bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capturing the Impact of the Doctor of Nursing Practice Degree on West Texas Health Care
Authors: Boswell Carol , Mintz-Binder Ronda , Batcheller Joyce , Allen Patricia , Baker Kathy A. 
Published: April 2021

Background:
This article describes findings from a Phase 1 investigation exploring the influence of Doctor of Nursing Practice (DNP)-prepared nurses in West Texas.

Method:
Following a focus group session with eight practicing DNPs, the focus group shared how their roles effected safer health care.

Results:
Final takeaways included their commitment to safer health care and prevention, moving care to the community, and a wish for more variety in projects generated in workplaces. Three themes emerged from the data: DNP leadership practice affects health outcomes through improved quality of care, influence, and innovation; DNP strengths include communication, leadership, and ability to change others' thinking; and the influence of DNP-prepared leaders at all external levels occurs through both increasing awareness of the role and influencing in multiple areas. DNP challenges include lack of understanding by others of the role and the lack of recognition and respect for their educational preparation.

Conclusion:

Leading, innovating, and communicating during constantly changing care models are key skills needed during the current health care crisis. These skills are basic to DNP practice.

[
J Contin Educ Nurs
. 2021;52(4):192–197.]
Feasibility of Bone Healing Measurement With External Fixation: Experimental Study
Authors: Bourgois R , Burny F 
Published: April 2021

ABSTRACT: The measurement of fracture healing is a problem before us now; many techniques are now being developed. One of them is strain gauge measurement, allowing control of the development of the callus stiffness. The mathematical models and the experimental controls always had to deal with "preliminary assumptions." Theoretically, the output of a single strain gauge bonded on the fixation rod drops rapidly accordingly to the quality of the healing. Our aim is to verify experimentally the validity of the method in cases where the "preliminary assumptions" are not strictly true.
We investigated the influence of the fixation rod on the loading of the tibia using strain gauges bonded on the bone. The tibial cortex was afterwards weakened by a 1 mm broad saw cut (and later a 5 mm one) in the middle of the bone. We again found the hyperbolic pattern of the theoretical curves.
The experiments confirm the theoretical result: the measurement of stress drops rapidly as the degree of healing increases. An asymmetrical healing does not seem to modify significantly the pattern of the curve.
EFFECT OF MODIFIED AEROBIC TRAINING ON MOVEMENT ENERGETICS IN POLIO SURVIVORS
Authors: Dean Elizabeth , Ross Jocelyn 
Published: April 2021

ABSTRACT
Given that individuals with disabilities may be unable to achieve maximal oxygen uptake in an exercise test and that maximal exercise testing may cause increased fatigue, pain, and muscle weakness, we examined the role of submaximal exercise testing and training based on objective as well as subjective parameters in polio survivors. Experimental (N = 7) and control subjects (N =13) were tested before and after a 6-week period. The experimental subjects participated in a 6-week exercise training program for 30 to 40 minutes, three times a week. The program consisted of treadmill walking at 55% to 70% of age-predicted maximum heart rates; however, exercise intensity was modified to minimize discomfort/pain and fatigue. Neither objective nor subjective exercise responses were significantly different in the control group over the 6 weeks. No change was observed in cardiorespiratory conditioning in the experimental group. However, movement economy, which is related to the energy cost of walking, was significantly improved; and walking duration was significantly increased at the end of training. Modified aerobic training may have a role in enhancing endurance and reducing fatigue during activities of daily living in polio survivors.
THE USE OF POSTOPERATIVE SUCTION DRAINAGE IN TOTAL HIP ARTHROPLASTY
Authors: Acus Raymond W , Clark John M , Gradisar Ivan A , Kovacik Mark W 
Published: April 2021

ABSTRACT
Two hundred eight primary total hip arthroplasties were reviewed to evaluate the effect of closed suction drainage. This review included 45 hips in which closed drains were used and 163 hips in which drains were not used. These two groups were compared for possible differences in wound problems, temperature elevations, changes in Hgb/Hct, and the need for transfusions. There was no statistically significant difference in postoperative temperatures or decrease in Hgb. However, there were four superficial wound infections in the drained group and three superficial wound infections in the nondrained group (P<.025). There were no deep infections in either group. These findings suggest closed suction drainage provides no apparent advantage in uncomplicated primary total hip arthroplasty.
DISLOCATION FOLLOWING THA: COMPARISON OF TWO ACETABULAR COMPONENT DESIGNS
Authors: Brien William W , Salvati Eduardo A , Wright Timothy M , Burstein Albert H 
Published: April 2021

