bluuebunny/crossref_metadata_2025_split huggingface dataset:
HIP FUSION IN YOUNG ADULTS
Authors: Barnhardt Todd , Stiel James B 
Published: April 2021

ABSTRACT
Hip arthrodesis remains an option for treatment of severe arthritis in young persons resulting primarily from osteonecrosis, congenital dysplasia, and joint sepsis. The authors reviewed six patients who underwent fusions as young adults (average age: 30.8 years) with an average follow-up period of 11.7 years. Solid arthrodesis without infection was noted in all cases. Patients who worked returned to prior employment without limitation. All patients complained of symptomatic low back pain and felt ambulation was limited by ipsilateral knee pain. Five of six noted impaired sexual function; although childbearing was not affected in one case. Four of six were satisfied with the operation, but only three of six would undergo it again given the alternative of total joint arthroplasty.
COMPARISON OF TENDO-ACHILLES LENGTHENING ALONE AND COMBINED WITH NEURECTOMY OF THE GASTROCNEMIUS MUSCLE IN THE TREATMENT OF EQUINUS DEFORMITY OF THE FOOT ASSOCIATED WITH CLONUS IN CHILDREN WITH CEREBRAL PALSY
Authors: Camacho Francisco J , Isunza Agustin , Coutino Betty 
Published: April 2021

ABSTRACT
In a prospective study of 12 children with spastic cerebral palsy and equinos deformity (21 extremities) complicated by clonus, the results of two surgical techniques were compared. Six children had tendo-Achilles lengthening (TAL) alone and six had TAL combined with neurectomy of the gastrocnemius muscle. The equinus deformity was corrected in all children, but of those with neurectomy clonus subsided in 50%, compared to only 27% in those with TAL alone.
LONG-TERM RESULTS OF FOREFOOT ARTHROPLASTY IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: Patsalis T , Georgousis H , Göpfert S 
Published: April 2021

ABSTRACT
Disabling forefoot deformity of rheumatoid origin frequently requires surgical intervention. Twenty-three patients (36 feet) who underwent excision of the metatarsal heads in our unit between 1980 and 1987 were assessed clinically and radiologically (n=12) and by questionnaire (n=11) at an average 10.5 years (range: 4 to 15) following surgery. Although the procedure was initially successful at the time of review, the result was classified as unsatisfactory because of restriction of walking ability due to pain in the forefoot area in 56% of patients. Recurrence of the deformity-more frequently involving the great toe-had occurred in 72% of patients, and painful callosities were present in 61%. In the patients examined clinically and radiologically, unsatisfactory results were due mainly to mal-alignment of the great toe and extensor tendon tightness. Hindfoot deformity also significantly contributed to pain in the forefoot area. Diminished arthroplasty space, irregular resection cascade, and development of bony spikes were frequently associated with recurrence and callosities. The result of forefoot arthroplasty deteriorates with time. Failure to maintain a plantigrade great toe, intrinsic weakness, and hindfoot deformity were the main factors contributing to an unsatisfactory result.
Hip Fracture in the Elderly: The Effect of Anesthetic Technique
Authors: Koval Kenneth J , Aharonoff Gina B , Rosenberg Andrew D , Schmigelski Carl , Bernstein Ralph L , Zuckerman Joseph D 
Published: April 2021

ABSTRACT
Seven hundred forty-nine community-dwelling, previously ambulatory, elderly patients who sustained a femoral neck or intertrochanteric fracture underwent prospective follow-up to determine whether anesthetic technique (spinal or general) had an effect on inpatient morbidity and mortality, or 1-year mortality. One hundred seven patients were excluded from the study as the anesthetic technique was "predetermined" based on a underlying medical condition. Of the remaining 642 patients, 362 (56.4%) received general and 280 (43.6%) received spinal anesthesia. Twenty (3.1%) patients died during hospitalization; 73 (1 1 .4%) patients developed one or more postoperative medical complications. The T -year mortality rate was 12.1%. There was no difference in inpatient morbidity and mortality, or 1-year mortality rates between patients receiving general or spinal anesthesia.
Tensile Force in Limb Lengthening: Histogenesis or Only Mechanical Elongation
Authors: Matsushita Takashi , Nakamura Kozo , Kurokawa Takahide 
Published: April 2021

