bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sports-Related Fractures in South East Scotland: An Analysis of 990 Fractures
Authors: Aitken Stuart A , Watson Bruce S , Wood Alexander M , Court-Brown Charles M 
Published: October 2016

Purpose. To describe the characteristics of all sports-related fractures in patients aged ≥15 years in South East Scotland in one year. Methods. Medical records of 990 consecutive patients aged ≥15 years who presented to the Orthopaedic Trauma Unit of the Royal Infirmary of Edinburgh with sports-related fractures between 1 July 2007 and 30 June 2008 were reviewed. Acute fractures of the upper limbs, lower limbs, pelvis, and cervical spine were included, but those of the skull, facial bones, and thorax were excluded, as were stress and chronic fractures. Results. The incidence of sports-related fractures was 1.8/1000/year (82% involving men). The median age of patients was 25 (interquartile range, 19–35) years. Sports-related fractures accounted for 24.6% and 5.1% of all fractures in men and women, respectively. Men aged 15 to 19 years were 9 times more likely to have sports-related fractures than women of the same age. The sports-related fractures involved the upper limbs (52.4%), lower limbs (45.4%), and axial skeleton (2.2%). 12 of 49 sports (football, rugby, skiing, snowboarding, 3 cycling disciplines, horse riding, motocross, basketball, martial arts, and ice skating) accounted for 82.8% of all sports-related fractures. Upper limb fractures outnumbered lower limb fractures in all sports, except for horse riding and motocross that the proportions were similar. Conclusion. In South East Scotland, most sports-related fractures involved the upper limbs
Reconstruction for Chronic Grade-II Posterior Cruciate Ligament Deficiency in Malaysian Military Personnel
Authors: Ahmad Shahrulazua , Mahidon Rafedon , Shukur Mohammad Hassan , Hamdan Amiruddin , Kasmin Musa 
Published: October 2016

Purpose. To evaluate the outcome of reconstruction for chronic grade-II posterior cruciate ligament (PCL) deficiency in Malaysian military personnel. Methods. Medical records of 16 male military personnel aged 25 to 41 years who underwent reconstruction for chronic grade-II PCL deficiency using the quadruple hamstrings tendon by a single surgeon were reviewed. The mean time from injury to surgery was 43.6 (range, 3–104) months. 10 patients had grade-I (n=4), grade-III (n=2), and grade-IV (n=4) lesions of the medial femoral condyles. Seven patients had medial (n=6) and lateral (n=1) meniscus tears. At the 2-year follow-up, patients were asked to complete a questionnaire consisting of the Lysholm score, Tegner activity level, and International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form. Posterior drawer test, KT-2000 arthrometer test for posterior translation of the tibia, and military health grade (MHG) were assessed by an independent assessor. Results. At the 2-year follow-up, the mean Lysholm score was 83; the score was excellent in 2 patients, good in 9, fair in 4, and poor in one. The mean IKDC subjective score was 74. The median Tegner activity level increased from 5.5 to 6. The posterior drawer test of 11 patients improved to grade I and the remaining 5 remained at grade II. The mean posterior translation of the tibia was 2.4 mm postoperatively; the posterior translation was normal in 8 patients, nearly normal in 7, and abnormal (≥6 mm) in one. The MHG improved in 14 patients and remained unchanged in 2. The latter 2 patients had no chondral lesion or meniscus injury. The first one was 40 years old with a postoperative IKDC score of 55 and a Tegner activity level of 2. The second one was 34 years old with a postoperative IKDC score of 65 and posterior translation of the tibia of 6 mm. Conclusion. Surgical reconstruction for chronic grade-II PCL injury achieved satisfactory outcome and may be appropriate for military personnel.
Ceramic-on-Ceramic Total Hip Arthroplasty in Patients Younger Than 55 Years
Authors: Shah Roshan P , Scolaro John A , Componovo Roger , Garino Jonathan P , Lee Gwo-Chin 
Published: October 2016

