bluuebunny/crossref_metadata_2025 huggingface dataset:
A Pilot Program to Promote Professional Growth for Neuroscience Nurses
Authors: Weeks Michele J , Counsell Colleen M , Guin Peggy R
Published: April 2021

ABSTRACT

A pilot program was developed as a strategy to increase professional growth on a neuroscience unit. The primary objective of the program was to allow staff nurses to participate in activities that interface with the neuroscience patient population. Nurses could choose an area of interest that related to their unit responsibilities. This experience provided the participants with the unique opportunity to participate in patient care from the perspective of another discipline. The staff were enthusiastic about the experience and shared it eagerly with their peers. Participants' evaluation of the program was overwhelmingly favorable. The data suggest that this program was an effective means of increasing professional growth and staff development.
Preparing Nurses for the Inevitable: The New Madrid Earthquake
Authors: VanArsdale Stephanie K , Hammons James O
Published: April 2021

ABSTRACT

Although this article discusses earthquake preparedness for the New Madrid seismic zone, registered nurses in any location will be on the front line as patient caregivers and managers in the event of a damaging earthquake. Two self-instructional modules were developed to educate registered nurses about earthquake preparedness. Statistical analyses of pretest and posttest scores from nurses who completed the modules and from nurses who participated in a control group reveal that the modules are effective educational tools. This information will make them more effective as nurses during and after an earthquake and emphasizes the need for their involvement in disaster mitigation and planning.
How Do Older Nurses Perceive Their Clinical Competence and the Effects of Age?
Authors: Wheeler Linda A
Published: April 2021

ABSTRACT

In 1996, the first of the baby boomer population bulge that includes registered nurses (RNs) will reach age 50. Considering the prevailing negative stereotypes about women, nurses, and older adults in general, it is necessary to understand the abilities and needs of older nurses. This qualitative study was the first stage of a needs assessment of professionally mature RNs. Eight female RNs, employed full-time in an acute care setting and over age 50, were interviewed to determine their perceptions, attitudes, and beliefs about their own professional competence and how they believed they were perceived by others. Results indicated that older RNs felt good about themselves and the profession, and valued traditional bedside nursing and professional behaviors. Of the eight recurring themes found, the need for continuing education generated the most discussion. Will the methods and resources of the past meet the educational needs of the older nurses? Further study is recommended to discover their needs and the needs of their employers.
Two-Way Interactive Video: Maximizing Distance Learning
Authors: Havice Pamela A , Knowles Michelle H
Published: April 2021

ABSTRACT

The challenge of providing continuing education courses in a timely manner is becoming increasingly difficult because of the rising costs in travel and presentation materials. Two-way interactive video (TWIV) presents an opportunity for delivering programs in a user-friendly, affordable, and convenient way. This article covers the history of two-way interactive video (TWIV), the necessary equipment for a TWIV classroom, significant research findings and uses for TWIV. Also discussed are ways of using TWIV to enrich the practice and art of nursing.
Let Me Entertain. . .er. . .Teach You: Gaining Attention Through the Use of Slide Shows
Authors: Gigliotti Eileen
Published: April 2021

ABSTRACT

The lecture method has been and continues to be the object of criticism. But, perhaps, it is not the lecture which should bear the brunt of the criticism, but rather the lecturer. All too often the audience is bored. This article examines several popular media currently used to enliven the lecture. Instructional design theory is used to discuss their limitations. The use of a self-assembled slide show, featuring novelty and humor, is advocated in order to assist the lecturer in gaining attention and, thereby, avoiding the boredom pitfall. Useful suggestions for developing a slide presentation are provided.
An Innovative Solution to Assessing Staff Learning Needs
Authors: Maloney Patricia , Kane Janie W
Published: April 2021

ABSTRACT

Traditional needs assessments for continuing education reflect personal interests and perceptions of learning needs rather than actual knowledge deficits. With an influx of new staff in a rapidly expanding neonatal ICU, time constraints made it imperative to accurately assess the learning needs of the novice practitioner. A needs assessment tool, developed by the unit-based education committee, identified gaps in knowledge among NICU staff. The questionnaire consisted of direct questions covering aspects of clinical and professional issues in neonatal care. The respondents were asked to indicate their ability to answer the questions completely, partially, or not at all. The questions were categorized according to patient populations and professional issues, thereby providing curriculum for continuing education specific to identified learning needs.
Mandatory Inservice Offerings: Implementation of an All-Day Method
Authors: Bagnall Deborah L , Schemmel Mary E , Hansen Mary C
Published: April 2021

ABSTRACT

This article describes the development and evaluation of an alternative approach to providing mandatory inservice offerings, whereby all yearly inservice requirements are presented during a 1-day program. Results of the evaluation of the allday method employed to meet goals of compliance with attendance, cost-effectiveness, and participant and management satisfaction are also presented. The all-day approach used to provide mandatory inservice offerings was found to be an effective method for providing quality, costeffective mandatory staff education.
MobyEd: A Mobile Educator Unit
Authors: Evanoski Carol Ann , Henderson Doris W
Published: April 2021

ABSTRACT

A mobile educator unit is a cost-effective teaching tool that can be easily implemented in an acute hospital setting to assist in teaching patients, visitors, and personnel about health and wellness. The educator unit cannot replace the face-to-face interactions between professional and patient or visitor, but it can supplement and make information more readily available than a stationary display.
Perception of Learning Needs and Preferred Learning Methods About AIDS/HIV Among Registered Nurses Working in the Community in Texas
Authors: Demirbag Birsel Canan , Ridenour Nancy
Published: April 2021

