bluuebunny/crossref_metadata_2025_split huggingface dataset:
One-Year Multidrug Treatment for Tuberculosis of the Cervical Spine in Children
Authors: Agarwal Anil , Kant Kumar Shashi , Kumar Anubrat , Shaharyar Abbas 
Published: October 2016

Purpose. To review the clinical and radiological features and treatment outcome in 22 children who underwent one-year antitubercular multidrug treatment for tuberculosis of the cervical spine. Methods. Records of 13 boys and 9 girls aged 2 to 12 (mean, 9.1) years who underwent one-year antitubercular multidrug treatment for tuberculosis of the cervical spine were reviewed. Tuberculosis involved the atlantoaxial region (C1–C2) in 7 patients, mid-cervical region (C3–C7) in 8, cervicodorsal region (C6–T3) in 3, contiguous multilevels in 2, and non-contiguous multifocal areas in 2. The mean number of vertebrae involved was 2.8 (range, 1–8). The mean symptom duration was 2.5 (range, 0.25–6) months. Three patients had neurological deficits. Antitubercular multidrug treatment included an intensive phase for 2 months and a continuation phase for 10 months, using isoniazid, rifampicin, pyrazinamide, and ethambutol. Results. At a mean of 2.25 (range, 0.5–5) years after treatment, no patient had recurrence, pain, or dynamic instability. Full range of movement was achieved after a mean of 2.7 (range, 1–4) months in all but 3 patients. In the 3 patients with neurological deficits, recovery was achieved after a mean of 8 (range, 5–14) weeks. Soft tissue swelling resolved after a mean of 11 (range, 8–12) weeks. Remineralisation of vertebrae occurred after a mean of 2 (range, 2–6) months. Spontaneous vertebral fusion occurred in only 6 of 22 patients after a mean of 36 (range, 18–72) months. Three patients developed kyphotic deformity. Conclusion. Antitubercular multidrug treatment is a viable option for children with tuberculosis of the cervical spine, even in the presence of neurological deficits. Development of deformity is not common; interbody fusion is usually delayed. Patients with contiguous multilevel involvement with vertebral erosion or collapse should be closely monitored for development of late deformity.
Tibial Tuberosity–Trochlear Groove Distance in Chinese Patients with or without Recurrent Patellar Dislocation
Authors: Tse Michael Siu Hei , Lie Chester Wai Hung , Pan Nin Yuan , Chan Chi Hin , Chow Hung Lit , Chan Wai Lam 
Published: October 2016

Purpose. To compare the tibial tuberosity–trochlear groove (TTTG) distance in Chinese patients with or without recurrent patellar dislocation. Methods. The TTTG distance of 14 knees in 5 men and 9 women aged 16 to 38 years with recurrent patellar dislocation were compared with that of 73 control knees using magnetic resonance imaging. Results. The mean TTTG distance was significantly greater in patients with recurrent patellar dislocation than in controls (16.4 mm vs. 10.1 mm, p<0.001). Six (43%) knees with recurrent patellar dislocation had the TTTG distance greater than the cut-off threshold of 16.4 mm, compared to none in controls. Conclusion. The TTTG distance is related to height and is shorter in Chinese than Caucasian patients; the threshold for tibial tuberosity transfer should be lower in Chinese patients.
Autologous Morselised Bone Grafting for Medial Tibial Defects in Total Knee Arthroplasty
Authors: Sugita Takehiko , Aizawa Toshimi , Sasaki Akira , Miyatake Naohisa , Fujisawa Hirokazu , Kamimura Masayuki 
Published: October 2016

