bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELECTROPHYSIOLOGY AND ELECTRODIAGNOSIS OF THE POST-POLIO MOTOR UNIT
Authors: Trojan Daria A , Gendron Daniel , Cashman Neil R 
Published: April 2021

ABSTRACT
Post-poliomyelitis syndrome refers to new symptoms that may occur years after recovery from poliomyelitis. The most common of these symptoms are new weakness, fatigue, and pain. This article describes electrodiagnostic studies - conventional electromyography (EMG), single fiber electromyography (SFEMG), and macroelectromyography (macro-EMG) - that have provided information on the post-polio motor unit and on the possible etiology of some post-polio syndrome symptoms. Muscular fatigue, and indirectly, general fatigue, may be due to neuromuscular junction transmission defects in some post-polio individuals, as suggested by reduction of the compound motor action potentials on repetitive stimulation, and increased jitter and blocking on SFEMG. Progressive weakness and atrophy in post-polio syndrome is probably due to a distal degeneration of post-polio motor units with resultant irreversible muscle fiber denervation. Electrodiagnostic evidence of ongoing denervation includes fibrillation and fasciculation potentials on conventional EMG, increased jitter and blocking on SFEMG, and smaller macroEMG amplitudes in newly weakened postpolio muscles. However, even though electrodiagnostic studies have provided insight into the possible causes of some postpolio syndrome symptoms, no specific electrodiagnostic test for the syndrome is currently available.
IMMUNE RESPONSES TO OSTEOCHONDRAL ALLOGRAFTS: NATURE AND SIGNIFICANCE
Authors: Friedlaender Gary E , Horowitz Mark C 
Published: April 2021

ABSTRACT
Osteochondral allografts evoke immune responses. The nature of these immune responses and their biologic significance are still only partially understood. It is clear, however, that cell surface antigens of the major histocompatibility complex represented on the cellular elements of bone grafts cause T-cell activation, specifically those of the suppressor/cytotoxic phenotype. In numerous animal models, the most immunogenic bone allografts (mismatched, fresh) have demonstrated the poorest clinical and biologic outcomes, while more closely matched and/or grafts treated to reduce immunogenicity (frozen, freeze-dried) have more successfully incorporated. These observations support the hypothesis that immune responses against bone-graft related antigens have biologic significance and that reducing these responses may improve clinical results.
FRESH AND FROZEN ARTICULAR CARTILAGE ALLOGRAFTS
Authors: Thmford William W , Springfield Dempsey S , Mankin Henry J 
Published: April 2021

ABSTRACT
Fresh and frozen cartilage allografts both function well to relieve joint pain due to cartilage injury. Fresh cartilage allografts appear to remain alive for many months and are most applicable to small injuries such as osteochondritis dissecans, traumatic defects, and osteonecrosis. Frozen cartilage allografts have been used mostly for treatment of bone tumors which most often involve the subchondral and the metaphyseal areas of the long bones, particularly around the knee and hip. Frozen cartilage allografts appear to survive well and maintain joint space for several years. Deterioration of either type of graft does not appear to result in joint pain, making these grafts useful for long periods of time.
A NEW SCALE FOR THE CLINICAL ASSESSMENT OF SPINAL CORD FUNCTION
Authors: Botsford D J , Esses S I 
Published: April 2021

ABSTRACT
The systems currently used for grading the severity of neurologic injuries have serious limitations. The authors have developed a neurologic grading system to assess spinal cord function. This is a new, functionally oriented scale which can be used at the bedside and requires no special tests other than those done in a routine clinical neurological examination. This scale includes assessment of motor and sensory function, rectal tone, and bladder control. A major advantage of this scale is that motor function is assessed on a functional rating system. To evaluate the usefulness of this scheme, patients who have been previously entered into a prospective study on the surgical treatment of burst fractures were re-evaluated. A significant number of patients under our new reclassification system were noted to have had significant improvement which had been overlooked using the Frankel Grade system. The authors conclude that their new spinal cord assessment technique has many advantages and suggest that it be used by spinal cord injury centers.
THE MEDIAL APPROACH TO THE HIP REVISITED
Authors: Mallon William J , Fitch Robert D 
Published: April 2021

