bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Surgical Repair or Reconstruction of the Cruciate Ligaments versus Nonsurgical Treatment in Patients with Traumatic Knee Dislocations
Authors: Richter Martinus , Bosch Ulrich , Wippermann Burkhard , Hofmann Axel , Krettek Christian 
Published: July 2017

Background: Studies of traumatic knee dislocations have failed to provide a consensus regarding the best method of treatment. Purpose: Our purpose was to evaluate the results after surgical repair or reconstruction versus nonsurgical treatment and to compare the influence of prognostic factors. Study Design: Retrospective study. Methods: Eighty-nine patients were treated for traumatic knee dislocation. Surgical repair or reconstruction of the cruciate ligaments was performed in 63 patients (repair, 49; reconstruction, 14). In 26 patients, nonsurgical treatment was undertaken. Results: At an average follow-up of 8.2 years, the mean Lysholm and Tegner scores were 75 and 3.7, respectively. The outcome in the surgical group was better than in the nonsurgical group. The scores were higher in patients who were 40 years of age or younger, who had sports injuries rather than motor vehicle accident injuries, and who had undergone functional rehabilitation rather than immobilization. Conclusions: Surgical repair or reconstruction of the cruciate ligaments was superior to nonsurgical treatment. Functional rehabilitation was the most important positive prognostic factor. Surgical repair or reconstruction of the cruciate ligaments is mandatory to achieve sufficient stability for functional rehabilitation. In cases of cruciate ligament avulsion, repair with transosseous fixation is a reasonable alternative to reconstruction, provided that it is performed within 2 weeks of trauma.
Revisiting the Open Bankart Experience
Authors: Magnusson Lennart , Kartus Jüri , Ejerhed Lars , Hultenheim Ingrid , Sernert Ninni , Karlsson Jon 
Published: July 2017

Background The open Bankart technique for posttraumatic recurrent anterior instability has become the procedure of choice for patients who do not respond to nonoperative treatment. Hypothesis The open Bankart procedure renders stable and well-functioning shoulders in the long term in a large proportion of patients. Study Design Retrospective follow-up study with independent reexaminers. Methods Fifty-four patients (54 shoulders) with symptomatic, posttraumatic, recurrent anterior shoulder instability underwent an open Bankart reconstruction procedure with suture anchors. All of the patients had a Bankart lesion. Forty-seven patients (87%) were reexamined by independent observers at a mean follow-up period of 69 months (range, 48 to 114). Results The recurrence rate, including both dislocations and subluxations, was 17% (8 of 47). The median Rowe score was 90 points (range, 24 to 100) at the follow-up, and the median Constant score was 88.5 points (range, 41 to 100). External rotation in abduction was a median of 90° (range, 25° to 125°) in the involved shoulders, as compared with 97.5° (80° to 125°) in the noninjured shoulders (P < 0.0001). Conclusions We conclude that, in the long term, the open Bankart procedure resulted in an unexpectedly high number of patients with failure in terms of stability. These results emphasize the importance of performing long-term follow-up studies after surgical reconstruction for unidirectional, posttraumatic, anterior shoulder instability using any type of technique.
Anterior Cruciate Ligament Rupture after Thermal Treatment in a Canine Model
Authors: Lopez Mandi J. , Markel Mark D. 
Published: July 2017

Background: The use of radiofrequency energy to treat damaged anterior cruciate ligaments is gaining popularity. However, complete rupture of the ligament after treatment has been reported. Purpose: To evaluate the effect of thermal energy applied arthroscopically to normal, intact anterior cruciate ligaments in mature dogs. Study Design: Controlled laboratory study. Methods: Monopolar radiofrequency energy was applied to the normal anterior cruciate ligament of 1 knee in 18 dogs. The contralateral anterior cruciate ligament (also normal) was sham treated. Force-plate gait analysis was performed preoperatively and at 4, 8, 12, 16, 26, and 36 weeks after surgery. Anterior cruciate ligament rupture was detected by a sudden onset of nonweightbearing and a positive drawer sign. Results: All treated ligaments ruptured approximately 55 days after surgery (mean, 55 days; standard error, 1.6). Conclusions: Although monopolar radiofrequency energy may have some potential in the treatment of lax anterior cruciate ligaments, in the application described here the result was a highly predictable deterioration and rupture of all treated anterior cruciate ligaments. Clinical Relevance: On the basis of these findings, we strongly recommend that strict selection and application criteria be used when considering use of this modality on anterior cruciate ligaments that are stretched or partially disrupted, or both. Use of this modality should be followed by adherence to a highly conservative rehabilitation protocol.
Multistranded Hamstring Tendon Graft Fixation with a Central Four-Quadrant or a Standard Tibial Interference Screw for Anterior Cruciate Ligament Reconstruction
Authors: Starch David W. , Alexander Jerry W. , Noble Philip C. , Reddy Suraj , Lintner David M. 
Published: July 2017