ABSTRACT
One hundred ninety-seven consecutive primary cemented total hip arthroplasties using 22 mm heads were evaluated for the rate of dislocation. All surgery was performed by one surgeon through a posterior approach. A Charnley type femoral component was used in each case. Patients were divided into three groups based on the acetabular component used. Group I had 60 Charnley HPW cups implanted between January 1985 and December 1986; group II had 70 Tibac cups implanted between January 1987 and August 1987; and group ?? had 67 Charnley HPW cups implanted between September 1987 and February 1988. The groups were similar with regards to age, sex, original diagnosis, and surgical technique. There was a total of 11 dislocations (5.6%), of which 8 (11.4%) occurred in group II (Tibac cup). Furthermore, 6 patients (3%) developed recurrent hip dislocations, 5 (7.1%) of which were from group II. Group II had a statistically significant increase in the dislocation rate (P<.05). The authors conclude that the dislocation rate with the 22 mm Tibac cup is unacceptably high and that the design of the Charnley cup affords greater stability to the artificial hip joint than the hemispherical design of the Tibac cup.
ARTHROSCOPIC MANAGEMENT OF WRIST TRIANGULAR FIBROCARTILAGE COMPLEX INJURIES IN THE ATHLETE
Authors: Whipple Terry L , Geissler William B 
Published: April 2021

ABSTRACT
Wrist arthroscopy can facilitate early definitive diagnosis of debilitating soft tissue injuries in athletes. Many such injuries can be treated successfully with minimally invasive arthroscopic techniques, reducing the morbidity associated with surgical exposure and permitting earlier return to competition. The triangular fibrocartilage complex (TFCC) is vulnerable to injury from rotational forces or axial load applied to the hand. Under arthroscopic control, injuries to the central articular disk can be treated by excision of unstable tissue fragments; peripheral separation of the disk from the dorsal or volar ligaments can be repaired with sutures to achieve complete healing. Avulsion fractures from the dorsal ulnar margin of the sigmoid notch of the radius are better treated through a small arthrotomy after initial arthroscopic evaluation.
OSTEOSARCOMA OF THE DIAPHYSIS OF LONG BONES: CLINICOPATHOLOGIC FEATURES AND TREATMENT OF 51 CASES
Authors: Sim Franklin H , Frassica Frank J , Unni K Krishnan 
Published: April 2021

ABSTRACT
Of 1000 osteosarcoma cases recorded in the Mayo Clinic records, approximately 7% of the lesions occurred in the diaphysis of long bones, mostly in the femur, tibia, and humerus. The average age of the patients with these lesions was 28 years (range: 8 to 67). The duration of their symptoms before diagnosis was greater than that for patients with conventional osteosarcoma in the metaphysis. In approximately 20% of the cases, the radiographic appearance mimicked that of Ewing's sarcoma. Amputation surgery was the major form of treatment. The 2-, 5and 15-year survival was 42%, 29%, and 20%, respectively.
TREATMENT OF ACQUIRED MUSCLE SPASTICITY USING PHENOL PERIPHERAL NERVE BLOCKS
Authors: Botte Michael J , Abrams Reid A , Bodine-Fowler Sue C 
Published: April 2021

ABSTRACTThe use of phenol motor nerve blocks is advantageous in the early period of acquired spasticity (ie, that occurring following traumatic brain injury or incomplete spinal cord injury), when increased muscle tone is often the most severe. Because acquired spasticity is dynamic and usually improves slowly, a temporary treatment method used to ameliorate increased muscle tone is desirable. Phenol nerve infiltration provides a temporary motor nerve block that lasts for weeks or months. It allows passive limb mobilization in a comprehensive rehabilitation program that attempts to prevent fixed soft tissue contractures. Permanent or irreversible methods such as operative tendon lengthening, muscle release or recession, or neurectomy are usually best delayed until the spasticityhas become static, when the need for surgical correction becomes more firmly indicated, and outcomes of operative intervention are more predictable. Although phenol nerve blocks were initially administered at the spinal cord level to control spasticity, the potential side effects have caused a loss of popularity of this method of administration. The safer and more common use of phenol infiltration at the peripheral nerve level is now more accepted for brain injury and spinal cord injury patients. This report reviews the indications, current concepts, and development of the different methods used to administer phenol nerve blocks. Comparisons to other methods to control spasticity are discussed.
CLUBFOOT DEFORMITY IN DOWN'S SYNDROME
Authors: Miller Paul R , Kuo Ken N , Lubicky John P 
Published: April 2021

