bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cementless Total Shoulder Arthroplasty: Preliminary Experience With Thirteen Cases
Authors: Faludi D Dennis , Weiland Andrew J 
Published: April 2021

ABSTRACT: From February 1978 to March 1981, 13 English-McNab cementless, semiconstrained, implant shoulder arthroplasties were performed in 12 people. The ages of the patients at the time of surgery ranged from 53 to 73 years with an average of 62 years. The preoperative diagnoses were rheumatoid arthritis, primary osteoarthrosis, posttraumatic osteoarthritis, avascular necrosis, and failed hemiarthroplasty. Followup ranged from 27 to 62 months with an average of 44.3 months. Criteria for total shoulder replacement were intractable pain commensurate with destruction of the glenohumeral joint on x-ray. The UCLA shoulder rating system was used for evaluation of pain, function, muscle power, and motion.
Preoperative UCLA mean scores were 1.7 for pain, 1.8 for function, 4.0 for muscle power and motion. At followup, mean scores were 6.6, 5.6, and 4.8 respectively. Significant complications occurred.
Our conclusions are that uncemented total shoulder arthroplasty with an unconstrained prosthesis can, in selected patients, offer significant relief of pain and increase overall function while modestly improving strength and motion. The complications are consistent with those reported in the literature although loosening of this prosthesis has not been noted.
Treatment of the Juvenile Bunion by Mitchell Osteotomy
Authors: Ball John , Sullivan J Andy 
Published: April 2021

ABSTRACT: Twelve patients who had a total of 18 Mitchell bunionectomies were reviewed to assess the long-term results of the procedure. Although metatarsus varus correction was maintained in all cases, hallux valgus recurred in 11 of the 18 cases. Sixty-seven percent reported complete relief or improvement of preoperative pain. Although lateral metatarsalgia did occur, the most common area of persistent pain remained the first metatarsal. Six of 18 procedures had marked loss of active joint motion, associated with pain and an unsatisfactory result. Of 18 procedures, 11 (61%) were satisfied with the results of their osteotomy.
Although the Mitchell osteotomy corrected the metatarsus primus varus in each case, the current series shows a discouraging incidence of later recurrence of hallux valgus and restriction of metatarsophalangeal motion causing the abandonment of this procedure for the management of juvenile bunion.
Free Vascularized Flaps for Lower Extremity Reconstruction
Authors: Frykman Gary K , Leung Vincent C L 
Published: April 2021

ABSTRACT: Large wounds of the lower extremity, particularly distal to the knee, have been difficult to cover by traditional means such as skin grafts, local flaps, cross-leg flaps and jump flaps. These wounds, particularly when associated with fractures and osteomyelitis, have frequently resulted in amputation of the lower extremity. Microvascular surgical techniques have allowed the transfer of large flaps of skin and/or muscle from a remote site of the body to the defect in the leg for soft tissue coverage and additional blood supply to the defect. Although these techniques are more tedious and require longer operating times, they usually shorten the patient's hospital stay, heal the wounds faster and shorten disability time.
With wider experience, improved techniques and greater microsurgical skill, lower limbs with large defects due to trauma or tumor resection can be salvaged and reconstructed with acceptable risks and minimal donor site morbidity.
Intramedullary Reaming and Nailing: Its Early Effects on Cortical Bone Vascularization
Authors: Olerud Sven , Strömberg Lennert 
Published: April 2021

ABSTRACT: The early effect of reaming the medullary cavity prior to intramedullary nailing using Küntscher's method, on human cortical bone vascularization in the femur is discussed.
In sections of the femur where the medullary tissue had been totally reamed, the inner two-thirds of the cortical bone tube was completely avascularized one week after the reaming. In the outer third of the cortex the vascularization was only moderately decreased. In the parts of the femur where the medullary tissue was not totally destroyed there was a marginal effect on the amount of intact cortical vessels. The observation is thus in accordance with corresponding results from experimental studies on animals. Microcracks, and cracks in the cortical wall, caused by the reaming and procedure are also described in the article.
Zielke Instrumentation
Authors: Hammerberg Kim W , Rodts Mary F , DeWald Ronald L 
Published: April 2021

