bluuebunny/crossref_metadata_2025_split huggingface dataset:
Calcaneus Fractures: Rationale for the Medial Approach Technique of Reduction
Authors: Bunleaux Billie D 
Published: April 2021

ABSTRACT: The fractured calcaneus is an enigma to many orthopedic surgeons. Because of this they are often not reduced as well as they might be. The majority of these fractures can be adequately reduced by the medial approach. This approach is based on the fact that a definite pattern of fracture occurs on the medial side of the calcaneus, whereas there is no pattern on the lateral side. If one restores the medial wall of the calcaneus, which is most accurately done from the medial side, the height, length, and much of the width is restored. Strong pressure over the lateral bulge is necessary to completely restore normal width. Generally, the tongue or joint depression-type fragments can be reduced from the medial side. If not, a separate, lateral incision is used to insure their reduction.
The neurovascular bundle is no longer dissected out, removing a psychological barrier to the medial approach. A strong recommendation is made to use the longitudinal pin method of fixation. It is simple, and extremely strong. A classification of calcaneus fractures is presented, which can help in preoperative planning for reduction of these fractures.
Wrist Arthroplasty: A Retrospective Study
Authors: Cimino Peter M , Riordan Daniel , Edmunds J Ollie , Brunet Michael E , Haddad Ray J , Davis Michael J 
Published: April 2021

ABSTRACT: A retrospective study was conducted to evaluate the long-term effectiveness of wrist arthroplasties in patients with various arthritic conditions. A total of 39 wrist arthroplasties were performed in 29 patients (average age, 52.5 years) by the orthopedic staff at Tulane University School of Medicine. Rheumatoid arthritis was the major presenting diagnosis in 84.6% of these operative cases and pain was the most common indication for surgery (79.5%).
Postoperative relief of pain was reported in all of the cases reviewed, with an average follow up period of 51.2 months (range, 12 to 118 months). A group of 15 patients who were examined clinically had an average grip strength of 19.2 lb (range, 6 Ib to 45 Ib). Pinch measurements averaged 1.9 Ib and arc of motion averaged 59.5° (range, 20° to 100°) for these patients. Postoperative complications included dislocation (3 cases), fracture of the prosthesis (2 cases), and infection (2 cases). No complications were observed in 32 (82.1%) of the 39 cases reviewed.
This retrospective study revealed that at an average follow up period of 51.2 months, pain relief was excellent and patient acceptance was good, with 94.9% of the wrists having been improved by the procedure. The majority (82.1%) of the cases were free of complication. It is concluded from this study that wrist arthroplasty is a viable alternative to wrist arthrodesis.
Adhesive Capsulitis of the Shoulder: Current Concepts and Treatment
Authors: Murnaghan J Patrick 
Published: April 2021

ABSTRACT: Primary adhesive capsulitis of the shoulder is a common cause of a painful shoulder in clinical practice. The pathogenesis remains unclear. Many patients continue to have significant long-term restrictions in their range of motion although few are functionally restricted.
Prevention is the ideal treatment. Patients respond to treatment plans directed at pain relief and improving the range of motion, however, ongoing controlled therapeutic trials are necessary to better refine the selection of treatment for individual patients.
PROXIMAL METATARSAL SEGMENTAL RESECTION: A TREATMENT FOR INTRACTABLE PLANTAR KERATOSES
Authors: Spence Kenneth F , O'Connell Stephen J , Kenzora John E 
Published: April 2021

ABSTRACT
For the past 15 years, a procedure the authors have termed proximal metatarsal segmental resection has been used for the treatment of intractable, painful, submetatarsal plantar keratoses which have failed nonoperative treatments. This simple procedure basically is the resection of a cylindrical segment of proximal metatarsal bone approximately 0.5 cm long. Fifty-four patients (70 metatarsals) underwent the procedure and were followed a mean of 6 years. Good to excellent results were reported in 89% of these patients. Transfer lesions occurred in 18% of feet and were responsible for all fair and poor results. When the procedure was carried out in association with a bunion correction, transfer lesions occurred in 23%; whereas when performed as an isolated metatarsal procedure, transfer lesions followed in 12%. Recurrent keratoses developed in 7%. This technically simple procedure is associated with minimal patient morbidity and should be considered an option in the surgical management of metatarsalgia.
RESULTS OF AKIN TYPE PROXIMAL PHALANGEAL OSTEOTOMY FOR CORRECTION OF HALLUX VALGUS DEFORMITY
Authors: Plattner Paul F , Van Manen John W 
Published: April 2021