ABSTRACT
Several muscular intervals have been described to approach the hip through a medial incision. We studied in detail the original descriptions of these surgical planes and found that several of them are nearly identical. We attempt to clarify the anatomic intervals available to the surgeon in hope of eliminating ambiguity in future reporting.
THE BIOLOGY OF ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTIONS
Authors: McFarland Edward G 
Published: April 2021

ABSTRACT
Ligaments, including the anterior cruciate ligament (ACL), have a limited biological response to injury. The same healing process affects graft tissues used to reconstruct the ACL. These biological processes interact with mechanical forces to transform the grafts into tissues, which are expected to functionally replace the ACL. Although these grafts may undergo "ligamentization," they may not undergo "ACL-ization." Further study of the important relationship between these biological and biomechanical interactions is warranted.
INTRAARTICULAR ACL RECONSTRUCTION USING THE PATELLAR TENDON: ARTHROSCOPIC TECHNIQUE
Authors: Baker Champ L , Graham John 
Published: April 2021

ABSTRACT
Endoscopie ACL reconstruction using the bone-patellar tendon-bone autografi has been shown to have good, reliable results. The procedure provides excellent reproducible fixation immediately and allows for early aggressive rehabilitation that includes range of motion, strengthening) and rapid return to sports.
SOFT TISSUE COVERAGE FOR THE UPPER EXTREMITY
Authors: Watumull Denton , Orenstein Harry H 
Published: April 2021

ABSTRACT
Soft tissue coverage of the upper extremity continues to be a challenging and evolving field. The expeditious and reliable methods of soft tissue coverage currently in use are discussed with reference to their shortcomings and advantages. For soft tissue coverage of fingertip injuries, open treatment or local flaps from the hand remain the mainstay of treatment. For dorsal and volar hand defects, distal axial flaps, such as the groin flap or microvascular tissue transfer, are utilized most commonly. For large defects proximal to the wrist, trunk axial pattern flaps, microvascular transfer, or the radial forearm flap have the greatest utility. Finally, technical points necessary for the success of some of the flaps are discussed.
USE OF LASERS IN ORTHOPEDIC SURGERY: CURRENT CONCEPTS
Authors: Abelow Stephen P 
Published: April 2021

Abstract
A surgical laser is a new, multipurpose tool that can cut, coagulate, and vaporize tissues. It utilizes a low profile handpiece that allows easy access to tight places and small joints. The holmium laser at 2.1 µm wavelength is gaining wide acceptance among orthopedic surgeons as a useful arthroscopic surgical tool. It has a minimal amount of thermal necrosis and is able to cut and ablate tissues with great ease.
Current investigation with laser tissue - agglutination and tissue welding - may make it possible to repair torn tissues with laser energy. The future will bring minimally invasive and minimally damaging laser orthopedic surgery.
HOLMIUM LASER SURGERY
Authors: Dillingham Michael F , Price Janet M , Fanton Gary S 
Published: April 2021

Abstract
This relatively new form of laser energy, with its powerful and precise ability to ablate the dense tissues of the musculoskeletal system as well as its transmissibility in fiberoptic cables and a fluid medium, makes this an ideal tool for use in orthopedic surgery. Its importance as a new orthopedic modality may well lie in its unique ability to gain access to small articular compartments while providing superior homeostatic control, thereby decreasing postoperative morbidity. While not yet in widespread use, its popularity is rapidly spreading and research into a variety of new applications is growing steadily.
OBTURATOR INTERNUS BURSITIS: A COMMON FACTOR IN LOW BACK PAIN
Authors: Swezey Robert L 
Published: April 2021

ABSTRACT
The presence of irritation of the obturator internus bursa (OIB) is identified as a common but thus far overlooked focus of myofascial irritability in association with low back pain. Eighteen of 50 consecutive patients with low back pain (36%) demonstrated the presence of tenderness at the anatomical site of the OIB. OIB was found in 11% of men and 43% of women. Nineteen of the 50 patients had regional myofascial pain; of these, eight (42%) had OIB tenderness. Palpation of the OIB will commonly reveal local tenderness in patiente suffering from low back pain. In these patients, conservative treatment of regional myofascial disorders may be made more effective when therapy and/or local steroid injections are appropriately directed to the obturator internus bursa.
SECONDARY PREVENTION OF VENOUS THROMBOEMBOLISM IN JOINT REPLACEMENT USING DUPLEX ULTRASONOGRAPHY
Authors: Walker Richard H 
Published: April 2021