ABSTRACT: Ziefke modified Dwyer's anterior spinal Instrumentation to produce the Ventral Derotational Spondylodesis (VDS) System. The primary indication for VDS instrumentation is the treatment of progressive, single, major lumbar or thoracolumbar curves in idiopathic scoliosis. The surgical technique, including selection of appropriate curvatures and levels of instrumentation, is described.
A group of 25 consecutive patients undergoing VDS instrumentation for lumbar or thoracolumbar curvatures was reviewed. The average correction of the major curve was 76%. The minor curvature was corrected with an average of 47%. A significant complication was a 20% incidence of pseudarthrosis and rod breakage. The implications of these problems are discussed. Zielke instrumentation is a powerful technique for the correction of selected curves. The system provides greater correction of the major curve, improved frontal and sagittal alignment, and preservation of distal motion segments.
Anterior Knee Dislocation: Case Report and Discussion
Authors: Pearsall Albert W , Schueller Dean 
Published: April 2021

Case Report
A 34-year-old man presented to the emergency room with a complaint of left knee pain and deformity. The patient recalled that while fleeing several armed assailants, he struck his left foot on a curb with his knee in full extension. He immediately fell to the ground and was unable to bear weight on his left leg.
Upon examination he had a left knee hyperextension deformity with no evidence of gross varus/valgus malalignment. He was neuro vase ularly intact bilaterally. Radiographs of the patient's left knee were obtained (Fig 1). Diagnosis: Anterior knee dislocation.
VANCOMYCIN VS TOBRAMYCIN ELUTION FROM POLYMETHYLMETHACRYLATE: AN IN VITRO STUDY
Authors: Lawson Kevin Jon , Marks Kenneth E , Brems John , Rehm Susan 
Published: April 2021

ABSTRACT
We fabricated batches of cement containing 0.5 gm, I. O gm* and 2.0 gm vancomycin and one with 1.0 gm tobramycin and shaped them into cylinders. They were immersed into 0.5 L of normal saline and the fluid volume was changed daily. Samples of fluid were obtained on days 1 , 2, 3, 5, 7, 14, and 28. All fluid samples had antibiotic assays performed to quantitate the amount of elution for vancomycin or tobramycin. \ancomycin elution from PMMA occurred under our study conditions in similar quantities to that measured for tobramycin controls, \bncomycin-loaded PMMA cement may have a clinical role in the treatment of musculoskeletal sepsis caused by gram-positive bacteria, particularly if organisms resistant to the usual antibiotic agents are identified.
VASCULARIZED BONE GRAFTS
Authors: Pirela-Cruz M A , DeCoster T A 
Published: April 2021

ABSTRACT
Free vascularized bone grafts allow living bone tissue to be transplanted to replace a bone defect. The use of vascularized bone grafts requires microvascular dissection and attachment to a recipient site artery and vein, whereas rotational or pedicle grafts are moved, while still attached to their blood supply, to a new site. Conventional nonvascularized bone grafts heal by resorption and creeping substitution. The major benefits of vascularized bone grafts are more rapid and complete incorporation of the graft which provides immediate structural support, the ability of the transplanted (living) bone to form new bone, and the addition of new blood supply to the recipient area. The technique of the free vascularized fibula transplantation is described.
GUNSHOT FRACTURES: A MEDICAL, SOCIAL, AND ECONOMIC ANALYSIS
Authors: Hakanson Robyn , Nussman Donna , Gorman Richard A , Kellam James F , Hanley Edward N 
Published: April 2021

ABSTRACT
One hundred ten fractures due to gunshots were reviewed to examine the medical, social, and financial impacts of such injuries. The population was predominantly male (91%), unemployed (56%), and uninsured (79%). Sixty-eight percent were documented substance abusers, and 65% of the injuries appeared to be related to illicit drug activities. There were 94 long bone fractures and 16 intraarticular fractures. Early operative treatment was employed in 64 patients (58%) with formal internal fixation in 31. There was no difference between type of treatment, associated injury variables, and outcome, and no increase in complications with acute operative management employing internal fixation. Medical charges averaged $13 108 per patient, a 1200% increase over injuries treated at this institution in 1972 and a rise far in excess of the medical care inflation rate (334%) during the same period.
RISK FACTORS FOR RESTRICTED MOTION AFTER ANTERIOR CRUCIATE RECONSTRUCTION
Authors: Graf Ben K , Ott Judson W , Lange Richard H , Keene James S 
Published: April 2021