ABSTRACT

It is important for nurses and other healthcare workers to recognize that patients who present themselves for health care could already be infected with human immunodeficiency virus (HIV). Therefore, appropriate and sensible infection control precautions should be taken at all times. An assessment of nurses' knowledge of acquired immunodeficiency syndrome (AIDS)/HIV provides information to guide further continuing education efforts. This study describes the learning needs and preferred learning methods regarding AIDS/HIV among registered nurses working in a community in Texas. Respondents confirmed the need for important content areas regarding primary, secondary, and tertiary prevention such as universal precautions, protection from infectious diseases, and occupational hazards for healthcare providers. Several teaching methodologies were included. Self-paced instruction was the least preferred teaching-learning method; hands-on methodology was most preferred for the topics of clinical manifestations, long-term care, testing, and counseling.
Pilot Testing an Independent Study Series on Research
Authors: Reineck Carol A
Published: April 2021

ABSTRACT

The Army Nurse Corps developed The Critical Reading of Research Publications (CRRP) program, an independent study series for small groups. The goal of the program is to improve patient care by providing a means for nurses to learn basic research principles in a self-paced format, while reading and discussing nursing research articles of clinical relevance. Continuing education (CE) approval of the program required pilot testing to evaluate its ease of use, effectiveness, and allocation of CE contact hours. The purpose of pilot testing was to improve both the participants' experience and the administrative management of the CE program. The constructive feedback received by potential consumers resulted in incremental improvement of an innovative educational program in nursing research.
The Time Has Come-A Study of Geriatric Continuing Education in Ohio Visiting Nurse Associations
Authors: Hekelman Francine P , Niles Sheila A , Snyder Clint W , Stricklin Mary Lou
Published: April 2021

ABSTRACT

A majority of nurses working in the community lack formal educational preparation to care for older adults. This study examined the perceived learning needs of Visiting Nurse Association (VNA) executives and agency staff nurses in Ohio related to continuing education in gerontology. Twenty-six executives and 478 staff nurses were asked to complete a gerontologic education survey; 17 executives and 344 staff nurses returned surveys. Findings suggest that few Ohio VNAs have focused on continuing education in gerontology. Indications exist that executives and staff nurses are not always in agreement regarding the importance of content needed for updating gerontological knowledge and skills. Educational and organizational strategies are offered to provide minimal standards for gerontologic professional practice in home care.
Focus Group Interviews: Assessment of Continuing Education Needs for the Advanced Practice Nurse
Authors: Brooks Evelyn L , Fletcher Kathy , Wahlstedt Patricia A
Published: April 2021

ABSTRACT

This article reports the use of focus group interviews to promote the development of continuing education programs that meet the needs of advanced practice nurses (APNs). The three major needs identified were: a) enhancement of clinical practice skills and knowledge in specialty areas, b) education about future changes in the APN role, and c) education in management strategies for the changing health care delivery system. A summary of the investigation and implications for continuing nursing education departments are also presented.
Creative Strategies for Updating Knowledge on Sexually Transmitted Diseases
Authors: Stephenson Nancy L N , Lee Belinda Temple
Published: April 2021

ABSTRACT

Updating knowledge is important in maintaining effective nursing competency. The hectic pace of health care delivery in the 1990s does not always allow for attending day-long continuing education sessions. This article presents creative teaching-learning strategies that are self-paced, interesting, and less time intensive, designed to update nurses on sexually transmitted diseases.
Learning Needs Assessments: Definitions, Techniques, and Self-Perceived Abilities of the Hospital-Based Nurse Educator
Authors: Mailloux Judith Pomeroy
Published: April 2021

ABSTRACT

The purpose of this article is to describe survey research on learning needs assessment, conducted to determine definitions, techniques, and confidence levels of the hospital-based educator. Confidence levels related to fulfillment of the needs assessment role and resources available to the nurse educator are described. In a survey of 223 hospitals, a 69% return rate showed that the hospital educator used "real need" (lack of understanding, skill, or ability) as their primary definition. Professional standards, records and reports, and technological and institutional changes were primary sources of program determination. The nurse educator was confident in traditional roles but less confident in developing competency-based evaluations and clinical simulations.
The Dilemmas of Experiential Teaching: Toward an Interpretive Approach
Authors: Andrew Mary
Published: April 2021

ABSTRACT

Continuing education in nursing uses the experience of the learner as a basis for the examination of practice issues. The unique and personal nature of this experiential learning is, however, particularly problematic where assessment of the learner or the course is required. This article offers part of the findings from an evaluative, ethnomethodological study into the reflections of learners attending an experiential course in communication in palliative care. In the part of the study described here, the critical perceptions of three learners following one experiential exercise are compared with the stated aims of the facilitators and their subsequent actions. The analysis uses the conceptual framework of Schön's reflection-in-action. It is suggested that an interpretive approach toward teaching in the experiential domain may lead to a more relevant assessment of learning.
Integrating Ongoing Evaluation Process for International Pediatric Nursing Courses
Authors: Katz Shira , Hendel Tova
Published: April 2021