ABSTRACT
Prophylaxis of venous thromboembolism can be categorized as primary prevention and secondary prevention. Primary prevention is the deterrence of a disease process before it begins. Secondary prevention is the detection and treatment of an asymptomatic disease process before it becomes symptomatic.1 This discussion deals with duplex ultrasonography as a method of secondary prevention of venous thromboembolism after total joint replacement.
Routine screening by venography and by duplex ultrasonography has been advocated by several authors in cases of total hip arthroplasty (THA) and total knee arthroplasty (TKA).2-11 However, compared with venography, duplex ultrasonography has the advantages of being portable, painless, noninvasive, without side effects, less expensive and, depending on the institution, reliable as a screening and surveillance tool for managing deep vein thrombosis (DVT).
Part one of a three-part study was designed to substantiate reliability of duplex ultrasonography in detecting DVT after total joint replacement hi the lower extremity at our institution (Scripps CUnIc and Research Foundation in La Jolla, CaUf). Parts two and three were designed to evaluate the utility of duplex ultrasonography for routine screening and surveillance of DVT after THA and TKA.
ONE HUNDRED YEARS OF AUTOMOBILEINDUCED ORTHOPEDIC INJURIES
Authors: Duncan Gregory J , Meals Roy 
Published: April 2021

ABSTRACT
As the automobile has evolved over its first 100 years, many changes have improved its safety and have resulted in lower fatality rates. To a great extent, physicians have provided the thrust for these improvements. Now, as more people survive automobile accidents, injuries to the musculoskeletal system take on importance as causes of individual disability and social cost. The patterns of automobile-induced orthopedic injuries continue to change. This article reviews the first 100 years of these injury patterns and relates their occurrence to specific automobile design features and oversights. Because any one automobile accident is likely to injure only a few people at most, trends and patterns are much more difficult to ascertain than for mass transit vehicular accidents. For this reason, physician awareness of contemporary injury patterns is the first step toward safer automobile design.
THE DIAGNOSIS OF DEEP VEIN THROMBOSIS IN THE MULTIPLY INJURED PATIENT WITH PELVIC RING OR ACETABULAR FRACTURES
Authors: Gruen Gary S , McClain Edward J , Gruen Rebecca J 
Published: April 2021

ABSTRACT
Thirty-one patients with unstable displaced pelvic or acetabular fractures were admitted and underwent an open reduction and internal fixation of their fracture. All patients were studied prospectively for the incidence of proximal deep vein thrombosis (DVT) utilizing venous duplex ultrasound. Duplex scans were repeated at 1 week postoperatively in all patients. Additional scans were performed when clinically indicated. A total of 61 scans were completed. DVT developed in three patients (approximately 10%). Two of the three positive scans were noted only on postoperative examination. The third scan was positive on the preoperative phase. Duplex ultrasound was easily applied and well tolerated by the multiply injured patient.
THE EFFECT OF INTERCARPAL JOINT MOTION ON WRIST MOTION: ARE THERE KEY JOINTS? AN IN VITRO STUDY
Authors: Seradge Houshang , Owens Willis , Seradge Espanta 
Published: April 2021

ABSTRACT
The contribution of each intercarpal joint individually and as a member of a regional group to total wrist motion was analyzed in 10 fresh, frozen cadaver specimens. Each intercarpal joint had an effect on the total wrist motion, but the contribution of each to the different planes of motion was not equal. The scaphoid-capitate joint had a governing effect on the motion of a region comprised of scaphoid-trapezium, scaphoid-trapezoid, and scaphoid-capitate. The lunate-capitate joint had a governing effect on the motion of a region comprised of the lunate-triquetrum, lunate-capitate, triquetrum-hamate, and hamate-capitate complex. Elimination of motion in either of the key governing joints affected total wrist motion the same as elimination of motion in all the joints in that region. Intercarpal fusion for treatment of ligament injury of the proximal intercarpal row may be limited to the scaphoid-capitate or lunate-capitate joint. There is no need to attempt fusion in all joints of either of the two regions.
THE ROLE OF HIP ARTHROSCOPY IN THE DIAGNOSIS AND TREATMENT OF HIP DISEASE
Authors: McCarthy Joseph C , Busconi Brian 
Published: April 2021

