bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thoracoscopic resection of right auricular masses in dogs: 9 cases (2003–2011)
Authors: Ployart Stéphane , Libermann Stéphane , Doran Ivan , Bomassi Eric , Monnet Eric 
Published: December 2012

Abstract
Objective—To determine the feasibility of thoracoscopic resection of masses located on the right auricle in dogs.
Design—Retrospective case series.
Animals—Dogs (n = 9) with a mass on the right auricle.
Procedures—Hospital records from 2003 to 2011 were reviewed. Only dogs that underwent thoracoscopic resection of a mass on the right auricle were selected. Data collected included history, clinicopathologic findings, surgical technique, and outcome.
Results—All dogs with pericardial effusion were examined by means of echocardiography. Cardiac masses on the right auricle were identified in 5 dogs. Eight dogs had clinical signs of cardiac tamponade and right-sided heart failure. All dogs underwent thoracoscopic resection of a mass on the right atrium. Eight hemangiosarcomas and 1 pyogranulomatous lesion were resected. One dog with a mass located at the base of the right auricle died during surgery. No postoperative complications were noted.
Conclusions and Clinical Relevance—Right auricular masses were successfully removed in 8 dogs. Masses close to the base of the right atrial appendage may not be amenable to resection with thoracoscopy. Resection of small masses at the tip of the right auricular appendage can be performed thoracoscopically.
Contrast-enhanced computed tomography of the gastrointestinal tract in clinically normal alpacas and llamas
Authors: Stieger-Vanegas Susanne M. , Cebra Christopher K. 
Published: December 2012

Abstract
Objective—To assess the feasibility and usefulness of CT enterography to evaluate the gastrointestinal tract in clinically normal llamas and alpacas.
Design—Prospective observational study.
Animals—7 clinically normal alpacas and 8 clinically normal llamas.
Procedures—The imaging protocol included orogastric administration of iodinated contrast material mixed with water. Three hours later, helical CT scanning was performed of the entire abdomen with transverse and multiplanar sagittal and dorsal projections before and after IV iodinated contrast agent injection.
Results—Both oral and IV contrast agents were well tolerated, and no adverse reactions were observed. Transverse images depicted the gastrointestinal tract and pancreas in the short axis; however, dorsal and sagittal projections aided in localizing and differentiating the various gastrointestinal segments, including the pancreas. In all camelids, the wall of the gastrointestinal tract was well differentiated. In all but 2 camelids, all gastrointestinal segments were well visualized and differentiated. In those 2 animals, the cecum was difficult to identify. Good distention of the small intestine was achieved by use of the oral contrast agent. The dorsal projections were useful to identify the pancreas in its entire length.
Conclusions and Clinical Relevance—The present study supplied new information about gastrointestinal wall thickness, intestinal diameter, and location of the pancreas and ileocecocolic junction in alpacas and llamas. Multiplanar contrast-enhanced CT was useful to reveal the various segments of the gastrointestinal tract, pancreas, and abdominal lymph nodes. The shorter time delay before imaging, compared with the delay with conventional barium studies, makes this technique complementary or superior to conventional radiographic or ultrasonographic studies for evaluation of the gastrointestinal tract.
2013 Initiatives: Extending JOSPT's Reach and Value
Authors: Simoneau Guy G. 
Published: December 2012

For the last several years, the Journal of Orthopaedic & Sports Physical Therapy has made a concerted effort to provide information that fosters evidence-based practice not only in the United States, JOSPT's home base, but also around the world. We have sought to reach new audiences through partnerships with professional organizations in other countries and to deliver greater value to all our readers through the Journal's website. In 2013, we will continue to pursue these goals and describe a few of our initiatives briefly in this editor's note. J Orthop Sports Phys Ther 2013;43(1):1–2. doi:10.2519/jospt.2013.0101
Fibular Stress Fracture in a High School Athlete
Authors: Greenberg Elliot M. , Gohn Nicholas , Grady Matthew 
Published: December 2012

The patient was a 15-year-old adolescent male who was referred to a physical therapist for a chief complaint of bilateral posterolateral lower-leg pain, which was worse in the right lower extremity than in the left. Due to findings that were concerning for a stress fracture, the patient was referred to a pediatric sports medicine physician. Subsequent radiographs revealed findings that were concerning for a stress fracture along the medial aspect of the midshaft of the right fibula. J Orthop Sports Phys Ther 2013;43(1):29. doi:10.2519/jospt.2013.0401
Medicolegal Cases for Spinal Epidural Hematoma and Spinal Epidural Abscess
Authors: French Keisha L. , Daniels Eldra W. , Ahn Uri M. , Ahn Nicholas U. 
Published: December 2012