Purpose. To review the outcomes of 65 patients younger than 55 years who underwent uncemented total hip arthroplasty (THA) using third-generation ceramic-on-ceramic prostheses. Methods. Medical records of 30 men and 35 women (80 hips) aged 18 to 55 (mean, 39) years who underwent uncemented THA using third-generation ceramic-on-ceramic prostheses by a single surgeon were reviewed. 61 THAs used the Reflection cup with the Synergy stem (n=49), Spectron stem (n=7), or Anthology stem (n=5), and 19 THAs used the Trident cup with the Secur-Fit stem. Outcomes were assessed based on the UCLA Activity Score and Harris Hip Score, as well as radiolucency around the implants, malposition, and subsidence on radiographs. Patients were asked about their satisfaction with current activity level (yes/no), activity limitation (no limitation, musculoskeletal limitation, psychological impediments and lack of motivation, and pain or disability of the operative hip), and change in occupational activity level (same or similar, more active, and less active or disability). Results. The mean follow-up period was 54 (range, 24–110) months. Six patients were excluded from the analysis owing to prosthetic failure secondary to ceramic liner fracture after falling (n=2), acetabular component loosening (n=1), intolerable squeak (n=1), periprosthetic fracture (n=1), and instability (n=1). The mean UCLA Activity Score improved from 4.0 (range, 1–10) to 7.7 (range, 2–10) [p<0.001], and the mean Harris Hip Score improved from 52.8 (range, 25–69) to 91.0 (range, 38–100) [p<0.001]. No hip had evidence of subsidence, loosening, or osteolysis. 52 (80%) patients were satisfied with their activity level; 28 (43%) patients reported no activity limitation; and 57 (88%) patients kept the same or similar occupation. Conclusion. Ceramic-on-ceramic THA achieved acceptable clinical and radiographic outcomes.
Total Hip Replacement Using a Highly Cross-Linked Polyethylene Liner in Asians with Small Acetabulum
Authors: Chua Weiliang , Roy Shuvendu , Sng Jonathan , Liang Shen , De Shamal Das 
Published: October 2016

Purpose. To evaluate the medium-term outcomes of total hip replacement (THR) using a thin highly cross-linked polyethylene (HXLPE) liner in an Asian population. Methods. Medical records of 20 men and 44 women aged 26 to 80 (mean, 59) years who underwent 80 THRs using a thin HXLPE liner by a single surgeon were reviewed. Indications for THR included dysplasia (n=26), avascular necrosis (n=26), osteoarthritis (n=22), rheumatoid arthritis (n=4), and ankylosing spondylitis (n=2). The surgical technique, implant used, and rehabilitation protocol were standardised. Radiographs were evaluated for cup migration and peri-implant radiolucency. Femoral head penetration was assessed at day 1 and last follow-up using the Kang modification of the Dorr and Wan method and the PowerPoint method. Results. After a mean follow-up of 7.5 (range, 5.0–11.9) years, no patient had undergone acetabular revision. Two hips were revised for the femoral stem. Femoral head penetration did not correlate with sex, age at surgery, hip pathology, acetabular inclination angle, cup size, or liner thickness. The maximum femoral head penetration was 0.09 mm/year, which was below the osteolysis threshold of 0.1 mm/year. The mean±standard deviation femoral head penetration was 0.29±0.12 mm (or 0.04±0.02 mm/year) by the PowerPoint method and 0.17±0.22 mm (or 0.02±0.03 mm/year) by the Kang modification of the Dorr and Wan method. Femoral head penetration correlated with the number of years of follow-up (p=0.012). Conclusion. The use of a thin HXLPE liner in primary THR for patients with small acetabulum achieved good outcomes after a mean of 7.5 years.
Leukocyte-Poor Platelet-Rich Plasma versus Bupivacaine for Recalcitrant Lateral Epicondylar Tendinopathy
Authors: Behera Prateek , Dhillon Mandeep , Aggarwal Sameer , Marwaha Neelam , Prakash Mahesh 
Published: October 2016

Purpose. To compare a single leukocyte-poor (type-4B) platelet-rich plasma (PRP) injection versus bupivacaine injection for recalcitrant lateral epicondylar tendinopathy (LET). Methods. 25 patients aged 27 to 50 years with painful and recalcitrant LET of the humerus were randomised to receive leukocyte-poor (type-4B) PRP (n=15) or bupivacaine (n=10) injection. Outcome measures included visual analogue scale (VAS) for pain, modified Mayo clinic performance index for elbow (MMCPIE) for elbow function, and Nirschl score for activity-related pain at 1, 3, 6, and 12 months by a single assessor. Results. At baseline, the PRP and bupivacaine groups were comparable in terms of age, sex, duration of symptoms, VAS for pain, MMCPIE score, and Nirschl score. After one month, the percentage of improvement was less in the PRP than bupivacaine group in terms of the VAS for pain (17.7% vs. 26.5%), MMCPIE score (24.0% vs. 27.6%), and Nirschl score (20.7% vs. 31.1%). Nonetheless, improvement in the respective scores was greater in the PRP than bupivacaine group after 3 months (42.5% vs. 30.9%, 34.1% vs. 27.2%, and 50.7% vs. 39.6%), 6 months (67.3% vs. 20.1%, 40.6% vs. 16.3%, and 71.4% vs. 31.1%), and one year (83.2% vs. 45.6%, 47.0% vs. 21.7%, and 76.6% vs. 56.3%). The differences in scores between groups were significant at 6 months and one year only (p<0.001). Conclusion. Leukocyte-poor (type-4) PRP injection for recalcitrant LET enabled good improvement in pain and function.
Arthroscopic Resection of Humeroradial Synovial Plica for Persistent Lateral Elbow Pain
Authors: Rajeev Aysha , Pooley Joesph 
Published: October 2016