ABSTRACT

Two international pediatric courses for nurses from developing countries were planned and implemented in Israel during the past 2 years. The courses consisted of 53 RNs from 29 countries. The purpose of this article is to describe the ongoing evaluation and follow-up process of these courses. Findings indicated that the majority of nurses expressed: a) high satisfaction with the course and felt it enhanced their professional capacity and practice, and benefited their colleagues and superiors; b) high motivation and enthusiasm to improve nursing practices in their home countries; c) changes in attitudes and beliefs relating to pediatric nursing.
The Use of Gaming Strategies in a Transcultural Setting
Authors: Gary Rebecca , Marrone Stephen , Boyles Catherine
Published: April 2021

ABSTRACT

Saudi Arabia's vast economic resources have enabled the development of state-of-the-art hospitals. Nurses recruited from around the world staff these hospitals creating one of the most multicultural practice settings in the world. Ethnic, educational, and experiential diversity; language and communication barriers; and alternative ways of knowing and learning challenge nurse educators to be more creative and explore opportunities for greater participation and learning among various cultural groups. Gaming, as a teaching-learning strategy for multicultural participants, affords the necessary flexibility and nonthreatening atmosphere which facilitates positive interactions among different, and often competing, communication patterns and learning styles. This article explores how and why gaming is as an effective educational strategy in a transcultural setting.
Lessons Learned: A Process Evaluation of the Rural Elder Awareness of Medication Safety (REAMS) Program
Authors: Haughtigan Kara S. , Jones M. Susan , Main M. Eve , Burke K. Kendall
Published: April 2021

This process evaluation of the Rural Elder Awareness of Medication Safety (REAMS) program provided identification of successful and unsuccessful elements along with barriers to and facilitators of this home-based pilot program. The REAMS program was developed to assist rural older adults aged >65 years and community health care organizations with strategies to improve health literacy related to medications. Recruitment of older adults, rurality of the program's setting, time constraints, and the onset of the COVID-19 pandemic were the greatest barriers. The collaborative relationship developed with community health care partners was the greatest facilitator. This relationship promoted shared ideas and adjustments in program design to achieve the outcome goals. The lessons learned from process evaluation may benefit future researchers or community health promotion planners with designing community-based programs for older adults in rural areas. Future research should focus on expanding recruitment opportunities in acute care, primary care, and home health with the inclusion of all established health care providers in the community. [
Journal of Gerontological Nursing, 47
(4), 7–12.]
Sensory Devices for Older Adults With Behavioral Disturbance in the Emergency Department: A Descriptive Study
Authors: Cabilan C. J. , Meyer Audrey , Elmore Rebecca , Nash Terry , Eley Robert , Tuckett Anthony
Published: April 2021

Nonpharmacological strategies are advocated for the management of behavioral disturbance in older adults due to risk of harm from pharmacological therapy; however, limited evidence supports their use in emergency departments (EDs). The current descriptive study was conducted to investigate the use of sensory devices for nonpharmacological management of behavioral disturbance and their perceived impact. Data were collected from the sensory device registry, electronic medical records, and survey. Patient-level data (
N
= 33) showed that sensory devices, such as tactile blankets or toys and music, can be used in EDs to alleviate behavioral disturbance among older adults. ED staff (
n
= 22) expressed an interest to increase device supply. A patient and caregiver (
n
= 2) suggested that the devices be initiated earlier in ED care. Further research is required to strengthen evidence on the impact of these devices on patient outcomes. [
Journal of Gerontological Nursing, 47
(4), 22–27.]
CUTANEOUS RHIZOPUS INFECTION ASSOCIATED WITH ELASTOPLAST WOUND DRESSING
Authors: Torres-R Jaime R , Maki Neil J , Taddonio Rudolph F , Sanders Charles V
Published: April 2021

ABSTRACT: A case of primary zygomycosis due to Rhizopus spp associated with Elastoplast bandage use in a young, healthy surgical patient is reported. Lesions resolved without complications after removal of the bandage from the wound and a short course of amphotericin B. Rhizopus spp was recovered from material obtained by scraping the lesions, and from unused Elastoplast bandage retrieved from the operating room.

Epidemiological, clinical, diagnostic and therapeutic aspects of the condition are discussed.
BILATERAL RADIOCARPAL DISLOCATION: A CASE REPORT
Authors: Bounds Terrell B
Published: April 2021

ABSTRACT: Radiocarpal dislocation is an uncommon orthopedic injury;15 even more uncommon is a bilateral radiocarpal dislocation associated with compression of the median nerve in the carpal canal bilaterally.
RECONSTRUCTION FOR CHRONIC LATERAL INSTABILITY OF THE ANKLE: A REVIEW OF TWENTY EIGHT SURGICAL PATIENTS
Authors: Rechtin Glen R , McCarroll John R , Webster Dwight A
Published: April 2021

ABSTRACT: Twenty-five patients with chronic lateral ankle instability were treated with lateral ankle reconstruction. At an average follow-up of 24% months, 21 of the patients had good or excellent results and four had fair or poor results. It took at least six months for postoperative discomfort to resolve. The two most common complications were skin sloughs and sural nerve dysesthesias. The modified Elmslie lateral ankle reconstruction appears to provide satisfactory stability for symptomatic chronic lateral ankle instability. Key words: instability, talar tilt, ligament.
SURGICAL MANAGEMENT OF THE SYMPTOMATIC CERVICAL SPINE IN RHEUMATOID ARTHRITIS
Authors: Smith Duret S , Yuan Hansen A
Published: April 2021

