bluuebunny/crossref_metadata_2025_split huggingface dataset:
Laminoplasty for Patients Aged 75 Years or Older with Cervical Myelopathy
Authors: Ishii M , Wada E , Ishii T , Kawai H , Kaneko N , Fuji T 
Published: October 2016

Purpose. To assess the neurological and walking status of 56 elderly patients after cervical myelopathy to determine whether the surgery was justified. Methods. Records of 23 men and 33 women aged 75 to 86 (mean, 79) years who underwent laminoplasty for cervical myelopathy were retrospectively reviewed. They had been followed up for a mean of 3.5 (range, 0.2–8.6) years. Walking status was assessed according to long-term care insurance criteria. In 45 patients with more than 2 years of follow-up, neurological status was evaluated according to the Japanese Orthopaedic Association (JOA) score. Neurological recovery rate was classified as excellent, good, fair, poor, and worse. Results. Postoperatively, of the 47 patients still living, 22 could walk independently, 22 required assistance outdoors, 2 were using a wheelchair, and one was bedridden. The mean JOA score was 9.7 preoperatively, 12.2 one year postoperatively, and 11.8 at final assessment (p<0.001). The mean neurological recovery rate was 29% at one-year follow-up and 24% at final assessment (p=0.06). Conclusion. Although excellent results were not expected in elderly patients, surgery to maintain independent walking status was justified in most of our patients.
Dynamic Movement of the Long Head of the Biceps Tendon in Frozen Shoulders
Authors: Kanbe K , Inoue K , Inoue Y 
Published: October 2016

Purpose. To assess the importance of the dynamic movement of the long head of the biceps (LHB) tendon for treatment of frozen shoulder. Methods. 87 consecutive patients (with 88 frozen shoulders) aged 36 to 77 (mean, 54) years underwent arthroscopic capsular release by a single surgeon. Preoperative treatments included rehabilitation, steroid and/or hyaluronic acid injections. The inclusion criteria were severe night pain, no improvement of flexion and external rotation, and poor response to rehabilitation for at least 6 months. Shoulders were divided into 3 types; types A/B/C indicate slight/moderate/severe degree of synovitis and adhesion of the LHB tendon to the rotator interval. 23 shoulders were type A, 26 type B, and 39 type C. 18 of the 39 type-C shoulders were controls with release of the capsule alone but not the LHB tendon. Patients were followed up for a mean of 21 (range, 12–35) months. Changes in the American Shoulder and Elbow Surgeons (ASES) score, range of movement, and muscle strength (flexion and external rotation) among types A, B, C, and controls were compared. Results. The severity of the adhesion of the LHB tendon to the rotator interval was associated with the ASES score. In all adhesion types, muscle strength and the range of movement in flexion, external rotation, and internal rotation improved postoperatively. Conclusions. Arthroscopic capsular release for adhesion of the LHB tendon to the rotator interval improves the sliding movement and thereby shoulder function.
Anatomic Study for Pubic Medullary Screw Insertion
Authors: Suzuki T , Soma K , Shindo M , Minehara H , Itoman M 
Published: October 2016

Purpose. To study the anatomy of the pubic ramus and adjacent structures in 160 Japanese to establish a safer pubic screw fixation technique. Methods. 80 male and 80 female Japanese aged 16 to 89 (mean, 50) years (10 persons in each decade of age) underwent 3-dimensional computed tomographic scanning of their pelvises. The angle at which the screw should be targeted, the appropriate length of the screw, the size of the canal for screw insertion, and the proximity to the bladder, iliac artery, and iliac vein were determined. Correlations between the canal diameters (of the acetabular, base, and parasymphyseal areas) and body features (age, height, and weight) were analysed. Results. In men and women respectively, the appropriate mean screw length was 124.6 and 123.8 mm; the guide wire should be targeted at a mean of 66° and 67° cephalad and 54.1° and 55.9° laterally for insertion of a retrograde pubic screw; the minimum distances from the pubis to the bladder/iliac artery/iliac vein were 0 and 0 mm/4.9 and 4.6 mm/0.8 and 0.2 mm. In both men and women, the canal diameters at the base were positively correlated to weight. In women, the canal diameters at the parasymphyseal area were correlated to height and weight. Canal diameters at the acetabulum were not correlated to height and weight. Conclusion. Pubic screw fixation may be potentially disastrous (owing to joint penetration and iliac vein injury) and should be performed with caution. When the canal diameter at the acetabulum is extremely narrow, plate fixation, computer-assisted surgery, or changing to a smaller-diameter screw is recommended.
Heparin versus Danaproid for Prevention of Venous Thromboembolism after Hip Surgery
Authors: Nakase J , Toribatake Y , Mouri Y , Seki H , Kitaoka K , Tomita K 
Published: October 2016