Purpose. To review the outcome of 121 patients who underwent arthroscopic resection of a humeroradial synovial plica for persistent lateral elbow pain. Methods. 92 men and 29 women aged 24 to 56 (mean, 38) years with chronic lateral elbow pain underwent arthroscopic resection of a humeroradial synovial plica using a motorised soft tissue shaver, followed by intensive physiotherapy. The modified elbow score and range of motion were assessed, as were wound healing, infection, soft tissue swelling or effusion, tenderness, ligamentous instability, and motor strength. Results. No patient had any ligamentous instability. 80 patients were pain-free at 3 months; only 3 patients were taking pain medication at 6 months. All patients had full pronation and supination; the mean range of motion was 3° to 135° of flexion. The mean modified elbow score at 12 months was 93.2 (range, 72–100). The percentages of patients with excellent, good, fair, and poor score were 70%, 17%, 8%, and 5% at 3 months, 74%, 20%, 3%, and 3% at 6 months, and 76%, 18%, 3%, and 3% at 12 months, respectively. Conclusion. A humeroradial synovial plica is one of the causes of chronic lateral elbow pain. Arthroscopic resection of the synovial plica followed by intensive physiotherapy achieved good outcome.
Factors Associated with One-Year Outcome after Distal Radial Fracture Treatment
Authors: Cowie Jonathan , Anakwe Raymond , McQueen Margaret 
Published: October 2016

Purpose. To identify factors that affect functional outcome one year after distal radial fracture treatment. Methods. 521 women and 121 men aged 16 to 92 (mean, 59) years with distal radial fractures underwent external fixation (n=123), open reduction and internal fixation (n=63), a combination of both (n=10), distal radial osteotomy for symptomatic malunion (n=90), or casting with (n=194) or without (n=162) prior closed manipulation under regional anaesthesia. The indication for surgery (rather than casting) was metaphyseal instability. Radiographic evaluation (dorsal angulation, radial shortening, carpal malalignment, and malunion) was made before and after treatment and after fracture healing. Functional evaluation (range of movement, grip strength, and activities of daily living) was made at a mean of 16 (range, 6–54) months after injury. Results. After multiple regression analysis, poorer functional score was associated with increasing age (p<0.001), dorsal angulation after healing (p<0.016), presence of volar comminution (p=0.005), and pain (p<0.001). Poorer grip strength was associated with non-dominant side injury, increasing age, dorsal angulation after healing, positive ulnar variance, comminution, and pain (all p<0.001). Predicted malunion showed colinearity with age ( r=0.657), dorsal comminution ( r=0.694), and dorsal angulation ( r=0.626). Conclusion. Understanding factors associated with outcome helps surgeons to make the treatment decision for distal radial fracture to achieve optimum outcome.
Total Hip Arthroplasty Using a Short-Stem Prosthesis: Restoration of Hip Anatomy
Authors: Amenabar Tomas , Marimuthu Kanniraj , Hawdon Gabrielle , Gildone Alessandro , McMahon Stephen 
Published: October 2016

Purpose. To evaluate hip parameters such as vertical centre of rotation (VCR), horizontal centre of rotation (HCR), femoral offset, and leg length after total hip arthroplasty (THA) using the Nanos short-stem prosthesis. Methods. Medical records of 73 men and 74 women aged 25 to 92 (mean, 63) years who underwent THA using the Nanos short-stem prosthesis by a single surgeon were reviewed. Prior to the surgery, the optimal cup and stem size, head length, and level of the neck osteotomy were determined using radiographs. Intra-operatively, the leg length and femoral offset were checked, and the level of neck resection and head length were adjusted. VCR, HCR, femoral offset, and leg length of the operated and contralateral sides were compared. Functional outcomes were assessed using the Harris Hip Score (HHS). Results. Compared with the normal contralateral hips, the operated hips had a mean increase of 0.4 mm in VCR (p=0.032), a mean decrease of 1.4 mm in HCR (p=0.027), a mean increase of 0.6 mm in femoral offset (p=0.043), and a mean increase of 0.36 mm in leg length (p=0.035). For these respective parameters, the difference between the normal contralateral side and the operated side was within 5 mm in 89%, 80%, 71%, and 96% of patients. The HHS improved from a mean of 53 to 91 at one year (p<0.001). Conclusion. THA using the Nanos short-stem prosthesis enabled restoration of hip anatomy (VCR, HCR, femoral offset, and leg length).
Minimally Invasive Plate Osteosynthesis for Proximal Humeral Fractures
Authors: Koljonen Paul Aarne , Fang Christian , Lau Tak Wing , Leung Frankie , Cheung Nigel WK 
Published: October 2016