ABSTRACT
Although bone response can be evaluated by radiography, there have been no reports in human confirming formation of new soft tissue in limb lengthening. This study evaluated the tensile force between pin clamps in 14 lower limb lengthenings. Legs were lengthened 0.5 mm every 1 2 hours and the tensile was measured continuously. The tensile force increased simultaneously with each lengthening and decreased gradually. However, the reduction rate of tensile force during the nighttime (120±22%) was significantly higher than that during the daytime (72±10%). This differed from the stress relaxation phenomenon shown by viscoelastic material and suggested the presence of other phenomena such as histogenesis.
Migration of the Uncemented CLS Femoral Component
Authors: Davies M S , Parker B C , Ward D A , Hua J , Walker P S 
Published: April 2021

ABSTRACT
The migration of uncemented CLS (Cementless Total Hip Replacement System) femoral stems was measured retrospectively from standard anteroposterior pelvic radiographs using a digitizer and software specifically designed for this study. The study population was comprised of 117 patients with 126 uncemented CLS femoral stems. All radiographs were reviewed and the incidence of thigh pain obtained by means of a questionnaire. The mean clinical follow-up was 3 years and the mean follow-up for radiographic review was 2.77 years.
The mean femoral stem migration was 2 mm at 2 years and 3.66 mm at 7 years. Radiographic features varied little with no specific predictive features in patients with excessive early migration or those who complained of thigh pain. There was no statistical relationship between the presence of thigh pain and femoral stem migration.
The Microvascular Anatomy of the Physis as Revealed by Osteomedullography and Correlated Histology
Authors: Oni Olusola O A 
Published: April 2021

ABSTRACT
The microvascular anatomy of the physis has been demonstrated by perfusing the epiphysis with an aqueous suspension of barium sulfate. Plain radiographs taken immediately after perfusion reveal escape of dye into the metaphysis and into the system veins. Mieroradiographs reveal a labyrinthine network of channels on either side of the physis. The density of these channels is much greater than the density of vessels observed in histologic sections.
Magnetic Resonance Imaging Evaluation of Thecal Sac Diameters Following Laminectomy in the Lumbar Spine
Authors: Ebraheim Nabil A , Farooq Amjad , Xu Rongming 
Published: April 2021

ABSTRACT
Sagittal magnetic resonance images (MRIs) from 20 patients who had postoperative persistent or recurrent low back pain were reviewed to study the thecal sac diameter at laminectomy sites. The thecal sac anteroposterior diameter was measured in three sites: the maximum AP diameter at the laminectomy site, and the proximal and distal levels to the laminectomy site. A comparison between the thecal sac AP diameter at laminectomy sites and the average diameter of both the proximal and distal levels was then made.
Based on the measurements, the diameters of the thecal sac were divided into three groups. Patients in group A (5 cases) had a constriction (the thecal sac AP diameter at the laminectomy site was less than the average diameter of both the proximal and distal levels) of the thecal sac at the laminectomy site. Patients in group B (12 cases) had an expansion (the thecal sac AP diameter at the laminectomy site was more than the average diameter of both the proximal and distal levels) of the thecal sac. Patients in group C (3 cases) demonstrated no change. This study suggests that there was no correlation between the thecal sac AP diameter at laminectomy site and postoperative low back pain.
High Tibial Osteotomy Without Internal Fixation for Medial Unicompartmental Osteoarthrosis
Authors: Khan Muhammad Tahir , Matthews J G 
Published: April 2021

ABSTRACT
Between 1982 and 1993, a total of 35 patients underwent high tibial osteotomy for medial unicompartmental osteoarthrosis. The osteotomy was performed high in the tibia without the use of jigs, and internal fixation devices were avoided. Patients were assessed using the British Association for Surgery of the Knee score, and satisfactory results with minimal complications were obtained. Our results indicate that in a select group of patients, high tibial osteotomy preserves bone stock and is performed near the deformity so that excellent correction is achieved and recurrence of varus deformity is avoided.
Monitoring of Somatosensory and Motor Evoked Potentials During Open Reduction and Internal Fixation of Pelvis and Acetabular Fractures
Authors: Arrington Edward D , Hochschild David P , Steinagle Timothy J , Mongan Paul D , Martin Steven L 
Published: April 2021

