bluuebunny/crossref_metadata_2025_split huggingface dataset:
FRACTURES OF THE FEMORAL SHAFT ADJACENT TO LONG STEM FEMORAL COMPONENTS OF TOTAL HIP ARTHROPLASTY: REPORT OF SEVEN CASES
Authors: Missakia Maylene L , Rand James A 
Published: April 2021

ABSTRACT
Seven femoral shaft fractures adjacent to the distal aspect of long stem revision femoral components of total hip arthroplasty were evaluated at a mean of 6 years (range: 2 to 12) after fracture. Nonoperative treatment with a spica cast was used in four patients. Complications were delayed union in two patients and malunion in two. Operative treatment included revision and bone grafting in one patient and open reduction and internal fixation in two. Plate fracture and delayed union occurred in one patient. Operative treatment resulted in no malunions and earlier recovery of function than with nonoperative management. Femoral shaft fractures adjacent to long stem total hip arthroplasties are difficult to manage; the complication rate is 71%.
MECHANICAL PROPERTIES OF BONE AFTER GRAFTING WITH CORALLINE HYDROXYAPATITE: AN EXPERIMENTAL STUDY
Authors: Szabó G , Schmidt B 
Published: April 2021

Abstract
Based on animal experiments, mechanical properties of rabbit radii after grafting artificial gaps with a coralline hydroxyapatite (CH) material are discussed. Healing velocity of complete and partial gaps after the same kind of grafting is also analyzed. Based on the results obtained from 48 gaps of 24 animals it is stated that fused grafts in both types of gaps showed bending strength of the radii similar to that of normal bone. The incidence of nonunions and infections are also discussed. It is concluded that CH is suitable in the treatment of incomplete bone defects.
LASER THERAPY: SCIENTIFIC BASIS AND CLINICAL ROLE
Authors: Basford Jeffrey R 
Published: April 2021

ABSTRACTThe ability of laser irradiation to destroy tissue is well known. Less well known is the fact that the same radiation, at much lower intensities, can non-destructively alter cellular function. This latter phenomenon, which occurs in the absence of significant heating, is now a basis for the conservative treatment of a variety of musculoskeletal, neurological, and soft tissue conditions in many parts of the world. This review first examines the 25-year history and scientific basis of "láser therapy." Clinical applications are discussed and the reasons for its relative lack of acceptance in the US are examined. The article concludes with an overview of current research and the impact it will have on laser therapy's role in US clinical practice.
INTERNAL FIXATION OF THE THORACIC AND LUMBAR SPINE USING ROY-CAMILLE PLATES
Authors: Simpson J Michael , Ebraheim Nabil A , Jackson W Thomas , Chung Stanley 
Published: April 2021

ABSTRACT
Thirty patients underwent fixation of the thoracic and lumbar spine from 1986 to 1990 using the Roy-Camille pedicular screw fixation system. The spine was stabilized for a variety of pathologic entities including fracture, tumor, spondylolisthesis, postlaminectomy Instability, and pseudarthrosis. All but one patient obtained solid fusion based on radiographic and clinical criteria with an average foflow up of 19.5 months. All patients reported subjective Improvement in preoperative pain levels. There were no neurologic complications associated with the surgical procedure. Roy-Camille plate fixation appears to offer a stable surgical construct in the treatment of thoracic and lumbar spine instability.
SIMULTANEOUS HIGH TIBIAL OSTEOTOMY AND ACL RECONSTRUCTION FOR COMBINED GENU VARUM AND SYMPTOMATIC ACL TEAR
Authors: Neuschwander David C , Drez David , Paine Russell M 
Published: April 2021

ABSTRACT
This article reviews the subjective, objective, functional, and radiographic results of five patients with symptomatic anterior cruciate instability, genu varum, and varus rotational instability treated by sequential high tibial osteotomy and anterior cruciate ligament reconstruction at one operative procedure. The average patient age was 27 years (range: 21 to 35), and the average follow up was 2.5 years (range: 2 to 3). AU patients had symptomatic instability with anterior tibia subluxation, which was documented by KT- 1000 testing. All patients also had a varus alignment clinically and radiographically with medial compartment pain. Postoperatively, the medial compartment pain was improved, and instability episodes were eliminated. Side to side differences (KT-1000 - manual maximum) were reduced to 3.1 mm. There were no complications. The instability episodes were eliminated, and functional levels were improved in all patients. We concluded that, for this select group of patients, simultaneous extremity realignment and ligament stabilization will effectively manage both conditions without compromising the results of either procedure.
RECONSTRUCTION OF THE ANTERIOR CRUCIATE LIGAMENT WITH ACHILLES TENDON AUTOGRAFT
Authors: Seo Jai-Gon , Cho Duck-Yun , Kim Key-Yong 
Published: April 2021