Educational Objectives

As a result of reading this article, physicians should be able to:

1.
Diagnose spinal epidural hematoma and spinal epidural abscess.

2.
Outline the most common neurological deficits that occur from a spinal epidural hematoma or spinal epidural abscess.

3.
Identify indications for a good or poor prognosis.

4.
Minimize adverse outcomes for the provider.

Spinal epidural hematoma and spinal epidural abscess are rare surgical emergencies resulting in significant neurologic deficits. Making the diagnosis for spinal epidural hematoma and spinal epidural abscess can be challenging; however, a delay in recognition and treatment can be devastating. The objective of this retrospective analysis study was to identify risk factors for an adverse outcome for the provider.
The LexisNexis Academic legal search database was used to identify a total of 19 cases of spinal epidural hematoma and spinal epidural abscess filed against medical providers. Outcome data on trial verdicts, age, sex, initial site of injury, time to consultation, time to appropriate imaging studies, time to surgery, and whether a rectal examination was performed or not were recorded. The results demonstrated a significant association between time to surgery more than 48 hours and an unfavorable verdict for the provider. The degree of permanent neurologic impairment did not appear to affect the verdicts. Fifty-eight percent of the cases did not present with an initial deficit, including loss of bowel or bladder control.
All medical professionals must maintain a high level of suspicion and act quickly. Physicians who are able to identify early clinical features, appropriately image, and treat within a 48 hour time frame have demonstrated a more favorable medicolegal outcome compared with their counterparts in filed lawsuits for spinal epidural hematoma and spinal epidural abscess cases.
Functional Data for the Diagnosis of Patellofemoral Laxity Obtained by MRI During Quadriceps Isometric Contraction
Authors: Lomasney Laurie McAdams , Demos Terrence C. , Neveu Melissa , Fedors Nathan Holt , Tonino Pietro , Cheung Leo Wang-Kit 
Published: December 2012

Patellofemoral instability is related to anatomy. Magnetic resonance imaging (MRI) provides anatomic detail, but spoiled gradient echo (SPGR) imaging during isometric quadriceps contraction provides objective functional data for diagnosing patellofemoral laxity.
Knee MRI studies and medical charts of 398 patients were retrospectively reviewed. Two independent blinded observers evaluated the knee MRI studies for patellofemoral morphology and patellar position on axial SPGR images during relaxation and isometric quadriceps contraction for lateral patellar migration. Charts were reviewed for history of patellofemoral instability or dislocation. Patients were divided into 2 groups: group 1 comprised patients with 2.5 mm or more of lateral patellar migration on axial SPGR images, and group 2 comprised patients with less than 2.5 mm of patellar subluxation. Logistic regression models were used to determine relationships between patellofemoral subluxation of 2.5 mm or more and (1) history of dislocation or clinical patellofemoral instability, (2) grade 4 chondromalacia on MRI, (3) corrected central trochlear height, and (4) differential trochlear height (corrected for lateral condylar height). Statistically significant associations were found between patellar subluxation and each of the above 4 clinical/morphologic measures. Lateral patellar migration of 2.5 mm or more on SPGR obtained during quadriceps contraction had statistically significant associations with the above 4 measures.
Evaluation of SPGR of quadriceps contraction provides objective functional information about patellofemoral instability for management decisions.
Articulating Spacers for the Treatment of Infected Total Knee Arthroplasty: Effect of Antibiotic Combinations and Concentrations
Authors: Nettrour John F. , Polikandriotis John A. , Bernasek Thomas L. , Gustke Kenneth A. , Lyons Steven T. 
Published: December 2012