ABSTRACT
Monitoring of motor and somatosensory evoked potentials provides instantaneous intraoperative assessment of a patient's neurologic status. Monitoring of the sciatic nerve through motor and somatosensory evoked potentials can be used during open reduction and internal fixation of pelvic and acetabular fractures. A review of 12 pelvic and acetabular fractures treated with open reduction and internal fixation was conducted and assessed with a combination of intraoperative motor and somatosensory evoked potential monitoring.
Results revealed intraoperative motor evoked potential monitoring was 1 00% sensitive and 1 00% specific in predicting postoperative sciatic nerve deficits, whereas somatosensory evoked potentials were not accurate in predicting postoperative sciatic nerve deficits. Combined monitoring of the sciatic nerve with motor and somatosensory evoked potentials is beneficial at predicting postoperative sciatic nerve deficits during open reduction and internal fixation of pelvic and acetabular fractures.
Effect of Intermittent Administration of Parathyroid Hormone on Fracture Healing in Ovariectomized Rats
Authors: Jahng Jun Seop , Kim Hyun Woo 
Published: April 2021

ABSTRACT
The effects of intermittent administration of parathyroid hormone on fracture healing in ovariectomized rats were examined to evaluate its potential use as a therapeutic agent for osteoporotic fractures. Three months postovariectomy, bilateral tibial shaft fractures were induced and stabilized by intramedullary nailing with Kirschner wires. Saline, 1 7ß-estradiol (Sigma Chemical Corp, St Louis, Mo), or recombinant human parathyroid hormone (1-84) (Korean Green-Cross Pharm Corp, Seoul, Korea) was given once a day for 30 consecutive days during fracture healing. Fracture healing was assessed by morphometric and mechanical analysis of fracture callus. Intermittent parathyroid hormone administration increased the morphometric and mechanical parameters in a dose-dependent manner. A bone-resorption inhibiting agent, 1 7β-estradiol did not offer advantage in terms of fracture healing in ovariectomized rats. Findings suggest intermittent parathyroid hormone administration may benefit osteoporosis and fracture.
Endoscopic Harvesting of the Sural Nerve Graft: A Cadaveric Investigation
Authors: Oliveira M T , Marttos A C C , Fallopa F 
Published: April 2021

ABSTRACT
This study investigated an endoscopic technique of harvesting the sural nerve graft. Using endoscopic instrumentation, the sural nerve was harvested from six cadaveric legs. A 2-cm longitudinal incision was made immediately posterior to the lateral malleolus, and a 5mm endoscope was introduced. The path of the nerve was followed to the popliteal space, and nerve dissection was performed from proximal to distal. Air inflation of a balloon was used to enlarge the endoscopic cavity. The cavity created around the nerve was insufflated with carbon dioxide gas, allowing complete nerve isolation. Using a 0.5-cm transverse incision, the nerve was cut and removed. This endoscopic sural nerve grafting approach offers potential advantages such as less injury to soft tissues, decreased pain, nerve integrity preservation, and good aesthetic results.
Comparison of Migration in Modular Sockets With Ceramic and Polyethylene Inlays
Authors: Böhler M , Schachinger W , Wölfl G , Krismer M , Mayr G , Salzer M 
Published: April 2021

ABSTRACT
This study compared migration in 73 cementless total hip arthroplasties (THAs) with either alumina ceramic (n=23) or polyethylene (n=50) inlays; prosthesis sockets and stems were identical except for the inlays. After 7 years of follow-up, 5 sockets (4 with ceramic and 1 with polyethylene inlays) had been revised an average of 63.3 months (range: 49-81 months) after implantation, and survival analysis showed a significantly higher revision rate for sockets with ceramic inlays (89±6%) versus polyethylene inlays (98.2±1.7%) (P=.032). Migration analysis of the first three postoperative years revealed significantly higher vertical migration in sockets with ceramic inlays (P=.047), in patients aged <60 years (P=.02), and in osteoporotic type C bone (A versus C, P=.0071 and B versus C, P=.0004).
The Pain and Function of the Hip (PFH) Scale: Patient-Based Instrument for Measuring Outcome After Total Hip Replacement
Authors: Alonso Jordi , Lamarca Rosa , Martí-Valls Josep 
Published: April 2021

ABSTRACT
The Pain and Function of the Hip (PFH) scale was developed following the recommendations of the Société International de Chirurgie Orthopédique et Traumatologie to assess the outcomes of total hip replacement (THR). This study evaluated metric properties of the PFH scale and its ability to measure clinical change (responsiveness) in consecutive patients undergoing THR. Patients were evaluated preoperatively and at 3 and at 12 months postoperatively. The PFH scale and the Nottingham Health Profile (NHP) were administered.
Complete data were collected for 79 patients. Mean overall preoperative PFH score was 26.5 and mean overall PFH score 1 2 months postoperatively was 69.8 (P<.01). Correlation with the NHP was high (r=-0.64), and the magnitude of improvement (effect size) as assessed by the PFH scale was large (3.6 compared with 1 .7 for the NHP). The PFH scale is simple and valid, and may complement routine clinical evaluation of hip replacement. Residual pain after hip replacement may have been previously underestimated.
The Effects of Severe Femoral Bone Loss on the Flexion Extension Joint Space in Revision Total Knee Arthroplasty: A Cadaveric Analysis and Clinical Consequences
Authors: Krackow Kenneth A , Mihalko William M 
Published: April 2021