ABSTRACT: Eleven spinal fusions were performed on 10 patients with symptomatic cervical spines secondary to rheumatoid arthritis. A variety of surgical procedures and various types of postoperative immobilization were used. The average patient age at surgery was 43.2 years, with an average followup of 36.9 months. Six of these patients had instability at C1-2, one each at C4-5, C5-6, and C6-7, and one patient had a complete myelographic block without instability at C5-6. Six of the patients presented with neurologic symptoms - all improved; some dramatically. There were no deaths, four transient complications, and no pseudarthroses. Some authors advocate routine, supine, prolonged skull traction postoperatively. We believe that this is not necessary in the uncomplicated rheumatoid spinal fusion, and may be detrimental. Other recommendations for conservative and surgical management are also made.
The Effect of Abductor Forces on Femoral Stem Stresses in Cemented Prosthetic Hip Replacement
Authors: Skinner Harry B , Cook Stephen D , Penix Arnold R
Published: April 2021

ABSTRACT: Abductor insufficiency has been reported as a clinical factor contributing to femoral stem fracture. The objective of this study was to investigate the stresses in the femoral stem as it is affected by abductor insufficiency.

A two-dimensional plane stress finite element model of a femur with a cemented straight stem prosthesis, with the material properties of either Co-Cr-Mo alloy or Ti-6AI-4V alloy, was constructed. Each femur/prosthesis composite was then loaded, using a one-legged stance condition, accounting for both joint reaction and abduction forces. Stress profiles along the medial and lateral aspects of the femoral component were then calculated.

The finite element models were also loaded using conditions representing abductor insufficiency with walking aids and without walking aids (Trendelenburg's gait). The abduction force was reduced to zero, and the joint reaction force reduced to superimposed body weight at a vertical angle to simulate Trendelenburg's gait with the pelvis tilted. To simulate the conditions with walking aids, the pelvis was maintained level, the joint reaction force was maintained constant, and the abductor force was varied. Stress profiles were again determined along the medial and lateral aspects of the femoral component.

The prosthesis loaded under Trendelenburg conditions showed decreased femoral stem stresses, both medially and laterally, when compared to the normal physiological (one-legged stance) loading. The titanium alloy prosthesis demonstrated lower stem stresses in each loading condition when compared to the Co-Cr-Mo alloy prosthesis.

The results of the study indicate that during the one-legged stance a patient with abductor insufficiency (who shifts his weight over his prosthesis) actually places less stress on his femoral component than the patient with normal abduction strength, and probably is not a major consideration in femoral component failure.
Evolution and Development of Operative Arthroscopy 1974 to Present
Authors: Guhl James F
Published: April 2021

ABSTRACT: This discussion illustrates the history and development of operative arthroscopy, as well as the present state of the art, and also attempts to make some predictions. The information is based on the author's experience gained in his practice and the knowledge obtained as a faculty member in many courses on operative arthroscopy. Technological improvements in instrumentation along with the development of new portals of approach are described, as well as their application in many new procedures. Numerous pathological entities of the knee nave subsequently become amenable to arthroscopic surgical treatment. These techniques are discussed along with their indications. The application of future principles, procedures and research in the field of operative arthroscopy of the knee and other joints is expressed.
Osteoblastoma
Authors: Wiss Donald A , Naimark Allan
Published: April 2021

RADIOLOGIC CASE STUDY
Lipomeningocele
Authors: Yngve David A
Published: April 2021

ANSWER PLEASE
Metal Hypersensitivity in Total Joint Replacement: Review of the Literature and Practical Guidelines for Evaluating Prospective Recipients
Authors: Kumar Prem , Bryan Christopher E , Leech Stephen H , Mathews Ronnie , Bowler James , D'Ambrosia Robert D
Published: April 2021

ABSTRACT: Metal hypersensitivity may play a role in total joint failure. This review elaborates on contact sensitivity to metals, and critically analyzes evidence for and against the role of metal hypersensitivity in the failure of total joint replacement. Finally, we attempt to set practical guidelines by which the orthopedic surgeon can rule out metal hypersensitivity prior to implantation of a first prosthesis or for revision surgery.
Avulsion of the Transverse Ligament Associated With a Fracture of the Atlas: A Case Report
Authors: Levine Alan M
Published: April 2021

ABSTRACT: Avulsion or rupture of the transverse ligament may occur in combination with a Jefferson fracture of the atlas as a result of the spreading of the lateral masses of C1. In this patient, an avulsion of the transverse ligament was associated with a fracture of the atlas without spreading of the lateral masses and in combination with a wedge compression fracture of the body of C5. It is also important to consider that multiple injuries to the upper cervical spine (occiput to C2) can and do occur with relative frequency. Appropriate management is based not on the principle of stabilizing all injuries with one procedure, but rather techniques that may be used sequentially to achieve stabilization with minimal morbidity.
Animal Studies and Clinical Trials of Chymodiactin® (Chymopapain)
Authors: McDermott Daniel
Published: April 2021

ABSTRACT: The comparative toxicology studies using chymopapain (Discase®) versus the refined form of chymopapain (Chymodiactin®) are summarized, along with the double-blind clinical studies leading to the release of Chymodiactin®.
The Mechanism of Sciatic Pain Relief by Chemonucleolysis
Authors: Spencer David L , Miller James A A
Published: April 2021

ABSTRACT: Chemonucleolysis must relieve sciatic pain by some means other than the removal of the disc protrusion from the neural canal, because the protrusion characteristically persists despite the resolution of sciatic pain. This paper analyzes the mechanism of symptom production in sciatica and identifies how chemonucleolysis relieves these symptoms.