ABSTRACT
The increasingly serious complications of artificial ligaments and allografts have brought them into disrepute. Recently, autografts have drawn more attention. A new type of autograft, the Achilles tendon autograft, has been developed and applied to anterior cruciate ligament reconstructions. This report describes the advantages of the Achilles tendon autograft used and presents the results of a prospective study of 21 patients with minimum 2 year follow up. Of the 21 cases, 16 patients (75%) had a rating of excellent; 2 (10%) good, 2 (10%) fair, and 1 (5%) poor. Preoperative knee scores of 56.7 were improved to 89.5 postoperatively. The authors removed less than half of the Achilles tendon with the calcaneal bone incorporated. Through magnetic resonance imaging we confirmed that the remaining Achilles tendon of the donor site regained its volume and strength within a year without significant complication. Achilles tendon autograft offers the advantages of length, elastic strain modulus, reproducibility in technique, and consistency of the result without significant complications.
CURRENT CONCEPTS IN MENISCAL REPAIR
Authors: Diment Michael T , DeHaven Kenneth E , Sebastianelli Wayne J 
Published: April 2021

ABSTRACT
As the importance of meniscal preservation has become recognized, meniscal repair has become a more commonly practiced procedure. We briefly review the current, commonly accepted indications, techniques, and our rehabilitation protocol for meniscal repair. Both open and arthroscopic repairs are reviewed, including the arthroscopic techniques classified as inside-out, outside-in, and all inside. We conclude with a review of the results of meniscal repair and some thoughts on future directions.
ARTHROSCOPIC MANAGEMENT OF INSTABILITY OF THE SHOULDER
Authors: Snyder Stephen J , Strafford Brereton B 
Published: April 2021

ABSTRACT
Anterior shoulder dislocation in the young athlete may be difficult to treat and, without proper care, usually results in recurrent episodes of instability. By permitting direct visualization of all intraarticular pathology, the arthroscope assists in the diagnosis and helps to determine appropriate therapeutic interventions. Numerous techniques have been developed for arthroscopic reconstruction of unstable shoulders. These can be classified according to the type of fixation employed. The categories include metal devices such as staples or screws, absorbable devices, and suture-based methods, both anterior and transglenoid. An anterior suture anchor method using a new suture passing device known as a Shuttle Relay (Linvatec Corp, Largo, Fla), which allows the surgeon to incorporate non-absorbable mattress sutures in the repair, is described in detail.
EFFECTS OF EPIDURAL ANESTHESIA ON INCIDENCE OF VENOUS THROMBOEMBOLISM FOLLOWING JOINT REPLACEMENT
Authors: Haas Steven B 
Published: April 2021

ABSTRACT
Deep vein thrombosis (DVT) and pulmonary embolism are serious complications following Mp and knee replacement surgery. Both surgical procedures have significantly high postoperative rates of DVT. In total hip replacement, the rate of proximal thrombi tends to be higher. However, total knee replacement produces a high rate of calf thrombi and a higher overall rate of thrombosis.
In a search for innovative ways to reduce the risk of thrombosis, three types of anesthesia were examined: general anesthesia, epidural anesthesia, and hypotensive epidural anesthesia in which a controlled hypotension is provided. The hypotension commonly exists with epidural anesthesia also, unless blood pressure is maintained with an agent such as ephedrine. When blood pressure is allowed to drop in a controlled fashion, hypotensive anesthesia is effected.
PROPHYLAXIS OF DEEP VEIN THROMBOSIS IN TRAUMA PATIENTS
Authors: Vrahas Mark S 
Published: April 2021

ABSTRACT
Orthopedists who use prophylaxis for deep vein thrombosis (DVT) in total joint arthroplasty are often called on to care for trauma patients. Much less is known or published about the effects of such prophylaxis in the trauma patient than in the arthroplasty patient The questions to ask are: what is the incidence of DVT in trauma patients; what are the benefits of DVT prophylaxis; and what are the risks of DVT prophylaxis, and do the risks outweigh the benefits?
A PROSPECTIVE, RANDOMIZED COMPARISON OF OPEN VS ARTHROSCOPICALLY ASSISTED ACL RECONSTRUCTION
Authors: Cameron Scott E , Wilson William , St Pierre Patrick 
Published: April 2021