ABSTRACT
The results of 26 Akin proximal phalangeal osteotomies in 22 patients for hallux valgus deformities are reported. The average follow up was 53 months (range, 12 to 97 months). Subjectively, 16 feet had a satisfactory result (61.5%). Objectively, 14 feet met the criteria for a satisfactory result (53.8%). The authors found that the Akin osteotomy was unpredictable as an isolated procedure, and not indicated in a hallux valgus deformity with an incongruent joint.
CUSTOM-MOLDED ORTHOTICS IN POSTOPERATIVE HALLUX VALGUS IMMOBILIZATION
Authors: Donatto Keith C , Rightor Nicholas , D'Ambrosia Robert 
Published: April 2021

ABSTRACT
Bunion surgery is one of the most frequently performed operations on the foot. The majority of established procedures use some form of soft tissue manipulation with or without an osteotomy as the means of achieving correction. Long-term success depends on operative technique and adequate postoperative immobilization. The authors describe a custommolded thermoplast splint that effectively maintains hallux position in the healing phase of hallux valgus surgery. It is easy to construct, comfortable to wear, and has several advantages over other forms of immobilization.
ORTHOPEDIC EXPERIENCE IN A MASH UNIT IN POSTWAR IRAQ
Authors: Johnson William L , O'Hearn Charles J , Dobner Joseph J 
Published: April 2021

ABSTRACT
The orthopedic experience of a U.S. Army MASH unit deployed in southern Iraq is discussed. Seventy major casualties were surgically treated in a short time span. A high percentage of extremity trauma was observed (69%). Many patients had multiple extremity involvement. The emergency wartime surgical treatment of four specific types of trauma is explored. A new algorithm is presented for the rapid evaluation of penetrating joint injuries. We summarize the current concepts of war surgery as they apply to orthopedic injuries, and add specific observations from this experience.
PRINCIPLES OF RADIATION THERAPY IN THE TREATMENT OF BONE METASTASES
Authors: Frassica Deborah A , Gunderson Leonard L 
Published: April 2021

ABSTRACT
The radiation oncologist is an important member of the multidisciplinary team involved in the management of patients with metastatic bone disease. Radiation therapy provides local tumor control of the metastatic deposit and effective pain relief in the majority of patients. If there is a risk of fracture, prophylactic fixation is done before radiation therapy.
THE INFLUENCE OF AGE, SEX, AND INITIAL FIT ON BONY INGROWTH STABILIZATION WITH THE AML FEMORAL COMPONENT IN PRIMARY THA
Authors: Shaw James A , Bruno Anthony , Paul Emmanual M 
Published: April 2021

ABSTRACT
A radiographic review of 178 consecutive primary total hip arthroplasties using the AML femoral component with a mean follow up of 40.1 months identified 92.3% to be stabilized by bony ingrowth and 7.7% by fibrous tissue. None were classified as loose. The quality of fit in the isthmus and calcar regions was identified as an important factor in achieving bony ingrowth stabilization. Bony ingrowth was achieved in all age groups with equal frequency. No relationship between sex and the type of stabilization was identified. A clinical correlation utilizing a subset of patients with identical prosthetic components identified equivalent clinical results across all age groups. Thirty-four percent of patients experienced some residual thigh pain. No statistically significant relationship between the presence of thigh pain and the type of femoral component stabilization (bony vs fibrous) could be identified. Ninety-eight percent of patients expressed unconditional satisfaction with their hip replacements.
POSTTRAUMATIC STIFFNESS: DISTRACTION ARTHROPLASTY
Authors: Morrey Bernard F 
Published: April 2021

ABSTRACT
Loss of motion after elbow trauma is a common complication. At times, the limitation of motion may significantly impair function. Options to improve posttraumatic motion by surgery depend on whether the joint surface has been severely involved (intrinsic vs extrinsic contracture). Increasing experience with the surgical release of the posttraumatic stiff elbow has been enhanced by the use of distraction with or without interposition arthroplasty. Current experience suggests that approximately 85% of patients will be satisfactorily treated with surgical intervention.
IMMEDIATE PLATE FIXATION OF HIGHLY COMMINUTED FEMORAL DIAPHYSEAL FRACTURES IN BLUNT POLYTRAUMA PATIENTS
Authors: Riemer Barry L , Butterfield Spencer L , Burke Charles J , Mathews David 
Published: April 2021