Purpose. To report the outcome after minimally invasive plate osteosynthesis (MIPO) through the deltoid-splitting approach for proximal humeral fractures. Methods. 10 men and 30 women aged 37 to 88 years underwent MIPO through the deltoid-splitting approach using the Proximal Humerus Internal Locking System or the Locking Proximal Humerus Plate for 2-part (n=18), 3-part (n=20), and 4-part (n=2) proximal humeral fractures. The rehabilitation protocol was standardised. Results. All 40 patients were followed up at 3 months, 34 (85%) at 6 months, 30 (75%) at one year, and 13 (33%) at 2 years. Two patients had malunion. No patient had avascular necrosis, infection, nerve palsy, or nonunion. The mean Constant score at one year and 2 years was 75 and 87.5, respectively. The Constant score at 6 months correlated to that at one year ( r=0.926, p<0.0001) and at 2 years ( r=0.874, p=0.0001). In younger patients, improvement in the range of motion was faster. The early plateau group (those with no further improvement after 6 months) and the late plateau group (those with no further improvement after one year) did not differ significantly in age, fracture grade, or hand dominance. Conclusion. MIPO for fixation of proximal humeral fractures using a locking plate is safe and effective in enabling an early return of shoulder function.
Distal Femoral Fracture during Primary Total Knee Arthroplasty
Authors: Delasotta Lawrence A , Orozco Fabio , Miller Adam G , Post Zachary , Ong Alvin 
Published: October 2016

Purpose. To review 6 cases of periprosthetic distal femoral fracture during total knee arthroplasty (TKA). Methods. Of 778 women and 691 men who underwent primary TKAs using posterior-stabilised (n=1240), cruciate-retaining (n=165), or semi-constrained (n=64) implant, 5 women and one man with a mean age of 73.3 years and a mean body mass index of 31.6 kg/m2 sustained an intra-operative periprosthetic distal femoral fracture and were followed up for a mean of 12.8 (range, 2–39) months. Results. Respectively in patients with a posterior-stabilised, cruciate-retaining, or semi-constrained implant, the intra-operative fracture rates were 0.32%, 0%, and 3.13%. For women, the respective rates were 0.46%, 0%, and 5.10%. Intra-operative fracture was 9.69 times (p=0.03) more likely to occur in patients with a semi-constrained implant than those with a posterior-stabilised implant, and was 4.44 times (p=0.22) more likely to occur in women than in men. Half of the fractures occurred during the trial phase when the tibia was reduced onto the femur, and half during final prosthesis implantation. Conclusion. Distal femoral fracture during primary TKA is rare and associated with the use of a semi-constrained implant. Preserving as much bone in the distal femur is advised.
Lateral Plantar Nerve Release with or without Calcaneal Drilling for Resistant Plantar Fasciitis
Authors: Sadek Ahmed Fathy , Fouly Ezzat Hassan , Elian Mostafa Mohammed 
Published: October 2016

Purpose. To compare the outcome following lateral plantar nerve release with or without calcaneal drilling for resistant plantar fasciitis. Methods. 30 women and 3 men aged 30 to 60 (mean, 45) years with resistant plantar fasciitis were randomised to undergo release of the first branch of the lateral plantar nerve with (group 1, n=18) or without (group 2, n=15) calcaneal drilling. Results. Patients were followed up for a mean of 27 months. According to the modified Mayo scoring system for plantar fasciotomy, group 1 was superior to group 2 in terms of score (93.9±6.97 vs. 83±8.2, p<0.001) and grading (15 excellent, 2 good, and one fair vs. 6 excellent, 4 good, and 5 fair; p=0.031). Three patients in group one and one patient in group 2 (16.7% vs. 6.6%, p=0.381) developed complications of heel numbness, foot oedema, and 2 cases of superficial wound infection, respectively. Conclusion. Adding calcaneal drilling to release of the first branch of the lateral plantar nerve achieves better outcome than release alone in patients with resistant plantar fasciitis.
Intra-Articular Tranexamic Acid Wash during Bilateral Total Knee Arthroplasty
Authors: Zhu Meng , Chen Jerry Yongqiang , Yew Andy Khye Soon , Chia Shi-Lu , Lo Ngai Nung , Yeo Seng Jin 
Published: October 2016