ABSTRACT
A prospective, randomized study comparing arthroscopic and open anterior cruciate ligament (ACL) reconstructions was undertaken. Neither the patients nor the physical therapists were made aware of which technique was used. The central one third of the patellar tendon with proximal and distal bone plugs was utilized as the graft material to reconstruct the ACL in all cases. Rehabilitation was identical for each group. The following variables were compared: postoperative pain score, operating time, estimated blood loss (EBL), quantity of analgesics used, complications, range of motion at 1, 3, and 6 months, a 6-month evaluation consisting of Lachman's, anterior drawer, and pivot shift tests, amount of thigh atrophy, and Cybex II tests. Statistical significance was achieved (P<.05) in only three parameters. The 1month postoperative range of motion, the 6-month postoperative thigh atrophy, and the Cybex II test (knee extension at 607sec) were statistically different favoring the arthroscopic method.
DIAPHYSEAL HUMERUS FRACTURES: NATURAL HISTORY AND OCCURRENCE OF NONUNION
Authors: Foulk Douglas A , Szabo Robert M 
Published: April 2021

ABSTRACT
We reviewed 38 fractures of the humeral shaft which had been treated non-operatively to identify factors prognostic of nonunion. Of these, 23 healed uneventfully and 15 progressed to nonunion. Factors prognostic of nonunion included long oblique fracture pattern, alcohol abuse, and obesity. In patients with these risk factors, lack of clinical and radiographic evidence of healing 8 to 10 weeks post-injury suggests an impending nonunion, and operative intervention should be considered.
RESULTS OF LUMBAR DISK SURGERY IN A CITY COMPENSATION POPULATION
Authors: Bosacco Stephen J , Berman Arnold T , Bosacco David N , Levenberg Richard J 
Published: April 2021

ABSTRACT
This is a retrospective analysis of 118 patients who underwent 132 operations in a city compensation setting for the treatment of lumbar disk disease from January 1976 to December 1987. Each of these patients had a work-related injury. There was a minimum 2-year follow up with an average follow up of 6.9 years. No patients were lost to follow up. The purpose was to determine what percentage of patients treated in a work-related setting could be expected to return to a sustained, pre-injury employment state following a carefully executed lumbar spine surgical procedure. Satisfactory surgical results were considered achieved only by those patients who returned to full-duty work status. Only 31 of the 118 patients (26%) returned to full duty and were considered satisfactory. Regarding the number of surgical procedures, 31 of 132 operations (23%) were successful. Sixteen reoperations in 13 patients all resulted in failure. Only 16 of the 64 patients (25%) treated with laminectomy and diskectomy alone had a satisfactory result. When a two-level, posterior lateral spinal fusion was added the success rate was increased to 44%, with 12 of 27 patients returning to work. Six patients with spinal stenosis underwent decompression laminectomy and entry level foraminotomies, and all had unsatisfactory results. Five patients with isthmic spondylisthesis underwent a Gill procedure and fusion. Only one of these patients (25%) returned to work. For a 2-year period chymopapain injection was given to 14 patients. Only two returned to work, with a 14% success rate. Overall, the surgical treatment of lumbar disk disease in this group of city compensation patients resulted in a 74% rate of permanent disability.
THE EFFECTS OF THE INTEROSSEOUS MEMBRANE AND PARTIAL FIBULECTOMY ON LOADING OF THE TIBIA: A BIOMECHANICAL STUDY
Authors: Thomas Kevin A , Harris Mitchel B , Willis Michael C , Lu Yun , MacEwen C Dean 
Published: April 2021

ABSTRACT
The biomechanical basis for the treatment of delayed union of tibial fractures by partial fibulectomy has yet to be fully evaluated. To gain further insight into this problem, nine intact cadaveric lower extremities were instrumented with strain gauges on the surfaces of the tibia and fibula. The limbs were then subjected to axial loading with the ankle and subtalar joints placed in multiple positions. The specimens were loaded either through the distal femur or by direct loading of the tibial plateau. All specimens were first tested intact then after sectioning of the interosseous membrane and finally after partial fibulectomy.
It was shown that during loading of the leg, the primary effects of the interosseous membrane were to stabilize the fibula and constrain its posterolateral bending. The fibular strains were not reduced to zero following sectioning of the interosseous membrane. Tibial strains measured on the anteromedial and anterolateral surfaces were consistently in relative tension, indicating a posterior bending force (anterior bowing) of the tibia. After partial fibulectomy, strains on these surfaces became relatively more compressive. With the ankle and subtalar joints in neutral position (0° flexion, 0° inversion/eversion) the strains on the anterior surface averaged approximately 10% more compressive relative to the intact condition. Tibial strains were observed to vary with the position of the ankle and subtalar joints. The fact that the anteromedial and anterolateral tibia surfaces were always in tension may explain why partial fibulectomy has not proved to be a uniformly successful treatment method for delayed union of the tibia. Furthermore, it points to the important role of "fracture personality" in the selection of treatment.
A TRIGONOMETRIC ANALYSIS OF DISTAL PATELLOFEMORAL REALIGNMENT
Authors: Gibson Wilford K , Dugdale Thomas W 
Published: April 2021

