bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspects of the Microbe: Host Relationship in Staphylococcal Hematogenous Osteomyelitis
Authors: Gillespie William J , Haywood-Farmer Mary , Fong Ray , Harding Susan M 
Published: April 2021

ABSTRACT: Nasal carriage of staphylococci, and some in vitro tests of host antimicrobial defense were studied in a group of children who had recovered from staphylococcal hematogenous osteomyelitis at least one year previously. The same studies were carried out in a group of first degree relatives, and in age- and sex-matched controls. Nasal carriage was significantly more common (P = .039) in these children than in age- and sex-matched controls, and commoner (P =.19) in the first degree relatives than in controls.
Total immunoglobulin G (IgG) levels were significantly lower in the children studied than in controls (P = .022), and in relatives than in controls (P = .032), but the levels remained within an accepted normal range. IgG levels were also significantly lower in carriers of Staphylococcus aureus than in non carriers (P = .033).
Other immunoglobulin levels, complement levels, leukocyte phagocytic and killing power, leukocyte Chemotaxis, and leukocyte migration inhibition, were indistinguishable between the children, their relatives, and controls. No statistically significant association between histocompatibility antigen profile and previous history of osteomyelitis, or nasal carriage of staphylococci, was found. More detailed studies are required to confirm and clarify the associations.
GROSS POLYETHYLENE FAILURE IN TOTAL KNEE ARTHROPLASTY
Authors: Heck David A , Clingman Jeffrey K , Kettelkamp Donald G 
Published: April 2021

ABSTRACT
A total of 12 total knee replacements in nine patients with evidence of gross polyethylene failure at the time of revision surgery were identified. There were nine tibial and three patellar component failures. The average time from index to revision arthroplasty was 6 years (range: 0.75 to 9.63). A retrospective cohort group was identified based on date of operation. The average patient weight of the initial group was 89.6 kg (range: 76 to 104 kg), compared with 74.8 kg (range: 47 to 108 kg) (P = .04) in the control group. There was a male sex preponderance in the failure group (F = .045). The average height of the study group was 176 cm, compared to 161 cm for the control group (P = .003). Using the modified OASDI scale, the failure group had a higher activity level (P =.023). Pre-revision limb alignment in patients with failed TKA was statistically different from controls and served as an indication of polyethylene failure (P = .04). The selection of modular prosthetic component systems that allow for easy polyethylene revision is indicated in the high risk patient group identified. Close follow up is needed to minimize the sequela of polyethylene failure.
OPERATIVE TREATMENT OF BICONDYLAR INTRAARTICULAR FRACTURES OF THE DISTAL HUMERUS
Authors: Sanders Richard A , Raney Ellen M , Pipkin Stuart P 
Published: April 2021

ABSTRACT
Orthopedists' lack of consensus on treatment regimens for bicondylar fractures of the distal humerus warrants further review of this uncommon fracture. We present a series of 17 bicondylar fractures of the distal humerus that had a minimum follow up of 2 years. Of these fractures, the 13 that were treated exclusively with internal fixation had 92% excellent or good results. The operative technique we describe is modified from the technique recommended by the AO group. We have found it helpful to use the radial column as the site of primary fixation with a 3.5 mm dynamic compression plate in the sagittal plane. Additional fixation is provided by a reconstruction plate placed posteriorly on the ulnar column in the coronal plane. This system of dual plates in perpendicular planes provides rigidity for early motion which, when supervised, is beneficial to a satisfactory outcome.
POSTTRAUMATIC TIBIAL OSTEOMYELITIS: A COMPARISON OF THREE TREATMENT APPROACHES
Authors: Koval Kenneth J , Meadows Steve E , Rosen Howard , Silver Lester , Zuckerman Joseph D 
Published: April 2021

ABSTRACT
The treatment of 25 tibias in 25 patients with posttraumatic chronic osteomyelitis was reviewed. The approaches to soft tissue management fell into three groups: 1) muscle flap coverage; 2) primary closure with suction irrigation; and 3) open cancellous bone grafting. Treatment success was judged by the presence or absence of drainage and the local signs or symptoms of infection, and by the status of the tibial nonunion. Overall, 19 of 25 tibias (76%) had successful treatment. We found flap coverage to have a higher success rate (80%) than either primary closure with suction irrigation (45.5%) or open cancellous bone grafting (40%), These results further attest to the refractory nature of chronic osteomyelitis.
SEGMENTAL BLOOD PRESSURE AFTER TOTAL HIP REPLACEMENT
Authors: Gebuhr Peter , Soelberg Michael , Henriksen Jens H 
Published: April 2021