ABSTRACT
The association of Down's syndrome (trisomy 21) with clubfeet has not previously been elaborated. Eight patients with a total of 15 clubfeet were identified for review. Five of these had trisomy 21 noted by chromosomal analysis, and 1 had a mosaic pattern. Two patients did not have chromosomal documentation, but had characteristic features of Down's syndrome. Interestingly, 2 patients had evidence of arthrogryposis as well as Down's syndrome. Four of the 8 patients had other orthopedic anomalies, including scoliosis, atlantoaxial instability, brachydactyly, and coxa valga. All 8 patients had an initial period of casting prior to any surgical intervention. Fourteen of the 15 feet required surgical intervention to afford correction of the deformity. The 6 feet with relatively long-term follow up (average: 5 years) showed that there was 1 excellent, 4 good, and 1 fair result using the criteria of Turco. It appears that, even though Down's syndrome is usually characterized by ligamentous laxity, when clubfeet are associated with this syndrome they are often resistant to nonoperative treatment, and surgical treatment seems to produce an acceptable result.
THE HALO SKELETAL FIXATOR: CURRENT CONCEPTS OF APPLICATION AND MAINTENANCE
Authors: Botte Michael J , Byrne Thomas P , Abrams Reid A , Garfin Steven R 
Published: April 2021

ABSTRACT
The halo device provides the most rigid cervical immobilization of all cervical orthoses. Despite its established efficacy, reported complications include pin loosening (36% to 60%), pin-site infection (20% to 22%), severe pin discomfort (18%), ring migration (13%), pressure sores (4% to 11%), unacceptable scars (9% to 30%), nerve injury (2%), dyspha
gia (2%), prolonged bleeding at pin sites (1%), and dural puncture (1%). Appreciation of skull anatomy and established application guidelines can help minimize these complications. A relative "safe zone" for anterior pin placement is located 1 cm above the orbital rim, superior to the lateral two thirds of the orbit. This position avoids injury to the nearby frontal sinus (medially), temporalis fossa (laterally), and sensory nerves (supraorbital and supratrochlear nerves medially, and zygomaticotemporal nerve laterally). Posterior pin positions are less critical, located roughly diagonal to the contralateral anterior pins. Pins should enter the skull perpendicular to the cortex, with the ring or crown sitting below the equator of the skull, passing about 1 cm above the helix of the ear. Pins are inserted at 8 in-lbs and re-tightened once at 48 hours. A loose pin can be re-tightened to 8 in-lbs if resistance is met; otherwise, a loose pin requires replacement in a nearby site. Superficially infected pins are managed with oral antibiotics and local pin care. Refractory infections require pin removal, parenteral antibiotics, and incision and drainage as indicated. Dysphagia (difficulty in swallowing), produced by exaggerated cervical extension, may necessitate repositioning of the C-spine. Dural pin puncture is managed with hospitalization, antibiotics, and elevation of the head of the bed to decrease cerebrospinal fluid pressure and allow dural healing. Pressure sores are treated by prevention with well-padded vests/casts and the use of skin precautions, especially in sensory-deprived spinal cord injury patients. Inability to maintain reduction with a halo fixator usually requires open reduction and internal fixation of the cervical spine.
A PORTABLE TENSIOMETER FOR ASSESSING KNOT-TYING TECHNIQUE
Authors: Franz David A , Batra Erich K , Morgan Raymond F , Edlich Richard F 
Published: April 2021

ABSTRACT
The purpose of this study was to determine the influence of orthopedic surgeons' tying techniques on knot security using 2-0 and 4-0 monofilament and multifilament nylon sutures. Using an Instron® Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. Using the portable tensiometer, their knot-tying techniques were judged to be superior to those used by orthopedic surgeons. The orthopedic surgeon's faulty technique can easily be corrected by didactic information and psychomotor skill training.
COMPARTMENT PRESSURE MONITORING DURING INTRAMEDULLARY FIXATION OF TIBIAL FRACTURES
Authors: Moehring H David , Voigtlander James P 
Published: April 2021

