bluuebunny/crossref_metadata_2025_split huggingface dataset:
Venous Thromboembolism in Japanese Patients with Fractures of the Pelvis and/or Lower Extremities Using Physical Prophylaxis Alone
Authors: Niikura Takahiro , Lee Sang Yang , Oe Keisuke , Koh Akihiro , Koga Takaaki , Dogaki Yoshihiro , Okumachi Etsuko , Kurosaka Masahiro 
Published: October 2016

Purpose. To investigate the rate of venous thromboembolism (VTE) in Japanese patients with fractures of the pelvis and/or lower extremities using physical prophylaxis alone. Methods. Records of 66 men and 60 women aged 15 to 95 (mean, 57) years with fractures of the pelvis and/or lower extremities were retrospectively reviewed. They were screened for VTE based on D-dimer values. Contrast-enhanced computed tomography and/or ultrasonography were performed when the D-dimer value did not decline predictably or exceeded 20 μg/ml even 5 days after injury or surgery. Physical prophylaxis for VTE in terms of graduated compression stockings and intermittent pneumatic compression were applied for all patients. Results. Of the 126 patients, 24 were detected to have VTE (10 of 29 with multiple fractures and 14 of 97 with single fractures). Six patients were detected to have asymptomatic pulmonary thromboembolism (PTE), whereas 20 patients were detected to have deep vein thrombosis (bilaterally in 7). The rates of VTE were high in patients with multiple fractures (35%), pelvic fractures (18%), and femoral shaft fractures (50%). The rate of PTE was high in patients with pelvic fractures (12%). Conclusion. The rate of VTE in the Japanese patients was similar to that in western populations. Our screening method was useful for preventing fatal PTEs. Surgeons should be vigilant for VTE during the first 2 weeks after injury, especially in patients with multiple and pelvic fractures.
Triplane Fractures of the Distal Tibia in Children
Authors: Tan Adrian Chong Beng , Chong Roland Weng Wah , Mahadev Arjandas 
Published: October 2016

Purpose. To review 28 cases of paediatric triplane fractures of the distal tibia over a 7-year period in a tertiary paediatric hospital. Methods. Records of 21 boys and 7 girls aged 11 to 15 (mean, 13) years presented with triplane fractures of the left (n=14) and right (n=14) ankles were retrospectively reviewed. Results. Injury mechanism included low-energy trauma (n=10) and moderate-energy trauma (n=18). Fractures were 2-part in 20 patients, 3-part in 6, and 4-part in 2. 11 patients had concomitant fibular fractures. Articular displacement was <2 mm in 17 patients and ≥2 mm in 11 patients. 17 patients were treated conservatively (cast immobilisation); 11 were treated surgically by closed reduction and percutaneous pinning (n=1), open reduction and percutaneous pinning (n=5), closed reduction and internal fixation (n=3), or open reduction and internal fixation (n=2). Transepiphyseal partially threaded cannulated screws were used for fixation. The mean period of casting was 5.8 weeks, and the mean non–weight bearing period was 6.1 weeks. The mean follow-up period was 14.2 (range, 9–20) weeks. All patients had excellent outcome. No patient had any infections, delayed or non-union. Six patients had decreased range of motion and 4 had pain 4 weeks after cast removal. Conclusion. Treatment outcome of triplane fractures of the distal tibia in children is good when guidelines are closely adhered to.
Antibiotic-Coated Pins for Prevention of Pintract Infection: A Rabbit Study
Authors: Rahimnia AR , Abbaspour A , Rezaei Yadollah , Khodadadi A , Alizadeh AM , Mohagheghi MA , Semeyari H , Fooladi AA Imani , Izadi M , Keshavarz P , Yasui N 
Published: October 2016