ABSTRACT
Twenty-nine patients due to have a total hip replacement had their systemic systolic and segmental blood pressures measured prior to operation and 1 and 6 weeks postoperatively. No patients had signs of ischemia. The segmental blood pressure was measured at the ankle and at the toes. A significant drop was found in all pressures 1 week postoperatively. The decrease followed the systemic pressure and was restored to normal after 6 weeks. In a group of six patients with preoperatively decreased ankle pressure, a significant transient further decrease in the ankle-toe gradient pressure was found on the operated side. None of the patients had symptoms from the lowered pressure. We conclude that in patients without signs of ischemia, the postoperative segmental pressure decrease is reversible and therefore not dangerous.
BOTH-BONE FOREARM FRACTURES IN CHILDREN
Authors: Carey Patrick J , Alburger Philip D , Betz Randal R , Clancy Michael , Steel Howard H 
Published: April 2021

ABSTRACT
Treatment of both-bone forearm fractures remains a difficult dilemma for the orthopedist. We assessed the results of 33 children treated with closed reduction and a long-arm cast using traction with finger traps in neutral rotation. Patients were grouped according to age and analyzed for residual angulation and range of motion (ROM). Despite some residual angulation and loss of rotation, all patients were fully active with no functional restriction at follow up. For patients 10 years old or younger with less than 30° of post-casting angulation, full ROM and minimal residual angulation on radiograph can be expected. For patients ages 11 to 15 years (the oldest patient in this series was 15), residual angulation is likely and approximately 60% of patients will have residual loss of less than or equal to 30° of rotation. In spite of this, we found no evidence of functional loss at follow up. Our series supports the continued use of closed manipulation as an effective treatment in children with both-bone forearm fractures.
QUADRICEPSPLASTY: THE JUDET TECHNIQUE AND RESULTS OF 21 POSTTRAUMATIC CASES
Authors: Merchan E C R , Myong Chong 
Published: April 2021

ABSTRACT
Twenty-one quadricepsplasty procedures were carried out on 21 patients over a 14-year period due to posttraumatic stiffness of the knee joint. Three patients (14.2%) required mobilization under anesthesia in the early postoperative period. The average interval between injury and quadricepsplasty was 18 months (range: 5 to 49 months). Preoperatively, all cases showed less than 90° knee flexion. At follow up, 12 cases (57.2% ) achieved more than 90° flexion, while nine patients (42.8%) exhibited under 90° flexion. Flexion gain was between 60° and 90° in six cases (28.5%) and less than 60° in 15 cases (71.5%). Results were assessed according to Judet et al. There were 14 excellent and good (66.6%) and seven fair (33.3%) results. No poor results were found in this series.
DEEP VENOUS THROMBOSIS FOLLOWING LUMBAR LAMINOTOMY AND LAMINECTOMY
Authors: Ferree Bret A 
Published: April 2021

ABSTRACT
Sixty consecutive patients undergoing lumbar laminotomy or laminectomy underwent preoperative and postoperative compression ultrasonography of the lower extremities to detect acute deep venous thrombosis (DVT). Compression stockings were the only method of prophylaxis. Three patients (5%) developed postoperative calf DVT. Despite continued treatment with only compression stockings, serial scanning failed to detect propagation of the thrombus proximal to the knee in any patient. The average age of patients who developed DVT, 62 years, was significantly greater (P<.05) than the age of patients who did not, 45 years. There were no statistically significant differences in DVT rates when compared by: sex, addition of one- or twolevel fusion, length of procedure, or number of days of bedrest.
THE USE OF KETOROLAC IN THE MANAGEMENT OF POSTOPERATIVE PAIN
Authors: DeAndrade J Robin , Maslanka Marc , Maneatis Thomas , Bynum Lincoln , Burchmore Michael 
Published: April 2021