Background Tibial fixation of hamstring tendon grafts has been the weak link in anterior cruciate ligament reconstruction. Hypothesis Use of a central four-quadrant sleeve and screw provides superior fixation when compared with standard interference screw fixation. Study Design Controlled laboratory study. Methods In eight pairs of cadaveric knees each anterior cruciate ligament was reconstructed using either an interference screw or a central sleeve and screw on the tibial side. The specimens were then subjected to cyclic loading followed by a load-to-failure test. Results The load required to cause 1 and 2 mm of graft laxity, defined as the separation of the femur and the tibia at the points of graft fixation, was significantly greater with the sleeve and screw than with the interference screw (at 2 mm: sleeve and screw, 216.1 ± 30.1 N; interference screw, 167.0 ± 33.2 N). The force at initial slippage for each of the graft strands was significantly higher with use of the central sleeve and screw. Conclusions The four-quadrant sleeve and screw device may provide greater surface area for healing of hamstring tendon grafts and allow equal tensioning of graft strands before fixation. These factors are associated with increased strength of fixation and reduced laxity of the graft after cyclic loading. Clinical Relevance Use of the central four-quadrant sleeve and screw system offers increased strength of fixation in anterior cruciate ligament reconstruction with hamstring tendon graft.
Compaction Drilling Does Not Increase the Initial Fixation Strength of the Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction in a Cadaver Model
Authors: Nurmi Janne T. , Kannus Pekka , Sievänen Harri , Järvinen Markku , Järvinen Teppo L. N. 
Published: July 2017

Background Compaction of the bone tunnel walls has been proposed to increase the fixation strength of soft tissue grafts fixed with an interference screw in anterior cruciate ligament reconstructions. Hypothesis Compaction drilling does not increase the initial fixation strength of the hamstring tendon graft in comparison with conventional extraction drilling. Study Design Randomized experimental study. Methods Initial fixation strength of quadrupled hamstring tendon grafts fixed with bioabsorbable interference screws was assessed in 22 pairs of human cadaveric tibiae. Bone tunnels were drilled with either a compaction drill or a conventional extraction drill. Specimens underwent a cyclic-loading test and the surviving specimens were then loaded to failure in a single-cycle load-to-failure test. Trabecular bone mineral density at the site corresponding to the actual site of the tibial bone tunnel was determined by using peripheral quantitative computed tomography. Results During the cyclic-loading test, no significant stiffness or displacement differences were observed between the two drilling techniques. Three specimens failed in the compaction-drilling group, whereas there were no failures in the extraction-drilling group. In the subsequent single-cycle load-to-failure test, no significant differences between the two drilling techniques were found with regard to displacement at yield load, stiffness, or mode of failure. There was no significant difference in trabecular bone mineral density between the two groups. Conclusions Compaction drilling does not increase the initial fixation strength of the hamstring tendon graft compared with conventional extraction drilling.
Injuries in a Modern Dance Company
Authors: Bronner Shaw , Ojofeitimi Sheyi , Rose Donald 
Published: July 2017