Purpose. To compare the prevalence of deep vein thrombosis (DVT), pulmonary thromboembolism (PTE), and bleeding complications in patients receiving heparin or danaproid after hemiarthroplasty or osteosynthesis for hip fractures. Methods. 37 men and 138 women aged 47 to 100 (mean, 80) years underwent either hemiarthroplasty or osteosynthesis for hip fractures; 5 patients with dementia were excluded. All patients received preoperative elastic stocking and postoperative intermittent pneumatic compression. They were divided into 3 groups based on their admission period: controls (n=71), unfractionated heparin (n=44), and danaproid sodium (n=55). Drugs were administered from postoperative day 1 to 7. At day 7, all patients undertook radioisotope venography of the legs and lung perfusion scintigraphy. Results. In the control, heparin, and danaproid groups respectively, the DVT rates were 31%, 9.1%, and 5.5%, and the PTE rates were 5.6%, 4.5%, and 1.8%. Only the DVT rate in the control group was significantly higher than that in the heparin and danaproid groups. In the heparin group, one patient had gastrointestinal bleeding, 5 developed wound haematomas, and one had leakage from the drain site for 2 weeks. Conclusion. Danaproid sodium appeared more effective and safer than heparin, with no bleeding complications occurred.
Philos Plate Fixation for Proximal Humeral Fractures
Authors: Martinez AA , Cuenca J , Herrera A 
Published: October 2016

Purpose. To evaluate the efficacy of Philos plate fixation for proximal humerus fractures. Methods. Functional outcomes of 31 men and 27 women aged 36 to 73 (mean, 61) years who underwent Philos plate fixation for proximal humeral fractures were retrospectively reviewed. Indications for surgery were 3-part (n=33) or 4-part (n=25) closed proximal humeral fractures with angulation of more than 45 degrees or displacement of more than 1 cm. Functional outcomes and shoulder range of movement were assessed based on the Constant scoring system. Results. Patients were followed up for 12 to 18 (mean, 15) months. All fractures healed satisfactorily, except in one patient with a valgus 4-part fracture who had malunion. No wound infections, vascular injuries, avascular necrosis, or loss of fixation ensued. Two patients with axillary nerve palsy recovered spontaneously within 3 months. Functional outcome was excellent in 13 patients, good in 36, moderate in 8, and poor in 1. The mean Constant score was 80 (range, 40–100). Conclusion. The Philos plate fixation is appropriate treatment for proximal humeral fractures.
Unreamed Intramedullary Nailing with Oblique Proximal and Biplanar Distal Interlocking Screws for Proximal Third Tibial Fractures
Authors: Singh VK , Singh Y , Singh PK , Goyal RK , Chandra H 
Published: October 2016

Purpose. To assess the outcome of unreamed intramedullary nailing through the lateralised entry point using oblique proximal and biplanar distal interlocking screws. Methods. 15 men and 3 women aged 25 to 58 (mean, 37) years underwent unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third metaphyseal tibial fractures. The entry point was kept proximal to the tibial tuberosity and slightly lateral to midline. Proximal locking was at 45° to the coronal and sagittal planes. Biplanar distal locking was in the coronal and sagittal planes. Results. 16 patients had bone union within 20 (mean, 17; range, 14–27) weeks; 2 underwent dynamisation for delayed union. Three patients had valgus angulation of <5°; 2 had a loss of terminal knee flexion; 3 had a loss of ankle dorsiflexion; and 3 had shortening of >0.5 cm. Functional outcomes were excellent in 13, good in 4, and fair in one patient. No patient endured neurovascular injury, compartment syndrome or implant failure. Conclusion. Unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third tibial fractures was effective in preventing malalignment.
Total Hip Arthroplasty Using Proximal Porous Coating Stem with Distal Sleeve: Mid-Term Outcome
Authors: Saito M , Takahashi KA , Fujioka M , Ueshima K , Sakao K , Inoue S , Kubo T 
Published: October 2016