Purpose. To compare the outcome after simultaneous bilateral total knee arthroplasty (TKA) with or without an intra-articular tranexamic acid (TXA) wash in terms of blood loss, haemoglobin change, and transfusion requirement. Methods. 35 women and 10 men (mean age, 67.5 years) who underwent primary simultaneous bilateral TKA by a single senior surgeon were compared with 45 matched controls. In the TXA group, 1500 mg of TXA diluted in 100 ml of 0.9% sodium chloride was administered as a wash after cementing of implant and before closure of the retinaculum. At least 5 minutes of contact time was allowed before wound closure and tourniquet deflation. No drain was used. Results. No patients had thromboembolic complication. Compared with controls, the TXA group had lower perioperative blood loss (920 vs. 657 ml, p=0.001), total blood loss (997 vs. 679 ml, p<0.001), blood transfusion rate (60% vs. 37.8%, p=0.035), percentage of patients requiring more than one blood unit (24.4% vs. 8.9%, p=0.048), and length of hospitalisation (6 vs. 4 days, p<0.001). Nonetheless, the 2 groups were comparable in blood units and volume transfused. Conclusion. An intra-articular TXA wash during simultaneous bilateral TXA reduced total blood loss and resulted in a difference of 22.2% in blood transfusion rate and a 2-day reduction in the length of hospital stay.
Radiography versus Multidetector Computed Tomography in Assessing Graft Integration after Acetabular Reconstruction
Authors: Fernandez-Valencia Jenaro Ángel , Gallart Xavier , Tomás Xavier , Piñeros Daniel , García Sebastián , Riba Josep 
Published: October 2016

Purpose. To compare radiography with multidetector computed tomography (MDCT) in the evaluation of graft integration following acetabular reconstruction for failed total hip arthroplasty (THA). Methods. Records of 5 men and 6 women aged 60 to 78 (mean, 71.8) years who underwent acetabular reconstruction using structural allografts for severe acetabular deficiency secondary to aseptic loosening (n=9) or septic loosening (n=2) were reviewed. The mean survival time of the THA was 136.4 (range, 12–360) months. Acetabular defects were classified as IIC (n=2), IIIA (n=3), or IIIB (n=6). Structural allografts were fixed with impaction followed by a reinforcement ring (n=10), an antiprotrusio cage (n=2), and/or an oblong cup (n=1) with gentamicine-loaded cement. Cup loosening, graft integration, and graft resorption were evaluated using radiography. In addition, graft integration was evaluated using MDCT. Results. At a mean follow-up of 4.2 (range, 2–11) years, the survival of the acetabular reconstruction was 90.9%. No patient had any signs of infection. One patient underwent reoperation 22 months later for dislocation secondary to abductor deficiency caused by nonunion of the trochanteric fracture. According to radiography, all patients had graft integration. One patient had definitive and another had possible cup loosening. Four patients had minor graft resorption. According to MDCT, graft integration was complete in only one patient, partial >50% in 3, partial <50% in 4, and absent in 2. Conclusion. MDCT is more accurate than radiography in evaluating graft integration following acetabular reconstruction.
Posterior Condylar Cartilage Thickness and Posterior Condylar Offset of the Femur: A Magnetic Resonance Imaging Study
Authors: Wernecke Gregory C , Seeto Bradley G , Chen Darren B , MacDessi Samuel J 
Published: October 2016

Purpose. To measure the femoral posterior condylar cartilage (PCC) thickness and the posterior condylar offset (PCO) and determine the correlation between the 2 parameters in 530 normal subjects using magnetic resonance imaging (MRI). Methods. Records of 287 male and 243 female patients (mean age, 40.7 years) who underwent MRI for traumatic soft tissue knee injuries not involving the femoral PCC and did not have symptomatic knee arthritis were reviewed. Results. The PCC thickness was comparable in the lateral and medial sides (2.04 vs. 1.99 mm, p=0.13). Males had thicker PCC in the medial (2.05 vs. 1.92 mm, p=0.0006) and lateral (2.16 vs. 1.86, p<0.0001) sides than females. Age did not correlate with PCC thickness. The bony PCO was larger in the medial than lateral side (25.8 vs. 22.6 mm, p<0.0001). Males had a larger PCO than females in the medial side only (26.1 vs. 25.5 mm, p = 0.0195). The bony PCO did not correlate with PCC thickness. Conclusion. Femoral PCC thickness was comparable in the medial and lateral sides. Males had thicker PCC in the medial and lateral sides than females.