Purpose. To evaluate the outcome of autologous morselised bone grafting for a medial tibial defect of ≥10 mm deep in 45 total knee arthroplasties (TKAs). Methods. 38 patients aged 46 to 85 (mean, 73) years underwent 45 TKAs and autologous morselised bone grafting for a medial tibial defect of ≥10 (range, 10–25) mm in depth by a single surgeon. In the first 19 TKAs, 2 resected subchondral bone plates from the lateral tibial plateau were driven into 2 gutters made on the floor of the medial tibial defect as bony support posts. Morselised cancellous bone grafts were then impacted around these posts. In the remaining 26 TKAs, multiple drill holes were made on the floor of the defect to decrease the remodelling time. Morselised cancellous bone grafts were impacted to fill the defects. The tibial components were fixed with cemented (n=34) or non-cemented (n=11) technique. Internal fixation devices were not used; stem extension was used in only 2 TKAs (in a patient with Charcot joint and a patient undergoing revision TKA). Results. After a mean follow-up duration of 65 (range, 24–174) months, no patient showed gait disturbance. The mean knee flexion angle was 113.8° (range, 90°–130°). No absorption or collapse of the grafted bone, or component loosening were noted on radiographs. The grafted bone completely incorporated into the host bone, with bony trabeculae crossing the interface within 2 years in the first 19 TKAs and within one year in the latter 26 TKAs. The margin of the grafted area resembled bony cortex in 30 TKAs. Conclusion. Autologous morselised bone grafting is a viable option for most medial tibial defects during TKA.
Gender Difference in Outcome after Total Knee Replacement
Authors: Lim Jason Beng Teck , Chi Chong Hwei , Lo Lup Ean , Lo Woon Theng , Chia Shi-Lu , Yeo Seng Jin , Chin Pak Lin , Tay Keng Jin Darren , Lo Ngai Nung 
Published: October 2016

Purpose. To compare the outcome after primary total knee replacement (TKR) for end-stage knee osteoarthritis (OA) in men versus women. Methods. Records of 214 men and 1040 women who underwent primary TKR for end-stage knee OA and were followed up for a minimum of 2 years were reviewed. Knee flexion, Oxford Knee Score, Knee Society Score (KSS), and 8 subscores of Short Form 36 (SF-36) were recorded preoperatively and at postoperative 6 months and 2 years. Results. Men and women were comparable only in age (67.9 vs. 67.3 years, p=0.244); men had a lower mean body mass index (27.0 vs. 28.3 kg/m2, p<0.001). Preoperatively, men had better knee flexion (117° vs. 114.8°, p=0.05), Oxford Knee Score (33.5 vs. 36.8, p<0.001), KSS knee score (44.3 vs. 40.3, p=0.001), KSS function score (52.5 vs. 47.1, p<0.001), and all 8 subscores of SF-36 (p=0.005 to p<0.001). Compared with men, women achieved greater improvement at 6 months in Oxford Knee score (13.2 vs. 15.1, p=0.009) and KSS knee score (36.9 vs. 41.6, p=0.016), and at 2 years in Oxford Knee Score (15.0 vs. 17.9, p<0.001), KSS knee score (39.8 vs. 43.9, p=0.009), and SF-36 subscores of social functioning (23.6 vs. 35.1, p<0.001) and mental health (3.9 vs. 8.2, p=0.003). Conclusion. Compared with men, women had poorer preoperative knee flexion, Oxford Knee Score, KSS, and 8 subscores of SF-36, but achieved greater improvement in the Oxford Knee Score and KSS knee score at 6 months and 2 years, as well as in SF-36 subscores of social functioning and mental health at 2 years.
Development of Secondary Ossification Centres of the Acromion in Japanese Youth: A Computed Tomographic Study
Authors: Fujii Koji , Takeda Yoshitsugu , Miyatake Katsutoshi 
Published: October 2016