ABSTRACTKetorolac tromethamine (Toradol) is a nonsteroidal antiinflammatory drug (NSAID) available in intramuscular (IM) and oral formulations for the management of acute pain. Intramuscular ketorolac is the only parenteral NSAID available for analgesic use in the US. The clinical profile is reviewed, and clinical studies most applicable to a postoperative patient are discussed in detail. The results of a clinical study performed at Emory University School of Medicine are presented. In this single-dose study, 176 patients received either 10 ntg of oral ketorolac, 5 mg or 10 mg of IM morphine, or placebo after orthopedic surgery. The analgesic efficacy of ketorolac was comparable to both doses of morphine and significantly superior to placebo. Ketorolac, when administered intramuscularly or orally, is a safe and effective analgesic agent for the short-term management of acute postoperative pain and can be used as an alternative to opioid therapy.
ANTERIOR PARAMEDIAN RETROPERITONEAL SURGICAL APPROACH TO THE LUMBAR SPINE
Authors: Crofts Kim M , Wong David A , Murr Peter C 
Published: April 2021

ABSTRACT
While routinely used in pediatric general surgery, the extraperitoneal paramedian approach to the spine and retroperitoneum has been employed infrequently in the adult population. We have utilized this technique successfully in 15 adult patients with pathologic conditions of the spine requiring radical vertebral body resection, dura decompression, and/or spine reconstruction. The anterior paramedian retroperitoneal dissection has definite advantages over the traditional transperitoneal or sympathectomy approaches. Wide exposure of the spine is obtained with minimal risk of contamination of the peritoneal cavity. Ease of orientation for identification of anatomic structures and radiographs is greatly enhanced.
TRANSCRANIAL MAGNETIC MOTOR-EVOKED POTENTIALS IN SCOLIOSIS SURGERY
Authors: Glassman Steven D , Zhang Y Ping , Shields Christopher B , Johnson John R , Linden R Dean 
Published: April 2021

ABSTRACT
Spinal cord monitoring using SSEPs is an accepted adjunct in the surgical correction of spinal deformities, but does not directly assess motor function. Motor-evoked potentials have been introduced in an effort to meet this important need. In this series of 18 patients, the feasibility of intraoperative monitoring using transcranial magnetic motor-evoked potentials is documented. The potential value of this neurophysiologic monitoring technique, as well as the pitfalls in interpretation, are reviewed.
FREE VASCULARIZED TEMPORAL PARIETAL FLAP IN HAND SURGERY
Authors: Seradge Houshang , Adham Mehdi Navid , Seradge Espanta , Hunter David 
Published: April 2021

ABSTRACT
Free vascularized temporo-parietal fascia (TPF) flap is a flap of thin, pliable and vascularized tissue which can cover an area measuring up to 12 cm × 14 cm. The flap is harvested based on temporal vessels, which provide a smooth, gliding surface for tendon function and eliminates the need for secondary procedures usually required by the pedicled or bulky free vascularized myocutaneous flaps. The donor pedicle is long and consistent with an average diameter of 3 mm in adults. This flap is versatile. In 12 resurfacings for traumatic wounds of hand and wrist, no flaps were lost. Donor site morbidity, except for a transient sideburn hair loss in one case, was not encountered. We recommend this flap as a viable one-stage procedure for coverage of complex hand wounds.
SPLINT IMMOBILIZATION OF GAMEKEEPER'S THUMB
Authors: Landsman Jonathan C , Seitz William H , Froimson Avrum I , Leb Robert B , Bacher Evan J 
Published: April 2021

ABSTRACT
Thirty-nine patients diagnosed with 40 acute complete ruptures of the ulnar collateral ligament of the thumb metacarpophalangeal joint were treated primarily with thumb spica splint immobilization. Duration of splinting ranged from 8 to 12 weeks. Thirtyfour of these injuries (85%) followed for 1 to 5 years (average 2.4 years) healed without significant instability, arthrosis, pain, or stiffness (range of motion within 80% of the contralateral hand). Six ruptures (15%) demonstrated persistent instability and pain at 12 weeks and were treated with surgical reconstruction. Currently accepted guidelines for surgical intervention as primary treatment for ligamentous disruption at the thumb metacarpophalangeal joint may need revision. This study suggests that splint immobilization is an effective primary treatment modality. The minority of patients who demonstrate persistent laxity can be successfully treated surgically with excellent results.
RESULTS OF CFV TOTAL WRIST ARTHROPLASTY: REVIEW AND EARLY REPORT
Authors: Ferlic Donald C , Clayton Mack L 
Published: April 2021