Ben K. Graf, MD
Judson W. Ott, MD
Richard H. Lange, MD
James S. Keene, MD
ABSTRACT
A retrospective review of 373 patients who had undergone anterior cruciate ligament (ACL) reconstruction utilizing the central third of the patellar tendon was undertaken to identify those factors that placed a patient at risk for restricted postoperative motion (flexion ≤ 125° or flexion contracture ≥ 10°). Stepwise logistic regression analysis determined that the variables most strongly correlated with restricted final range of motion (ROM) were open surgery (P =.0008) and reconstruction performed ^ 7 days after the initial injury (P =.004). Age, associated meniscal repair, or associated collateral ligament injuries did not significantly affect the ROM. A subgroup of 204 patients arthroscopically reconstructed more than 7 days post-injury were significantly less likely to have limited motion when ROM exercises were begun within 2 days of surgery (P= .008). These data support delayed, arthroscopic ACL reconstruction followed by early ROM exercises as useful techniques for avoiding postoperative motion problems.
PAIN DYSFUNCTION SYNDROME OF THE KNEE
Authors: Neuschwander David , Drez David , Heck Suzy 
Published: April 2021

ABSTRACT
Pain dysfunction syndrome is a descriptive term recommended by Amadio1 to describe patients whose pain is excessive, nonanatomic, and out of proportion to their injury. This retrospective review reports the effectiveness of a differential epidural block in the evaluation of these patients. Four patterns of response were identified with the block: 1) reflex sympathetic dystrophy (RSD) (14%), 2) somatic (9%), 3) mixed sympathetic and somatic (27%), and 4) central (50%). The inciting injury in 70% of the patients was a minor strain, sprain, or contusion. Despite accurate diagnosis, the results in compensation cases with pain dysfunction syndrome are exceedingly poor.
LONG-TERM RESULTS OF 56 REVISION TOTAL KNEE REPLACEMENTS
Authors: Gustilo Tara , Comadoll James L , Gustilo Ramon B 
Published: April 2021

ABSTRACT
Fifty-six consecutive revised total knee arthroplasties (TKA) were followed for an average of 8.3 years (range: 3 to 15 years). The purpose of this study was to evaluate the results of revision TKA to determine any trend's in either the good outcomes or the failures. We found that the success rate for revision TKA was comparable to that for primary TKA. Eighty-nine percent of the knees rated at least fair, with 73% of these rating good or excellent, and 4% poor result. Moreover, the findings suggest that if prostheses are aligned correctly at implantation, there is only slight deterioration in their performance over time. Outcome was not affected by the type of prosthesis used in either the previous surgery or the revision. There is a correlation between the number of revisions and the functional knee rating; the more revisions, the less chance for success. There was also a direct correlation between varus knee alignment and significant increased incidence of failure. No appreciable difference was found between degenerative arthritis patients and rheumatoid patients, except that the rheumatoid patients had a higher incidence of delayed infections.
BONE GRAFT IN HINDFOOT ARTHRODESIS: ALLOGRAFT VS AUTOGRAFT
Authors: McGarvey William C , Braly W Grant 
Published: April 2021

ABSTRACT
From 1990 to 1992, all arthrodeses of the socalled triple joints, combined or isolated and performed by one surgeon, were reviewed to allow a minimum follow up of 18 months from the time of the index procedure. Type of bone graft was selected based on the patients' decision after the risks of each were explained by the surgeon. There were 37 patients undergoing 41 procedures (4 bilateral) including double and triple arthrodesis, as well as isolated subtalar fusions. Twenty-nine of these were performed for either degenerative or posttraumatic arthritis. Ten others were performed for joint incongruity resulting from posterior tibial tendon insufficiency, and the rest for hemiparesis or residual clubfoot. All patients were placed into a routine postoperative regimen of casting, bracing, weight bearing, and therapy. They were evaluated based on subjective complaints, physical examination, and postoperative radiographs. Any patient suspected of having a nonunion underwent a computed tomography scan for confirmation. Overall, 24 patients received allografts and 17 iliac crest grafts. There were four nonunions, three of which utilized banked bone graft, with the only nonunion in the autograft group occurring in a patient following open calcaneus fracture. Of the four nonunions, three opted for revision surgery and the only one to choose allograft again incurred the only recurrent nonunion. There were two infections, one in each group, resulting in prolonged intravenous antibiotic therapy.
TRUE EPINEURAL NEUROLYSIS IN MORTON'S NEUROMA: A 5-YEAR FOLLOW UP
Authors: Diebold P F , Daum B , Dang-Vu V , Litchinko M 
Published: April 2021