Purpose. To determine the age range when the secondary ossification centres of the acromion appear and fuse in Japanese youth using computed tomography (CT). Methods. CT scans of 85 shoulders in 35 male and 14 female consecutive patients aged 6 to 20 (mean, 16) years were reviewed. No patient had pain or tenderness at the acromion. Appearance and fusion of the secondary ossification centres of the acromion were determined twice by an orthopaedist. A secondary ossification centre was considered to have appeared when a low-density line was noted at the juxta-epiphyseal area and to have fused when the line had disappeared. Intra-observer reliability was determined. Results. The intra-observer reliability was 0.93. The secondary ossification centres of the acromion had appeared at around 10 years of age and had fused at around 15 years of age, with one exception. Conclusion. In these Japanese subjects, the secondary ossification centres of the acromion had appeared at around 10 years of age and had fused at 15 to 16 years.
Outcome following Total Knee Arthroplasty in Obese versus Non-Obese Asian Patients
Authors: Goh Graham Seow-Hng , Liow Ming Han Lincoln , Mitra Amit Kanta 
Published: October 2016

Purpose. To compare the outcome following total knee arthroplasty (TKA) in obese and non-obese Asian patients. Methods. 27 obese patients were compared with 27 non-obese controls matched for age, gender, diagnosis (osteoarthritis), prosthesis, preoperative Knee Society knee and function scores, preoperative Oxford Knee Score, and follow-up duration. All TKAs were performed by a single surgeon. Patients were assessed at 6 months and 2 years for the range of motion, Knee Society knee and function scores, Oxford Knee Score, and Short Form-36 Health Survey (SF-36). Results. The obese and non-obese groups did not differ significantly in pre- and post-operative variables: range of motion, Knee Society knee and function scores, Oxford Knee Score, and SF-36 score. Using revision as an end-point, implant survival was 100%. There were no intra- or post-operative complications in either group. Conclusion. Obese and non-obese Asian patients achieved a comparable outcome following TKA.
Total Knee Arthroplasty in Women with Asymptomatic Urinary Tract Infection
Authors: Singh Harjoban , Thomas Simon , Agarwal Shekhar , Arya Subhash C , Srivastav Shekhar , Agarwal Naresh 
Published: October 2016

Purpose. To compare early outcome after total knee arthroplasty (TKA) in women with a positive or negative urine culture. Methods. 128 women underwent bilateral (n=89) or unilateral (n=39) primary TKA. Diabetes mellitus was present in 38%, obesity in 53%, and asymptomatic urinary tract infection (positive urine culture) in 36% of women. Women with a positive or negative urine culture were compared. Results. In the 46 women with a positive urine culture, Escherichia coli (n=29) and Klebsiella (n=17) were grown. Women with a positive or negative urine culture were comparable in terms of the incidence of diabetes (28% vs. 43%, p=0.1), obesity (52% vs. 54%, p=0.87), fever (9% vs. 15%, p=0.32), leucocytosis (28% vs. 17%, p=0.13), and delayed wound healing (0% vs. 1%, p=0.45). Conclusion. Women with or without a positive urine culture had comparable early complication rates following TKA.
The Neviaser Portal for Superior Glenoid Anchor Insertion: An Anatomic Study
Authors: Haughton Benjamin Alexander , Serrano-Pedraza Ignacio , Boada Eduardo , Candal-Couto Jaime Jose 
Published: October 2016

Purpose. To measure the angular relationship between the Neviaser portal and the superior glenoid labrum in 60 cadaveric specimens to determine whether this portal can be used for reliable anchor placement. Methods. The Neviaser portal of 30 left and 30 right unpaired dry cadaveric scapulae with clavicles were measured by a single observer using an analogue vernier caliper. The angular relationship between the Neviaser portal and the 12 o'clock position of the glenoid labrum was calculated. Results. 13 of the 60 scapulae were excluded from analysis, because the Neviaser portal was medial to the glenoid rim making safe anchor insertion unfeasible. For the remaining 47 scapulae, the mean angles α and β were 58.2° and 57.9°, respectively. Compared with the ideal angles α and β of 30° and 0°, respectively, all the 47 Neviaser portals were more posterior (relative to the 12 o'clock position) and closer to the transverse plane, making insertion of suture anchors in the optimum position unfeasible, except for one that was within 10° of the ideal angles in both planes. Conclusion. Reliable insertion of suture anchors at the 12 o'clock position of the glenoid labrum through the Neviaser portal is unfeasible in most patients.
Tuberculosis of the Sternoclavicular Joint
Authors: Jain Anuj , Jajodia Nitesh , Aggarwal Aditya , Singh Jaswinder , Gupta Siddharth 
Published: October 2016