Pressure can be exerted on a nerve root by a disc protrusion without compression against the posterior wall of the neural canal. This pressure is the result of tension produced in the nerve root when it is deformed by the disc protrusion. A previously unrecognized principle of nerve root-disc protrusion mechanics is identified. For a given disc protrusion, narrowing the disc reduces the tension in the nerve root and therefore the pressure on the nerve root; conversely, widening the disc increases the tension and pressure on the nerve root. Disc narrowing is in itself a mechanism by which chemonucleolysis relieves sciatic pain.
Current Practice With Chymopapain for Treatment of Herniated Nucleus Pulposus
Authors: Dabezies Eugene , Beck Charles , Shoji Hiromu
Published: April 2021

ABSTRACT: Chemonucleolysis is found to compare favorably with laminectomy (71% good to excellent results versus 63% good to excellent) in the treatment of herniated nucleus pulposus. From a base of over 400 chemonucleolysis cases, recommendations for equipment and patient selection are developed. Disc space narrowing did not correlate with the end results.
Outpatient Discolysis With Chymopapain
Authors: McCulloch J A
Published: April 2021

ABSTRACT: Findings in a two- to four-year followup of 231 patients who have undergone outpatient chemonucleolysis are reported. Successful outcomes were determined in 88% of cases by the respondents themselves, and in 67% by an independent reviewer. Concerns of outpatient conduct of chemonucleolysis are discussed, noting that all instances of intraoperative complications were successfully managed, including two cases of anaphylaxis.
Anaphylaxis Secondary to Chymopapain
Authors: Whisler Walter W
Published: April 2021

ABSTRACT: Anaphylaxis occurs in approximately 1% of the patients treated with chymopapain. The incidence of anaphylaxis is ten times higher in women than in men. The severity of the reaction may be attenuated by pretreatment with H
1
- and H
2
-histamine receptor antagonist. Once anaphylaxis occurs, prompt and correct treatment must be instituted.
Advantages of Ambulatory Metrizamide Myelography with Contrast CT Tomography
Authors: Lestrange Nile R , Wilkov Howard R , Tate Charles F , Astl Audrey J
Published: April 2021

ABSTRACT: Outpatient metrizamide cervical and lumbar myelography complimented by CT scanning is a safe and effective method of assessing the contents of the neural canal. By minimizing the dose of metrizamide and using a small needle, the incidence of side effects is reduced. The techniques of needle insertion metrizamide injection and radiography as well as pre- and post procedure care are described in detail.
Localized Acquired Hypertrichosis Associated with Fractures of the Arm in Young Females: A Report of Two Cases
Authors: Harper Marion C
Published: April 2021

ABSTRACT: Two cases of transient hypertrichosis of the upper extremity in young females associated with closed fractures are presented in support of the concept of the "regional acceleratory phenomenon" as proposed by Frost wherein trauma evokes increased regional blood flow and increased metabolism on the part of all local soft tissues. This abnormality which was of much concern in terms of cosmesis resolved over approximately six months.
THE SECTION OF TRAUMA KAROLINSKA HOSPITAL STOCKHOLM, SWEDEN
Authors: Eriksson Ejnar
Published: April 2021

Guest Editorial
Injuries in Swedish Elite Basketball
Authors: Colliander Erland , Eriksson Ejnar , Herkel Mike , Sköld Pia
Published: April 2021

ABSTRACT: All Swedish male and female elite basketball players were interviewed concerning their injuries during 1981/1982. Fifty-eight percent of the male and 62% of the female players reported injuries. The injury frequency was 2.5 injuries/1,000 activity-hours in male and 2.85 injuries/1,000 hours of activity in female players. This corresponds to 8.6 injuries/male team/season and 7.5 injuries/ female team/season. An ankle twist was the most common injury (52%) while a knee injury was involved in 18%. Prophylactic orthoses for knee and ankle are suggested.
The Influence of Nylon Cerclage on Diaphyseal Bone Strength: An Experimental Evaluation of Partridge Bands on Rabbits
Authors: Strömberg Lennart , Karlström Göran
Published: April 2021

ABSTRACT: Partridge-designed nylon bands which are used for the cerclage of fractured osteoporotic bones. These bands were given etevations on their inner surfaces to raise the band from the bone surface and thus minimize the negative effects on the periosteal blood circulation.

It has previously been shown that the Partridge bands, when applied to a diaphyseal bone, cause a mechanical irritation to the periosteum resulting in an increased callus formation by comparison with the case when corresponding bands with no elevations are applied. It has been suggested that the increased amount of callus would result in increased strength. We have studied the effect of bands designed in accordance with Partridge, compared with corresponding bands having no elevations, in terms of torsion strength (maximum torque capacity), on intact rabbit femora. The results show an increased torsion strength in the femora to which Partridge bands had been applied for eight weeks, while the femora to which corresponding plain nylon bands had been applied had decreased in strength.

