bluuebunny/crossref_metadata_2025 huggingface dataset:
WHAT HAS BEEN HAPPENING AT UTSSN?
Authors: Huchison Dorothy J
Published: April 2021

Even in a Bicentennial Year, the fight for responsible freedom in nursing is not yet won. . . .
The Androgynous Nurse Manager
Authors: Ziel Susan
Published: April 2021

The key to an understanding of androgyny is in the recognition that androgyny is not a state to he attained but, rather an ideal to be sought and a way of life into which energy can he effectively directed. Androgyny is the act of becoming more conscious and therefore more whole - because only by discovering and rediscovering ou rselves in all of our many aspects, do we increase the range and quality of our consciousness.
Notes on Continuing Education
Authors: Sonnen Barbara E
Published: April 2021

The Faculty of Continuing Education in Nursing from the University of Wisconsin-Extension discuss various aspects of continuing education in this bi-monthly feature. Readers are invited to submit articles for consideration for this column. Articles should be brief, may be philosophical, theoretical, or practical in nature.
Evaluation of an Arthritis Continuing Education Program
Authors: Dickinson Glenda R , Holzemer William L , Nichols Elizabeth
Published: April 2021

ABSTRACT

A knowledge test and chart audit were used to evaluate the way in which a formal continuing education program affected nurse behavior at a visiting nurse association. An experimental (n=13) and a control (n=15) group were randomly selected from a pool of visiting nurses. The experimental group attended a two-part, four-hour continuing education program on arthritis-related problems and interventions. The control group did not attend the program. Three to four weeks after the program was given, three charts of each nurse were randomly selected and examined by trained auditors who counted the number of arthritis problems and interventions recorded two to three weeks post program (n=84 charts audited).

It was anticipated that nurses who attended the continuing education program would be more knowledgeable about arthritis and be more likely to utilize new knowledge in patient care. A knowledge test was admin istered to both groups at the end of the training session. A t test revealed that the experimental groups scores were significantly higher (t=3.82, df=23, p=.001) than the control group.

It was hypothesized that those who attended the continuing education program would record more interventions. The nonpararaetric test, Mann Whitney U, revealed that the experimental group was significantly more likely to record arthritis interventions (p=.032). Thus, evaluation evidence supported the validity of the continuing education project.
Utilization of Efficiency Analyses in a Educational Department: Making an Informed Decision
Authors: Huegel Elizabeth A
Published: April 2021

ABSTRACT

The decision to utilize cost-benefit and cost-effectiveness analysis in a hospital education department may not represent the most efficient use of the departments resources. To make an informed decision requires an understanding of the potentialities and limitations of efficiency analysis and an appraisal of the decisions impact on the department. A critical examination of the pros and cons of cost-benefit and cost-effectiveness analysis is presented, followed by a suggested framework for decision-making. The weighing of the benefits and costs of efficiency analysis in terms of departmental needs and priorities allows the nurse educator to make a decision that optimizes the use of the department's resources.
Role of Continuing Educators in Encouraging Use of Clinical Practice Guidelines
Authors: Brunt Barbara A
Published: April 2021

ABSTRACT

With the current emphasis on outcomes and quality improvement, continuing educators need to encourage the use of clinical practice guidelines. Specific strategies to assist educators with this task are outlined. Use of clinical practice guidelines can facilitate research linking interventions and outcomes and lead to practice that is both more scientific and cost-effective.
Nursing Skills Fair: Gaining Knowledge with Fun and Games
Authors: Bradbury-Golas Kathleen , Carson Linda
Published: April 2021

ABSTRACT

The body of nursing knowledge continues to expand and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) mandates managers and educators to maintain competence in their nursing staff members. Stricter reimbursement criteria for hospital care, however, severely restrict education budgets. Educational programs can be offered at a reasonable cost without putting the adult learner to sleep! The development and implementation of a successful nursing skills fair is discussed.
Benefits of Collaboration in Continuing Education: A Partnership Between a University Provider and a Nursing Specialty Organization
Authors: Kalnins Irene , Mahon Suzanne M , Casperson Donna S
Published: April 2021

ABSTRACT

During the past 2 years, a university provider of nursing continuing education and the local chapter of a specialty nursing organization have successfully collaborated in the delivery of continuing education. This collaborative approach has been effective for providing continuing education in oncology nursing that serves the needs of nurses in the geographic area and maximizes the effective use of the resources of both partners. This approach has also prevented overlaps in program planning dates and duplication of content within the geographical area. Additional benefits include a growth in membership for the specialty organization and a sustained level of interest and attendance in programs sponsored by the university provider.
Political Savvy in Staff Development: Building an Indispensable Department
Authors: Avillion Adrianne E
Published: April 2021

ABSTRACT

Political savvy is not something with which one is born; instead it is a process that is learned, sometimes painfully, always demandingly. The purpose of this article is to identify strategies that will make a staff development department essential to organizational functioning and that will enhance both productivity and political survival. Critical to survival is the promotion of the three Vs of staff development: visibility, viability, and validity. Power and politics must be utilized to create an indispensable department.
Research in Psychiatry: Increasing Staff Knowledge and Experience
Authors: Roper Janice M
Published: April 2021