ABSTRACT
Articulated total wrist arthroplasties have been used in the United States since 1974. In the 1980s the CFV wrist was developed in an attempt to reduce the incidence of imbalance, loosening, and bone resorption that has been seen in the early implants, and also to eliminate the use of bone cement. Since 1988, we have implanted 15 of these wrists. To date, nine patients are satisfied because of pain relief and motion; however, there have been 6 failures: 2 for infection, 3 because of a loose distal component, and 1 because of balance. Other problems that have been observed are flexor tenosynovitis, carpal tunnel syndrome, and a balancing problem.
The Risk of Venous Thromboembolism in the Orthopedic Patient: Epidemiological and Physiological Data
Authors: Paiement Guy D , Mendelsohn Cerrah 
Published: April 2021

ABSTRACT
Venous thromboembolism is responsible for 500,000 deaths annually in industrialized countries. It is probably the most common preventable cause of death in elective orthopedic surgery patients. Rates of deep vein thrombosis (DVT) and fatal pulmonary embolism (PE) in unprotected orthopedic patient populations are high. The overall DVT rate is >40% in patients undergoing hip or knee arthroplasty or suffering from multiple injuries. The proximal DVT rate for these patients is ≥15%, and the fatal PE rate is ≥1%. Risk factors associated with venous thromboembolism are related to the vascular injury, activation of blood coagulation, and venous stasis. Lower extremity orthopedic procedures carry a risk greater than that of surgery itself. Thus, orthopedic patients are at high risk for venous thromboembolic conditions. A systematic assessment of this risk should be performed in every patient, and an appropriate management plan should be implemented.
The Post-Hospital Discharge Venous Thrombosis Risk of the Orthopedic Patient
Authors: Planes André , Vochelle Nicole 
Published: April 2021

ABSTRACT
A prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospitalization, those without venogram-proven DVT at discharge were randomly assigned to continue prophylaxis with enoxaparin (N=90) or receive placebo (N=89). At the end of 21 days' treatment, intention-to-treat analysis in 173 evaluable patients demonstrated a significantly lower incidence (P=0.018) of DVT in the enoxaparin group (7.1%; N=6) compared with the placebo group (19.3%; N=17). These findings were confirmed by perprotocol analysis in 155 patients. Minor bleeding episodes occurred in three patients in the enoxaparin group and one in the placebo group. Thus, total hip replacement patients have a significant risk of developing DVT after hospital discharge. Continued prophylaxis with enoxaparin is effective in reducing this risk.
Decrease in Knee Joint Pain and Increase in Function in Patients With Medial Compartment Arthrosis: A Prospective Analysis of Valgus Bracing
Authors: Hewett Timothy E , Noyes Frank R , Barber-Westin Sue D , Hedcmann Timothy P 
Published: April 2021

ABSTRACT
We studied a brace designed to decrease loads on the medial tibiofemoral compartment in knees with chronic pain and arthrosis to determine if pain symptoms decreased, function improved, and dynamic gait characteristics altered during walking. Eighteen patients with symptomatic medial compartment arthrosis were fitted with a commercially available brace. All were evaluated after an average of 9 weeks of brace wear, and 13 patients were evaluated after 1 year of brace wear. The Cincinnati Knee Rating System and additional pain scales were used to analyze symptoms and functional limitations. Nine subjects underwent a dynamic gait analysis and were compared with a control group of 11 normal subjects matched for age and walking speed.
The brace was worn an average of 7 hours a day, 5 days a week. Following 9 weeks of brace wear, statistically significant improvements were found for all pain parameters, and these improvements continued at the 1 year evaluation. Before brace wear, 78% had pain with activities of daily living, but after the first evaluation, only 39% continued to have such pain, and at the second evaluation, only 31% were so affected. Before brace wear, patients had a walking tolerance of 51 minutes prior to the onset of pain symptoms. At the first evaluation, patients could walk 138 minutes without pain, and after 1 year, they could walk 107 minutes without pain. Before brace wear, 78% rated their overall knee condition as fair or poor whereas at the first evaluation, only 33% continued to provide this rating. No differences were found in the dynamic gait parameters measured with and without the brace.
While this brace did not provide the dramatic improvements in symptoms, function, and patient satisfaction obtainable after high tibial osteotomy, it did help the majority of patients. If the goal of brace use is to buy a short amount of time for patients who cannot undergo or wish to avoid osteotomy or knee arthroplasty, then bracing appears to offer a reasonable alternative for short-term pain relief and improved function.
Functional Distal Interphalangeal Joint Splinting for Trigger Finger in Laborers: A Review and Cadaver Investigation
Authors: Rodgers Jeffrey A , McCarthy Jack A , Tiedeman Jeffrey J 
Published: April 2021