Purpose. To review the diagnosis and treatment of tuberculosis of the sternoclavicular joint in 13 patients. Methods. Records of 9 men and 4 women aged 26 to 47 (mean, 36.5) years who presented with tuberculosis of the right (n=8) or left (n=5) sternoclavicular joint were reviewed. Results. All 13 patients had a raised erythrocyte sedimentation rate at presentation. Nine patients presented with systemic symptoms including malaise, fever, or loss of weight/appetite. Local symptoms included cold abscess (n=5), tenderness and non-fluctuant swelling (n=4), and discharging sinus (n=4). The mean duration of symptoms was 2.7 (range, 1–7) months. Four patients had multifocal involvement of the proximal ulna (n=1), lung (n=2), and meninges (n=1). Aspiration (n=3), fine needle aspiration cytology (n=4), drainage (n=2), or curettage (n=4) of the swelling, abscess, or sinus was performed, and the diagnosis was confirmed by histopathology (n=8), polymerase chain reaction (n=5), or culture (n=1). Two patients were diagnosed based on clinical suspicion. 11 patients responded to antituberculous therapy (ATT), and symptoms resolved after 6 to 8 weeks. Two patients did not respond to ATT after 3 months and were screened for immunocompromising disorders or drug resistance. Their CD4 count and CD4:CD8 ratio was low, and an immunomodulation regimen was prescribed as an adjunct to ATT. Conclusion. A high level of clinical suspicion is needed to diagnose tuberculosis of the sternoclavicular joint in patients with pain/tenderness, discharging sinus, or cold abscess. A combination of histopathological and microbiological tests, and PCR can confirm the diagnosis.
Volar Locking Plate Osteosynthesis for Distal Radial Fractures
Authors: Javed Saqib , Shahid Rizwan , Thimmiah Ravi , El-Deen Muj 
Published: October 2016

Purpose. To review the one-year outcome after volar locking plate fixation for distal radial fractures. Methods. Records of 22 men and 40 women aged 17 to 86 (mean, 52.5) years who underwent volar locking plate fixation for distal radial fractures were reviewed. According to the Fernandez classification, the distal radial fractures were classified as type 1 (n=20), type 2 (n=24), type 3 (n=6), type 4 (n=6), or type 5 (n=6). Three types of plate were used: Stryker Variax (n=33), Synthes LCP (n=20), and Smith & Nephew Peri-Loc (n=9). Wrist function was assessed at one year using the validated patient-rated wrist evaluation (PRWE) questionnaire. Results. 14 (23%) of the 62 patients had 24 complications: stiffness (n=13), median nerve symptoms (n=4), malunion (n=2), implant removal for persistent pain and stiffness but no improvement shown (n=2), complex regional pain syndrome (n=2), and carpal arthritis (n=1). The complication rates for types 1, 2, 3, 4, and 5 fractures were 20%, 17%, 67%, 0%, and 33%, respectively (p=0.052). The complication rates for low-risk (types 1 and 2) and high-risk (types 3, 4, and 5) fractures were 18% and 33%, respectively (p=0.315). The complication rates for Stryker Variax, Synthes LCP, and Smith & Nephew Peri-Loc were 26%, 20%, and 14%, respectively (p=0.75). At one year, the mean PRWE score was comparable in patients with low-risk or high-risk fractures (14 vs. 19, p=0.5). 79%, 13%, and 8% of the patients recovered >50%, 20–50%, and <20% of range of movement of the contralateral side, respectively. Conclusion. Volar locking plate fixation followed by early rehabilitation for distal radial fractures achieved good outcome, with a low rate of implant-related complications.
Driving with a Short Arm Cast in a Simulator
Authors: Mansour Damian , Mansour Kristin Gotaas , Kenny Benjamin William , Attia John , Meads Bryce 
Published: October 2016