Purpose. To evaluate the efficacy of antibiotic-coated pins for prevention of pin tract infection in a rabbit model. Methods. 10 rabbits were divided into 2 groups. A unilateral external fixator was applied to the tibia with 4 self-taping 1.8-mm pins. In the test group, pins were coated with hydroxyapatite and antibiotic. In the control group, pins were not coated. All pins were then placed in Staphylococcus aureus–containing media. At postoperative day 5, all 40 pin sites were subcutaneously inoculated with S aureus. The sites were clinically examined for signs of pin tract infection. Nine days later, a piece of soft tissue around the pin site was harvested for microbiologic examination. Results. In the test group, all except one pin sites appeared clean and without clinical infection, and the culture media remained clear. In the control group, all pin sites showed evidence of clinical infection and yielded positive cultures, and the culture media became dark indicating growth of S aureus. Conclusion. Antibiotic-coated pins were effective in preventing pin tract infection.
Cephalomedullary Nail versus Sliding Hip Screw for Unstable Intertrochanteric Fractures in Elderly Patients
Authors: Chua Ivan Tjun Huat , Rajamoney Ganesan Naidu , Kwek Ernest Beng Kee 
Published: October 2016

Purpose. To compare the short-term ambulatory function of elderly patients after fixation of unstable intertrochanteric fractures with either the AO-ASIF proximal femoral nail anti-rotation (PFNA) device or the dynamic hip screw (DHS). Methods. 63 patients aged ≥60 years underwent fixation for unstable intertrochanteric fractures (AO types A2 and A3) using the PFNA (n=25) or DHS (n=38). The decision for the type of implant used was based on the lead surgeon's preference, according to perceived fracture stability and clinical experience. In patients having PFNA fixation, weight bearing ambulation and rehabilitation was commenced on day 2. The extent of weight bearing was decided by the lead surgeon based on the stability of the fracture. In patients having DHS fixation, non-weight bearing and ambulation with a walking aid was commenced on day 2. Ambulatory function before injury and after surgery was measured using the Parker Mobility Score (PMS). The 2 groups were compared in terms of the PMS, ambulatory independence, and environmental mobility. Results. Respectively in PFNA and DHS patients, 32% and 13% (p=0.035) were ambulant with a walking frame at discharge; the remainder were wheelchair bound. Patients treated with PFNA had significantly higher median PMS at 6 months (4 vs. 2, p=0.002), median ambulatory independence score at 6 months (4 vs. 3, p=0.004) and at 12 months (5 vs. 4, p=0.001), and median environmental mobility score at 6 months (2 vs. 1, p=0.007). They also had significantly higher percentage of patients able to ambulate outdoor and in community at 6 months (64% vs. 29%, p=0.02) and able to walk independently or with a walking aid at 12 months (96% vs. 69%, p=0.01). There were 3 complications. Two patients treated with PFNA had blade cut-out, owing to poor fracture reduction. One patient treated with DHS had screw cut-out and subsequently developed avascular necrosis of the femoral head. Conclusion. Unstable intertrochanteric fractures in elderly patients with good pre-fracture ambulatory function stabilised with the PFNA resulted in better short-term ambulatory function.
Proximal Femoral Locking Plate versus Dynamic Hip Screw for Unstable Intertrochanteric Femoral Fractures
Authors: Dhamangaonkar Anoop C , Joshi Deepak , Goregaonkar Arvind B , Tawari Akhil A 
Published: October 2016