Performing 2-stage procedures using articulating antibiotic cement spacers to eradicate infection while providing pain relief and maintaining function has become common among many surgeons. Despite the efficacy of antibiotic cement spacers in the treatment of infected total knee arthroplasty, questions remain regarding the dosing of the antibiotic cement.
The authors assessed their experience with different antibiotic regimens and concentrations for the eradication of infection. Sixty-nine infected total knee arthroplasties with an average follow up of 31 months (range, 6–70 months) treated with articulating antibiotic spacers were retrospectively reviewed. Treatment groups were divided according to spacer antibiotic agents used and the amount of antibiotics added to the cement. Low-dose spacers were defined as those incorporating less than 4 g of antibiotic per 40-g bag of cement, and high-dose spacers were defined as those incorporating 4 g or more of antibiotic per 40-g bag of cement. High- vs low-dose spacers using a single or multiple antibiotic agents were compared. The overall rate of infection eradication was 88%. Dose dependency was not detected for spacers that incorporated single or multiple antibiotic agents, and multiple-agent spacers produced comparable success rates despite more frequent use in patients with impaired immune function.
Further study of optimal combinations and concentrations of antibiotic agents incorporated into these spacers is needed to help minimize treatment failures while maximizing treatment efficacy.
Deltoid Muscle Pressures During Arthroscopic Rotator Cuff Repair
Authors: McBrayer Daniel E. , Debelak Benjamin P. , Fernicola Patrick J. , Tu Renjin , Baker Champ L. 
Published: December 2012

The purpose of this study was to investigate deltoid compartment pressures during arthroscopic rotator cuff repair using modern pressure pumps to achieve visualization.
Twelve patients undergoing arthroscopic rotator cuff repairs were monitored for deltoid compartment pressure changes intraoperatively. Pre-, intra-, and postoperative intramuscular pressures were recorded. All patients demonstrated varying degrees of swelling due to fluid extravasation. Swelling was qualified as mild, moderate, or severe by clinical assessment and quantified objectively using a pressure monitor to record deltoid compartment pressures. Clinically, severe swelling occurred in 4 patients, all of whom underwent procedures lasting longer than 90 minutes. Objectively, no patient had evidence of dangerously elevated pressure measurements. The mean increase in compartment pressures was 9 mm Hg. All patients were treated and discharged as outpatients. No patient required more than oral narcotic analgesics for postoperative pain control beyond the postanesthesia care unit stay.
Arthroscopic rotator cuff repair may lead to clinically impressive swelling, but within the current study group, no evidence existed of clinically significant, persistent elevation of deltoid compartment measures using current arthroscopic techniques and arthroscopic pump systems. However, caution should be observed with regard to extended operative times and elevation of pump pressures.
MRI Study of Associated Shoulder Pathology in Patients With Full-thickness Subscapularis Tendon Tears
Authors: Li Xinning , Fallon Jonathan , Egge Natalie , Curry Emily J. , Patel Ketan , Owens Brett D. , Busconi Brian D. 
Published: December 2012

Subscapularis tendon tears are a well-established cause of shoulder pain. The objective of the current study was to evaluate the associated shoulder pathology in patients with full-thickness subscapularis tendon tears using magnetic resonance imaging. Forty-seven magnetic resonance imaging studies taken between 2008 and 2009 with a diagnosis of full-thickness subscapularis tendon tears were reviewed. The size of the subscapularis tendon tear, amount of muscle volume loss, Goutallier grade, biceps tendon pathology, coracohumeral distance, and associated rotator cuff tears were recorded. Statistical analysis was performed. Patients 55 years and older vs those 54 years and younger had an average subscapularis tear size of 35 vs 19 mm, an average Goutallier grade of 2.7 vs 0.8, and a total muscle volume loss of 25% vs 5%, respectively. Patients with a dislocated vs normal biceps tendons had an average subscapularis tear size of 37 vs 23 mm, an average Goutallier grade of 3 vs 0.9, and a total muscle volume loss of 28% vs 7%, respectively. Patients with vs without concomitant rotator cuff tears had an average subscapularis tear size of 32 vs 17 mm, an average Goutallier grade of 2.3 vs 0.6, and a total muscle volume loss of 21% vs 3%, respectively. Overall average coracohumeral distance measured in the axial plane was 10.8±4.6 mm. Average coracaohumeral distance was 14.8 vs 8.1 mm in patients with a Goutallier grade of 0 vs 3 or 4, resepectively, and 13.6 vs 8.5 mm in patients with no rotator cuff tear vs those with a supra- and infraspinatus tear, respectively.
Increased age, dislocated biceps tendons, and concomitant rotator cuff tears in patients with full-thickness subscapularis tendon tears are associated with larger subscapularis tendon tear size, higher Goutallier grades, and increased subscapularis muscle volume loss. Decreased coracohumeral distance is associated with a higher Goutallier grade and rotator cuff tears.
Computer-aided Analysis of Radial Head Morphometry
Authors: Puchwein Paul , Heidari Nima , Dorr Katrin , Struger Lukas , Pichler Wolfgang 
Published: December 2012