The experimental study performed supports Partridge's recommendation to use the bands as cerclage in the internal fixation of fractured osteoporotic bones, preferably in combination with further internal fixation materials.
Sporotrichosis of the Knee: A Case Report
Authors: Yacobucci Gerald N , Santilli Mario D
Published: April 2021

ABSTRACT: Articular infections due to the fungus Sporothrix schenkii are rare. Only 46 cases of Sporotrichosis arthritis have been well-documented in the English literature to date.1'3 The presentation may be limited to a monoarticular synovitis, hence the diagnosis may be confused with other more common causes resulting in costly delays in proper treatment. Reported is a case of Sporotrichosis of the knee misdiagnosed multiple times over a three-year period yet illustrating important clinical features that could lead to earlier diagnosis and management.
Allogenic Transplantation of Ultra-Deep Frozen Osteochondral Grafts: An Experimental Study in Dogs
Authors: Vishwakarma G K , Bhatia C K , Raj Gita Ashok , Nagrani Prakash
Published: April 2021

ABSTRACT: Twenty dogs were subjected to allotransplantation of the lower end of the femur, frozen at - 1960C for 24 hours in liquid nitrogen, and stored at - 300C. Two dogs were sacrificed at monthly intervals, providing the grafted bone for histological study. Eight dogs were excluded from the study following infection or death, resulting in a follow up of only 6 months. Monthly roentgenograph ic assessment showed bridging of the host-graft unit by the second month, with posterior subluxation of the graft with subsequent malunion. Histologically, exuberant callus was seen arround the interface with progressive incorporation of the graft. However, the articular cartilage degenerated after 2 months. Attempts to repair the articular surface with new fibrocartilage were poor in the malunited grafts. The technical problems in surgery including control of infection, sound mechanical fixation and repair of tendons and ligaments must be solved to ensure a successful allograft.
Coexistent Mycobacterium Intracellulare Gonarthritis and Patellar Osteomyelitis in a Patient with Pulmonary Sarcoidosis: A Case Report and Literature Review
Authors: Namey Thomas C , Frogameni Anthony D
Published: April 2021

ABSTRACT: We present a 48-year-old man with known pulmonary sarcoidosis who developed septic arthritis of the left knee with concomitant patellar osteomyelitis due to Mycobacterium intracellulare. The patient underwent synovectomy and was started on appropriate combination chemotherapy, but clinical improvement did not occur until patellectomy was performed. Both bone and radiogallium scans were important in the medical and surgical management of this patient.
Breakage of the Patellar Component of a Kinematic Total Knee Arthroplasty: A Case Report
Authors: Conway William F , Gilula Louis A , Serot Donald I
Published: April 2021

ABSTRACT: Most complications of total knee arthroplasty have been of a general nature (ie, infection, pulmonary embolus, nerve palsy), or have involved either the tibial or femoral components. Occasionally, problems involving the patellar implant have been described including subluxation/dislocation, soft tissue impingement and patellar fractures. This article provides the first description of a new complication, fracture of the patellar implant at the stem-button interface.
Thermography: A Call for Scientific Studies to Establish Its Diagnostic Efficacy
Authors: Frymoyer John W , Haugh Larry D
Published: April 2021

ABSTRACT: Thermography is reported to provide objective evidence of physiologic dysfunction in patients with low back pain and sciatica. This diagnostic test is appealing because it is painless, non-invasive, has no known adverse biologic effects, presents comprehensible graphic information, requires only a moderate investment in equipment, and should be an inexpensive procedure to perform. Unfortunately, the complete scientific information necessary to assess its diagnostic reliability is not available. This article discusses other experiments which have been performed to assess the diagnostic accuracy of tests for low back pain and sciatica and outline some features of an experimental protocol which would be essential to establish the reliability of thermography in the diagnosis of low back pain and sciatica due to herniated nucleus pulposus.
Cubital Tunnel Syndrome: Anterior Transposition With Epicondylar Osteotomy
Authors: Mass Daniel P , Silverberg Bruce
Published: April 2021

ABSTRACT: In this article we reviewed nine consecutive patients operated on for cubital tunnel syndrome. They underwent a modification of the Learmonth procedure in which a medial epicondyle osteotomy was performed. The dissection was completed within intermuscular tissue planes to allow the ulnar nerve to be transposed submuscularly. The medial epicondyle was then replaced and secured using two 4.0 mm AO cancellous screws.

This article describes an operative technique, which has not been definitively described previously. Eight of nine patients demonstrated both subjected and objective improvement postoperatively. Eight patients returned to work following surgery. We feel that medial epicondylar osteotomy and screw fixation has minimized operative bleeding, subsequent inflammation, and fibrosis. Immediate range of motion activities have been encouraged, and earlier complete rehabilitation demonstrated.
EOSINOPHILIC GRANULOMA OF THE SPINE WITH NEUROLOGICAL DEFICIT
Authors: Kumar Anant
Published: April 2021

ABSTRACT

A case of a 14-year-old boy with a solitary eosinophilic granuloma of the thoracic spine, with paraplegia secondary to the collapse of the vertebra and peridural spread of tumor, is presented. It is the 14th case recorded in literature to this date. This disease is selflimiting, and there is no role of steroids or radiotherapy observed.
ANSWER PLEASE
Authors: Berman Arnold T , Levenberg Richard
Published: April 2021