ABSTRACT
Patellofemoral malalignment is often treated successfully with realignment procedures. Although distal patellar realignment has been used widely with excellent results, there is no published equation to predict degrees of change in the Q angle with millimeters of medialization. The purpose of this study was to quantify this relationship. In 20 fresh cadaver knees, threaded Kirschner (K) wires were placed in the anterior superior iliac spine, center of patella, and tibial tubercle. Q angles and measurements from the center of the patella to tibial tubercle were obtained. After using Fulkerson's technique of anteromedialization, Q angles were measured with 5 mm and 10 mm of medialization in a plane parallel to the floor and perpendicular to the threaded K-wires. The triangle formed by the center of the patella, tibial tubercle (initial), and tibial tubercle (medialized) was in one plane and could be studied by trigonometric analysis. A formula derived from the Law of Cosines to predict the change in the Q angle with medialization was found to be highly accurate. The authors present an equation that can be used to ensure adequate correction of the Q angle in distal patellar realignment.
A CUSTOM DISTAL FEMORAL PROSTHESIS FOR RECONSTRUCTION OF LARGE DEFECTS FOLLOWING WIDE EXCISION FOR SARCOMA: RESULTS AND PROGNOSTIC FACTORS
Authors: Muschler George F , Ihara Koichiro , Lane Joseph M , Healey John H , Levine Marc J , Otis James C , Burstein Albert H 
Published: April 2021

ABSTRACT
Between 1979 and 1986, 37 patients with sarcoma of the distal femur underwent limb salvage using a custom prosthetic knee replacement. Thirteen (35%) had early complications. Fourteen (38%) had late complications, which consisted of 6 aseptic femoral loosenings, 1 aseptic tibial loosening, 2 tibial fractures, 2 contractures, 1 femoral fracture, 1 prosthetic fracture, and 1 septic loosening. By 1988, nine patients died. Thirteen prostheses failed in 12 patients, resulting in 9 revisions, 2 above-knee amputations, and 2 Van Nes rotationplasties. The 2- and 5-year prosthetic survival rates were 82% and 57%, respectively. Twenty-two of the 26 survivors (85%) had successful limb salvage. Preventable factors were implicated in the loosening of six femoral components and in one femoral fracture. The mean Hospital for Special Surgery Knee Score was 69 (range: 62 to 86).
CLINICAL EFFICACY OF ELECTRONEUROMETER SCREENING IN CARPAL TUNNEL SYNDROME
Authors: Beckenbaugh Robert D , Simonian Peter T 
Published: April 2021

ABSTRACT
The authors evaluated the motor latency values of 72 median nerves assessed with the compact, hand-held, battery-powered NervePace Electroneurometer. Results of this test were compared to those of clinical examination, standard electrodiagnostic tests, and median nerve findings of compression at the time of surgery in 23 patients. The motor latency values obtained with an electroneurometer correlated positively with those from routine electromyography (EMG): sensitivity and specificity were calculated for the ability to diagnose carpal tunnel syndrome (CTS) (>3.9 ms considered abnormal). This study identified a sensitivity of 85.7% and a specificity of 87.5% in predicting CTS, as confirmed by complete EMG and electroconduction studies.
SPINAL OSTEOMYELITIS: A REVIEW OF 10 YEARS' EXPERIENCE
Authors: Bateman Judith L , Pevzner Martin M 
Published: April 2021

ABSTRACT
Spinal osteomyelitis is an infrequent cause of back pain, but it can cause severe neurologic compromise or death if not treated effectively. We report 71 cases of spinal osteomyelitis. Ninety-three percent of patients complained of back pain that had been present for several weeks (average: 59 days) at the time of hospitalization. Localized tenderness and an elevated erythrocyte sedimentation rate were often the only abnormal signs. Plain radiographs were abnormal in 39 of 56 cases. At our institution, computed tomography-guided biopsy was safe and effective, yielding a pathogenic organism in 19 of 30 procedures vs 24 of 32 cultures of open surgical specimens.
ANTERIOR STABILIZATION OF THORACOLUMBAR BURST FRACTURES USING THE KANEDA DEVICE: A PRELIMINARY REPORT
Authors: Kirkpatrick John S , Wilber R Geoffrey , Likavec Matthew , Emery Sanford E , Ghanayem Alexander 
Published: April 2021

