bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Role of Anterior Stabilization With Instrumentation in the Treatment of Thoracolumbar Burst Fractures
Authors: Harris Mitchel B 
Published: April 2021

Abstract
Several areas of controversy still exist when discussing the treatment of burst fractures in the thoracolumbar and lumbar regions of the spine. This article addresses the role of anterior stabilization with instrumentation in these regions. Pertinent clinical and biomechanical data will be reviewed so that readers will be able to identify the relative indications and contraindications for this procedure.
THE RISK OF INJURY TO THE AXILLARY NERVE, ARTERY, AND VEIN FROM PROXIMAL LOCKING SCREWS OF HUMERAL INTRAMEDULLARY NAILS
Authors: Riemer Barry L , D'Ambrosia Robert 
Published: April 2021

ABSTRACT
An elderly female cadaver fore-quarter amputation was dissected, and a custom straight intramedullary nail with a 55° oblique downward lateral to medial proximal screw was inserted with a trocar protruding beyond the medial cortex of the humeral surgical neck. The main trunk of the axillary nerve was found to be at risk with any penetration from anterior to posterior and any screw penetration beyond the medial cortex with internal rotation. The axillary artery and vein were at risk with penetration of over 3 cm by a drill point or screw tip whether a transverse or oblique downward screw was used. Transverse screws inserted through the humeral neck from lateral to medial have the potential for damaging a small branch of the axillary nerve laterally, and care must be taken of the lateral humerus while inserting these screws. Screws inserted in a downward direction near the greater tuberosity, if originating above the equator of the humeral head, may cause impingement.
AVASCULAR NECROSIS AFTER FRACTURE-SEPARATION OF THE DISTAL END OF THE HUMERUS IN CHILDREN
Authors: Yoo Chong Il , Suh Jeung Tak , Suh Kuen Tak , Kim Yong Jin , Kim Hui Taek , Kim Young Ho 
Published: April 2021

ABSTRACT
Fracture-separation of the distal end of the humerus in children has been reported infrequently, and may be misdiagnosed as a fracture of the condyle or a traumatic dislocation of the elbow. We discuss eight cases of a seldom reported complication following fracture-separation of the distal end of the humerus. This complication consists of dissolution of the trochlea within three to six weeks postinjury and a defect of the medial or central part of the condyle that develops later. The fractures were severely displaced fracture-separation of the distal end of the humerus with large medial or lateral metaphyseal fragment, but initially misdiagnosed as a fracture of the medial, lateral condyle or a traumatic dislocation of the elbow in six of eight cases. We performed open reduction in six cases because of initial misdiagnosis or because of difficulty in satisfactory closed reduction. We speculated that this complication is due to avascular necrosis of the distal end of the humerus, and that fracture-separation of the distai end of the humerus is more common than reported.
TOTAL HIP REPLACEMENT IN PATIENTS WITH OSTEOARTHRITIS OF THE HIP: IMPROVEMENT IN PAIN AND FUNCTIONAL STATUS
Authors: Gogia Prem P , Christensen Cecil M , Schmidt Carol 
Published: April 2021

ABSTRACT
A simple, self-rating questionnaire was developed to assess the clinical outcome related to pain and function after total hip replacement surgery followed by physical therapy. Twentytwo patients, 57 to 86 years of age, with osteoarthritis of the hip who underwent total hip replacement surgery and received physical therapy following surgery, participated in the study. A questionnaire consisting of 11 items was developed to ascertain the level of pain, functional ability and the assistive ambulatory device used to perform selected activities of daily living. A maximum cumulative score of 55 points was possible. The functional categories monitored included: sitting, standing, sleeping, functional walking, distance walking, stair climbing, sitting/ standing from a toilet seat, driving, and sexual activities. The questionnaires were completed preoperatively, and postoperatively at 3 and 6 months. The results showed an overall improvement of 56% at 3 months and 64% at 6 months after surgery. Twenty of 22 patients obtained "excellent" results with total hip replacement surgery and follow-up physical therapy. Results of this study indicated that total hip replacement followed by physical therapy decreases joint pain and improves function in patients with osteoarthritis of the hip.
VENOMOUS SNAKE BITE: CURRENT CONCEPTS OF TREATMENT
Authors: Seiler John Gray , Sagerman Scott D , Geller Robert J , Eldridge John C , Fleming Lamar L 
Published: April 2021