ABSTRACT

In a large psychiatric inpatient facility, a course on writing a research proposal was developed in response to nurses' requests to learn about conducting research. The research course was provided to a cross-section of registered nurses with a variety of education and experience backgrounds. The goal was the development of a proposal by each student by the end of the eight classes. The success of this first course was attributed to RN/instructor enthusiasm, support from nursing administration, and the ability to continue mentoring of RNs as they conducted their studies.
Creating a New Learning Experience: "The Story of Art" and "Prudent Art"
Authors: Bonheur Barbara Brown
Published: April 2021

ABSTRACT

The signs and symptoms of an impending cardiac arrest and the appropriate interventions are two concepts that need to be taught in the American Heart Association's Basic Life Support (BLS) course. CPR education is also required annually for all hospital employees who are direct caregivers. Developing teaching strategies that renew interest in the content and facilitate learning and retention is a challenge for BLS instructors. "The Story of Art" and "Prudent Art" utilize narrative and visual images to teach the signs and symptoms of an impending cardiac arrest and appropriate interventions. This article describes the development of this creative learning experience.
How Do You Want to Improve Yourself? Nursing Education Administration and Faculty Attitudes Toward Types of Faculty Development
Authors: Dunkley Norma A
Published: April 2021

ABSTRACT

The purpose of this study was to survey the perceived effectiveness of: (1) on-campus workshops, (2) off-campus workshops, (3) consultations, (4) leaves, (5) grants, (6) courses or seminars, and (7) special assignments for the faculty development of academic roles of nursing faculty. Faculty roles considered were: (1) classroom teaching, (2) clinical teaching, (3) research, (4) service to the institution, (5) community service, and (6) leadership. The samples of the study included 12 nursing administrators and 105 full-time and parttime faculty of the 13 nursing programs in the City University of New York (CUNY). Faculty development grants were rated highest by both administrators and faculty members. Both rated off-campus workshops second. Administrators and faculty perceived developmental activities in the area of research as most effective, followed by classroom teaching, clinical teaching, leadership, service to the institution, and community service. Faculty perceptions of the effectiveness of the seven techniques of faculty development were uniformly higher than administrator perceptions. Faculty members perceived development for classroom teaching, clinical teaching, and service to the institution more positively than did administrators.
The Relationship Between a Calculation Test Given in Nursing Orientation and Medication Errors
Authors: Calliari Donna
Published: April 2021

ABSTRACT

This article presents a descriptive study that investigates the relationship between pass/fail scores on a medication test given to registered nurses in orientation and medication errors made on nursing units. Medication errors made during a 3-year period of time were reviewed to determine number of errors made and the nurses who made the errors. Pass/fail scores from the medication test given in orientation were checked to see whether the nurses who made the errors had passed or failed the test. Chi square, t test, and multiple regression analysis were used to evaluate the data. Results showed that nurses who failed the medication test were more likely to make medication errors than nurses who had passed the medication test.
Addressing the Educational Needs of Shiftworkers: Should Shift Be a Consideration?
Authors: Staring Susan Lea
Published: April 2021

ABSTRACT

159 ICU nurses in 2 university teaching hospitals were surveyed regarding their motivational orientations for continuing education attendance. Overall, the sample was primarily motivated by reasons related to cognitive interest and professional advancement. T tests between day shift and night shift on each of 6 subscales of the Education Participation Scale were not significant. Significant correlations between mean scores on some subscales and demographic and social data were revealed. Implications for nursing administrators and educators are discussed.
Using Videoteleconferencing for Continuing Education and Staff Development Programs
Authors: Heidenreiter Terrence J
Published: April 2021

ABSTRACT

In times of tight budgets for continuing nursing education and staff development, using live, interactive videoteleconferencing is one approach to maintaining the quality and viability of continuing education programs. Participation in professionally produced closed circuit, satellite, or cable broadcast continuing education programs can be the first step in that effort. Careful planning for and promotion of the use of such broadcasts may not only enhance a hospital's education programs and facilitate learning, but may also prove financially beneficial.
A Win-Win Situation: The Pilot Program
Authors: Muoio Roberta , Wolcott Linda , Seigel Harriet
Published: April 2021

ABSTRACT

The purpose of this article is to present a process framework for developing pilot programs. Tools that can assist in analysis and evaluation are provided. Readers can adapt this framework and utilize the tools provided in their specific facilities.
The Summer I Learned to Write
Authors: Scholler-Jaquish Alwilda
Published: April 2021

ABSTRACT

A summer course in English grammar challenged a registered nurse student to learn new behaviors and acquire effective writing skills. A confident nursing writer now, the author shares her experience for registered nurse students who continue to face some of the same challenges.
Is Research in the Practice Setting Feasible?
Authors: Wade Gail Holland
Published: April 2021

ABSTRACT

Staff development educators are in key positions to assist staff nurses with practice-oriented research, a necessary part of clinical practice. The first step in developing an environment conducive to practice-oriented research is the establishment of a "working committee" within existing quality assurance or standards committees. As committee chairpersons, staff development educators can help staff nurses recognize the research potential inherent in practice by relating research terminology to the nursing process. Examples of client care problems illustrate how nurses can exert control over their practice and effect positive change.
Development and Implementation of a Leadership Skills Course for the Charge Nurse
Authors: Cartier Theresa L
Published: April 2021