ABSTRACT
This two-part study evaluates the efficacy of functional distal interphalangeal joint (DIP) splinting for the treatment of trigger finger. Thirty-one fingers from 21 meat packing plant workers were treated with DIP splinting. A single corticosteroid injection was offered if triggering was stage 4 or greater. All workers returned to work immediately. Eighty-one percent of the digits were treated successfully (mean follow-up: 1 year). Treatment failure correlated with duration of symptoms and stage of triggering but did not correlate with age, race, sex, disease in multiple digits, or prior treatment. For the second part of the study, the effect of DIP splinting on flexor digitorum profundus (FDP) tendon excursion was studied in 16 fingers from 4 fresh cadavers. Excursion decreased 4.8 mm for the Stax splint and 4.2 mm for the dorsal Alumafoam splint. We conclude that DIP splinting provides a reliable and functional means of treating work-related trigger finger without lost time from work. Our cadaver investigation supports our theory that DIP splinting significantly decreases FDP excursion.
Cortical Strut Grafting for Enigmatic Thigh Pain Following Total Hip Arthroplasty
Authors: Domb Benjamin , Hostin Emmanuel , Mont Michael A , Hungerford David S 
Published: April 2021

ABSTRACT
Enigmatic thigh pain remains a difficult problem to treat after total hip arthroplasty. This article reports on the use of strut cortical allografting for the treatment of recalcitrant enigmatic thigh pain following total hip arthroplasty in patients with a well-fixed cemented or cementless femoral component.
Iliac Crest Bone-Muscle Transfer in Periacetabular Osteotomy
Authors: Santore Richard , Nelson Fred R T , Muldoon Michael 
Published: April 2021

ABSTRACT
Ganz et al1 reported acetabular osteotomy for extensive acetabular reorientation without changing the acetabular diameter. This article reports our modification of this surgical technique, which preserves the integrity of the tensor fascia latea muscle as well as providing viable bone for bone graft at the anterior iliac osteotomy site. The interval between the sartorius and tensor fascia lata is developed distal to the anterosuperior iliac spine. After iliac osteotomy through the anterosuperior iliac spine, the distal portion of the anterosuperior iliac spine (acetabular segment), along with its slip of tensor fascia lata (1 -2 cm), is separated and shaped to fit the anterior bone gap. Two small holes are drilled into that segment and also into the distal cut surface in the anterior portion of the remaining crest so that when the sutures are tightened, the tensor muscle is preserved anatomically and bone grafting is achieved.
Computed Tomography in the Determination of Transarticular C1-C2 Screw Length
Authors: Nadim Yasser , Sabry Fady , Xu Rongming , Ebraheim Nabil 
Published: April 2021

ABSTRACT
This study evaluated the significance of computed tomographic (CT) measurements of the upper cervical vertebrae and their clinical implications in transarticular C1-C2 screw placement. In the first part of the study, analysis of axial CT scans of the atlas of 46 patients who had a normal C1-C2 region was performed. Measurements included the vertical distance between the middle of the ventral cortex of the lateral mass and the anterior-most point of the anterior tubercle, and the angle of the anterior ring of C1 relative to the frontal plane.
In the second part, axial CT scans of the upper cervical spine were performed in seven cadaveric cervical spines and analyzed using the same criteria. Using the Magerl technique of transarticular Cl -C2 screw placement, one screw was placed in each cervical spine. Following each placement, a strict lateral radiograph was taken and the distance between the tip of the screw and the anteriormost point of the anterior tubercle of Cl was measured. Analysis of the cervical cadaveric specimens showed the vertical distance between the middle of the ventral cortex and the anterior-most part of the anterior tubercle when measured on CT scan corresponded to the distance measured on lateral radiographs after placement of the Cl -C2 transarticular screw.
The study of the 46 patients with normal Cl -C2 region had shown the mean values of linear and angular measurements to be greater in males than in females, although no significant difference was found between the two groups (P>.05). The mean distance between the anterior-most point of the anterior tubercle and the middle of the ventral cortex of the lateral mass was 6.5±1 mm, and the mean transverse angle of the anterior ring relative to the frontal plane was 22°±3.G.
Axial CT evaluation of the individual anatomic relationships of the atlas is simple and may be a useful guide in the determination of the length of the transarticular screw when performed during surgery under lateral fluoroscopic control.