances where conventional bone grafting techniques are unlikely to succeed. Factors affecting selection of donor bone and technical peculiarities relative to the recipient sites are discussed. The results of 49 cases at the Mayo Clinic for management of nonunion, segmental gaps or following tumor resection suggest a union rate of 82%. The most consistent rate of success was found for reconstruction of defects affecting the tibia, mandible or forearm bones.
The Dorsalis Pedis Island Pedicle Flap for Small Defects of the Foot and Ankle
Authors: Gould John S
Published: April 2021

ABSTRACT: The dorsalis pedis island pedicle flap is used frequently for coverage of small soft tissue defects (3 cm to 5 cm) of the foot and ankle. Defects overlying the malleoli, heel, and distal tibia can be covered by mobilization of the anterior tibial pedicle. For these small flaps the venous comitates provide adequate outflow. These flaps should be considered in preference to cross leg and free flaps when feasible due to their relative efficacy and reliability.
The Role of the Microsurgical Laboratory in Orthopedic Training Programs
Authors: Gould Sheryl H
Published: April 2021

ABSTRACT: A well-organized, efficiently run microsurgical research and training laboratory can be a valuable asset to an orthopedic training program. The three areas in which the laboratory can lend support are teaching, research, and clinical. Organization and utilization of the laboratory as a multifunctional facility can enable it to provide maximum support for the microsurgical aspects of the orthopedic training program.
Elastic Intramedullary Nailing in Shaft Fractures of the Femur and Tibia
Authors: Mollica Quintino , Gangitano Roberto , Longo Gianfranco
Published: April 2021

ABSTRACT: The excellent results obtained in the stabilization of lateral and subtrochanteric fractures of the neck of the femur by the use of Ender nails have encouraged us to extend this method, with some technical modifications, to shaft fractures of the femur, it is proposed to be an alternative in the surgical treatment of such fractures.

We propose to use this alternative when local conditions counterindicate, or the risk factor in other surgical techniques is too high. This method is simple, easily executed and assures a rapid and functional recovery.

Ender Intramedullary nailing achieves a dynamic stabilization controlled by the elasticity of the nails, muscle tone and weight bearing. The stabilization allows slight interfragmentary movements and produces the formation of periosteal bone callus.
A Simple Treatment of Genu Recurvatum in Ataxic and Athetoid Cerebral Palsy
Authors: Nuzzo Roy M
Published: April 2021

ABSTRACT: An inexpensive, simple treatment for ataxic- or athetoid-related genu recurvatum is presented with analysis of the relevant gait mechanics. An exaggerated posterior heel flair is used in combination with a functionally dorsiflexed, below-knee orthosis to overcome terminal swing phase recurvatum at heel strike, and to provide an effective forward knee thrust through the solid ankle link. This combination is very effective in some patients, even when more extensive treatments have failed. It is easily reversible. Computerized gait analysis, used in this report for illustration, is not essential for implementation, nor for patient selection. However, video examinations are useful for adjustment of the treatment geometry.
Zone Approach to Knee Arthroscopy
Authors: Rich Christopher , Drez David , DeLee Jesse
Published: April 2021

ABSTRACT: The zone approach to knee arthroscopy divides the knee into ten anatomic zones. This article presents the zone classifications and describes the combination of portals for the arthroscope, the probe, and the operating instruments. The particular leg position which is thought to allow the best visualization of each zone is also described. Alternate portals are necessary in certain situations, as in knees with tight ligamentous structures. This list of standard and alternate portals is not meant to be all-inclusive, but we do urge that all ten zones are examined during arthroscopy.

The objectives of this article are to describe a method of arthroscopic examination that is both systematic and comprehensive, and to develop an arthroscopic nomenclature that allows easy localization and reporting of pathology in the knee joint.
Evaluation of Gait With Multichannel Electrical Stimulation
Authors: Malezic M , Bogataj U , Gros N , Kelih B , Kljajic M , Acimovic-Janezic R
Published: April 2021

ABSTRACT: Short, intensive multichannel electrical stimulation therapy was evaluated in 14 hemiplegics after stroke or head injury. The stimulation of the peroneal nerve, soleus, quadriceps, hamstring, gluteus maximus, and triceps brachii muscles with individually preprogrammed sequences was applied by surface electrodes at the beginning of gait rehabilitation. The patients started walking with the support of a therapist, gradually increased the walking distance and all reached independent ambulation with a crutch after an average of 14 stimulation sessions. A portable microprocessor six-channel stimulator/stride analyzer enabled the collection of gait parameters and recording of statistical mean values of stride time, gait symmetry, right and left stance times, and their standard deviations. Without additional equipment, several hundred stimulated strides were measured during each stimulation session.
RADIOLOGIC CASE STUDY
Authors: Awwad Eric E , Abouzahr Kamel , Sundaram Murali
Published: April 2021