ABSTRACT
Morton's neuroma is a frequent cause of metatarsalgia. Neuroma resection was the usual recommended surgical treatment. Failure rate of neurectomy can be as high as 14% to 21%, and treatment of recurrences is difficult. The authors have treated Morton's neuroma by neurolysis since 1985. They present their results in a group of 40 patients with 5 years follow up. Thirty-seven of 40 patients had an excellent result after neurolysis and 35 patients had normal toe sensitivity at the date of examination. Thirty-nine patients stated they would undergo the operation again if necessary.
CHRONIC LAXITY OF THE SUBTALAR JOINT
Authors: Pisani G 
Published: April 2021

ABSTRACT
Chronic laxity of the subtalar joint derives from the functional significance of the joint with the talo-calcaneal interosseous ligament as the articular "pivot." The laxity of the subtalar joint is usually associated with traumatic or degenerative pathology of the interosseus ligament. The characteristic pain is present along the sinus tarsi and at times also more proximally along the posterior subtalar joint. Radiographic examination is not significant; however, with arthrography, the normal synovial recess of the posterior subtalar joint corresponding to the sinus tarsi is not visualized. With magnetic resonance imaging it has been possible to document structural alterations of ligament. Reconstruction of the interosseus talo-calcaneal ligament has a reasonable expectation of success. The author presents the results of this treatment in 47 operations (44 patients, 3 bilateral) between January 1982 and June 1992.
LONG-TERM RESULTS OF THE MODIFIED EVANS REPAIR FOR CHRONIC ANKLE INSTABILITY
Authors: Rosenbaum Dieter , Becker Horst-Peter , Sterk Jürgen , Gerngross Heinz , Claes Lutz 
Published: April 2021

ABSTRACT
We treated 19 patients for chronic ankle instability with a modified Evans procedure. All patients were evaluated after an average follow up of 128 months with detailed questionnaire, clinical examination, and stress radiographs. Although the subjective results were reported as 8 excellent, 7 good, and 4 fair, residual pain was reported by 11 patients. There was a significantly increased number of osteophytes in the treated ankle joint Stress radiographs demonstrated significantly improved stability in the operated ankle joint. Range of motion was significantly reduced in hindfoot inversion. The results showed that the modified Evans procedure achieved sufficient joint stability at the expense of inversion range of motion. This reconstruction method apparently did not prevent the development of arthrosis.
HELAL METATARSAL OSTEOTOMY FOR THE TREATMENT OF METATARSALGIA: A CRITICAL ANALYSIS OF RESULTS
Authors: Trnka H-J , Kabon B , Zettl R , Kaider A , Salzer M , Ritschl P 
Published: April 2021

ABSTRACT
We reviewed the results of treatment of 114 feet in 96 patients with pressure metatarsalgia treated with a metatarsal osteotomy performed according to the technique of Helal. Clinical examination was performed according to a standardized evaluation questionnaire using the American Orthopaedic Foot and Ankle Society Lesser Metatarsophalangeal-Interphalangeal Scale. The results were correlated with number of metatarsal osteotomies, the length of the follow up, the age of the patient, and type of additional procedures performed. Sixty-one percent of the patients rated the operation as excellent or good. Patient age and number of osteotomies did not influence the results; however, the length of time following surgery and associated Keller-Brandes resection arthroplasty influenced the outcome negatively. There was a high incidence of increased transfer of weight to adjacent metatarsals. We concluded that the Helal type metatarsal osteotomy is unlikely to predictably achieve symptom relief over a long period.
PLANTAR FOREFOOT ULCERATION WITH EQUINUS DEFORMITY OF THE ANKLE IN DIABETIC PATIENTS: THE EFFECT OF TENDO-ACHILLES LENGTHENING AND TOTAL CONTACT CASTING
Authors: Lin Sheldon S , Lee Thomas H , Wapner Keith L 
Published: April 2021

ABSTRACTBetween 1993 and 1995, 93 neuropathic diabetes mellitus patients with foot ulcers underwent a total contact cast (TCC) protocol. A randomly chosen group of 21 patients (Group I) demonstrated ulcer healing in a mean time of 43.5 days. Despite 9 weeks of TCC, 15 patients (Group II) with forefoot ulcers failed to heal. Physical examination of Group I revealed plantarflexion/dorsiflexion range of motion of the ankle of 33.871.9° compared to 32.3°/-10.5° of Group II, demonstrating an ankle equinus deformity and limited joint motion. Group II patients underwent a correction of the equinus deformity with percutaneous tendo-Achilles lengthening (TAL), followed by a TCC. All but one ulcer (93.3%) healed within 39.4 days. Four (19.0%) ulcers recurred (at the same site) in Group I, compared to none in Group II at the latest follow up of 17.3 months. Surgical correction with percutaneous TAL and TCC results in healing of forefoot ulcer and helps prevent ulcer recurrence.
CARPECTOMY AND FUSION IN ADULT-ACQUIRED HAND SPASTICITY
Authors: Pinzur Michael S 
Published: April 2021