ABSTRACT
Five revision total knee arthroplasties (TKAs) involving severe femoral bone loss were performed in 1 994. Each had sufficiently severe femoral bone loss in which collateral ligament origins and posterior capsular attachments were violated. A paradoxical phenomenon was observed in each case. Unlike primary TKAs, in which larger distal femoral bone resection leads to laxity of the knee joint in extension, these cases with severe distal femora! bone loss, after initial component selection, developed the opposite situation, a flexion contracture. It was hypothesized that femoral bone loss involving collateral ligament origins would permit distraction of the tibia below the femur with the knee held in flexion, but when the knee was brought to full extension, intact posterior structures would maintain a normal tibia! position.
To investigate this hypothesis, six fresh-frozen cadaveric lower limbs were tested in full extension and 45° and 90° of flexion after release of the femoral attachments of the collateral ligaments and the posterior capsule from the femur. Joint space changes were measured via a motion tracking device. Results showed that with loss of collateral attachments, 17.2±8.9 mm of joint space is created in 90° of flexion, whereas the joint space in full extension is conserved (1.5±1.7 mm). With additional loss of the posterior capsule, the joint space at 90° of flexion increased to 26.2±6.1 mm, with minimal changes in the extension gap (3.4±0.8 mm). Distal femoral bone loss was associated with an increase in the flexion gap compared to the extension gap.
Long-Term Results After Operative Treatment of Femoral Neck Fractures With Ceramic Head Prostheses
Authors: Degreif J , Müller L P , Runkel M , Blum J , Willmann G 
Published: April 2021

ABSTRACT
From 1 985-1 990, a total of 277 elderly patients underwent hemiarthroplasty using a ceramic head prosthesis. Average patient age was 81.7 years. Of these, 77 patients were available for follow-up examination in 1993. A standardized score was calculated assessing activity, gait, and hip pain; the average score was 58 out of 78 possible points. Three patients had hip pain, and in 4 patients, radiographic examination revealed protrusio acetabuli. Two of 4 patients underwent revision surgery for replacement of the cup, leaving the stem in situ.
Because of the small number of prosthetic-related complications, hemiarthroplasty using a ceramic head prosthesis is the recommended surgical treatment for femoral neck fractures in elderly patients. In the rare patient with protrusio acetabuli, revision surgery can be performed to replace the cup, leaving the stem in situ.
Comparison of Metal Versus Absorbable Implants in Tension-Band Wiring: A Preliminary Study
Authors: Morgan William J , Slowman Lisa A Schulz , Wotton Harold M , Nairus James 
Published: April 2021

ABSTRACT
The strength of tension-band wiring using bioabsorbable materials versus metal implants was assessed with a rabbit knee fusion model. Ten rabbit knees were osteotomized and rigidly fixed using a tension-band technique: five with metal implants (2 pins and 24-gauge wire) and five with absorbable implants (2-mm pins [Bionx, Blue Bell, Pa] and 1 Maxon [Davis and Geck, Danbury, Conn]). Biomechanical testing of the fixation strength was completed using a servohydraulic mechanical testing machine and a specifically designed four-point bending jig. The parameters assessed were maximal load, relative stiffness, displacement, and bending moment of the constructs. Results of the biomechanical testing showed no statistical difference between the constructs on any of the parameters assessed.
Sacroiliac Joint Dysfunction: A Long-Term Follow-Up Study
Authors: Sasso Rick C , Ahmad Rick I , Butler James E , Reimers Deborah L 
Published: April 2021

ABSTRACT
Sixty-nine patients with sacroiliac joint dysfunction were prospectively evaluated and treated with a structured physical therapy program. Follow-up clinical outcome was obtained from a patient questionnaire administered by an independent reviewer a minimum of 2 years after treatment. Average patient age was 40 years, and 80% were women. Ninety-five percent rated their result as good or excellent, while 5% believed their outcome was fair or poor.
A structured physical therapy program can produce good long-term results in most patients; however, 5% continue to be symptomatic. This small subset may be candidates for more invasive evaluation.
Exchange Nailing for Failure of Initially Rodded Tibial Shaft Fractures
Authors: Mercado Edwin M , Lim Edward V A , Stern Peter J , Aquino Neal J 
Published: April 2021