Purpose. To test the ability to steer in a driving simulator in subjects with a short arm cast. Methods. 17 men and 13 women aged 23 to 67 (mean, 37) years who had a valid driver's licence were randomised to the cast-first group (n=16; 7 had the cast on the dominant arm) or the cast-second group (n=14; 8 had the cast on the dominant arm) and drove in a simulator. A short arm plaster-of-Paris cast was applied in a neutral position, allowing free movement of the metacarpophalangeal joints, thumb, and elbow joint. Outcome measures included the number of driving off track instances, the number of crashes, the lap time, and the effect of hand dominance on these parameters. Subjects were asked whether the cast had impeded their steering ability. Results. Subjects with or without a cast were comparable in terms of the number of driving off track instances, number of crashes, and lap time. Compared with no cast, the odds ratio (OR) of a subject in a cast driving off the track was 1.02 (p=0.921) and having a crash was 0.79 (p=0.047). All subjects were 1.23 times more likely to drive off the track in their first lap (OR=2.66, p=0.019). The mean lap time decreased for each consecutive lap from the 2nd to 5th laps. Subjects driving with a cast on the dominant or non-dominant arm were comparable. 26 out of the 30 participants considered that the plaster cast impeded their steering ability. Conclusion. Compared with no cast, driving with a short arm cast did not significantly decrease steering ability in a driving simulator.
Percutaneous Repair Followed by Accelerated Rehabilitation for Acute Achilles Tendon Ruptures
Authors: Al-Mouazzen Louay , Rajakulendran Karthig , Najefi Ali , Ahad Nurul 
Published: October 2016

Purpose. To evaluate the outcome after percutaneous repair followed by accelerated rehabilitation for acute Achilles tendon ruptures. Methods. 21 men and 9 women (mean age, 41 years) underwent percutaneous repair by a single senior surgeon for acute Achilles tendon ruptures, followed by early weight bearing and accelerated rehabilitation. Outcome measures included the Achilles tendon re-rupture rate, the Achilles tendon total rupture score (ATRS) at 3 and 6 months, the incidence of sural nerve injury, wound infection, wound dehiscence, patient satisfaction, and the time to return to pre-rupture activity. Results. The mean follow-up period was 12.5 months. The mean ATRS score improved from 57.65 at 3 months to 86.95 at 6 months (p<0.001). No patient had intra-operative complications, tendon re-rupture, sural nerve injury, wound dehiscence, or deep infection. Two patients developed a superficial wound infection, which was resolved with oral flucloxacillin. Two patients had a mass at the transverse incision, but neither had any symptoms or functional restriction. All patients were able to bear full weight comfortably without the walker boot at 8 weeks, and return to their work by 3 months. The mean time to return to pre-rupture activity, including sports, was 10.4 months. The mean satisfaction rate was 87% at 6 months. Conclusion. Percutaneous repair of the Achilles tendon followed by early weight bearing and accelerated rehabilitation achieves good functional outcome.
Forefoot Flexibility and Medial Tibial Stress Syndrome
Authors: Kudo Shintarou , Hatanaka Yasuhiko 
Published: October 2016