ABSTRACT

Formal education in leadership behaviors and skills is paramount to the development of staff nurses as effective leaders. The need for effective leadership during the present transformation of healthcare, and the Joint Commission for Accreditation of Health Care Organization's mandate to educate and train staff as appropriate to their job responsibilities, resulted in the development and implementation of a leadership skills course for the staff charge nurse. A literature review, input from experienced charge nurses, and clinical nurse managers' perspectives of what is effective leadership for a charge nurse played key roles in development and implementation of the course.
A Descriptive Study of Continuing Nursing Education Programs in Academic Settings
Authors: Kuramoto Alice M
Published: April 2021

ABSTRACT

This article describes survey results from 24 collegiate continuing nursing education programs in the United States. The purpose was to collect baseline data regarding the role of the continuing education (CE) administrator, the characteristics of financial information, and the organizational structure of the department. The findings showed that roles and responsibilities of the directors in continuing nursing education include both administrative activities and faculty responsibilities. The trend toward decreasing enrollments of CE registrants will make it imperative for the CE administrator to explore creative programming directions, configure an affordable staffing arrangement within the organization, and generate new sources of program revenue.
A Comparative Evaluation of Two Educational Strategies to Promote Publication by Nurses
Authors: Henninger Dawn E , Nolan Marie T
Published: April 2021

ABSTRACT

Background: Two group educational strategies to promote publication by nurses at The Johns Hopkins Hospital were evaluated and found to result in similar success rates.

Method: Eighteen nurses, divided into two groups, attended three monthly sessions for instruction, guidance, and encouragement on writing and publishing. One group received additional guidance and encouragement during quarterly meetings for 1 year. Data were collected on participants' characteristics and publication success rates.

Results: Both groups achieved similar publication success rates.

Conclusion: A group education program to promote publication by novice nurse authors achieved positive outcomes and used resources more cost-effectively than the traditional method of individual instruction and guidance. Two factors having positive effects on publication success were: a) having a clear topic for publication at the outset of the educational program, and b) holding a positive perception of the value placed on publication within one's practice environment. The authors suggest alternative educational and other strategies to encourage nurses to share their clinical knowledge through publication.
Knowledge, Perceptions, and Practice of Nurses Toward HIV+/AIDS Patients Diagnosed With Tuberculosis
Authors: Messmer Patricia R , Jones Sande , Moore Jackie , Taggart Bonnie , Parchment Yvonne , Holloman Faye , Quintero Lisa Mitchell
Published: April 2021

ABSTRACT

Background: Tuberculosis (TB) continues to be a major health problem in the United States. Nurses may be exposed to TB and not realize their risks for becoming infected. The presentation of HIV-associated TB is somewhat different from "standard TB."

Purpose: The purpose of this study was to determine if an educational program could improve nurses' attitudes, level of knowledge, and compliance with infection control standards for HIV/AIDS patients diagnosed with TB.

Method: Participants included 50 staff nurses. The experimental group (35) and control group (15) completed a knowledge test and an attitude survey. Researchers observed participants for compliance with infection control standards pretest and posttest.

Results: Following an educational program, the experimental group demonstrated a greater knowledge of TB than the control group who did not participate in the educational program (F [1,47] = 14.43, p = .000). In addition, the experimental group had a greater improvement in their Nursing Intervention Observation Tool adherence to respiratory isolation and universal precaution protocols scores as compared to the control group (F [1,47] = 8.95, p = .004). However, there was not a tangible increase in knowledge level of AIDS, attitudes or concerns about caring for these patients.

Conclusion: This nursing research study supports the need for an ongoing educational program with continual monitoring of infection control practices to positively affect client and caregiver outcomes.
Preparing Nurses for the Acute Care Case Manager Role: Educational Needs Identified by Existing Case Managers
Authors: Nolan Marie T , Harris Alexandra , Kufta Amanda , Opfer Nancy , Turner Holley
Published: April 2021

ABSTRACT

Background: There is little in the literature about how best to prepare nurses for case manager roles.

Method: Twenty acute care case managers were asked to identify skills and knowledge that would be of value to nurses new to case manager roles.

Results: Community resources, discharge planning, and third party reimbursement were the top three educational needs identified by all case managers. Baccalaureate prepared case managers identified clinical issues to be of value, such as family coping, patient education, quality of life, and social support, while master's prepared nurses identified only system-related issues.