BRODIE'S ABSCESS: A DIAGNOSTIC DILEMMA AND THERAPEUTIC CHALLENGE
IMPEDANCE PLETHYSMOGRAPHY FOR SURVEILLANCE OF DEEP VENOUS THROMBOSIS FOLLOWING EARLY DISCHARGE OF TOTAL JOINT REPLACEMENT PATIENTS
Authors: Mallory Thomas H , Vaughn Bradley K , Lombardi Adolph V , Mitchell Maria B
Published: April 2021

ABSTRACT

Between April 1988 and February 1989, 877 patients undergoing total hip (394 patients) and total knee (483 patients) replacement surgeries were given warfarin prophylaxis perioperatively and were tested with impedance plethysmography (IPG) approximately 17 days postoperatively (10 days post-discharge) in the outpatient office. There were 69 positive IPG tests (7.8%). Further assessment of patients with positive IPG results using duplex scanning or venography confirmed DVT in 25 of the 69 patients (3.6%) in the popliteal or thigh areas, and ruled out venous disease in 44 patients.

All 25 patients were readmitted for anticoagulation therapy with intravenous (IV) heparin and warfarin. There were no cases of pulmonary embolus. This study indicates that IPG testing is a safe and effective method of screening patients for DVT and its potentially fatal sequela of pulmonary embolus. Furthermore, IPG testing has proven to be cost effective, as it is a relatively simple procedure which can be administered by non-professional personnel in the outpatient office setting.
METASTATIC CARCINOMA OF THE SPINE WITH NEUROLOGIC COMPLICATIONS: AN AUTOPSY REVIEW
Authors: Leeson Mark C , Zechmann Jerome P
Published: April 2021

ABSTRACT

We conducted post-mortem examinations on 12 patients who had documented metastatic carcinoma to the spine with attendant neurologic complications. The examinations were studied to determine the location of the metastatic lesion in relation to the spinal cord. Both gross and microscopic examinations were performed, with particular attention to the level of compression. The majority of the metastatic tumors involved the vertebral body and pedicles anterior to the spinal cord. The findings of this autopsy review support previous surgical findings, and re-emphasize the importance of considering tumor location before treating compression of the spinal cord secondary to metastatic carcinoma.
USE OF A MODIFIED QUENGEL HINGE TO PREVENT POSTERIOR DISPLACEMENT OF THE TIBIA DURING TREATMENT OF PCL INJURY
Authors: Lee Eun Woo , Jang Eui Chan , Paek Nam Chul
Published: April 2021

ABSTRACT

During treatment of posterior cruciate ligament (PCL) injuries, posterior displacement of the tibia may occur inside the cast due to the effect of gravity on the lower leg. To prevent this problem the authors attempted to apply the original Quengel cast, first described by Mommsen in 1922 and perfected by Jordan, to correct the flexion contracture of the knee in hemophiliacs. However, the authors found that the cast was not effective in preventing the posterior displacement of the tibia during management of PCL injuries. They modified the design of the original Quengel hinge to obtain a more effective anterior traction on the tibia parallel to the knee joint line. Of the 32 patients who used the modified Quengel brace, IS who could be followed had less than a 3 mm difference between the injured and uninjured knee 3 months postoperatively.
THE ANTERIOR ACROMIAL APPROACH FOR ANTEGRADE INTRAMEDULLARY NAILING OF THE HUMERAL DIAPHYSIS
Authors: Riemer Barry L , D'Ambrosia Robert , Kellam James F , Butterfield Spencer L , Burke Charles J
Published: April 2021

ABSTRACT

At three institutions, 71 humeral intramedullary nails were inserted into the shoulder; 67 were reviewed at 6 months and at completion of treatment. Fifty-one utilized the anterior acromial approach and 16 were inserted lateral to the acromion. Shoulder motion was rated as: excellent (asymptomatic and within 15° of normal); good (normal daily function within normal motion); and poor. Nails were also inserted into the humeral diaphysis of eight cadaver shoulders. Fifty-one nails were inserted via the anterior acromial incision; 48 were graded as excellent, one as good, and two with traumatic axillary neuropathy and reflex sympathetic dystrophy as poor. Sixteen nails were inserted lateral to the acromion; 8 were rated, 7 good, and 1 poor. Motion returned in an average of 17 weeks (range:0-29). The greatest clinical concern is not ultimate shoulder function, but the rate of return. The authors conclude that either the anterior acromial approach or an extraarticular entry portal must be utilized for antegrade humeral diaphyseal nailing.
Postoperative Results of Rheumatoid Arthritis Patients on Methotrexate at the Time of Reconstructive Surgery of the Hand
Authors: Kasdan Morton L , June Lisa
Published: April 2021

Abstract

We conducted a retrospective chart review examining the frequency of local postoperative infection and poor wound healing of 15 methotrexate-treated rheumatoid arthritis patients undergoing 155 procedures during 39 surgeries. The patients were compared to a group of rheumatoid patients not on methotrexate who underwent similar reconstructive surgery of the hand. The patients taking methotrexate were followed postoperatively for a minimum of 10 weeks, with a mean follow-up time of 1 year, 42 weeks. There were no postoperative complications that would lead to the belief that the administration of methotrexate results in poor wound healing or leaves the patient more susceptible to postoperative infection. Our findings and a review of the literature support a continuation of methotrexate therapy in rheumatoid arthritis patients scheduled for reconstructive surgery of the hand and wrist.
A SPECIAL HIGH TIBIAL OSTEOTOMY TECHNIQUE FOR TREATMENT OF UNICOMPARTMENTAL OSTEOARTHRITIS OF THE KNEE
Authors: Nakhostine Manoutch , Friedrich Niklaus F , Müller Werner , Kentsch Axel
Published: April 2021