Purpose. To report mid-term results of total hip arthroplasty (THA) using the Opti-Fix Plus Hip System (Opti-Fix Hip), and to assess the correlations between peri-implant bone changes and the distal medullary occupancy rate. Methods. 11 men (13 hips) and 53 women (58 hips) aged 24 to 87 (mean, 61) years underwent THA using the Opti-Fix Hip, with a modular stem and a distal sleeve, and were followed up for a mean of 6.5 (range, 4.8–9.6) years. Clinical outcomes were evaluated using the Japanese Orthopaedic Association (JOA) hip score. Implant stability, bone changes around the implant, and the occupancy rate of the stem in the medullary space were examined radiologically. Bone changes around the implant were assessed based on the radiological evidence of a pedestal, osteolysis, stress shielding, and radiolucent lines. Results. The mean JOA score increased significantly after surgery and was maintained at the latest follow-up. Around the acetabular and femoral components respectively, 38 and 58 hips had radiolucent lines, whereas one and 54 hips developed osteolysis. A pedestal appeared in 21 hips and grade-III or higher stress shielding in 30 hips. Two hips showed loosening of the acetabular components, but none in the femoral components. Osteolysis around the stem was frequently observed in hips with poor distal medullary occupancy. Conclusion. Clinical and radiological outcomes of the Opti-Fix Hip were favourable. The low incidence of osteolysis in the distal stem suggests that the proximal circumferential porous coating was effective. Minor osteolysis around the proximal stem was frequently observed, indicating early excessive wear of the polyethylene liner. Its high distal medullary occupancy rate could inhibit stem micromotion and aseptic loosening.
Comparison of Acetabular Reamings during Hip Resurfacing versus Uncemented Total Hip Arthroplasty
Authors: Brennan SA , Harty JA , Gormley C , O'Rourke SK 
Published: October 2016

Purpose. To compare the quantity of bone removed from the acetabulum during resurfacing hip arthroplasty versus uncemented total hip arthroplasty (THA). Methods. 62 consecutive patients with osteoarthritis of the hip were prospectively studied. 24 men and 7 women aged 40 to 86 (mean, 59) years underwent Birmingham hip resurfacing. 13 men and 18 women aged 34 to 88 (mean, 61) years underwent uncemented THA using the trident acetabular cup. Obese elderly women at risk of femoral neck fracture and patients with large subchondral pseudocysts or a history of avascular necrosis of the femoral head were assigned to uncemented THA. Acetabular reamings were collected; marginal osteophytes were not included. The reamings were dehydrated, defatted, and weighed. Results. The mean weight of acetabular reamings was not significantly different between patients undergoing hip resurfacing and uncemented THA (p=0.57). Conclusion. In hip resurfacing, the use of an appropriately small femoral component avoids oversizing the acetabular component and removal of excessive bone stock.
Arthroscopy-Assisted Computer Navigation in High Tibial Osteotomy for Varus Knee Deformity
Authors: Lo WN , Cheung KW , Yung SH , Chiu KH 
Published: October 2016

Purpose. To assess the accuracy of knee alignment after high tibial osteotomy (HTO) for varus knee deformity using arthroscopy-assisted computer navigation. Methods. Six men and 4 women aged 47 to 53 (mean, 49) years underwent medial open wedge HTO for varus knee deformity and medial unicompartmental osteoarthritis using arthroscopy-assisted computer navigation with fluoroscopy. Patients were followed up for a mean of 23 (range, 11–32) months. Intra- and post-operative leg alignments were compared. Results. The mean postoperative coronal plane alignment was 2.7 (range, 1–4) degree valgus; the mean deviation from intra-operative computer images was one (range, 0.1–1.9) degree; 5 knees had less valgus in the postoperative radiographs than the intra-operative computer images. Conclusion. Despite being more technically demanding, time consuming, and costly, arthroscopy-assisted computer navigation is safe, accurate, and reliable for HTO.
Cytokine Synthesis by Chondroblastoma: Relation to Local Inflammation
Authors: Uchikawa C , Shinozaki T , Nakajima T , Takagishi K 
Published: October 2016

Purpose. To investigate cytokine production by chondroblastoma in inducing local inflammation and adjacent-joint arthritis. Methods. Immunohistochemical analyses of curetted tissues using anti-human interleukin (IL)-1β, IL-6, IL-8, and tumour necrosis factor (TNF)-α were performed for 6 patients with chondroblastoma and 3 patients with giant cell tumour (GCT) of bone. In addition, prostaglandin E2, IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, and TNF-α in the cyst fluid of one of the patients with chondroblastoma and 2 with GCT of bone were measured using immunoassay kits. Conclusion. Cytokines such as IL-1β, IL-8, TNF-α, and particularly IL-6 play an important role in local inflammation in patients with chondroblastoma.
Continuous Decompression Using a Cannulated Ceramic Pin for Simple Bone Cysts
Authors: Morii T , Mochizuki K , Satomi K 
Published: October 2016