Conclusion: Educational programs preparing baccalaureate prepared case managers could focus on both clinical and system issues, while programs preparing master's educated case managers could focus primarily on managing system issues. Staff development professionals may also call on experts inside and outside the institution to assist in teaching about health care finance and reimbursement issues.
Delaware RNs' Reasons for Nonparticipation in Continuing Education
Authors: Cullen Pamela D
Published: April 2021

ABSTRACT

A descriptive study determined the reasons for nonparticipation in continuing education (CE) for RNs living in Delaware, where lack of CE results in loss of licensure. Subjects were asked to complete a 40-item Deterrents to Participation Scale with a 13-item demographic questionnaire. The sample (N = 94) identified disengagement as the primary factor for predicting nonparticipation in CE, with the primary reason being they had higher priorities than CE in their lives. Implications for nursing administrators and educators are discussed.
Arranging a Clinical Practicum in a Health Care Facility
Authors: Seigel Harriet , Lucey Alice
Published: April 2021

ABSTRACT

Staff development educators and administra' tors collaborate frequently to establish clinical experiences for student nurses. This article outlines key elements to consider and a time line for planning practicums. Some tools are offered to assist in the process. Arranging a clinical practicum in a health care facility requires flexibility, negotiation, and attention to detail for both the school and the facility. A mutually beneficial affiliation flourishes in such a facultative environment.
Continuing Nursing Education: What Resources Do Bedside Nurses Use?
Authors: McDiarmid Sheryl
Published: April 2021

ABSTRACT

Continuing nursing education (CNE) has traditionally been considered a formalized learning experience. However, the results of this study indicated nurses providing direct patient care in a tertiary care hospital seldom participate in such activities. The nursing staff do use a variety of resources, both material and personnel, to meet their immediate learning needs. Most of their CNE activities appear to be undertaken within their work environment. The results of this study provide nurse educators and managers insight into how they can augment "on-the-job" learning opportunities for staff nurses.
MULTIPLE PROGRAMS AT UNIVERSITY OF MARYLAND FOCUS ON GERONTOLOGY
Authors: Anonymous
Published: April 2021

Interdisciplinary Aspects are Emphasized by Interprofessional Conference
MEET YOUR LEADERS
Authors: Anonymous
Published: April 2021

ANA Division on Gerontological Nursing Practice Executive Committee
ARTERIOGRAPHY OF OSTEOID OSTEOMA: AN AID IN DIFFERENTIATION AND MANAGEMENT
Authors: Murray John A , Thaggard Alvin , Wallace Sidney , Benmenachem Goram
Published: April 2021

ABSTRACT: The angiographic findings in four patients with osteoid osteoma, one patient with osteomyelitis and one patient with eosinophilic granuloma are presented. The use of arteriographic studies with subtraction and magnification technique is demonstrated to be helpful in delineating the site and extent of osteoid osteomas, as well as aiding in the differentiation from other radiographically similar lesions of bone.
PRESERVATION OF TERMINAL BRANCHES OF THE MEDIAN PALMAR CUTANEOUS NERVE IN CARPAL TUNNEL SURGERY
Authors: Nalebuff Edward A , Smith Joseph
Published: April 2021

ABSTRACT: Surgical decompression of the median nerve in the palm and wrist usually relieves the symptoms of carpal tunnel syndrome. However, a significant number of these patients develop postoperative dysesthesia and local tenderness at the base of the palm. We have altered our surgical approach to include exposure and preservation of the terminal branches of the palmar cutaneous nerve in order to minimize the risk of this complication.
DETECTION OF DEEP VEIN THROMBOSIS WITH DOPPLER ULTRASOUND TECHNIQUES IN PATIENTS UNDERGOING TOTAL KNEE REPLACEMENT
Authors: Bradford John A , Lewis Randall J , Giordano Joseph M , Edwards Cherie M
Published: April 2021

ABSTRACT: Thromboembolism is a common complication of elective orthopedic surgery and has a high incidence in patients undergoing total knee replacement.4,11,9,11,17,23 The insensitivity and lack of specificity surrounding clinical identification of deep vein thromboses in the lower extremities are well established.6,10,1,18,24 Doppler ultrasound has been described as potentially the simplest and fastest objective method of evaluating venous disease,1 although
p 125
I-fibrinogen scanning, cuff-impedance phlebography, and contrast venography also have been employed/'10'12'17 In this study we examine the accuracy of Doppler ultrasound and pulse volume recordings (PVRs) as methods for detecting deep vein thrombosis following total knee replacement.
THE USE OF ELECTROSURGERY FOR ARTHROSCOPIC SUBCUTANEOUS LATERAL RELEASE
Authors: Miller G Klaud , Dickason J M , Fox James M , Blazina Martin E , Del Pizzo Wilson , Friedman Marc J , Snyder Stephen J
Published: April 2021

ABSTRACT: 49 patients underwent subcutaneous lateral retinacular release for pa tell of emo ral malalignment syndromes by a new technique utilizing the arthroscope and electrocautery. In this technique, the tight lateral patellofemoral ligament and lateral retinaculum are transected with the electrocautery under direct arthroscopic visualization. It is possible to directly observe the progress and completeness of the release, and to cauterize any bleeding vessels sequentially as they are transected. The procedure is simple, quick, and has a low 3.8% rate of complication. In the postoperative period pain is minimal, requiring only non-narcotic medication. Patient hospital stay is reduced, with dismissal usually one day after surgery. Knee motion as well as quadriceps control are rapidly recovered. One week after surgery 90% of patients gained 90° or more of flexion, and the remaining patients achieved this by the second week after surgery.
UNIQUE ASPECTS OF DOWNHILL SKI INJURIES PART 1: EPIDEMIOLOGY AND EQUIPMENT
Authors: Buck Peter G , Sophocles Aristotle M , Beckenbauch Robert D
Published: April 2021

ABSTRACT: Skiing is an exciting sport with a significant potential /or serious injury. This potential for injury can be minimized but never entirely eliminated by modern safety equipment.