ABSTRACT
The optimal treatment of venomous snakebites remains controversial. Because of the variables involved in treatment, an ideal, prospective clinical trial likely will never be done. The purpose of this article is to review the available treatment methods and outline the treatment methods preferred in our institution for crotalidae envenomation.
THE CLINICAL EFFECTS OF INTENSIVE, SPECIFIC EXERCISE ON CHRONIC LOW BACK PAIN: A CONTROLLED STUDY OF 895 CONSECUTIVE PATIENTS WITH 1-YEAR FOLLOW UP
Authors: Nelson Brian W , O'Reilly Elizabeth , Miller Mark , Hogan Mike , Wegner Joseph A , Kelly Charles 
Published: April 2021

ABSTRACT
Eight hundred ninety-five consecutive chronic low back pain patients were evaluated. Six hundred twenty-seven completed the program. One hundred sixty-one began, but dropped out, and 107 were recommended for treatment but did not undergo treatment for various reasons. Average duration of symptoms prior to evaluation was 26 months. Forty-seven percent of patients were workers' compensation patients. The primary treatment was intensive, specific exercise using firm pelvic stabilization to isolate and rehabilitate the lumbar spine musculature. Patients were encouraged to work hard to achieve specific goals. Seventy-six percent of patients completing the program had excellent or good results. At 1-year follow up 94% of patients with good or excellent results reported maintaining their improvement. Results in the control group were significantly poorer in all areas surveyed except employment.
Clinical Value of Radiologists' Interpretations of Perioperative Radiographs of Orthopedic Patients
Authors: Clark Ron , Anderson Michael B , Johnson Blaine H , Moore David E , Herbert F David 
Published: April 2021

ABSTRACT
The content and accuracy of radiographic interpretations by radiologists was assessed to determine the reports' ability to provide sufficient information necessary to make clinical treatment decisions. A retrospective review was performed of 371 radiographic studies (21 1 consecutive patients) ana their reports which had been generated by three Board-certified radiologists. Data were collected regarding fracture assessment and description as well as the description and assessment of orthopedic implants. These descriptions were categorized by their ability to be used clinically (precise) or not (general). Fracture descriptions were considered complete for 85% of reports, while their assessment of alignment and displacement (necessary to determine fracture care) was complete on only 9%. Orthopedic implants were described precisely on 12% of reports with 7% of the descriptions in error. The effect and position of orthopedic implants were described precisely for only 27% and 25% of cases, respectively, while implant stability was assessed precisely in only 4% of cases. For 61 % of preoperative studies, the radiologist's report was not available until after the surgical procedure had already been performed. For all variables considered, an average of 3% of descriptions contained an error. Radiologists' reports of radiographs of these patients undergoing orthopedic procedures did not contain sufficient descriptive information to be used clinically, were not promptly available, and contained an error for 3% of variables studied. The attending orthopedic surgeon has traditionally interpreted such radiographs and should continue to do so to provide patients with more immediate and complete clinical evaluation and management
The Effects of Bone Resorption Inhibitors on the Growth Plate and Proximal Tibial Metaphysis of Rats: Clinical Implications
Authors: Pazzaglia Ugo E , Andrini Luca , Leutner Monica , Di Nucci Amalia 
Published: April 2021

ABSTRACT
This study investigated the effects of diphosphonates at scalar doses in a high bone turnover structure, namely, the proximal tibial metaphysis of rats. Arrest of bone modeling was represented by cylindrical-shaped metaphyses, increased height of the perichondrial bone bark, and persistence of primary metaphyseal trabeculae; these changes were dose-related. Higher doses of the inhibitors produced extension of the growth plate and arrest of the mineralization process. The dose-related dissociation between the effects on bone resorption and mineralization allows the therapeutic use of this class of drugs.
Bipolar Hemiarthroplasty for Primary Osteoarthritis of the Hip: A Review of 41 Cases With 8 to 10 Years of Follow-Up
Authors: Kindsfater Kirk A , Spitzer Andrew I , Schaffer Jonathan L , Scott Richard D 
Published: April 2021