Purpose. To report the outcomes of continuous decompression using a cannulated ceramic pin for simple bone cysts (SBCs). Methods. Seven boys and 3 girls aged 7 to 16 (mean, 11) years with SBCs underwent curettage and continuous decompression using a cannulated ceramic pin. The pin was made of hydroxyapatite and tricalcium phosphate. The clinical course, radiological findings, and complications were retrospectively assessed. Results. The mean follow-up duration was 41 (range, 12–84) months. Five patients were evaluated as ‘healed’, 2 as ‘healing with defect’, one as ‘persistent cyst’, and 2 as ‘recurrent cysts’. No peri-operative complications were encountered. One patient had a postoperative fracture at the pin insertion site. Seven patients had pain relief and good outcomes; 2 had a thin cortical rim and complained of occasional pain and their sports activities were restricted. Conclusion. Decompression using a cannulatedceramic pin for SBCs is minimally invasive, highly osteoconductive, and does not require bone grafting or a second operation to remove the device.
Conservative Management of Idiopathic Clubfoot: Kite versus Ponseti Method
Authors: Sanghvi AV , Mittal VK 
Published: October 2016

Purpose. To compare the long-term results of the Kite and Ponseti methods of manipulation and casting for clubfoot. Methods. 42 patients (with 64 idiopathic clubfeet) were equally randomised to Kite or Ponseti treatments in the early weeks of life. 14 males and 7 females (34 clubfeet) were treated by the Kite method, whereas 13 males and 8 females (30 clubfeet) were treated by the Ponseti method. All the clubfeet were manipulated, casted, and followed up (for a mean of 3 years) by one experienced orthopaedic surgeon. The final results were compared. Results. The success rates for the Kite and Ponseti treatments were similar (79% vs 87%). With the Ponseti method, the number of casts was significantly fewer (7 vs 10); the duration of casting required to achieve full correction was significantly shorter (10 vs 13 weeks); the maximum ankle dorsiflexion achieved was significantly greater (12 vs 6 degrees); and the incidence of residual deformity and recurrence was slightly lower. Conclusion. The Ponseti method can achieve more rapid correction and ankle dorsiflexion with fewer casts, without weakening the Achilles tendon.
Morphology of the Scapula Relative to the Reverse Shoulder Prosthesis
Authors: Torrens Carlos , Corrales Monica , Gonzalez Gemma , Solano Alberto , Caceres Enrique 
Published: October 2016

Purpose. To analyse the morphology of the scapula relative to the reverse shoulder prosthesis. Methods. Scapulas of 46 women and 27 men aged 16 to 84 (mean, 53) years with proximal humeral fractures (n=52) or recurrent antero-inferior instability (n=21) were assessed using 3-dimensional computed tomography (CT). For comparison, 108 cadaveric scapulas with unknown epidemiology were assessed using a goniometer and a caliper. The length of the glenoid neck, the angle between the glenoid surface and the upper posterior column of the scapula, and the angles between the major craneocaudal glenoid axis and (1) the base of the coracoid process and (2) the upper posterior column of the scapula were assessed. Results. The length of the glenoid neck was classified into short and long. In the respective CT and cadaveric groups, the anterior glenoid neck was short in 42% and 18% of scapulas and long in 58% and 82%, whereas the posterior glenoid neck was short in 34% and 60% of scapulas and long in 66% and 40%. The angle between the glenoid surface and the upper posterior column of the scapula was classified into types I (50°–52°) and II (62°–64°). In the respective CT and cadaveric groups, 61% and 71% of scapulas were type I and 39% and 29% were type II. All differences between groups were significant. The mean angles between the major craneocaudal glenoid axis and (1) the base of the coracoid process and (2) the upper posterior column of the scapula were 18° and 8°, respectively. Conclusion. Because of variations in scapular morphology, individualised adjustment is needed for reverse shoulder prostheses. Three-dimensional CT is valuable in preoperative planning.
Early Results of Total Knee Arthroplasty with a Low Contact Stress Anteroposterior Glide
Authors: Bauze Adrian J , Falworth Mark S , Oakeshott Roger D 
Published: October 2016