Purpose. To investigate the association between medial tibial stress syndrome (MTSS) and morphology and flexibility of the foot arches. Methods. 131 feet from 74 healthy subjects and 31 feet from 27 patients with MTSS were classified as normal feet (n=78 in 40 subjects), flat feet (n=53 in 34 subjects), or MTSS feet (n=31 in 27 patients). The medial longitudinal arch (MLA) ratio and the transverse arch length (TAL) were measured in both rearfoot and forefoot loading positions. The difference between the 2 positions indicated the flexibility of the MLA (diff–MLA ratio) and the transverse arch (diff-TAL). Results. The MLA ratio was higher in normal feet than MTSS feet or flat feet (15.1% vs. 12.8% vs. 12.3%, p<0.001). The diff-TAL was lower in MTSS feet than normal feet or flat feet (0.4% vs. 0.8% vs. 0.9%, p<0.001]). The 3 groups were comparable in terms of the diff–MLA ratio and the TAL. Respectively for the MLA ratio and the diff-TAL, the cut-off value was 11.9% and 0.61% based on the Youden index. The sensitivity, specificity, and odds ratio of the cut-off value were 0.4, 0.9, and 4.8 for the MLA ratio, and 0.6, 0.7, and 9.8 for the diff-TAL, respectively. Conclusion. Decreased flexibility of the transverse arch and decreased MLA ratio are risk factors for MTSS. In contrast, the flexibility of the MLA and the height of the transverse arch were not risk factors for MTSS.
Curettage without Bone Grafting for a Simple Bone Cyst in the Capitate
Authors: Bishay Sherif Naseef Girgis 
Published: October 2016

Purpose. To review the outcome after intralesional curettage without bone grafting for simple bone cysts in the capitate. Methods. Records of 12 hands in 10 consecutive females aged 14 to 21 (mean, 17.5) years who underwent intralesional curettage without bone grafting for a simple bone cyst in the capitate were reviewed. Clinical outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Wrist/hand pain was assessed using the modified Mayo wrist score. Patient satisfaction, range of motion, and grip strength were self-evaluated as improved, unchanged, or worse. Results. After a mean follow-up of 7.5 (range, 2.5–12.5) years, the mean DASH score was 12.3 (range, 0–25), and the mean modified Mayo wrist score was 85 (range, 70–95); the modified Mayo wrist score was excellent in 8 hands and good in 4 hands. All patients had bone union and preservation of capitate height. All patients had no pain except for 2 patients (4 hands) who reported pain after strenuous activity. All patients had improved range of motion, and all but 2 patients had improved grip strength. Conclusion. Curettage without bone grafting for a simple bone cyst in the capitate is a sufficient and viable option.
Correlation between Survival and Tumour Characteristics in Patients with Chondrosarcoma
Authors: Kamal Achmad Fauzi , Husodo Kurniadi , Prabowo Yogi , Hutagalung Errol Untung 
Published: October 2016

Purpose. To evaluate the correlation between survival and tumour characteristics in 23 patients with chondrosarcoma. Methods. Records of 15 men and 8 women aged 14 to 66 (mean, 37) years who were diagnosed with primary (n=19) or secondary (n=4) chondrosarcoma of the axial skeleton (n=8), proximal extremity (n=9), or distal extremity (n=6) were reviewed. The tumour diameter was <10 cm in 4 patients, 10–19 cm in 12, and 20–30 cm in 7. The tumour involved the intramedullary in 17 and the periosteum in 6 patients; tumour extension was intracompartmental in 5 and extracompartmental in 18 patients. The Evans histological grade for the tumours was grade 1 in 6 patients, grade 2 in 10, and grade 3 in 7. The mean tumour size was 12.3 cm for grade 1 tumours, 18.2 cm for grade 2 tumours, and 18.3 cm for grade 3 tumours. 13 patients had no metastasis and 3 of 10 patients with grade 2 tumours and all 7 patients with grade 3 tumours had metastasis to the lung at presentation. 17 patients underwent surgery, one underwent adjuvant treatment only, and 5 declined treatment. Results. The mean follow-up period for the 23 patients was 3.1 years (range, 3 weeks to 9 years). The 5-year survival rate was 43% overall, 83.3% for grade 1 tumours, 50% for grade 2 tumours, and 0% for grade 3 tumours. The median survival duration was 20 (95% confidence interval, 11–29) months. Two patients had local recurrence and 16 did not, and the 5 patients who declined treatment died. Survival correlated with Evans histological grading (p=0.004), the presence of metastasis at presentation (p=0.026) and local recurrence (p=0.004). Conclusion. The survival rate was lower in patients with higher Evan grading, metastasis, or local recurrence.