ABSTRACT
This article reports the results of 41 hips in 36 patients who underwent bipolar hemiarthroplasty for primary osteoarthritis of the hip. Surgical technique included a complete capsulectomy and light reaming of the acetabulum in all patients. The average follow-up was 8.9 years with a minimum of 8 years. Harris hip scores improved from 49 preoperatively to 93 at the latest follow-up, with 95% of the hips rated as excellent or good. Two patients had mild, intermittent groin pain, while a third developed recalcitrant pain necessitating revision. Migration of the bipolar cup was minimal with an average of 2.3 mm superior and 2.1 mm medial migration. Survivorship analysis demonstrated an 89.5% survival rate at 10 years.
Chondrocalcin as a Marker of Articular Cartilage Degeneration in Anterior Cruciate Ligament-Deficient Knees
Authors: Kobayashi Tatsuo , Yoshihara Yasuo , Samura Atsuyoshi , Tanaka Osamu , Shimmei Wasayuki 
Published: April 2021

ABSTRACT
This study assessed articular cartilage deterioration and the effect of meniscal tears to evaluate the usefulness of chondrocalcin as a joint fluid marker in 43 patients with anterior cruciate ligament (ACL) deficiency. A significant correlation was found between the cartilage damage and time after injury. The high incidence of long longitudinal tears of the medial meniscus with increased cartilage damage, especially in chronic cases, suggests that this type of meniscal tear contributed to the deterioration of ACL-deficient knees. Chondrocalcin concentrations were found to have a significant correlation with cartilage damage.
Initial Stability Comparison of Modular Hip Implants in Synthetic Femurs
Authors: Lee Thay Q , Danto Michael I , Kim William C 
Published: April 2021

ABSTRACT
Synthetic femurs were used to assess the initial bone-implant interface stability of three total hip systems: Wright Medical Technology's Infinity smooth trochanteric module (S-TM), Infinity porous-coated trochanteric module (PC-TM), and Johnson and Johnson S-ROM with a porous surface. The hips were implanted into synthetic femurs, rigidly fixed, and subjected to internal rotation and cyclic, axial compressive loads. The results showed that all three implants achieved good initial implant stability and would be expected to permit bone ingrowth. The porous-coated implants showed greater initial implant stability with less axial micromotion compared with the smooth implants. This finding suggests that surface texture plays a role in initial stability of uncemented prostheses if the bone behaves similar to the material used in this study.
Extremity Handgun Injuries in Children and Adolescents
Authors: Stricker Stephen J , Volgas David A 
Published: April 2021

ABSTRACT
The majority of gunshot wounds in the urban pediatric population are inflicted by handguns. This study reviewed the trauma center management of 66 handgun injuries to the upper and lower extremities among 51 children who were aged ≤16 years. As expected, gunshot wounds were more frequent in adolescent males and were usually intentional. About half of the children had police records prior to the gunshot wounds. Fifty-two percent of the extremity handgun injuries resulted in fractures, most commonly to the tibia or forearm. Seventy-nine orthopedic procedures were recorded with an average hospital stay of 4.3 days. Permanent morbidity was undoubtedly underestimated due to poor long-term follow-up.
Treatment of Fibrous Dysplasia Involving the Proximal Femur
Authors: Shih Hsin N , Chen Yeung J , Huang Tsung J , Hsu Kuo Y , Hsu Robert W W 
Published: April 2021

ABSTRACT
Twenty-two patients with fibrous dysplasia in the femoral neck or trochanteric area were treated with curettage and bone grafting with a sliding hip compression screw and plate. Follow-up ranged from 2 to 6 years (average: 4 years). Fourteen patients had monostotic and 8 had polyostotic disease. Four patients had pathologic fractures. Bone grafting included a deep-frozen allogeneic cortical strut and cancellous bone. After implanting the lag screw and cortical strut, the remaining defect space was filled with iliac bone. Postoperatively, all patients had good bone healing and complete incorporation of the implanted graft. There were no recurrences or complications, and functional results were rated as good and excellent.
Contact Stresses With an Unresurfaced Patella in Total Knee Arthroplasty: The Effect of Femoral Component Design
Authors: Matsuda Shuichi , Ishinishi Takashi , Whiteside Leo A 
Published: April 2021