Abstract
From January 1982 through December 1988, 150 patients with 153 Winquist Class ITI and IY comminuted diaphyseal femur fractures due to high energy blunt trauma were treated with immediate plate fixation. A total of 260 major gênerai surgical systems were injured in 150 patients. Forty-nine patients did not have adequate preoperative spine radiographs due to positioning or time factors. Nineteen patient« had spine fractures; nine were diagnosed post-femoral fixation. The average injury severity score (ISS) was 22.7. Three patients died (2%). Our institution predicted mortality with this ISS for patients without pelvic or femur fractures at 15% (P= .0003).
Six patients moved to other states and three were lost to follow up due to noncompliance. One of us reviewed 141 fractures in 138 patients at a minimum of 12 months follow up and completion of treatment. Forty-nine fractures were open; 8 grade 1, 25 grade ?, 10 grade ???, 4 ???, 2 HIC. A total of 153 pelvic or ipsilateral major orthopedic injuries were present in 141 fractures. An additional 188 major associated orthopedic injuries were noted.
The average time to union was 17.2 weeks. One plate was applied in 11° of varus. Five plates failed from fatigue and five from repeat traumas. Seven plate failures were rodded and healed within 8 weeks. There was one persistent nonunion. One fracture, open IIIC, became infected after uniting. One patient has 110° of knee motion and 140 fractures have greater than 130° of knee motion.
Plate fixation is a safe technique for immediate femoral stabilization in the face of high energy blunt trauma. Failures occur late and are easy to reconstruct Intramedullary nails are the preferred method of reconstruction. Ultimate knee function is excellent. Infection rates (1/49) in open fractures are acceptably low.
SURGICAL RESULTS IN ANTERIOR CERVICAL DISCECTOMY AND FUSION USING A COUNTERSUNK INTERLOCKING AUTOGENOUS ILIAC BONE GRAFT
Authors: Bosacco David N , Berman Arnold T , Levenberg Richard J , Bosacco Stephen J 
Published: April 2021

ABSTRACT
The purpose of this study was to evaluate the surgical results of anterior cervical discectomy and fusion using a countersunk interlocking autogenous iliac bone graft. Two hundred thirty-two patients were followed for an average of 6.8 years. All patients suffered neck and arm pain. Two hundred twenty patients received conservative treatment for at least six months. Overall results were satisfactory in 202 patients (87%) and unsatisfactory in 30 patients (13%). The pseudoarthrosis rate was 6.5% which is significantly lower than previous reports. The premise of this technique is that the interlocking graft prevents migration, promotes fusion by providing immobilization, and restores the height of the interspace. Anterior cervical discectomy and fusion, using a countersunk interlocking autogenous iliac bone graft, is a satisfactory surgical procedure in which successful pain relief is to be expected.
PAIN INHIBITION OF SHOULDER STRENGTH IN PATIENTS WITH IMPINGEMENT SYNDROME
Authors: Ben-Yishay Ari , Zuckerman Joseph D , Gallagher Maureen , Cuomo Frances 
Published: April 2021

ABSTRACT
Fourteen patients with Stage II or III impingement syndrome (average age 58 years) were studied. Nine patients had full-thickness rotator cuff tears documented by arthrograms. Patients initially underwent a thorough shoulder examination followed by baseline isokinetic strength testing. Abduction/ adduction testing was performed utilizing a Biodex dynamometer. Maximum concentric contractions were performed, and values for peak torque (PT), total work (W), and power (P) were obtained. All patients received a subacromial injection of 5 cc 1% lidocaine plus 5 cc 0.5% bupivacaine (Marcarne). After 5 minutes the testing sequence was repeated. Clinically, patients demonstrated marked improvement following injection. Eighty-six percent reported complete pain relief; the remaining two patients reported only mild discomfort at the extremes of motion. Improvement in functional activity of the affected shoulder was noted by all subjects. On manual muscle testing, 13 of 14 patients (93%) demonstrated increased abduction strength; 11 of 14 (79%) had improvement in external rotation. Mean increases in active forward elevation and external rotation were 36° and 11°, respectively (P<.01). Postinjection isokinetic changes in PT, W, and P for abduction/adduction were dramatic. For abduction, all patients showed significant increases in P (mean 82%), W (mean 90%), and PT (mean 48%) (all P<.05). No significant differences in range of motion testing or strength parameters were noted based on the presence or absence of a rotator cuff tear. For adduction, all patients showed significant increases in P (mean 208%), W (mean 183%), and PT (mean 41%) (all P<-05). Our findings indicate that pain is an important factor in the etiology of shoulder weakness documented by both clinical examination and isokinetic testing. Isokinetic muscle testing provides a method of quantitating the effect of pain on muscle function as measured by PT, W, and P. This information may be important in assessing the improvement in strength following acromioplasty with or without rotator cuff repair.
SURVIVORSHIP ANALYSIS OF ACETABULAR REVISION IN MEDIAL, LATERAL, AND GLOBAL PRIMARY OSTEOARTHRITIS
Authors: Bissacotti Joao Flavio , Cates Hal E , Keating E Michael , Faris M , Ritter Merrill A 
Published: April 2021