Purpose. To compare the outcome in patients who underwent surgery for unstable intertrochanteric femoral fractures using the proximal femoral locking plate versus the dynamic hip screw (DHS). Methods. 15 men and 5 women aged 32 to 78 (mean, 55) years were randomised to the proximal femoral locking plate group, whereas 14 men and 6 women aged 38 to 75 (mean, 59) years were randomised to the conventional 135° DHS group. The time to union, medialisation of the shaft, neck-shaft angle, limb shortening, varus collapse, and functional outcome (using the Hospital for Special Surgery Hip Rating System) were assessed. Results. Respectively in the locking plate and DHS groups, the mean times to union were 14.6 and 16.5 weeks (p=0.067) and the mean limb shortenings were 0.3 and 1.4 cm (p<0.001). Medialisation of the shaft occurred in 0 and 15 patients (p<0.0001); varus collapse occurred in 2 and 5 patients (p=0.408); the functional hip score was good-to-excellent in 18 and 11 patients (p=0.031); deep wound infection occurred in 3 and 2 patients; and implant cut-out occurred in one patient each group. Conclusion. A non-collapsing locking plate achieved bone union in unstable intertrochanteric fractures with lower risks of limb shortening and medialisation of the shaft.
Plating, Nailing, External Fixation, and Fibular Strut Grafting for Non-Union of Humeral Shaft Fractures
Authors: Padhye Kedar P , Kulkarni Vidhisha S , Kulkarni GS , Kulkarni Milind G , Kulkarni Sunil , Kulkarni Ruta , Patii Mayur D , Ravi Priyanka Y 
Published: October 2016

Purpose. To compare various treatment modalities (plating, Ilizarov external fixation, and non-vascular fibular cortical strut grafting) for non-union of humeral shaft fractures. Methods. Records of 9 women and 26 men aged 24 to 71 (mean, 42) years who presented with non-union of humeral shaft fractures were reviewed. The humeral shaft fractures were secondary to low-energy trauma (n=22) or vehicular accidents (n=13) and involved the proximal (n=9), middle (n=15), and distal (n=11) regions. 13 of the fractures were open. Infection was evident in 8 of the non-unions. For non-unions with infection (n=8), a 2-stage procedure entailing temporary Ilizarov fixation followed by plating was used. For non-unions without infection (n=23), one-stage plating and cancellous bone grafting was used. For non-unions of osteoporotic bone (n=4), one-stage non-vascularised fibular strut grafting was used. Outcome was measured using the Disabilities of the Arm, Shoulder and Hand (DASH) scoring system. Results. The 35 patients were followed up for a mean of 16 (range, 6–60) months. All achieved bone union except for one (who had persistent infection). Respectively for non-unions with infection, nonunions without infection, and non-unions of osteoporotic bone, the mean times to bone union were 6.5 (range, 4–10), 5 (range, 4–8), and 10 (range, 6–14) months, the mean improvement in DASH score was 30, 43, and 18, and malalignment was noted in 5, 2, and one patient. Three patients had a preoperative radial nerve palsy for which standard tendon transfer was performed 6 weeks after treatment for non-union. Conclusion. Compression plating achieved the best results. An external fixator may be used temporarily for infected non-unions. Fibular strut grafting may be used when non-unions warrant additional stability.
Verification of the Australian Orthopaedic Association National Joint Replacement Registry Using a Surgeon's Database
Authors: Jang Bob , Walsh Nichola A , Bruce Warwick JM 
Published: October 2016

Purpose. To assess the completeness of registration and any discrepancies between the senior author's database and the Australian Orthopaedic Association National Joint Replacement Registry (AOA NJRR). Methods. From 2002 to 2005, the senior author performed 231 primary total hip arthroplasty (THA) on 217 patients using the Corail femoral stem and one of the 3 types of the acetabular component: Pinnacle, ASR, or Duraloc/Option. The name of each patient was forwarded to the AOA NJRR for matching and verification. Results. The AOA NJRR recorded 230 of the 231 primary THAs; all but one was matched with the senior author's database. Nine (3.9%) of them were revised by the same (n=7) or another (n=2) surgeon. Three (43%) of the 7 revision surgeries were not recorded on the AOA NJRR. One patient revised for a ceramic liner fracture was incorrectly recorded as ‘wear acetabulum’ in the AOA NJRR. Conclusion. Although the AOA NJRR achieved high registration completeness for primary THA, accuracy for revision THA was much lower.
Outcome of Locking Compression Plating for Proximal Humeral Fractures: A Prospective Study
Authors: Chowdary Umapathi , Prasad Hari , Subramanyam P Krishna 
Published: October 2016