Background Professional dancers experience high rates of musculoskeletal injuries. Objective To analyze the effect of comprehensive management (case management and intervention) on injury incidence, time loss, and patterns of musculoskeletal injury in a modern dance organization. Study Design Retrospective/prospective cohort study. Methods Injury data were analyzed over a 5-year period, 2 years without intervention and 3 years with intervention, in a modern dance organization (42 dancers). The number of workers’ compensation cases and number of dance days missed because of injury were compared across a 5-year period in a factorial design. Results Comprehensive management significantly reduced the annual number of new workers’ compensation cases from a high of 81% to a low of 17% and decreased the number of days lost from work by 60%. The majority of new injuries occurred in younger dancers before the implementation of this program. Most injuries involved overuse of the lower extremity, similar to patterns reported in ballet companies. Benefits of comprehensive management included early and effective management of overuse problems before they became serious injuries and triage to prevent overutilization of medical services. Conclusions This comprehensive management program effectively decreased the incidence of new cases and lost time. Both dancers and management strongly support its continuance.
Rates and Risks of Injury during Intercollegiate Basketball
Authors: Meeuwisse Willem H. , Sellmer Rory , Hagel Brent E. 
Published: July 2017

Background Previous studies of basketball injury have not been able to assess injury incidence and risk. Purpose To determine rates and risks of injury in Canadian intercollegiate basketball. Study Design Prospective cohort study. Methods Standardized data were collected with a validated instrument from 98.1% of the 318 athletes on the eight men's basketball teams in the Canada West Division of the Canadian Intercollegiate Athletic Union. Results A total of 142 athletes sustained 215 injuries (44.7% of players injured) over the 2-year study period. The greatest number of injuries resulting in more than seven sessions of time loss involved the knee, whereas the most common injuries causing fewer than seven sessions of time loss involved the ankle. The most common mechanism of injury was contact with another player, especially in the “key.” Injuries occurred 3.7 times more often in games than during practice. Centers had the highest rate of injury, followed by guards, and then forwards. The relative risk of reinjury was significantly increased by previous injuries to the elbow, shoulder, knee, hand, lower spine or pelvis, and by concussions. Conclusions Risk factors for injury were previous injury, games as opposed to practice, player position, player contact, and court location.
Performance Characteristics of Volleyball Players with Patellar Tendinopathy
Authors: Lian Øystein , Refsnes Per-Egil , Engebretsen Lars , Bahr Roald 
Published: July 2017

Background Patellar tendinopathy is assumed to result from chronic tendon overload. There may be a relationship between tendon pain and jumping ability. Hypothesis There is no difference in performance characteristics between volleyball players with patellar tendinopathy and those without. Study Design Prospective cohort study. Method We examined the performance of the leg extensor apparatus in high-level male volleyball players with patellar tendinopathy (N = 24) compared with a control group (N = 23) without knee symptoms. The testing program consisted of different jump tests with and without added load, and a composite jump score was calculated to reflect overall performance. Results The groups were similar in age, height, and playing experience, but the patellar tendinopathy group did more specific strength training and had greater body weight. They scored significantly higher than the control group on the composite jump score (50.3 versus 39.2), and significant differences were also observed for work done in the drop-jump and average force and power in the standing jumps with half- and full-body weight loads. Conclusions Greater body weight, more weight training, and better jumping performance may increase susceptibility to patellar tendinopathy in volleyball players.
Concussion in Sports
Authors: Wojtys Edward M. , Hovda David , Landry Greg , Boland Arthur , Lovell Mark , McCrea Michael , Minkoff Jeffrey 
Published: July 2017