Purpose. To present early results of 400 consecutive low contact stress (LCS) anteroposterior (AP) glide total knee arthroplasties (TKAs) performed by a single surgeon. Methods. 304 consecutive patients aged 30 to 96 (mean, 66) years underwent 400 TKAs using LCS AP glides performed by a single surgeon. Only patients with an intact posterior cruciate ligament, a fixed flexion deformity of <15°, and a valgus deformity of <15° were included. Patients were assessed pre- and post-operatively using the American Knee Society (AKS) and Hospital for Special Surgery (HSS) scores. Range of motion was measured using a goniometer. AP and lateral radiographs were assessed for radiolucencies and osteolysis. Results. The mean follow-up period was 4.2 (range, 1–8) years. The mean fixed flexion improved to 1° from 11° and the mean active flexion improved to 120° from 111°. Both AKS and HSS scores improved significantly. There were 28 anterior soft tissue impingements; 9 of them were in the first year of the study. Thereafter, the anterior lip of the bearing was modified and any offending osteophytes, soft tissue, or fat pads were excised. Of 39 (10%) knees that underwent re-operation (16 were due to anterior soft tissue impingement), 20 (5%) did not require change of the AP glide bearing and the remaining 19 were converted to a rotating platform bearing. No patellar baja was noted after fat pad excision. No patient had catastrophic wear or failure of the polyethylene bearing. The survival rate of the AP glide bearing was 95%. Conclusion. The early-to-mid-term outcomes of the LCS AP glide TKA are promising.
Pick-up Test: An Indication for Opponensplasty in Patients with Severe Carpal Tunnel Syndrome
Authors: Yip Siu-Leung , Yen Chi-Hung , Chan Wai-Lam , Leung Hon-Bong , Mak Kan-Hing 
Published: October 2016

Purpose. To use a pick-up test to assess thenar motor deficit and results of opponensplasty. Methods. Eight consecutive patients with idiopathic severe carpal tunnel syndrome and severe thenar motor deficit were identified. All were females aged 39 to 60 (mean, 53) years and right-hand dominant. The severity of thenar motor deficit was assessed using the pick-up test. Failure to pick up a coin with the thumb and index finger only in a normal pulp-to-pulp pincer grip was an indication for an opponensplasty (in addition to open carpal tunnel release) to hasten recovery of thumb abduction. Treatment outcome was assessed using the pick-up test at 6, 8, and 12 weeks. Results. Preoperatively, all patients were unable to perform the pick-up test. At postoperative 6 weeks, all patients could pick up the coin with no difficulty and were satisfied with the result of opponensplasty. There was no relapse at subsequent follow-ups and no donor-site morbidity in terms of cosmesis, scar pain or infection. Grip strength and the range of wrist motion were 63% and 92% of the normal side, respectively. Conclusion. The pick-up test is a simple and reliable means of identifying those in need of an opponensplasty.
Flexor Hallucis Longus Tendon Transfer for Reconstruction of Chronically Ruptured Achilles Tendons
Authors: Mahajan Ravindra H , Dalal Rakesh B 
Published: October 2016

Purpose. To report the mid-term results of flexor hallucis longus (FHL) tendon transfer for reconstruction of chronically ruptured Achilles tendons. Methods. 24 men and 12 women aged 56 to 78 (mean, 70) years underwent FHL tendon transfer for reconstruction of chronically ruptured Achilles tendons by a single surgeon. Ruptures were secondary to trauma (n=20), long-term steroid intake (n=12), or chronic renal failure (n=6). Two patients had bilateral ruptures. The mean interval from rupture to surgery was 15 (range, 12–24) weeks. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) hind foot scores were compared. Wound healing, push-off, and patient satisfaction were evaluated. Results. The mean follow-up period was one year. The mean AOFAS scores were 69 (range, 58–76) preoperatively and 88 (range, 79–94) postoperatively; the mean improvement was 19 (p<0.001). 28 patients had excellent and 8 had fair results. 33 patients graded their outcome as ‘very satisfactory’ and 3 as ‘satisfactory’. Five patients developed wound healing complications but only one needed debridement. There was no fixation-related complication or sural nerve injury. Conclusions. Transfer of the FHL for reconstruction of chronically ruptured Achilles tendons is effective, safe and easily performed in patients with low-to-moderate demands.