bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Quality of Life Between Elderly Patients Undergoing TKA
Authors: Alentorn-Geli Eduard , Leal-Blanquet Joan , Guirro Pau , Hinarejos Pedro , Pelfort Xavier , Puig-Verdié Lluís 
Published: August 2014

The purpose of this study was to compare the short-term changes in quality of life for patients younger than 80 years with those 80 years and older undergoing total knee arthroplasty (TKA). It was hypothesized that patients 80 years and older had a similar quality of life after TKA compared with those younger than 80 years.
All consecutive patients undergoing primary TKA were enrolled in this prospective, comparative, prognostic (level I evidence) study and were stratified into 2 groups based on their age (younger than 80 years and 80 years and older). Data on quality of life assessed using the Short Form 36 health survey were obtained preoperatively and 1 year postoperatively (short-term follow-up) and were compared between groups. A total of 328 (83.89%) patients younger than 80 years (mean age, 70.7 years) and 63 (16.11%) patients 80 years and older (mean age, 82.1 years) were included. No significant differences in preoperative quality of life were observed between groups. Postoperative physical function, vitality, social function, and physical component summary were lower in patients 80 years and older. Older patients had a lower difference between pre- and postoperative values in Short Form 36 physical function and role–emotional scores.
Patients 80 years and older had a similar improvement in quality of life 1 year after TKA compared with patients younger than 80 years. Therefore, changes in quality of life justify TKA as a treatment option for elderly patients with end-stage knee osteoarthritis.
Computer-assisted Navigation in Orthopedic Surgery
Authors: Mavrogenis Andreas F. , Savvidou Olga D. , Mimidis George , Papanastasiou John , Koulalis Dimitrios , Demertzis Nikolaos , Papagelopoulos Panayiotis J. 
Published: August 2014

Educational Objectives

1.
Identify the available types of computer-assisted navigation in orthopedic surgery.

2.
Summarize the clinical applications of computer-assisted navigation in orthopedic surgery.

3.
Review the results of related series using computer-assisted navigation in orthopedic surgery.

4.
Recognize the disadvantages and pitfalls of computer-assisted navigation in orthopedic surgery.

Computer-assisted navigation has a role in some orthopedic procedures. It allows the surgeons to obtain real-time feedback and offers the potential to decrease intra-operative errors and optimize the surgical result. Computer-assisted navigation systems can be active or passive. Active navigation systems can either perform surgical tasks or prohibit the surgeon from moving past a predefined zone. Passive navigation systems provide intraoperative information, which is displayed on a monitor, but the surgeon is free to make any decisions he or she deems necessary. This article reviews the available types of computer-assisted navigation, summarizes the clinical applications and reviews the results of related series using navigation, and informs surgeons of the disadvantages and pitfalls of computer-assisted navigation in orthopedic surgery.
AO X-shaped Midfoot Locking Plate to Treat Displaced Isolated Greater Tuberosity Fractures
Authors: Chen Yun Feng , Zhang Wen , Chen Qiang , Wei Hai Feng , Wang Lei , Zhang Chang Qing 
Published: August 2014

Although various implants exist for 3- and 4-part fractures, few implants are appropriate for isolated greater tuberosity fractures. This retrospective study evaluated the efficacy of AO X-shaped midfoot locking plates for greater tuberosity fractures.
Between May 2008 and September 2009, nineteen patients with displaced greater tuberosity fractures were treated with open reduction and internal fixation using AO X-shaped midfoot locking plates. Postoperatively, radiographs, functional results, and complications were evaluated. All patients were followed up for a mean 33.2 months (range, 24–42 months). Mean healing time was 9.4 weeks (range, 8–14 weeks). Mean Constant score was 90.6±4.0 points (range, 77–95 points). Excellent results were obtained in 16 cases, good in 2 cases, moderate in 1 case, and poor in 0 cases. The excellent-good rate was 94.7%. No recurrence of dislocation occurred in the 11 cases with shoulder dislocation. All fractures healed without the complications of wound infection, skin numbness, subacromial impingement syndrome, nonunion, secondary displacement, and implant loosening.
The described technique is an effective, simple, and inexpensive method with a short learning curve.
Rate of Clinically Significant Posttraumatic Arthritis After Small Finger Intra-articular Carpometacarpal Fractures
Authors: Park Min Jung , Pappas Nick , Kim John , Bozentka David 
Published: August 2014