ABSTRACT
Compressive contact stresses between the patella and the anterior femur were measured with a digital electronic sensor before and after total knee arthroplasty (TKA) in 10 cadaver knee specimens. Contact stresses were measured first in normal knees, then after TKA with the Insall-Burstein Total Condylar, Miller Gafante II, Ortholoc II, Porous Coated Anatomic, and Profix knee prostheses implanted without resurfacing the patella.
The Insall-Burstein, Miller-Galante II, and Ortholoc Il prostheses had significantly higher contact stresses than the normal knee throughout the flexion arc. The Porous Coated Anatomic, which has a smooth patellar groove, maintained contact area as in the normal knee and did not have significantly higher contact stresses at flexion angles <90°. At flexion angles 3*105°, patellofemoral contact occurred in two small areas as the patella encountered the intercondylar notch in all components except the Profix. The Profix maintained full contact and low compressive stresses throughout the full flexion arc because of its posteriorly extended patellar groove.
Design features of the patellofemoral portion of TKA components are important factors that affect contact stresses in the patellofemoral joint. These features likely will affect the clinical results of TKA with an unresurfaced patella.
Factors Related to Hip Muscle Weakness Following Fixation of Acetabular Fractures
Authors: Matta Joel M , Olson Steven A 
Published: April 2021

ABSTRACT
Two hundred twenty-five acetabular fractures treated surgically by one surgeon using a single surgical approach were reviewed to identify the incidence of clinically significant hip muscle weakness. Clinical grade of fair or poor and presence of radiographic signs of osteoarthritis were most strongly correlated with hip muscle weakness (P<.0001). Other factors related to muscle weakness were >21 days to repair, abdominal trauma, infection, avascular necrosis, heterotopic ossification resection, chest trauma, and head trauma. The presence of arthritis at follow-up increased the incidence of hip muscle weakness (46% [41 /89]; P<.0001 ) independent of surgical approach.
Cost Effectiveness of Outpatient Anticoagulant Prophylaxis After Total Hip Arthroplasty
Authors: Wade William E , Hawkins David W 
Published: April 2021

ABSTRACT
Guidelines for deep venous thrombosis (DVT) and pulmonary embolism (PE) prophylaxis have been developed for patients undergoing total hip arthroplasty (THA). Studies suggest that risk for developing these complications may exist for as long as 3 months following surgery. Cost-effectiveness analyses were performed on three pharmacoprophylaxis regimens administered over a 30-day period using literaturereported values for incidences of DVT and PE in patients postdischarge following THA. A cost savings of $21,466.89 will occur for each thromboembolic event avoided if low-dose warfarin daily is used routinely compared to enoxaparin 40 mg daily. Additionally, a cost savings of $1 8,61 8.1 0 is experienced if enoxaparin 40 mg daily for 4 days plus low-dose warfarin daily is administered versus enoxaparin 40 mg daily. Clinicians may choose to continue prophylaxis postdischarge with enoxaparin 40 mg daily for 4 days in combination with warfarin for 30 days in these patients until results of more definitive studies become available.
Single-Incision Technique for Internal Fixation of Distal Tibia and Fibula Fractures
Authors: Shantharam Sanagaram S , Naeni Fariborz , Wilson Eric P 
Published: April 2021

ABSTRACT
Open reduction and internal fixation of distal tibia and fibula fractures generally involves two separate incisions: an anteromedial incision to approach the tibia and a lateral incision to approach the fibula. Exposing the distal tibia from the medial side is associated with the risk of wound dehiscence, infection, and discomfort to the patient since the hardware is directly beneath the skin. By using a single incision from the anterolateral side, the fibular fracture can be fixed and the lateral aspect of the distal tibia can be safely approached for internal fixation, thus eliminating the need for two separate incisions.
Prosthesis Cost Containment in Total Joint Replacement: A Physician-Driven Free-Market Approach
Authors: Christo Anthony E , Bargar William L , Morris Edward 
Published: April 2021