Upper extremity injuries have become relatively more common as the incidence of lower extremity injuries has decreased. Ankle and foot injuries have become infrequent since the advent of the rigid plastic boot, while the incidence of knee injuries has remained essentially constant.

Three major mechanisms of injury to the lower extremity include external rotation and abduction, forward fall, and internal rotation. Each mechanism can produce a distinctive set of injured structures.

The "skier at risk" is characterized by a lower level of ability, lighter weight, and extremes of age. Injuries can be minimized by purchasing good quality equipment and maintaining it properly; discarding obsolete equipment; using ski brakes, antifriction devices and pistol grip poles; using multirelease bindings for beginners or intermediates; good physical conditioning; taking ski lessons and coupling this with skiing experience; and skiing in control and using common sense on the slopes.

Areas which need the most improvement in equipment design include multi-release bindings suitable for all skiers and children's boots.
SYME'S TWO STAGE AMPUTATION IN DIABETIC DYSVASCULAR DISEASE
Authors: Pinzur Michael S
Published: April 2021

ABSTRACT: Diabetic dysvascular disease often results in tissue gangrene and a below or above knee amputation. The energy expenditure in such amputees required for ambulation with a prosthesis is often so great as to markedly diminish their ambulatory ability. Using Doppler arterial pressure measurements to evaluate amputation level, Syme's two stage ankle disarticulations were performed in 10 patients with only one failure.
Arthroscopic Anatomy
Authors: Joyce John J
Published: April 2021

ABSTRACT: The arthroscopic appearances of the structures of the knee are described, including instrument approaches and obstacles to visualization.
Reduction of Anterior Shoulder Dislocations With Use of a Modified Kocher Maneuver
Authors: Snell Robert W , Erickson Thomas L , Mess Dennis J , Watt David H , Thomas Leslie , Schmitz Nadine C , Malinick Richard L
Published: April 2021

ABSTRACT: In a 15-month period, 26 patients with 31 anterior dislocations of the shoulder were seen. A modified Kocher maneuver was first attempted without the use of analgesics or muscle relaxants. This was successful 19 of 31 times (61%). With use of analgesics or muscle relaxants, 30 of 31 (97%) were successfully reduced without complications or fractures with use of this maneuver. In those dislocations seen within 24 hours, without fracture of the greater tuberosity or without failed prior surgery, the modified Kocher maneuver was successful without premedication in 19 of 24 (79%). One patient required general anesthesia.
CAT Scan Evaluation of Traumatic Hip Dislocations With Associated Posterior Acetabular Fractures
Authors: Burkus J K
Published: April 2021

ABSTRACT: Computerized axial tomography (CAT scanning) was utilized in the evaluation and treatment of 11 patients with traumatic fracture dislocations of the hip. The results influenced the treatment of all patients studied, and demonstrated significant radiographic findings that were not apparent on standard plain radiographs and tomography. CAT scanning in fracture dislocations of the hip is an essential diagnostic tool in establishing adequate treatment regimens and prognosis for these severe injuries.
Functional Anatomy of the Lumbar Spine
Authors: King Andrew G
Published: April 2021

ABSTRACT: Active research continues in the fields of growth anatomy, biochemistry, biomechanics, and immunology of the lumbosacral spine. Basic knowledge in these fields is essential for understanding and developing effective treatment modes, such as intradiscal therapy.
Experimental Evaluation of Chymopapain in Cats
Authors: Ford Lee T
Published: April 2021

ABSTRACT: This report reviews a study in animal model confirming the safety of chymopapain injection, which refuted an earlier study that noted severe reactions.
Technique for Chemonucleolysis
Authors: Apfelbach Henry W
Published: April 2021

ABSTRACT: A technique for chemonucleolysis of a prolapsed lumbar disc is outlined, including discussion of planning, the performance and interpretation of discography, and administration of the enzyme.
Chemonucleolysis Under Local Anesthesia
Authors: Spencer Curtis W
Published: April 2021

ABSTRACT: A protocol for performing lumbar disc chemonucleolysis under local anesthesia is presented. Advantages are discussed, including early detection and management of anaphylaxis and shortened procedure time.
Acute Fractures of the Femoral Neck Managed by Total Hip Replacement
Authors: Sim Franklin H , Sigmond Eric R
Published: April 2021

ABSTRACT: The criteria for the management of patients with femoral neck fractures by internal fixation, hemiarthroplasty, or total hip replacement are becoming better defined. Our experience in 111 cases indicates that total hip arthroplasty has a definite role if the cases are carefully selected. The main indication is a high-risk fracture in an elderly patient with associated pre-existing joint disease.
Randomized Trial of Oral Naproxen or Local Injection of Betamethasone in Lateral Epicondylitis of the Humerus
Authors: Saartok Tönu , Eriksson Ejnar
Published: April 2021

ABSTRACT: A randomized pilot study, comparing oral naproxen and a single betamethasone injection, was carried out in 21 patients suffering from lateral epicondylitis of the humerus ("tennis elbow"). The naproxen dosage was 250 mg per day for two weeks. Six milligrams of betamethasone in a long-acting form was given as a local injection. To achieve "blindness," the patients receiving naproxen were also given an injection of saline into the area of maximal tenderness at the epicondyle, while the patients getting the betamethasone-injection were given oral placebo tablets.