ABSTRACT
Anterior decompression and fusion is a valuable technique in the treatment of thoracolumbar burst fractures. Anterior instrumentation has evolved to correct deformity and stabilize the spinal segments during decompression and bone grafting as a single-stage procedure. One anterior device developed by Kaneda has been used in our institution since 1989. This study is an initial review of our experience with this instrumentation. Anterior decompression and fusion augmented with the Kaneda device was performed in 20 patients with thoracolumbar burst fractures. Timing of surgery was early (<15 days) in 13 patients, intermediate (16 to 120 days) in 2, and delayed (>121 days) in 5. Sixteen patients were neurologically intact (Eismont grade D), 3 with distal weakness (Eismont grade B or C) and 1 with complete paraplegia (Eismont grade A). All patients with deficits recovered one Eismont grade after anterior decompression and fusion. Complications included pulmonary problems in 2 patients, a thoracic duct laceration requiring ligation, and a sympathectomy effect of the lower extremity. One patient had a pulmonary embolus and developed a hematoma at the graft harvest site while on anticoagulants with resultant meralgia paresthetica. There have been three screw failures and one definite pseudarthrosis. Anterior decompression and fusion supplemented by the Kaneda device was performed on 20 patients with thoracolumbar burst fractures. The average correction of kyphosis was approximately 50% acutely, with loss of approximately 50% of correction at follow up. In some patients, coronal plane deformity was created by the device. No effect on neurologic recovery could be shown with this small series. Perioperative complication rate was 30%, and 1 patient developed pseudarthrosis.
Spiral Computed Tomography With Two- and Three-Dimensional Reconstruction in the Management of Tibial Plateau Fractures
Authors: Liow R Y L , Birdsall P D , Mucci B , Greiss M E 
Published: April 2021

ABSTRACT
Spiral computed tomography (CT) with three-dimensional and multiplanar reconstructions was used in the evaluation of tibial fractures in nine patients. Computed tomography added important information to that obtained by plain radiographs. Five (55%) fractures were reclassified. The degree of articular depression was often underappreciated on plain radiographs. Furthermore, the fracture complexity and the spatial relation of fragments could be readily demonstrated with 3-D reconstruction. This technique is useful in planning operative reconstruction.
Combined Limited Internal Fixation With Circular Frame External Fixation of Intra-Articular Tibial Fractures
Authors: Raikin Steven , Froimson Mark I 
Published: April 2021

ABSTRACT
High-energy intra-articular fractures of the tibial plateau and plafond cause ongoing management problems for the orthopedic surgeon. This study retrospectively evaluated 37 such fractures treated with limited internal fixation and circular frame external fixators. Seventeen plateau fractures (5 open) and 20 plafond fractures (9 open) were treated. Time to union, number of procedures, complications, and functional outcomes were evaluated. All tibial plateau fractures healed within an average of 3.8 months. Eighteen of 20 plafond fractures healed at an average of 4.8 months. There was a high complication rate as is common with these injuries, but most of the complications were minor and easily treated.
Behavior of the Femoral Stem in the Bihapro Hip Prosthesis
Authors: Hernández-Vaquero D , Murcia-Mazón A , Paz-Jimenez J , Alegre-Mateo R , Martínez-García J , Pena-Vazquez J 
Published: April 2021

ABSTRACT
This study evaluated the hydroxy apatite-coated femoral stem of the Bihapro hip prosthesis (Biomet Ltd, Bridgend, United Kingdom) using radiography, TC-99 scintigraphy, and bone densitometry. Thirty stems with >2 years of follow-up (mean: 31 months) were evaluated. No loosening or changes in the position of the implant were seen, and the mean subsidence was 2.2 mm. Radiography revealed a densification in the metaphyseal zone with reconstruction of the trabecular lines in 21 cases, while in 22 patients, radiolucent lines in the distal area of the femoral component were observed. Scintigraphy showed a diaphyseal normo-captation in 19 cases and a hype rea ptation <1 .4 with a mean index of 1.1 in 1 0 patients. Metaphyseal hypercaptation >1.4 was seen in 24 patients. Bone densitometry revealed increased density in the metaphyseal zones in 29 patients with a peri prosthetic/normal bone quotient of 1.4.