Massive Mandibular Osteolysis in Progressive Systemic Sclerosis
Centrifugation of Antibiotic Impregnated Bone Cement
Authors: Walker Janet L , Gustke Kenneth , Toney John , Sinnott John
Published: April 2021

ABSTRACT: Centrifugation is used to increase the strength of bone cement in total joint arthroplasty. Antibiotics have been incorporated into cement for the treatment and prophylaxis of infection. To determine the effect of centrifugation on antibiotic containing cement, tobramycin and cefamandole impregnated Surgical Simplex P polymethylmethacrylate was centrifuged using manufacturers' techniques. The concentration of antibiotics was measured throughout the cement column by a zone of inhibition bioassay. No difference in the distribution of the antibiotics could be demonstrated as compared to hand mixed controls. Centrifugation decreased the number of large air inclusions overall, however, a significant number were noted to remain at the top of the centrifugation grathent. It was concluded that centrifugation of an antibiotic impregnated bone cement, utilizing this technique, may be used without disturbing the antibiotic distribution. Discarding the top 1 cm of liquid centrifuged column to remove residual air inclusions is recommended.
A Locking Collar for Luque Rods
Authors: McCarthy Richard E , McCullough Frances L , Peek Richard D , Harrison Barry H
Published: April 2021

ABSTRACT: The migration of hardware has been a problem in the Luque system of segmental spinal instrumentation. To prevent this migration, a device was designed to slip on the 3/ieth inch or Va inch Luque rod. This prevents movement between the wire-rod interface, stopping both distal and proximal rotation of the rod. This article reports 21 patients with neuromuscular scoliosis on whom this technique was used. There was no migration of hardware and only one wire breakage in an area separate from the locking collar. These results are a marked improvement from patients of previous reports who did not receive the new device. Laboratory testing on the locking collar determined the best location on the "L" rod to be in the middle third of the rod. Rod migration has essentially been eliminated with this technique.
Radial Carpal-Volar Lunate Dislocation: A Case Report
Authors: Gomez William , Grantham S Ashby
Published: April 2021

ABSTRACT: Lunate dislocations of the wrist are unusual injuries. A unique case of radial carpal-volar lunate dislocation is reported. The dislocation was treated with closed reduction and maintained by percutaneous pins. A good clinical and radiographic result was seen at 1year follow up.
Prediction of Fatigue Failure of a Total Knee Replacement Tibial Plateau Using Finite Element Analysis
Authors: Paganelli Jude V , Skinner Harry B , Mote C D
Published: April 2021

ABSTRACT: Recent reports of total knee prosthesis fractures have raised concerns over the long-term structural integrity of metalbacked tibial components. Both the development of a fibrous tissue membrane under the tibial plateau of a total knee prosthesis and loading conditions may seriously alter the fatigue life of the metal tibial tray. The effects of the cement and fibrous tissue at the bone-prosthesis interface were studied. Using the method of threedimensional finite element analysis, peak loads of normal gait were simulated at several locations on the plateau of a generic, single-stemmed, porous-coated, CoCrMo tibial component model, providing information on the effect of abnormal loading patterns. According to the analysis, stresses below the material endurance limit are predicted throughout the prosthesis prior to the development of the fibrous membrane. However, stresses exceeding the yield strength of the material are predicted in a prosthesis that is supported by a fully developed 1 mm membrane, meaning that it has a markedly increased risk of low-cycle fatigue failure. Lateral displacement of the loading is detrimental to prosthesis life because maximum stress increases 100% while posterior displacement of the loading increases maximum stress by only 30%. Anterior loading creates stresses similar to those created by central loading. Because of their susceptibility to low-cycle fatigue failure, simple, single-stemmed prostheses are not recommended in cases of questionable bone stock unless modified. Several design alternatives are proposed.
Three-Dimensional Computerized Reconstruction of Histologic Serial Sections for Orthopedic Research
Authors: Herzenberg John E , Carrol Norris C , Christofersen Mark R , Lee Eng Hin
Published: April 2021

ABSTRACT: New programs in image processing and computer graphics can now render three-dimensional images from serial tissue slices. Although neuroanatomists have used these techniques most intensively, there are exciting applications of this methodology in orthopedic research and investigative embryology. Three-dimensional reconstructions of histologic sections from newborn clubfeet have been used to determine the rotational alignment of the hindfoot bones. Similar studies could be undertaken to improve understanding of the normal and pathologic perinatal development of the spine, hip, and hand.