This is a special report of the findings of the Concussion Workshop, sponsored by the AOSSM in Chicago in December 1997. Here follows a listing of the members of the workshop: Julian Bailes, MD, American Association of Neurological Surgeons; Arthur Boland, MD, AOSSM; Charles Burke III, MD, National Hockey League; Robert Cantu, MD, American College of Sports Medicine; Letha “Etty” Griffin, MD, National Collegiate Athletic Association; David Hovda, PhD, Neuroscientist, UCLA School of Medicine; Mary Lloyd Ireland, MD, American Academy of Orthopaedic Surgeons; James Kelly, MD, American Academy of Neurology; Greg Landry, MD, American Academy of Pediatrics; Mark Lovell, PhD, Neuropsychology Specialist, Henry Ford Health Systems; James Mathews, MD, American College of Emergency Physicians; Michael McCrea, PhD, Neuropsychology Specialist, Waukesha Memorial Hospital; Douglas McKeag, MD, American Medical Society for Sports Medicine; Dennis Miller, ATC, National Athletic Trainers Association; Jeffrey Minkoff, MD, AOSSM; Stephen Papadopoulus, MD, Congress of Neurological Surgeons; Elliott Pellman, MD, National Football League; Richard Quincy, MS, PT, ATC, Sports Physical Therapy, El Pomar Sports Center; Herbert Ross, DO, American Osteopathic Academy of Sports Medicine; Bryan Smith, MD, National Collegiate Athletic Association; and Edward Wojtys, MD, Workshop Chairman, AOSSM. The views in this report do not necessarily represent the views of the entire group comprising the Concussion Workshop Group.
Alternatives to Acute Hospital Psychiatric Care in East-End Montreal
Authors: Lesage Alain D , Bonsack Charles , Clerc Do ris , Vanier Claude , Charron Maryse , Sasseville Marc , Luyet André , Gélinas Dan iel 
Published: July 2017

Objective: As pres sure mounts to re duce the number of costly acute care beds, gov ernments and the lit era ture pro pose top- down ra tios. Is this rea son able and fair to the re spon s ible medi cal of fi cers who, as the key care pro vid ers, will need to ad mit pa tients and de velo p dis charge plans in a reduced- beds en vi ron ment? Method: Treat ing phy si cians of all acute care in pa tients on a given day ( n = 212) and all new acute care ad mis sions over a 2- week pe riod ( n = 125) com pleted an adapted ver sion of the Not ting ham Acute Beds Use Sur vey (NABUS) Ques tion naire. Results: On a given day, only 62 of 212 in pa tients were un suited for any al ter na tive to acute care hos pi tali za tion. A floor ra tio of 18 acute care beds per 100 000 in habi tants seems ade quate for the catch ment area in ques tion, pro vided that al ter na tives to hos pi tali z ation are fully and ef fi ciently avail able. Al ter na tives es sen tially in volve an ar ray of the follow ing: su per vised resi den tial set tings, day hos pi tals, and in ten sive home care (2 to 6 hours weekly). The ra tio of in ten sive home care work ers re quired would be 25 per 100 000 in habi tants.
Breast Implants in Cosmetic Surgery: Use of Redon Postsurgery Draining
Authors: Benhamou Franck , Amri Mahrez , Picovski David , Ohana Sydney 
Published: July 2017

Introduction: This study concerns 200 female patients who received 400 breast implants over a period of 12 months between June 2006 and June 2007. In the first group, the surgeon put in some preventive bilateral regular postsurgery Redon drains; the second group did not receive any Redon drains. This study compares the occurrence of postsurgery side effects in both patient groups, particularly the risk of hematoma, infection, and lymphorrhea. Materials and Methods: Only patients receiving regular bilateral implants were included in this study. In the first 6 months, we used a Redon draining system, while in the next 6 months, nothing was used. Usual, routine postsurgery surveillance was done on both groups. Results: There were no significant differences in the occurrence of postsurgery hematoma, infection, or lymphorrhea in either group. Conclusion: Insertion of a postsurgery draining system to prevent hematoma should not be a routine procedure. However, concerning the use of implants inserted through axillary incision without endoscope, the benefits of a preventive draining system should be subject to further discussions. A complementary study in the midterm on the occurrence of capsular contracture also looks necessary.
Cosmetic Otoplasty
Authors: Niamtu Joe 
Published: July 2017

Introduction: Protruding ears are a common occurrence and can affect the aesthetics and psychosocial aspects of patients. Hundreds of procedures have been described over the years, but many do not adequately address the specific problem and can prove unstable. Materials and Methods: The author presents a literature review and discusses the demographics, anatomy, and diagnoses related to common protruding ear deformities and describes 2 surgical procedures that have been used to treat more than 100 cases of protruding ears over a 10-year period. Results: The Davis procedure for conchal bowl excess and the Mustardé procedure for reconstructing the antihelical fold, which are most often performed in conjunction, have been used to successfully treat protruding ears. Conclusions: Although numerous procedures exist for the treatment of protruding ears, some do not adequately address the actual anatomic problem at hand. Some surgeons advocate procedures designed to create an antihelix to treat cartilage excess, which can prove unstable. The Davis and Mustardé procedures address the actual anatomic problems and have proven predictable, safe, effective, and stable in the author's cosmetic facial surgery practice.
On Giving Substance to Collective Self-Reliance
Authors: Singh Tarlok 
Published: July 2017