ABSTRACT
This retrospective study evaluated 32 patients who underwent exchange nailing for initially rodded nonunited tibial shaft fractures during a 5-year period. High-energy trauma accounted for 22 fractures; 19 fractures were open. An unreamed nail was initially used to stabilize all but 2 fractures. Implant failure occurred in 31% of fractures, mostly in distal-third fractures, with a failure rate of 34%. Average time from injury to exchange nailing was 36 weeks (range: 6-148 weeks) and consisted of closed reamed nailing and fibulectomy in 27 cases.
Healing occurred an average of 20 weeks (range: 6-47 weeks) after postexchange nailing in 27 (84%) fractures. Four (12.5%) fractures healed after additional procedures. There was 1 persistent nonunion. Factors leading to delay in union time included comminution, healed fibula, and proximal location. Multiple regression analysis using survival data at P<.05 showed a significant correlation between fracture configuration and fixation method (locked, dynamic, and unlocked) on time to union.
Exchange nailing with closed reaming and fibulectomy is a viable option for treating failures of primarily nailed tibial fractures. Increased stability and stimulation of arrested bone healing may account for the good outcome. The advantages of repeat reamed nailings should be weighed against the possible adverse effect of reaming on bone vascularity.
The Economic Impact of Medical Complications in Geriatric Patients With Hip Fracture
Authors: Khasraghi Fardin A , Lee Eu Jin , Christmas Colleen , Wenz James F 
Published: April 2021

Abstract
The records of 510 elderly patients with hip fractures admitted to our institution between January 1995 and December 2000 were retrospectively reviewed to determine the incidence and type of developed medical complications and their economic implications. Of those 510 patients, 217 (43%) developed at least 1 medical complication, most frequently electrolyte imbalance (11%), urinary tract infection (10%), respiratory failure (10%), and delirium (9%). Patients who developed medical complications had significantly longer mean hospital stays (10 days) and higher mean hospital costs ($16,203) than patients without such complications (5 days and $10,284, respectively) (P<.001).
Thromboprophylaxis and Neuraxial Anesthesia
Authors: Horlocker Terese T 
Published: April 2021

Abstract
Spinal hematoma is a rare and potentially catastrophic complication of spinal or epidural anesthesia. Risk factors include traumatic needle/catheter placement, sustained anticoagulation in an indwelling neuraxial catheter, and catheter removal during therapeutic levels of anticoagulation. Generally, a patient's coagulation status should be optimized at the time of spinal or epidural needle/catheter placement, and the level of anticoagulation should be monitored during epidural catheterization. Signs of cord compression, such as severe back pain, progression of numbness or weakness, and bowel and bladder dysfunction, warrant immediate radiographie evaluation. A delay in diagnosis and intervention of spinal hematoma may lead to irreversible cord ischemia.
The Effect of Bone Graft Extenders to Enhance the Performance of Iliac Crest Bone Grafts in Instrumented Lumbar Spine Fusion
Authors: Girardi Federico P , Cammisa Frank P 
Published: April 2021

Abstract
Allograft bone extenders are commonly used in spinal surgery to increase the available graft volume, thereby promoting and achieving a solid fusion mass. We report a single surgeon's use and early results of autologous bone graft and allograft demineralized bone matrix in 65 patients undergoing lumbar spinal fusion. Of the patients included in this study, 59 (91%) patients underwent surgical intervention for lumbar spinal stenosis, three (5%) patients had lumbar spondylolisthesis, two (3%) patients had stenosis, and one (1%) patient had bilateral spondylolysis. Forty-three (64%) women and 22 (36%) men were included in the study. The average patient age was 56 years (20-85 years, SD=±16). Independent radiographic evaluation was performed. Each subsequent radiographic follow-up revealed increased improvement in average Lenke score and was statistically significant between the early (1 month) and recent (12 month) follow-ups. There were statistically significant changes in Lenke score between 1 month and 3 months follow-up (P<.01), between 3 months and 6 months follow-up (P<.001), and between 6 months and 12 months follow-up (P<.01). The gradual and constant increment of improvement in radiographic measurements in this preliminary series may indicate a positive effect of the use of bone graft extenders that may decrease the required amount of autologous bone graft. Bone graft extenders also may minimize the risks and complications associated with the harvesting procedure.