At a clinical control after two weeks, five of the ten patients receiving naproxen and five of the 11 patients receiving betamethasone injection were improved. Thus, no apparent difference in effect could be noted at an evaluation after two weeks' treatment. No significant side effects were noted with any of the treatments.
Vascular Injuries of the Extremities: Hazards of Unnecessary Delays in Diagnosis
Authors: Ben-Menachem Yoram
Published: April 2021

ABSTRACT: Delay in the diagnosis of vascular injuries of the extremities is still considered acceptable practice by many, despite its inherent high risk of morbidity and permanent disability. Such practice must be discouraged, because vascular wounding can be diagnosed early and with great precision by angiography. The arteriogram should become part of the initial emergency room assessment of all patients who sustain penetrating injuries of the extremities, as well as those who suffer violent blunt extremity trauma.
Periosteal Chondroma With Atypical Behavior in a 9-Year-Old Black Female: Case Report
Authors: Rankin Edward A , Wilcox Andrea , McMahon Carol
Published: April 2021

ABSTRACT: Periosteal chondroma is an uncommon benign cartilaginous tumor of bone reported most often in children and young adults but is as of yet unreported in a black cWW. This is a case ot periosteal chondroma in a 9year-old black female with unusual findings of 1) short duration of symptoms; 2) large size; 3) suspicious x-ray appearance and; 4) aggressive behavior. The lesion was histologically benign and has not recurred six years post curettage.
Occult Spinal Dysraphism: Case Report and Review of the Literature
Authors: Thompson W Frederick , McKay Marilynne
Published: April 2021

ABSTRACT: This case report and review of the literature is presented to create a greater diagnostic awareness of occult spinal dysraphism. Early recognition is based upon an understanding of this congenital anomaly and its variable presentations. These most commonly include abnormal gait, various cutaneous manifestations, particularly subcutaneous !»pomata, and less frequently urological complaints. Surgical intervention, to arrest disease progression, is the primary mode of treatment, and functional improvement is variable. Long-term prognosis is dependent upon severity of neurologic deficits prior to surgery and the type of lesion found intraoperatively. Familial occurrence has been reported and genetic counseling may be an important preventive measure. Recent radiologic investigations have been concerned with the use of ultrasonography in screening infants at risk.
Plaster-Associated Bacillus cereus Wound Infection: A Case Report
Authors: Rutala William A , Saviteer Susan M , Thomann Charlotte A , Wilson M Brejetta
Published: April 2021

ABSTRACT: Plaster of Paris and nonsterile cast padding have previously been implicated in wound infections. The observation of three pin site infections with Bacillus cereus following pin placement and plaster fixation of an open forearm fracture led to an epidemiologic investigation. Two hundred sixty-one bacterial cultures were taken from materials in the Steinmann pin application and plaster fixation procedures. B. cereus with a similar antibiogram and biotype as was identified in the pin site cultures was recovered from three of the 22 (14%) piasterimpregnated gauze rolls and six of seven (81%) tapwater samples. The Bacillus sp contamination rate of plaster when dry or wetted with sterile water or tapwater was 58%, 25% and 40% respectively. All cultures of plaster samples were negative after steam or gas sterilization. These results suggest that the patient may have acquired the infection from the plaster-impregnated gauze wetted in tapwater. In this case, the Steinmann pins may have facilitated infection by guiding the plaster-associated bacteria to the pin insertion site. The use of gas sterilized plaster materials should be considered in certain circumstances.
Arthrodesis of the Salvage Elbow
Authors: Rashkoff Evan , Burkhalter William E
Published: April 2021

ABSTRACT: An elbow arthrodesis was performed as a salvage procedure in seven patients with an open elbow arthrosis resulting from open trauma and the multiple surgeries that had followed. Patients had undergone an average of four previous elbow operations since their initial injury. Patients had pain, limited motion and instability that seriously compromised ipsilateral upper extremity function.

Hardware was placed posteriorly in five patients, and in two patients with predominantly posterior pathology and infection, it was placed anteriorly. All but one case was fused at 90° of elbow flexion. Wounds were all left open and spontaneously healed by secondary intention.

Six patients were available for an average follow up of 4 years. Time to fusion ranged from 4 to 9 months mean 6 months). Patients were graded in terms of relief of symptoms, clinical fusion, radiographic fusion, return to employment, wound healing, shoulder and hand function, and forearm rotation. Three patients had an excellent result, two good, and in one, the result was fair.

In our view, the surgical procedure of choice for a salvage elbow is an elbow arthrodesis.
EFFECT OF AN UNRESTRICTED KNEE-ANKLE-FOOT ORTHOSIS ON THE STANCE PHASE OF GAIT IN HEALTHY PERSONS
Authors: Cerny Kay , Perry Jacquelin , Walker Joan M
Published: April 2021

ABSTRACT

Twenty healthy women (mean age: 25 ± 3.6 years) were studied for postural adaptations produced when walking with unrestricted knee-ankle-foot orthoses. Stride characteristics, motion, floor reaction forces and their torques, and indwelling electromyographic activity of the lower gluteus maximus, as well as the long head of the biceps femoris, vastus lateralis, and soleus muscles were all measured during barefoot and orthosis walking.