Purpose. To evaluate the outcome of open reduction and internal fixation using locking compression plates for proximal humeral fractures. Methods. 54 men and 16 women aged 28 to 79 (mean, 54) years underwent open reduction and internal fixation using a locking compression plate for closed 2-part (n=22), 3-part (n=38), and 4-part (n=10) proximal humeral fractures. 10 of the patients also had dislocation of the humeral head; 4 had fractures extending to the shaft. Wound condition, functional outcome, bone union, amount of collapse, and malalignment were assessed. Functional outcome was assessed using the Constant-Murley score. Results. The mean follow-up period was 15 (range, 6–24) months. All fractures achieved union after a mean of 9 (range, 6–12) weeks. The mean Constant-Murley scores for the injured and normal shoulders were 72 and 82, respectively (88% of normal). The final outcome was excellent in 14 patients, good in 28, moderate in 22, and poor in 6. In the latter 6 patients, 2 had screw penetration, 2 had plate impingement, one had a mal-reduced greater tuberosity, and one had adhesive capsulitis. All were preventable. In all, 18 patients had 20 complications: subacromial impingement of the plate (n=6), mal-reduction of the greater tuberosity (n=6), screw penetration (n=2), adhesive capsulitis (n=2), superficial infection (n=2), and haematoma (n=2); 12 of these complications were technique-related. Conclusion. Locking proximal humeral plates enabled stable fixation in all Neer-type proximal humeral fractures. Most complications were technique-related.
Polyaxial versus Uniaxial Volar Locking Plate for Distal Radial Fractures
Authors: Al-Mouazzen Louay , Chou Daud Tai Shan , Kyriakopoulos Georgios , Hambidge John 
Published: October 2016

Purpose. To compare the penetration of the distal screws in relation to the thickness of the distal metaphysis in the polyaxial versus uniaxial volar locking plates. Methods. Records of 78 patients aged 16 to 79 years who underwent open reduction and internal fixation for distal radial fractures (n=81) were reviewed. All fracture subtypes were included. 20 men and 22 women aged 18 to 79 (mean, 50) years were treated with the uniaxial locking plate, whereas 15 men and 21 women aged 16 to 79 (mean, 51) years were treated with the polyaxial locking plate. The choice of plate was determined by the operating surgeon based on familiarity and perceived advantages of the 2 plates. Penetration of the distal locking screws in relation to the volar-dorsal thickness of the distal radial metaphysis was measured, and the percentage of subchondral bone unsupported by the screws calculated. Results. The mean percentage of unsupported subchondral bone was significantly lower in the polyaxial than uniaxial volar locking plate group (12% vs. 23%, p<0.001). No patient had screw overpenetration. Conclusion. The polyaxial volar locking plate system enabled deeper insertion of distal screws into the subchondral bone, and thus providing better buttress for the fracture fragments.
Total Knee Arthroplasty with an Oxidised Zirconium Femoral Component: A 5-Year Follow-up Study
Authors: Park Derek H , Leong Julian , Palmer Stephen J 
Published: October 2016