ABSTRACT

Tibial osteotomy is a well-established procedure for treatment of the varus osteoarthritic knee. A special new technique of oblique tibial osteotomy at the level of the tibial tubercle, preserving the medial cortex and iliotibial band, is presented which allows partial weight bearing the first postoperative day. Postoperatively the femorotibial alignment should be 5° to 7° of valgus in elderly patients. Because in younger individuals the intact iliotibial band is a strong restraint against varus deformity, we seek to correct to 3° to 5° of valgus in these patients. Of 172 cases treated with this technique between 1982 and 1986, 50 patients were retrospectively reviewed. After a follow-up period of 6 months to 3 years, pain was relieved in 46 patients. Complications consisted of 5 secondary wound healings, including 2 superficial infections, 1 tibial plateau fracture, and 3 varus recurrences.
INCLINATION OF THE ACETABULAR CUP IN ERECT POSTURE RADIOGRAPHS
Authors: Hoikka Veijo , Ylikoski Mauno , Eskola Antti , Santavirta Seppo
Published: April 2021

ABSTRACT

Inclination of the acetabular component was measured in a series of 100 patients who underwent total hip replacement. The radiographs were taken with the patients in erect posture. Two different reference lines were used in the measurements: the ischial reference line, and the true horizontal line perpendicular to a plumb-line used as a vertical reference line. The values measured using these two reference lines correlated well with each other, though there were important differences caused by pelvic tilt. Often an inclination that was within the normal range when measured, using the ischial tuberosity line as a reference, shifted excessively to horizontal or vertical when control measurements were performed using the true horizontal line as the reference. We conclude that inclination of the acetabular cup should be measured in erect posture radiographs, because pelvic tilt increases the degree of inclination on the side of pelvic adduction.
Assessing the Outcomes: What Really Works?
Authors: Bourne Robert B , Rorabeck Cecil H
Published: April 2021

Primary Femoral Fixation Options
The Management of Recurring Dislocation: Wits End!
Authors: Barrett William P
Published: April 2021

Hip Arthroplasty: Postoperative Management Problems
Arthroscopic Debridement: Tunnel Vision?
Authors: Scott W Norman
Published: April 2021

Knee Arthroplasty: Alternatives, Techniques, & Management Issues
The Painful Knee
Authors: Laskin Richard S
Published: April 2021

Knee Arthroplasty: Alternatives, Techniques, & Management Issues
Managing Bone Loss: Augmentation and Autograft
Authors: Stulberg S David
Published: April 2021

Problems After Knee Arthroplasty: "Things That Go Bump in the Night"
Constraint in TKA: Elderly Patient, Elderly Surgeon?
Authors: Insall John N
Published: April 2021

Optimizing Knee Arthroplasty
Percutaneous Hardware Removal After Open Reduction and Internal Fixation of Calcaneus Fractures
Authors: Stamatis Emmanouil D , Myerson Mark S
Published: April 2021

When hardware used to repair calcaneus fractures must be removed, the exposure using the original incision can be tedious due to scarring. The technique described here facilitates relatively easy and safe implant removal without the risk of wound complications.
Mini-Incision Total Hip Arthroplasty: A Comparative Assessment of Perioperative Outcomes
Authors: Wenz James F , Gurkan Ilksen , Jibodh Stefan R
Published: April 2021

Compared with patients with total hip arthroplasty (THA) via a direct lateral approach, patients treated with THA via a mini-incision approach had significantly earlier ambulation, less transfer assistance, and more favorable discharge dispositions; they also had decreased transfusion requirements and better functional recovery with early physical therapy. This procedure achieved accurate and reproducible implantation, regardless of patient habitus.
Surgical Management of Adjacent Level Degeneration Following Lumbar Spine Fusion
Authors: Glassman Steven D , Pugh Kevin , Johnson John R , Dimar John R
Published: April 2021

Abstract

Thirty-eight patients who underwent extension of a prior lumbar fusion for treatment of adjacent level degeneration were retrospectively evaluated. Patient age, pain relief with the initial surgical procedure, and distal level of fusion significantly affected outcome. Overall, this study suggests that adjacent level fusion yields results that are not optimal but provides significant clinical improvement for patients with symptomatic adjacent level degeneration.
Femoral Neck and Intertrochanteric Fractures: Radiographic Indicators of Fracture Healing
Authors: Szechinski J W , Grigorian M A , Grainger A J , Elliott J M , Wischer T K , Peterfy C G , Genant H K
Published: April 2021

Abstract

Serial hip radiographs from 280 patients with proximal femoral fractures were analyzed retrospectively by 3 radiologists to evaluate conventional radiographic healing patterns. Patients with hemiarthroplasty or insufficient follow-up were excluded, (n the remaining 41 patients, the fracture line and callus was assessed. Intertrochanteric fractures demonstrated increasing callus and sclerosis at the fracture site. No such association was seen in femoral neck fractures. Traditional indicators of fracture healing cannot be readily applied at the hip. Radiographic features relate more to fracture type and fixation method.