ABSTRACT
Acetabular revision rates after cemented total hip arthroplasty vary from series to series in the literature. Little attention has been paid to the type of primary osteoarthritis in these previous series. We studied 782 cemented total hips in 671 patients with an average follow up of 73 years. Acetabular revision rates were analyzed in medial, lateral, and global primary osteoarthritis using survivorship analysis. Medial osteoarthritis was associated with a higher acetabular revision rate when compared to lateral osteoarthritis (P=.015). No differences were noted in acetabular revision rates when the preoperative diagnosis was medial vs global or lateral vs global primary osteoarthritis (P=.18 and P=.45, respectively). According to this study, a preoperative diagnosis of medial primary osteoarthritis should be added to a list of several factors associated with increased cemented acetabular failure, especially in the Charnley prosthesis.
'Clearing' Cervical Spine Injuries in Polytrauma Patients: Is It Really Safe to Remove the Collar?
Authors: Harris Mitchel B , Waguespack Alexis M , Kronlage Steve 
Published: April 2021

ABSTRACT
Polytrauma patients are at increased risk for occult cervical spine injuries. Those unable to provide clinical dues to injury either remain in hard collars until they are able to cooperate with the physical examination or are deemed "clear of cervical injury" if the emergency room screening radiographs are without obvious bony abnormality. Cervical immobilization for a lengthy period of time is not without morbidity. Missed ligamentous injuries can lead to cervical instability, which in turn can result in permanent neurologic sequelae. This article reviews the current methodologies to "clear the cervical spine" and highlights the inadequacies.
The Clinical Utility of Duplicate Readings for Musculoskeletal Radiographs
Authors: Anglen Jeffrey , Marberry Kevin , Gehrke Jon 
Published: April 2021

ABSTRACT
It is a common practice in many hospitals to have all skeletal radiographs read by a second physician, usually a radiologist, as well as by the treating physician. A two-part study was performed in order to examine the cost and clinical benefit of this practice for plain films ordered by orthopedists. In the first part of this study, the attending orthopedic surgeons were surveyed about the clinical usefulness and effect on patient care of 1000 radiologic reports from plain films ordered on orthopedic patients. In the second part, the charts of 272 patients who had 704 radiographs were reviewed with the goal of identifying any discrepancies between the orthopedic interpretation and the radiologic reading.
Thirty-eight reports were discarded because they were not reports of plain skeletal films. One hundred twenty-nine of the remaining 962 radiologic reports were never read by the attending orthopedist. The average time between the taking of the film and an orthopedic attending reading the printed report was 6.1 days. Three radiology reports contained findings that were incorrect. Only one report contained findings that the orthopedist was unaware, and one report may have led to an alteration in treatment. No reports resulted in an unplanned trip to the operating room or a patient being called back to the clinic.
Of the 272 chart reviews (704 reports), 70 had no orthopedic interpretation recorded and 94 had no radiologic report in the chart. Twelve discrepancies were noted in the cases that had both reports. Four fracture displacements were identified by orthopedists, but not on the written radiology report; three of these required a return to the operating room. Four instances of hardware displacement or breakage were noted by orthopedists, but not commented on by the radiologists. Three incidental injuries (two fractures and an acromioclavicular injury) were noted on printed reports of films taken for other reasons, but not commented on by the orthopedist, and not treated. A dorsal bunion was noted on one film by the orthopedist, but not by the radiologist.
From this study, one can conclude that the benefit of routine duplicate radiograph interpretation by a second physician does not justify its cost.
Ganglion Cysts of the Lower Extremity: An Analysis of 54 Cases and Review of the Literature
Authors: Rozbruch S Robert , Chang Vivian , Bohne Walther H O , Deland Jonathan T 
Published: April 2021