Wearing a knee-ankle-foot orthosis increased stride length and decreased cadence and stance duration. The subjects walked in slightly more plantar flexion, knee flexion, and hip flexion, while increasing the duration of the corresponding floor reaction torques, resulting in an activity increase of the vastus lateralis, soleus, and biceps femoris muscles. These results, obtained in healthy subjects, show a definite effect of an unrestricted knee-ankle-foot orthosis on gait.
FEMORAL VARUS AND ACETABULAR OSTEOTOMIES IN CEREBRAL PALSY
Authors: Roye David P , Chorney Gail S , Deutsch Lawrence E , Mahon John H
Published: April 2021

ABSTRACT

Sixty-three patients with cerebral palsy underwent proximal femoral varus derotation osteotomy for 86 snbluxing or dislocating hips. Eleven hips underwent concomitant pelvic osteotomy. Adductor tenotomy was performed in all patients. The average preoperative femoral neck shaft angle was 158.2°, with a center edge angle of -2°. Femoral osteotomy effected an average femoral neck shaft angle of 132.2°, with a center edge angle of +8°. A Chiari osteotomy was performed when the acetabular index was >35°. This preoperative acetabular index of 46° improved to 28° postoperatively, and proved to be the most reliable indicator for need of an added pelvic osteotomy.
RADIOLOGIC CASE STUDY
Authors: Figler Thomas
Published: April 2021

CALCIFIC TENDONITIS OF THE LONGISSIMUS COLLI MUSCLE
Clinical Manifestations of a Sometimes Silent Disease
Authors: Engh Gerard A , Ammeen Deborah J
Published: April 2021

UHMWPE: The Good, Bad, & Ugly
Impaction Allografting of the Proximal Femur: Fact or Fad?
Authors: Haddad Fares S , Duncan Clive P
Published: April 2021

Revision Total Hip Arthroplasty: Fixation Options & Outcomes
When It Doesn't Work: Mechanisms of TKA Failure
Authors: Cuckler John M
Published: April 2021

Problems After Knee Arthroplasty: "Things That Co Bump in the Night"
Use of Polylactide Resorbable Film as an Adhesion Barrier
Authors: Welch William C , Cornwall G Bryan , Toth Jeffrey M , Turner A Simon , Thomas Kevin A , Gersten Peter C , Nemoto Edwin M
Published: April 2021

Abstract

The present investigation evaluates two thicknesses of a resorbable polylactide barrier film as an adhesion barrier to posterior spine scar formation. A readily contourable, thin film was placed directly over the dura. The thick film was placed above the lamina defect to act as a physical barrier inhibiting the prolapse of soft tissue into the epidural space. Through a combination of gross dissection with and without scar scores, quantitative analysis of collagen adjacent to the scar site, and histologic evaluation, the resorbable adhesion barrier membranes were found to be effective treatment for reduction of posterior adhesions. The gross dissection demonstrated that both thicknesses of resorbable polymer barrier films created a controlled dissection plane, facilitated access to the epidural space, and provided a reduction in the tissue adhered to the dura.
Resorbable Cages for Spinal Fusion: An Experimental Goat Model
Authors: Wuisman P I J M , van Dijk M , Smit T H
Published: April 2021

Abstract

A biomechanical cadaver study and an in vivo monosegmental spinal fusion study were performed to evaluate a novel bioresorbable poly-L-lactic acid (PLLA) cage. The yield strength of a spinal segment was chosen as the main design parameter for the resorbable cages to be used in a goat model. A 3-year in vivo study revealed a significantly faster and more complete fusion using PLLA cages as compared to titanium cages with the same dimensions. In the PLLA group, the intervertebral grafting height did not change and bone remodeling within the cage was completed 2 years after implantation. In terms of degradation of the PLLA, similar features were observed in vivo and in vitro. Degradation was almost completed 3 years after implantation. Tissue reaction was mild during the 3-year period.
Bioabsorbable Anterior Lumbar Plate Fixation in Conjunction with Anterior Interbody Fusion Cages
Authors: DiAngelo Denis J , Kitchel Scott , McVay Bobby J , Scifert Jeffrey L , Cornwall G Bryan
Published: April 2021

Abstract

An in vitro biomechanical study was conducted to determine the effects of anterior stabilization on lumbar interbody cage fusion biomechanics in a multilevel human cadaveric lumbar model. Three spine conditions were compared: harvested, bilateral multilevel cages (CAGES), and CAGES with bioabsorbable anterior plates (CBAP), tested under flexion/extension, lateral bending, and axial rotation. Measurements included vertebral motion, applied load, and bending/rotational moments. Application of anterior fixation decreased local motion and increased stiffness of the instrumented levels. Clinically, this spinal stability may serve to promote fusion. Coupled with the bioabsorbability of the plating material, the bioabsorbable anterior lumbar plating system is considered biomechanically advantageous.
Use of a Resorbable Sheet in Iliac Crest Reconstruction in a Sheep Model
Authors: Cornwall G Bryan , Thomas Kevin A , Turner A Simon , Wheeler Donna L , Taylor William R
Published: April 2021