ABSTRACT
Twenty-six legs in 25 patients were monitored prospectively for compartment pressures during intramedullary nailing of open and closed tibial shaft fractures. Twentythree patients were treated within 24 hours of admission. Twenty-three unreamed and three reamed intramedullary rods were utilized. Compartment pressures were measured initially, following fracture reduction, and during reaming. Pressures were also measured at the completion of nailing with the ankle dorsiflexed and at rest (plantar flexed) to determine positional effects on compartment pressures. Nine fractures (35%) were found to have persistently elevated pressures (>40 mm Hg) and underwent immediate fourcompartment fasciotomy. The remaining group of 17 fractures (65%) was monitored throughout the intraoperative period. No patient monitored intraoperatively developed postoperative compartment syndrome.
THE DIFFICULT DIAGNOSIS OF POSTERIOR TIBIALIS TENDON RUPTURE IN SPORTS INJURIES
Authors: Marcus Randall E , Goodfellow Donald B , Pfister Michael E 
Published: April 2021

ABSTRACT
Posterior tibialis tendon rupture is a diagnosis that is often missed in sports-related injuries. This is thought to be secondary to the nonspecific clinical findings in healthy, active individuals, and the lack of any laboratory or radiographic test to reliably confirm the diagnosis. We report five cases of surgically confirmed posterior tibialis tendon rupture secondary to sports-related trauma. Based on our review of these patients, the diagnosis of posterior tibialis tendon rupture should be strongly suspected in the adult patient presenting with a history of a twisting ankle injury, especially in the setting of highimpact loading and generalized medial ankle pain and swelling. A flexible asymmetric pes planus and forefoot pronation deformity with absence of posterior tibialis tendon function on manual testing is seen on examination. The patient is usually unable to perform ipsilateral single leg heel rise and has less severe pes planus of the contralateral foot. This study reviews the presentation, pathophysiology, diagnosis, and treatment of posterior tibialis tendon rupture.
Snowboard Traumatology: An Epidemiological Study
Authors: Pigozzi Fabio , Santori Nicola , Di Salvo Valter , Parisi Attilio , Di Luigi Luigi 
Published: April 2021

ABSTRACT
In the past 10 years, snowboarding has become a popular winter sport among young people, and the number of accidents has increased proportionately. The incidence of traumas from snowboarding is shown to be 4 to 6 for every 1 000 medical examinations, which is similar to that of downhill skiing. However, other important statistical differences exist between the two sports.
This study of 1 06 snowboarding-related injury cases analyzes the epidemiology of these injuries in Italy. Results found that 45.1% of injuries are located in the upper limbs and that significant advantages are obtained with the introduction of guards to protect the upper limbs during descent. Serious ligament injuries to the knee are more rare in snowboarding than in downhill skiing. In both sports, injuries are more common with rigid boots, which lead to a higher incidence of injury to the upper limbs. Finally, a high percentage of injury to beginners was found in this study. Training courses for those who are considering taking up the sport of snowboarding could significantly lower their risk of trauma.
The Vertebral Artery: Surgical Anatomy
Authors: Lu Jike , Ebraheim Nabil A 
Published: April 2021

ABSTRACT
Anterior cervical decompressive surgery is widely performed for spondylosis, herniated intervertebral disk, tumor, infection, and trauma in the subaxial cervical spine region. Laceration of the vertebral artery is the most challenging of surgical dilemmas during anterior cervical spine surgery, as gaining control of the massive hemorrhage from a ruptured vertebral artery is difficult and could possibly result in an uncertain neurologic morbidity. As such, the understanding the surgical anatomy of the vertebral artery is essential to prevent iatrogenic injuries.
Computed Tomographic Evaluation of the Internal Structure of the Lateral Sacral Mass in the Upper Sacra
Authors: Ebraheim Nabil A , Lin David , Xu Rongming , Stanescu Stephan , Yeasting Richard A 
Published: April 2021