ABSTRACT
Five adult patients with voluntary hand control, complicated by severe flexion contracture and spasticity secondary to brain injury, underwent subtotal carpectomy and radio-carpal or radiometacarpal fusion. None of the patients were capable of functional prehension before surgery, and all had difficulty with hygiene due to their deformity. The deformities were beyond the scope of correction with soft tissue release. Two of the patients had previously undergone flexor- prona tor origin release, musculo-tendinous lengthening of the wrist and finger flexors, or a combination of both. AU five patients progressed to union without complication. Four achieved meaningful gains in functional grasp-release of the hand following the surgery.
Thawing the Frozen Shoulder: The "Patient" Patient
Authors: Miller Mark D , Wirth Michael A , Rockwood Charles A 
Published: April 2021

ABSTRACT
Many different modalities have been advocated for the treatment of frozen shoulder (adhesive capsulitis), some of which can be associated with complications and morbidity. We retrospectively reviewed 50 patients with adhesive capsulitis treated by the senior author over a 10-year period. Treatment consisted of closely monitored home therapy using moist heat and antiinflammatory medication, and a physiciandirected rehabilitation program. Without exception, every patient regained a significant amount of motion and returned to activities of daily living without pain.
Assessing the Expected Outcomes of Orthopedic Surgical Care for Children
Authors: Lewis Charles E , Shaperman Julie 
Published: April 2021

ABSTRACT
A sample of 175 parents of children treated operatively for orthopedic problems were interviewed before surgery to ascertain their expectations with regard to specific functional changes postoperatively. They were interviewed about changes from 6 to 12 months after surgery. Medical records of a sample of this group were reviewed for any notes about functional status. Of this group, 54% said a specific function named preoperatively was "much better."' Only a third of the parents from Mexico understood the nature of the procedure performed 6 to 12 months postoperatively, and only 40% of medical records contained notes about functional status pre- or postoperatively.
Femoral Head Size: Variation Among Manufacturers
Authors: Ritter Merrill A , Meding John B , Faris Philip M , Keating E Michael 
Published: April 2021

ABSTRACT
Nine manufacturers were contacted for their specific femoral head diameters of the 22 mm, 28 mm, and 32 mm femoral components. The 22 mm heads averaged .869 in. (±.005) and 100% were within 1 standard deviation; however, the standard deviation was large. The 28 mm heads averaged 1.101 in. (± .002), and 89% were within 1 standard deviation. The 32 mm heads averaged 1.258 in. (± .002), and 78% were within 1 standard deviation. It seems that when a 28 mm or 32 mm femoral head is used, different femoral and acetabular components by different manufacturers can be intermixed. However, when changing a 22 mm femoral head, the manufacturer should possibly be notified and an attempt to use the same manufacturer is preferable.
Integrated Analysis of Thrombotic/Vascular Event Occurrence in Epoetin alfa-Treated Patients Undergoing Major, Elective Orthopedic Surgery
Authors: de Andrade J Robin , Frei Dieter , Guilfoyle Mary 
Published: April 2021

ABSTRACT
Data from four prospective, multicenter, randomized studies involving 869 major, elective orthopedic surgery patients were examined by means of a retrospective integrated analysis to evaluate whether perioperative Epoetin alfa use was associated with the occurrence of thrombotic/vascular events. The incidence of thrombotic/vascular events was similar between 619 patients treated with Epoetin alfa and 250 patients receiving placebo (7.4% versus 8.0%, respectively). Regression analyses identified age, cardiac history, hypertension, and cardiac medications, but not Epoetin alfa, as risk factors for thrombotic/vascular events. The analysis did not implicate an increase in the rate of rise in hematocrit or maximum hematocrit obtained prior to surgery as contributors to thrombotic events. Thus, Epoetin alfa, which enhances preoperative erythro poiesis and increases hematocrit, did not affect the probability of thrombotic/vascular events.