Purpose. To report the early results of the Oxinium Genesis II prosthesis with an oxidised zirconium femoral component in 55 patients. Methods. 71 knees in 21 men and 34 women aged 32 to 75 (mean, 55) years were evaluated; 16 of the patients had bilateral staged total knee replacements with a mean interval of 9 (range, 6–16) months between surgeries. The indications for surgery included osteoarthritis (n=57), rheumatoid arthritis (n=13) and revision from a unicompartmental knee replacement for osteoarthritis (n=1). Postoperatively, patients were evaluated using the Knee Society score (KSS), the modified Oxford Knee Score, and the SF-12 health survey, as were component position, leg and knee alignment, and prosthesis-bone interface or fixation on radiographs. Results. The mean follow-up was 62 (range, 51–88) months. The mean KSS, Oxford Knee Score, and SF-12 physical component score improved significantly. Radiolucent lines (<2 mm) were noted in the tibial cement-bone interface in 17 knees (most commonly in zones 4 and 1) and in the femoral cement-bone interface in one knee. The alignment of the knees and positioning of the components were acceptable. There were no revisions for septic or aseptic loosening. Conclusion. Early results of the Oxinium Genesis II prosthesis are comparable to the standard total knee prostheses.
Total Hip Arthroplasty through the Mini-Incision (Micro-Hip) Approach versus the Standard Transgluteal (Bauer) Approach: A Prospective, Randomised Study
Authors: Dienstknecht T , Lüring C , Tingart M , Grifka J , Sendtner E 
Published: October 2016

Purpose. To compare outcome after total hip arthroplasty (THA) through the mini-incision approach versus the standard transgluteal approach. Methods. 80 women and 63 men aged 33 to 89 (mean, 62) years with primary osteoarthritis of the hip were randomised to undergo unilateral THA through a mini-incision approach (Micro-hip, n=55) or standard, lateral, transgluteal approach (Bauer, n=88). Levels of haemoglobin, haematocrit, serum creatine kinase, and C-reactive protein, length of hospital stay, mobilisation, and any complication were recorded. Visual analogue scale (VAS) for pain was assessed. Hip function was assessed using the Harris Hip Score and the Oxford Hip Score, whereas general health was assessed using the EQ-5D general health questionnaire. The cup inclination and varus/ valgus of the stem position were measured using a goniometer. Results. The Micro-hip group achieved a significantly lower mean incision length (9.3 vs. 13.4 cm, p<0.001), mean surgical time (60 vs. 68 minutes, p=0.021), mean reduction in haemoglobin level (2.1 vs. 2.8 g/dl, p<0.001), and mean VAS for pain from hour 6 to day 6 (all p<0.05). One patient in the Micro-hip group developed early aseptic loosening of the cup and underwent revision surgery at month 4. Three patients in the Bauer group and one patient in the Micro-hip group sustained intra-operative non-displaced fractures of the proximal femur, which were fixed with cerclages. Two patients in the Micro-hip group developed deep vein thrombosis during week 1. Conclusion. THA through the Micro-hip approach achieved faster pain relief.
Anthropometric Estimation of Body Height after Surgical Correction of Scoliosis
Authors: Babu S Suresh , Kiran Kopuri Ravi , Babu TV Suresh , Mohanty SP 
Published: October 2016

Purpose. To estimate the height loss in 28 patients who had undergone surgery for scoliosis before skeletal maturity. Methods. 28 women patients aged 11 to 18 (mean, 15) years underwent Harrington instrumentation, segmental sublaminar wiring, and posterior spinal fusion for idiopathic scoliosis. The patients' mean age at menarche was 13 (range, 10–16) years. Pre- and post-operative radiographs of the spine were taken to determine curve types, the Cobb angle, and the degree of correction. The standing and sitting heights were measured using a flexible steel tape, and the expected standing and sitting heights were derived using formulae. Results. At the final follow up, the mean patient age was 20 (16–32) years. The mean standing height was 155.2 cm and the mean sitting height was 77.4 cm. Using the formulae, the mean expected standing height was 158.4 cm, indicating height loss of 3.2 cm ( t=4.6, p=0.0001), and the mean expected sitting height was 79.9 cm, indicating height loss of 2.6 cm ( t=3.84, p=0.001). The curve types of the 28 patients were sub-divided as thoracic (n=7), thoracolumbar (n=18), and double major (n=3). Patients with thoracolumbar curves achieved better correction and less loss of standing and sitting heights. Percentage loss of standing and sitting heights were not correlated with the apex of the curve or the degree of correction. Conclusion. Height loss after surgery was acceptable in comparison with height loss associated with progression of scoliosis without surgery.
Single-Door Cervical Laminoplasty Using Titanium Miniplates Alone
Authors: Tung Kam Lung , Cheung Philip , Kwok Tik Koon , Wong Kam Kwong , Mak Kan Hing , Wong Wing Cheung 
Published: October 2016