Abstract

Iliac crest bone graft harvesting can result in major complications that occur at rates of approximately 6%-8%. The objective of this study was to evaluate the postoperative regeneration of iliac crest donor defects in an animal model after harvesting a full-thickness tricortical graft. In skeletally mature sheep, a tricortical iliac crest graft was harvested. The graft sites were allowed to heal nonprotected or protected with the resorbable polylactic acid sheet material, MacroPore OS Protective Sheeting, (MacroPore Biosurgery, San Diego, Calif). After 6 months of healing, the sites were assessed by examination of undecalcified histologic sections. Histomorphometric measurements of the original defect area, the area of new bone within the defect site, and the percentage of defect filled with new bone were quantified for both control and protected groups. In all histologic sections, new bone growth within the defect sites appeared normal, with no excessive inflammatory cells observed. The developing bone tissue appeared to be remodeling normally. For the nonprotected sites, the area of new bone averaged 16.3 mm
p 2
(±7.2 mm
p 2
), and the percentage of the defect area filled with bone averaged 10.7% (±6.5%). In the protected sites, the area of new bone averaged 64.8 mm
p 2
(±11.6 mm
p 2
) and the percentage of the defect area filled with bone averaged 25.9% (±1.6%). Both differences in area of new bone growth and percentage of defect area filled were statistically significant. Literature review has indicated that regeneration of donor site defects is desirable. Based upon the results of the present study, MacroPore resorbable protective sheeting can improve bone regeneration significantly within the donor site following tricortical iliac crest graft harvesting.
Use of a Bioabsorbable Anterior Cervical Plate in the Treatment of Cervical Degenerative and Traumatic Disk Disruption
Authors: Vaccaro Alexander R , Venger Benjamin H , Kelleher Peter M , Singh Kush , Carrino John A , Albert Todd , Hilibrand Alan
Published: April 2021

Abstract

Anterior cervical diskectomy and fusion is a widely accepted treatment for anterior management of degenerative or traumatic instability of the cervical spine. To reduce or eliminate complications such as implant migration and failure, imaging degradation, and fusion stress shielding that are occasionally associated with spinal instrumentation, attention has been given to the use of bioresorbable anterior cervical plating devices. This paper is a preliminary report of a retrospective series in which a resorbable mesh and screw system (OS Reconstructive Mesh, MacroPore Biosurgery Inc, San Diego, Calif) was used for graft containment in single-level anterior cervical diskectomy and fusion. A review of patient charts and imaging studies was conducted to determine functional outcome, fusion success, and potential soft-tissue reaction to implant resorption. Nine patients with a diagnosis of cervical degenerative disk disease or traumatic disk disruption were treated between October 2001 and March 2002. Follow-up averaged 206 days. Eight patients were found to have an excellent result, one patient had a good result, and no patients had a satisfactory or poor result. At the time of follow-up, 77% of patients (7/9) were found to have a radiographically solid fusion. The two patients without a solid fusion were only on average 8 months out from their fusion procedure and manifested no symptoms related to fusion nonhealing. No significant soft-tissue reaction was noted clinically or radiographically in any of the patients. The results of this preliminary study indicate that bioresorbable anterior cervical plating for single-level anterior cervical diskectomy and fusion is both safe and effective.
Subvastus Approach for Total Knee Arthroplasty
Authors: Gore Donald R , Sellinger D Scott , Gassner Kevin J , Glaeser Scott T
Published: April 2021

The indications for the subvastus approach in total knee arthroplasty are the same for a medial parapatellar approach in the appropriately selected patient. The subvastus approach does not violate the quadriceps mechanism, reduces the need for lateral retinacular release, preserves the patella blood supply, and, with our modifications, can be used in most cases.
Alumina Ceramic Bearings for Total Hip Arthroplasty
Authors: D'Antonio James , Capello William , Manley Michael
Published: April 2021

This article presents an experience with alumina ceramic bearings involving the use of improved ceramic materials as well as new design considerations. The alumina-alumina ceramic hard bearing is a safe option for the younger, more active patient.
Idiopathic Osteoarthritis of the Hip: Incidence, Classification, and Natural History of 272 cases
Authors: Hartofilakidis George , Karachalios Theophilos
Published: April 2021

Abstract

Long-term clinical and radiographic data of 210 patients (272 hips) with idiopathic hip osteoarthritis were reviewed. Of the 272 hips, 218 (80%) were eccentric and 54 (20%) were concentric. In eccentric hips, the femoral head migrated superolaterally or superomedially, because of the eccentric development of the degenerative changes, which had deteriorated rapidly. Hips with eccentric idiopathic osteoarthritis underwent total hip arthroplasty (THA) at an average of 4 years after symptom onset. In concentric hips, the femoral head migrated medially, causing progressive thinning of the medial wall of the acetabulum, and degenerative changes progressed slowly. Hips with concentric idiopathic osteoarthritis underwent THA at an average of 10 years after symptom onset.