ABSTRACT
As an alternative to a limited vendor/volume discount approach, our hospital employed a physician-driven free market strategy aimed at reducing joint implant costs. Surgeons were provided with vendor pricing and peer profile comparisons of implant cost data and asked to select implants providing the best value based on patient need. Vendors were challenged to reduce prices where appropriate. Total savings based on the 19951 997 volume-adjusted cost difference were $1 ,059,1 59, a 1 7.5% decrease. These results demonstrate the possibility of reducing joint implant costs using a strategy that does not limit vendors or cap prices.
Long-Term Mechanical Stability of the Impacted Morselized Graft-Cement Interface in Total Joint Replacement: An Experimental Study in Dogs
Authors: Stamos Konstantinos G , Karachalios Theophilos , Papagelopoulos Panayiotis J , Xenakis Theodore , Korres Demetrios S , Koroneos Emilios , Hartofilakidis George 
Published: April 2021

ABSTRACT
This experimental study compared the long-term (12 months) mechanical stability of the morselized graftcement interface with the conventional bone-cement interface in both femoral bones of 1 0 adult dogs. For mechanical testing, three-point bending and push-out loading tests of composite bone-cement beams were used, while the incorporation of the graft was assessed by serial radiographs. Although the parameters fracture load and interface failure load showed inferior values in the specimens with a morselized graft-cement interface compared to those in specimens with a conventional bone-cement interface, no statistically significant differences were found between groups. Radiographic reconstitution of the lateral femoral cortex was observed in all animals at 3 months while signs of advanced remodeling were apparent at 6 months. These results indicate the long-term mechanical stability of the impacted morselized graft-cement interface is comparable to that of the conventional bone-cement interface created in primary total hip replacements provided the grafted area is protected from early heavy loading.
Risk Factors for Idiopathic Scoliosis: Review of a 6-Year Prospective Study
Authors: Soucacos Panayotis N , Zacharis Konstantinos , Soultanis Konstantinos , Gelalis John , Xenakis Theodore , Beris Alexandros E 
Published: April 2021

ABSTRACT
This study identified factors associated with the prevalence of idiopathic scoliosis and curve evolution in schoolchildren from northwestern and central Greece. A total of 85,627 children aged 9-15 years were screened for scoliosis. A subset of children with curves of at least 1 0° underwent clinical and radiographic follow-up. The total population screened and the cohort followed for curve progression were evaluated according to factors associated with curve evolution.
The prevalence of scoliosis was 1.7%, with most cases appearing at ages 13 and 14 years and small scoliotic curves (10°-19°) being most prevalent (prevalence 1.5%). Prevalence was associated with gender; age; and magnitude, apex, and direction of the curve. Progression of the curve occurred in 1 4.7% of 839 children, while 27.4% demonstrated spontaneous improvement of at least 5°. A high risk of curve progression was associated with the following: sex - girls, curve pattern - right thoracic and double curves in girls and right lumbar in boys, maturity - girls before the onset of menses, age - time of pubertal growth spurt, and curve magnitude - curves 2=30°. Although only a small percentage of scoliotic curves undergo progression, the pattern of the curve according to curve direction and the sex of the child plays a significant role in the ability to identify which curves will progress.
Evaluation of Intermittent Pneumatic Compression Devices
Authors: Whitelaw George P , Oladipo Olarewaju J , Shah Binod P , DeMuth Karen A , Coffman Jay , Segal David 
Published: April 2021

ABSTRACT
Venous blood flow rate in the lower extremity after applying different pneumatic compression devices was evaluated. Five healthy individuals, aged 21-35, were recruited for this study. The ability of six different pneumatic compression devices to increase femoral venous blood flow velocity was analyzed and compared to that of active and passive foot dorsiflexion. Baseline venous blood flow velocity was measured using an ATL Duplex Doppler before leg compression. Venous blood flow velocity was then monitored before, during, and after each compression cycle.
Average peak venous velocity increased >200% on dorsiflexion of the ankle. Among the investigated devices, the increase in venous velocity varied significantly. Design of compression chambers enabling compression on the lateral and medial aspects of the calf produced an increase in venous velocity closest to active foot dorsiflexion. Foot compression devices produced the smallest increase in venous velocity.
The relative effectiveness of pneumatic compression devices, particularly with respect to increasing venous blood flow in the lower extremity, may correlate well with how closely the device simulates the physiologic contraction of the calf muscles. Clinical trials are needed to further compare the effectiveness of these devices, as other less readily measured factors play a role in thromboprophylaxis.