ABSTRACT
Injuries to the hip are commonly encountered by orthopedic surgeons and will, for the most part, respond well to conservative therapy. When a patient's hip pain has not responded to the appropriate treatment and radiographic measurements have not shown any specific pathology, arthroscopy of the hip can be a valuable diagnostic and therapeutic procedure. We retrospectively reviewed 94 consecutive patients who experienced refractory hip pain that persisted longer than 6 months (average: 2.1 years) and who had an average follow up of 2.5 years. Statistical analysis was performed using Fisher's Exact Test (P value) and Pearson (r value) correlation coefficient to compare preoperative symptomatology and physical examination findings with intraoperative pathology. Statistically significant results were obtained when comparing preoperative symptoms of a painful hip click and mechanical symptoms of locking with acetabular labral injuries (P=.000, r=.896) and loose bodies (P=.000, r=.896), respectively. Radiologic studies were nondiagnostic in 76% of patients in this series. Hip arthroscopy can be a valuable and viable procedure in the diagnosis and treatment of protracted or progressive hip pain lasting more than 6 months.
Anatomic Considerations for Anterior Instrumentation of the Lumbar Spine
Authors: Ebraheim Nabil A , Xu Rongming , Urbancic Richard , Yeasting Richard A 
Published: April 2021

ABSTRACT
One hundred seventy lumbar vertebrae from L1-L4 were used to quantitatively evaluate the lumbar vertebral body and examine the relationship of the maximum posterior angles of screw placement to the spinal canal. Anatomic evaluation included dimensions of the vertebral body. Three entrance points on the lateral aspect of the vertebral body for screw insertion and an additional point 3 mm from the posterolateral corner of the spinal canal were defined and marked. The maximum posterior screw angles were determined as the angles between the line connecting the entrance point with the additional point and the corona! plane.
Results showed that vertebral body dimensions increased from L1-L4. The average vertebral body depth, width, and height were approximately 26 mm, 36 mm, and 22 mm at Ll , and 30 mm, 44 mm, and 23 mm at L4, respectively. The spinal canal may be penetrated if the screws are directed posteriorly 2°-5° at LI - L2 and 9°-14° at L3-L4 starting at the junction between the pedicle and vertebral body, 22°-32° at L1-L4 from the level of 1 0 mm anterior to the junction, and 43°-S0° from the level of 20 mm anterior to the junction. Therefore, mid-body screws should be directed perpendicular to the lateral plane of the vertebral body. For a more anteriorly placed screw, slightly posterior angulation is recommended.
Comparison of Postoperative Pain in Patients Receiving Interscalene Block or General Anesthesia for Shoulder Surgery
Authors: L Wu Christopher , Rouse Lucien M , Chen Jeffrey M , Miller Richard J 
Published: April 2021

Abstract
A retrospective review of 114 patients who underwent elective shoulder surgery from January 1, 1995 to December 31, 1996 was performed. Eighty-eight patients received general anesthesia and 26 patients received regional anesthesia (interscalene block). There were no differences in surgical and anesthesia time and time to hospital discharge between groups. Patients who received regional anesthesia had a shorter recovery room stay (63±25 minutes versus 85±33 minutes [P=.002]) and required less intraoperative fentanyl (174±96 µg versus 379±193 µg [P<.0001]) and morphine in the recovery room (2±3 mg versus 6±7 mg [P=.006]). A higher percentage of patients who received regional anesthesia had a lower pain rating at 4 hours. Regional anesthesia for shoulder surgery decreases pain and facilitates recovery in the immediate postoperative period.
Radiolucency Adjacent to the Tibial Component in Total Knee Arthroplasty
Authors: Lundberg-Jensen Allan , Kourakis Anette Holm , Rossen Benni , Kofoed Hakon 
Published: April 2021