ABSTRACT
Because dimensions of the upper sacral cortexes vary greatly among individuals, preoperative computed tomographic (CT) evaluation of individual sacrum may help surgeons choose sacral screw insertion techniques. Axial CT scans were performed on 40 dry sacrum specimens to quantitatively evaluate the internal structure of the lateral sacral mass in the first and second segments. The results showed that the greatest cortical thickness in the Sl vertebra was found in the anterior cortex (3.4±0.9 mm), followed by the anterolateral (3.2±1.2 mm), and anteromedial (2.9±1 mm). The greatest cortical thickness in the S2 region was noted in the anteromedial cortex (2.4±0.5 mm), followed by the anterior and anterolateral (2.2±0.9 mm). The mean percentage of the anterior cortex thickness versus the lateral sacral mass depth was 12.8±3.7 for Sl and 11.1 ±2.8 for S2. Bicortical screw placement is recommended to achieve stronger fixation, but care should be taken not to violate the vital structures anterior to the sacrum.
World Experience with Low Contact Stress Mobile-Bearing Total Knee Arthroplasty: A Literature Review
Authors: Stiehl James B 
Published: April 2021

Abstract
This article reviews recent data regarding the low contact stress (LCS) mobile-bearing total knee prosthesis recently published in the literature; conclusions are based on literature controls. The LCS Total Knee System (DePuy Orthopaedics Ine, Warsaw, lnd) has addressed the issues of implant polyethylene wear and implant-generated osteolysis. Patellar implant complications have been minimal despite the use of a mobile, metal-backed component. The original US Food and Drug Administration clinical investigation demonstrated favorable experience with cementless fixation. Results from numerous series indicate that the main problem with a mobile-bearing device is an early prosthetic failure resulting from bearing dislocation or breakage. Inadequate surgical technique will lead to femorotibial malalignment or ligamentous instability, which are factors that commonly result in revision. With the LCS Total Knee System, surgeons can use a tibia-cut-first approach with careful ligamentous balancing and flexion block spacing. The valgus lateral knee approach is an additional technique that has proved useful with this method.
Use of Injectable Calcium Phosphate in the Treatment of Intra-Articular Distal Radius Fractures
Authors: Tyllianakis Minos , Giannikas Dimitrios , Panagopoulos Andreas , Panagiotopoulos Elias , Lambiris Elias 
Published: April 2021

Abstract
This study reviewed 19 patients with intra-articular fractures of the distal end of the radius treated with augmented external fixation and injectable calcium phosphate (Norian SRS; Norian Corp, Cupertino, Calif) between November 1997 and July 2000. Average patient age was 52 years, and average follow-up was 16.3 months. Patients were evaluated clinically and radiographically using the modified Mayo Wrist Score and Knirk and Jupiter's criteria, respectively. Overall results are comparable to those from other studies of intra-articular distal radius fractures in which other grafts have been used.
A Comparison of the Effects of Solid, Articulated, and Posterior Leaf-Spring Ankle-Foot Orthoses and Shoes Alone on Gait and Energy Expenditure in Children with Spastic Diplegic Cerebral Palsy
Authors: Smiley Sara J , Jacobsen F Stig , Mielke Cary , Johnston Robert , Park Carol , Ovaska Gary J 
Published: April 2021

Abstract
Fourteen children with spastic diplegie cerebral palsy were evaluated wearing three different ankle-foot orthoses and shoes alone. The ankle-foot orthoses included solid, articulated ankle, and posterior leaf-spring types. Evaluation measures included computerized gait analysis, Energy Efficiency Index data, and individual preference. Highly significant kinematic differences were found at the ankle with shoes alone approaching normative data and braces showing abnormal dorsiflexion. No significant differences were found in velocity, cadence, stride length, or in the Energy Efficiency Index. Eight children preferred articulated braces, six chose posterior leaf-spring, and none chose the solid brace.
Arthroscopy Following Total Knee Arthroplasty
Authors: Teng Hsiu-Peng , Lu Yih-Chau , Hsu Chien-Jen , Wong Chi-Yin 
Published: April 2021

Abstract
Conservative treatment had previously been used in our institution to treat the painful stiff knee joint following total knee arthroplasty (TKA). However, the result was not satisfactory. Arthroscopic surgery was then performed in ? patients with painful knee joints with limited motion who had previously undergone TKA. Good results were achieved in eight patients. An average improvement of 56.3° was achieved for knee range of motion. Flexion improved up to 90° in all patients in the early postoperative period following arthroscopy. However, the benefits declined with time. To avoid the potential complications of manipulation and open arthrotomy, arthroscopic surgery is an option for treating the painful stiff knee joint.