ABSTRACT
This article reviews 54 consecutive patients with lower extremity ganglion cysts that were surgically removed and histologically confirmed at the Hospital for Special Surgery from 1981 to 1993. Lower extremity ganglia were more common among women. Patients' ages ranged from 13 to 80 years, with the fifth and sixth decades being the most common. Size of the cysts ranged from 3 cm to 10 cm (average: 2.9 cm). Thirty-six (67%) patients had ganglion cysts of the foot and ankle, and 18 (33%) patients had ganglion cysts of the knee area. Four (7%) patients had intraosseous ganglia located in the proximal tibia, patella, and the first metatarsal head.
Follow-up data of 40 (74%) patients at an average of 5.9 years (range: 1 to 12.5 years) were obtained. Satisfaction was reported by 83% of patients. Recurrence was seen in 10% of patients, and a report of no or mild pain was given by 86% of the group. Patients who underwent revision ganglion excision had inferior results. Only 25% reported satisfaction and 50% reported no or mild pain. Patients who underwent curettage of an intraosseous ganglion appeared to have superior results. All patients reported satisfaction and no or mild pain. The performance of a concomitant surgical procedure, the anatomic region of the ganglion, or type of postoperative immobilization did not appear to affect the outcome.
The Effects of Pulsed Electromagnetism on Fresh Fracture Healing: Osteochondral Repair in the Rat Femoral Groove
Authors: Grace Katie L R , Revell William J , Brookes Murray 
Published: April 2021

ABSTRACT
Some clinical studies have claimed significant reductions in the healing time of fresh fractures with the use of pulsed electromagnetic fields (PEMFs). Animal models, however, have produced more equivocal results. This investigation examined the effects of PEMF treatment on an osteochondral defect placed in the patellofemoral groove of the rat. The results indicated that PEMF enhances early vascular reaction and suppresses initial pannus proliferation. Early chondrogenesis and bone formation were consistently stimulated, and the restoration of normal bone trabeculae advanced. Pulsed electromagnetic field treatment therefore may be useful in advancing repair during the early proliferative stage. Later results were variable and suggest that prolonged use may have deleterious effects, enhancing chondrogenesis beyond a point observed in normal repair and thus delaying normal subsurface trabeculation.
Quadriceps Atrophy After Partial Resection of the Patellar Tendon: An Experimental Study in a Rat Model
Authors: Irie Kazunori , Inoue Kazuhiko , Kawai Mika 
Published: April 2021

ABSTRACT
Quadriceps muscle atrophy of rats was examined after resection of the central third (group 1) or the lateral two thirds (group 2) of the patellar tendon, the tensor fascia lata (group 3), or the medial hamstring (group 4). The quadriceps atrophied in groups 1 and 2, and more so in group 2, but there was no atrophy in groups 3 or 4. Thus, after an anterior cruciate ligament reconstruction procedure using the patellar tendon, resection of the patellar tendon itself leads to quadriceps atrophy and the extent of atrophy is related to the resected width.
Functional Outcome of Arthrodesis for Failed Total Knee Arthroplasty
Authors: Benson Eric R , Resine Susan T , Lewis Courtland G 
Published: April 2021

ABSTRACT
To establish the ability of a salvage procedure to restore an independent lifestyle, the SF-36 functional outcome instrument and the pain, mobility, and physical activity subscales of the Arthritis Impact Measurement Scale (AIMS) was used to assess patient function. Nine patients (10 knees) who had undergone arthrodesis for failed total knee arthroplasty were compared with a control group of successful primary total knee arthroplasty patients. Average clinical follow-up was 42 months (minimum: 24 months).
For six of the eight SF-36 categories, the average scores for the arthrodesis and arthroplasty groups were similar. The average global scores for the two groups were nearly identical. The arthroplasty patients scored better on the AIMS physical activity and mobility subscales than the arthrodesis group, although the latter group fared better on the pain subscale. Overall, global scores favored the arthroplasty patients. The only subscales to show a statistically significant difference between the arthrodesis and arthroplasty groups were the SF-36 physical functioning and the AIMS physical activity subscales.
This pilot study demonstrated the ability of a salvage procedure to allow for an independent lifestyle with minimal complications. Furthermore, despite its popularity, the SF-36 does not appear as sensitive as the AIMS to differences in functional status or health outcomes between total knee arthroplasty and arthrodesis patients.