Purpose. To review outcome of 29 patients who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone. Methods. Records of 20 men and 9 women aged 35 to 79 (mean, 64.3) years who underwent single-door cervical laminoplasty for myelopathy using titanium miniplates alone were reviewed. A total of 125 laminae were opened; 97 of them were fixed with a titanium miniplate. In 19 patients, a 20-hole titanium miniplate bent to the contour of a lamina was used and fixed into 3 laminae at alternate levels. In the remaining 10 patients, the pre-contoured ARCH Laminoplasty System was used and fixed into all laminae. In most patients, screw fixation was unicortical, and no spacer or bone graft was used. Results. The mean follow-up duration was 4 (range, 2–9) years. At one-year follow-up, the mean Japanese Orthopaedic Association (JOA) score improved from 9.2 to 13.2 (p<0.001). The mean JOA recovery rate was 64%. No patient had neurological deterioration. The mean anteroposterior diameter increased from 14.3 mm to 19.7 mm; the mean increase was 6.1 mm in the plated laminae and 5.3 mm in the unplated laminae (p=0.11). Out of the 125 laminae, there were 2 hinge non-unions in the unplated laminae, and 2 screw pullouts (not associated with plate loosening). No patient had penetration into the vertebral foramen or neuroforamen. Spring-back closure occurred in 5 (18%) of the 28 unplated laminae, with a mean of <3 mm loss of the initial expansion. Two patients developed transient C5 palsy presenting as shoulder abduction weakness. One patient had a delayed dural tear due to a sharp spike at the edge of the opened C6 lamina. Conclusion. Single-door cervical laminoplasty using miniplates alone is a safe technique and achieves a high hinge union rate, good canal expansion, and neurological recovery.
Weekly Injection of Teriparatide for Bone Ingrowth after Cementless Total Knee Arthroplasty
Authors: Kaneko Takao , Otani Takahiro , Kono Norihiko , Mochizuki Yuta , Mori Takeo , Nango Nobuhito , Ikegami Hiroyasu , Musha Yoshiro 
Published: October 2016

Purpose. To compare bone mineral density (BMD) in patients with or without weekly injection of teriparatide to promote bone ingrowth after cementless total knee arthroplasty (TKA). Methods. Records of 8 men and 32 women (mean age, 75.6 years) who underwent cementless TKA for medial knee osteoarthritis with (n=20) or without (n=20) once-weekly subcutaneous/hypodermic injection of teriparatide for 48 weeks were reviewed. BMD and bone volume/total volume (BV/TV) of the bone-prosthesis interface of the proximal tibia in 6 regions of interest (ROI) were assessed at 3, 6, 9, and 12 months using multi-detector computed tomography. Results. Patients with or without weekly injection of teriparatide after cementless TKA were comparable in terms of baseline characteristics and pre- and postoperative knee range of motion and Knee Society knee and function scores. In ROI 1 (medial), ROI 3 (anteromedial), and ROI 4 (posteromedial), the BV/TV increased throughout the postoperative period in patients with weekly injection of teriparatide and declined after 6 months in patients without weekly injection of teriparatide. These 3 ROIs of the 2 groups differed significantly only in BMD at 6, 9, and 12 months. In ROI 2 (lateral), ROI 5 (anterolateral), and ROI 6 (posterolateral), both BV/TV and BMD showed a decreasing trend, and these 3 ROIs of the 2 groups did not differ significantly. Conclusion. Weekly injection of teriparatide after cementless TKA promoted bone ingrowth mostly in the medial aspect of the bone-prosthesis interface.