Abstract
This study determined the accuracy of standard radiographs in observing radiolucency adjacent to the tibial component in total knee arthroplasty. A model of the proximal tibia was used. Plastic sleeves of different heights were glued under the tibial tray to imitate radiolucency. By tilting the x-ray tube 1° at a time, an investigation was performed to determine how many degrees it would take to cover the heights of the different plastic sleeves.
In a clinical study of patients at standard follow-up, 21 knees were examined using standard radiographs. Radiographs using image intensification were then taken of the same knees to obtain radiographs with views parallel to the plane of the tibial tray. The results of the study on the phantom showed that a 1 ° deviation of the x-ray beam from the optimal position would obscure a 0.5-mm "radiolucency." This was true for radiolucencies of 2, 3, 4, and 5 mm. This was confirmed in the clinical study where ≤4 mm of radiolucency was obscured on standard radiographs. Therefore, standard radiographs cannot be used to determine radiolucency. The 2-mm radiolucency normally associated with loosening is not clinically valid.
The Effect of Abduction Differences Between Cup and Contralateral Acetabular Angle on Polyethylene Component Wear
Authors: Kligman M , Michael H , Roffman M 
Published: April 2021

Abstract
One hundred forty-two patients who underwent cemented or uncemented hip replacement were studied radiographically to determine acetabular component wear. Mean duration of follow-up was 58 months (range: 35-92 months). Average linear wear was 0.78 mm (range: 0-1.9 mm), and average wear rate was 0.16 mm/year (range: 0-0.45 mm/year). An increased wear rate per year correlated with a discrepancy >18.3° between contralateral acetabular angle and acetabular cup inclination (P<.005). Statistical analysis revealed no significant correlation between cup inclination and polyethylene wear, which was studied without considering the contralateral hip (P>3). There was no relationship between polyethylene wear and cup design, weight, and initial polyethylene thickness.
Vulnerability of the Spinal Accessory Nerve in the Posterior Triangle of the Neck: A Cadaveric Study
Authors: Lu Jike , Haman Steve P , Ebraheim Nabil A 
Published: April 2021

ABSTRACT
Injury to the accessory nerve results in an obvious shoulder droop, loss of shoulder elevation, and pain. Prevention of inadvertent injury to the accessory nerve is critical in neck dissection. No previous study, however, anatomically demonstrates the mechanism of the spinal accessory nerve traction injury. Anatomic determination of the location and course of the spinal accessory nerve may be helpful for a better understanding of the mechanism of the nerve injury. The accessory nerve courses obliquely across the posterior triangle on the surface of the levator scapula muscle and reaches the trapezius. The length of the spinal accessory nerve in the posterior triangle is 34.7±6.3 mm. The nerve passes through the posterior border of the sternocleidomastoid muscle 50.7±12.9 mm below the tip of the mastoid process and reaches the anterior border of the trapezius 49.8±5.9 mm above the clavicle. It makes a posterior angle of 73.1°±19.4°, on average, relative to the posterior border of the stemocleidomastoid. When the shoulder is pulled down and the head is turned to the opposite direction, the spinal accessory nerve is stretched in the posterior triangle. In the posterior triangle, the nerve is vulnerable, since it is superficial and covered only by skin and subcutaneous fascia. Therefore, extreme caution should be taken with any surgical procedures in the posterior triangle. Traction injury of the spinal accessory nerve in the posterior triangle cannot be ignored.
Fixed- Versus Mobile-Bearing Total Knee Arthroplasty: Technical Issues and Surgical Tips
Authors: Crossett Lawrence S 
Published: April 2021

Abstract
Mobile-bearing knee arthroplasties have been used clinically for 25 years. The success of this technology depends on strict adherence to the principles of flexion-extension gap technique. The use of the fixed femoral landmarks for the rotational positioning of the femoral component (measured resection technique) is not acceptable if bearing dislocation is to be avoided. The principles of flexion-extension gap balancing, as well as the surgical technique, are reviewed in this article.
Advanced Mobile-Bearing Surgical Technique
Authors: Beverland David 
Published: April 2021

Abstract
Consistent success in total knee arthroplasty (TKA) is dependent on achieving basic surgical goals that include a neutral mechanical axis, a restored joint line, and equally balanced flexion and extension gaps. Although these surgical goals apply to both fixedbearing and mobile-bearing TKAs, concerns about bearing stability in mobile-bearing implants require surgeons to be aware of flexion gap stability. The increased awareness required to achieve flexion gap stability with the mobile-bearing implant not only provides stability but also encourages surgeons to adhere to basic surgical principles.