Operative treatment of displaced and comminuted radial head fractures involves internal fixation with plates and screws in cases where reconstruction is possible and replacement with a radial head prosthesis when comminution renders the radial head unreconstructable. The purposes of this study were to evaluate the morphometry of the radial head using a modern technique and to compare the findings with several commercially available radial head prostheses.
Computed tomography scans of 30 cadaveric elbows and 3-dimensional reconstructions were used to analyze the morphometry of the proximal radius. Results were compared with the manufacturer data of several radial head prostheses. Mean diameter of the radial head at the level of the fovea was 19±1.58 mm (range, 15.82–21.81 mm) in the anteroposterior plane and 18.62±1.78 mm (range, 15.48–22.21 mm) in the radioulnar plane. Mean diameter of the radial head at its widest part was 23.15±1.94 mm (range, 19.45–26.49 mm) in the anteroposterior plane and 22.44±1.73 mm (range, 19.64–25.44 mm) in the radioulnar plane. Mean diameter of the radial head at the level of the head–neck junction was 15.42±1.59 mm (range, 11.80–18.46 mm) in the anteroposterior plane and 14.75±1.39 mm (range, 12.32–17.31 mm) in the radioulnar plane. Statistically significant sex differences existed in the maximum diameter of the radial head, the diameter at the level of the head–neck junction, and the length of the radial head. Currently available radial head prostheses cover the range of sizes encountered. Products with a choice of head and stem sizes in any combination are preferable. In unstable elbow fractures, correct implant size is an important factor to avoid subluxation of the radial head (Mason type IV fractures) if collateral ligaments are sufficient.
Anatomic Mapping for Surgical Reconstruction of the Proximal Tibiofibular Ligaments
Authors: See Aaron , Bear Russell R. , Owens Brett D. 
Published: December 2012

Injury to the proximal tibiofibular joint is uncommon. Previous studies regarding the anatomy of this region have predominantly focused on joint orientation. As radiographic technology has advanced, later studies have attempted to evaluate the capsular anatomy. However, no reports specifically map the ligaments to this joint. The objectives of the current study were to define specific ligamentous structures that provide stability to the proximal tibiofibular joint, describe easily identifiable and reproducible surgical landmarks to aid in surgical reconstruction, and add to the understanding of the posterolateral structures of the knee previously described by other authors.
The proximal tibiofibular joint ligaments were identified in 10 fresh-frozen cadaveric specimens. Average ligament length, width, and thickness and area of the footprints of the tibial and fibular attachments were measured. Distances from the ligament footprints to known anatomic landmarks (eg, Gerdy’s tubercle, tibial articular surface, and fibular styloid) were also measured. The anterior ligament tibial attachment was a mean of 15.6 mm lateral and posterior to Gerdy’s tubercle and 17.3 mm anterior and inferior from the fibular styloid. Posterior ligament tibial insertion was a mean of 15.7 mm inferior to the tibial articular surface on the tibial side and 14.2 mm medial and slightly inferior from the fibular styloid.
Definable ligaments provide stability to the proximal tibiofibular joint and can be reconstructed in an anatomic fashion using the landmarks and parameters described. This information allows for an anatomic reconstruction of the proximal tibiofibular joint, which should provide patients with better outcomes and fewer postoperative sequelae.
Surgical Results of Zones I and II Fifth Metatarsal Base Fractures Using Hook Plates
Authors: Choi Jae Hyuck , Lee Kyung Tai , Lee Young Koo , Lee Jun Young , Kim Hwa Rye 
Published: December 2012