The central inspirations of non-alignment were political in nature. Nonaligned countries had sought to be independent of the great powers and of their military alliances and blocs. The concept of peaceful co-existence was designed to leave them free to pursue their own economic and social development. For many years, non-aligned countries thought of development primarily in national terms. Each country, acting alone, found itself in a condition of growing dependence on the richer countries. Therefore, it was natural that after the oil crisis of 1973 and the Declaration of the United Nations on the New International Economic Order, collective self-reliance should begin to be seen as the key element in the economic content of non-alignment. While non-aligned countries have continued to stress the dominance of politics above economics, they have increasingly acknowledged that their political goals will only be achieved to the extent economic aims are realized equally by individual countries, by groups of countries, and by all of them together. In this process, the distinction between the economic objectives of non-aligned countries and of “developing countries” in general has virtually disappeared and resolutions of the non-aligned countries have stressed their own role, not separately, but together with “other developing countries.” In considering ways of achieving greater collective self-reliance, therefore, the two combinations, described respectively as the Non-aligned Movement and the Group of 77, can be viewed as one, representing the deeply felt need of all less developed countries both for a more equitable international system and for greater economic and technical co-operation amongst themselves.
The Effect of In-Line Final Filtration on Occurrence of Phlebitis
Authors: Swift Robert G. , Searcy Donald M. , Pickard Ann S. 
Published: July 2017

Fifty post-operative urology patients were monitored to determine the effects of in-line final filtration on the occurrence of phlebitis and on changes in body temperature, pulse rate and diastolic blood pressure. In this study, modeled after a study done by Ryan, et al., at the University of Kentucky, no statistically significant difference was found between the patients utilizing final filters and those not utilizing final filters. Our findings were quite different from those of Ryan's, who found a very significant reduction in the incidence of phlebitis by utilizing in-line final filtration of intravenous fluids but similar to a study done by Collin, et al. Our results led to the conclusion that providing a “clean” intravenous solution to the patient by using final filtration is only a portion of the hospital's responsibility; the other part of our responsibility lies in assuring a proper, aseptic external environment for the administration of the solution. Both of these areas are essential in providing intravenous fluid therapy.
Assessment of the Palatability of Antistaphylococcal Antibiotics in Pediatric Volunteers
Authors: Matsui Doreen , Barron Alex , Rieder Michael J , Mena Rafaela , Mallet Louise 
Published: July 2017

Objective To evaluate the palatability of four commonly prescribed antistaphylococcal antibiotics, cloxacillin, cephalexin, erythromycin, and fusidic acid, in volunteer children. Design A single-blind taste test of four flavored antibiotic suspensions commonly used in the treatment of skin infections in pediatric patients. Setting University teaching hospital. Participants Twenty healthy volunteer children with a mean age of 9.2 ± 2.0 SD years (range 6–12). Main Outcome Measures The taste of each antibiotic was rated by the children on a 10-cm visual analog scale incorporating a facial hedonic scale. The children were also asked which antibiotic they thought tasted the best and which tasted the worst. Results Taste scores were as follows: cloxacillin 1.4 ± 1.8 cm, cephalexin 6.5 ± 2.7 cm, erythromycin 6.8 ± 3.0 cm, and fusidic acid 6.3 ± 2.4 cm. The taste rating of cloxacillin was significantly lower compared with the other three antibiotics (p = 0.001). Cloxacillin was chosen as having the worst taste by a significant proportion of the children (18 of 20). None of the antibiotics was clearly best tasting. Conclusions Given similar effectiveness, taste considerations may be important in the decision as to which antibiotic to prescribe. The perception that cloxacillin is poor tasting to children is supported by this study, which suggests that when compliance with oral medication is critical for successful treatment, prescription of cloxacillin suspension should be avoided.