The purpose of this study was to evaluate the results of surgical treatment of fifth metatarsal base fractures using a mini-hook plate. Seventeen patients with Lawrence classification zones I (n=6) and II (n=11) fifth metatarsal base fractures with an initial fracture displacement more than 2 mm and a small (less than 2 mm) comminuted avulsion fragment were included in the study. Patients treated using a mini-hook plate fixation method were prospectively evaluated. A mini-hook tubular plate was designed so that the last hole functioned as a hook for the application of compression force, grasping of comminuted fragments, and rotational stabilization in metatarsal base fractures. Clinically, the American Orthopaedic Foot and Ankle Society (AOFAS) midfoot scale questionnaire was administered preoperatively and 1 year postoperatively. Union was determined by 3-dimensional computed tomography as clinically nontender callus formation. Time to union and return to sports were calculated. Mean AOFAS midfoot scale scores were 48±8 points (range, 35–60 points) preoperatively and 91±7 points (range, 85–100 points) 1 year postoperatively. Mean time to complete union, as determined by computed tomography, was 54±11 days (range, 38–74 days). All patients reported returning to prior activities of daily living at a mean of 74±10 days (range, 63–98 days). One patient reported hardware irritation secondary to inadequate plate bending and screw curving.
Mini-hook plate fixation is an effective alternative surgical method for zones I and II displaced fifth metatarsal base fractures or comminuted small fragment fractures.
New Clinical Classification System for Atlantoaxial Dislocation
Authors: Xu JunJie , Yin QingShui , Xia Hong , Wu ZengHui , Ma XiangYang , Zhang Kai , Wang ZhiYun , Yang JinCheng , Ai FuZhi , Wang JianHua , Liu JingFa , Mai XiaoHong 
Published: December 2012

The purpose of this study was to define a new clinical classification of atlantoaxial dislocation based on its clinical manifestations, namely reducible atlantoaxial dislocation (RAAD), irreducible atlantoaxial dislocation (IAAD), and fixed atlantoaxial dislocation (FAAD). A total of 107 patients with atlantoaxial dislocation were respectively treated based on this clinical classification, including 66 patients with RAAD, 39 patients with IAAD, and 2 patients with FAAD. Six of the 66 patients with RAAD with rotatory atlantoaxial dislocation were treated with traction and a cervical collar, 9 with fresh type II dens fracture were treated with cannulated screw fixation, and 51 were treated with posterior atlantoaxial or occipitocervical arthrodesis. Thirty-eight patients with IAAD received a transoral atlantoaxial reduction plate system, and 1 with a giant cell tumor was treated with lesion resection and vertebral reconstruction by a shaped titanium mesh system followed by posterior occipitocervical screw–rod fixation. The 2 patients with FAAD underwent anterior decompression and received a transoral atlantoaxial reduction plate system. Follow-up data were obtained for a minimum of 6 months. All patients’ neurological symptoms improved postoperatively. Bony union was accomplished by 3-month follow-up. Donor-site infection was found in 1 patient, with no occurrence of other complications.
This article proposes a new classification of atlantoaxial dislocation indicating the severity and difficulty in reduction of the atlantoaxial joint. The classification system assists with decision making regarding therapeutic options. Transoral atlantoaxial reduction plate fixation and posterior atlantoaxial screw–rod fixation are commonly performed for atlantoaxial dislocation.
Ceramic Liner Fatigue Fracture: 3-D CT Findings in a Late Recurrent THA Dislocation
Authors: Trivellin Giacomo , Sandri Andrea , Bizzotto Nicola , Marino Marco Andrea , Mezzari Silvio , Sambugaro Elena , Regis Dario 
Published: December 2012

Dislocation is one of the most common complications of total hip arthroplasty (THA). To the authors’ knowledge, late recurrent dislocation of a THA with a ceramic-on-ceramic coupling secondary to fatigue fracture of the ceramic liner has never been described.
A 76-year-old woman with right hip osteoarthritis underwent cementless modular THA with a ceramic-on-ceramic coupling. Approximately 10 years postoperatively, she experienced right hip pain with no trauma, which resolved in 14 days. Family members reported that the patient had shown a progressive cognitive and muscular decline in the previous months. Six months later, the patient was admitted for THA dislocation, which was immediately reduced. Computed tomography revealed that the right acetabular component had a retroversion of 4° and an inclination angle of 45°. An orthopedic brace was applied, but dislocation recurred 2 days after discharge. A 3-dimensional CT reconstruction showed a fracture of the ceramic liner in the posterolateral region. The patient underwent revision surgery, and the ceramic liner breakage was confirmed. After removal of the acetabular components, a cemented polyethylene cup was implanted. The stability of the stem was verified. The existing modular neck was replaced with a chromium–cobalt neck, and a new ceramic head was applied. At 7-month follow-up, the patient had good functional recovery with no hip instability.
Fatigue failure of a ceramic liner should be considered as responsible for late dislocation after ceramic-on-ceramic THA. As part of the diagnostic strategy, 3-dimensional CT reconstruction should be used to evaluate ceramic liner breakage.