Although small finger intra-articular carpometacarpal joint fractures are relatively common hand injuries, few studies in the orthopedic literature report their clinical outcomes. The goal of this study was to analyze the rate of symptomatic posttraumatic arthritis following small finger intra-articular carpometacarpal joint fractures.
The authors performed a chart review of 82 consecutive patients with a small finger intra-articular carpometacarpal fractures treated at their institution over a 5-year period. Operative indications included irreducible small finger intra-articular carpometacarpal fractures and recurrent small finger carpometacarpal joint instability after attempted reduction. Group 1 included 66 patients with small finger intra-articular carpometacarpal fractures who were treated with cast immobilization alone for 6 weeks, whereas group 2 included 16 patients treated surgically followed by 6 weeks of cast immobilization. Clinical outcome parameters included posttreatment serial radiographs, a visual scale based on subjective pain scores (0–10) as part of a routine clinic intake form, and the need for subsequent small finger carpometacarpal arthrodesis. All patients included in the study had a minimum 12-month follow-up. In group 1, 6 (9.1%) of 66 patients developed symptomatic posttraumatic arthritis and required a subsequent small finger carpometacarpal arthrodesis. In group 2, none of the patients developed symptomatic posttraumatic arthritis or required arthrodesis. This study reports a relatively higher rate of small finger carpometacarpal arthrodesis after closed treatment alone for intra-articular small finger carpometacarpal fractures compared with open treatment, suggesting that anatomic alignment is important in this injury pattern.
Outcomes of Functional Weight-bearing Rehabilitation of Achilles Tendon Ruptures
Authors: Jackson Gillian , Sinclair Victoria F. , McLaughlin Charles , Barrie James 
Published: August 2014

The introduction of functional rehabilitation for patients with Achilles tendon rupture has dramatically changed treatment programs for this condition. The authors introduced a functional weight-bearing protocol for patients with an acute Achilles tendon rupture treated operatively and nonoperatively in 2002. They hypothesized that no significant differences would exist in the rerupture rates and functional outcomes between the groups.
Between 2002 and 2008, the authors collected data on 80 consecutive patients treated with a weight-bearing functional orthosis for complete Achilles tendon rupture. Following evidence-based counseling, 51 patients chose nonoperative treatment and 29 chose operative treatment. Outcome measures included rerupture rates, other complications, and functional scoring. The nonoperative group was a decade older (median age, 47 years [range, 27–80 years]) than the operative group (median age, 37 years [range, 24–55 years]). Rerupture was noted in 2 (4%) patients in the nonoperative treatment group and 1 (3%) patient in the operative group. Two (7%) patients in the operative group developed superficial wound infections and reported no nerve injuries. Median Achilles Tendon Total Rupture Score was 82 points in the nonoperative group and 94 in the operative group. Median Victorian Institute of Sports Assessment-Achilles tendinopathy questionnaire scores were 60 and 91 for the nonoperative and operative groups, respectively.
Both groups had low rerupture rates. Functional scores, using the newly validated Achilles Tendon Total Rupture Score, were lower in the nonoperative group.
Electrothermal Ring Burn From a Car Battery
Authors: Sibley Paul A. , Godwin Kenneth A. 
Published: August 2014

Despite prevention efforts, burn injuries among auto mechanics are described in the literature. Electrothermal ring burns from car batteries occur by short-circuiting through the ring when it touches the open terminal or metal housing.
This article describes a 34-year-old male auto mechanic who was holding a wrench when his gold ring touched the positive terminal of a 12-volt car battery and the wrench touched both his ring and the negative terminal. He felt instant pain and had a deep partial-thickness circumferential burn at the base of his ring finger. No other soft tissues were injured. He was initially managed conservatively, but after minimal healing at 3 weeks, he underwent a full-thickness skin graft. The graft incorporated well and healed by 4 weeks postoperatively. He had full range of motion.
The cause of ring burns has been controversial, but based on reports similar to the current patient’s mechanism, they are most likely electrothermal burns. Gold, a metal with high thermal conductivity, can heat up to its melting point in a matter of seconds. Many treatments have been described, including local wound care to split- and full-thickness skin grafts. Because most burns are preventable, staff should be warned and trained about the potential risks of contact burns. All jewelry should be removed, and the live battery terminal should be covered while working in the vicinity of the battery.
Internal Fixation of Distal Metacarpal Fractures: New Uses for an Old Plate
Authors: Sibley Paul A. , Jacoby Sidney M. , Abzug Joshua M. , Waddell Christina L. , Rivlin Michael , Bednar John M. 
Published: August 2014

Certain metacarpal fracture patterns require operative fixation to restore anatomy and optimize results. Compared with dorsal plating, the width of the minicondylar blade plate buttresses the deforming volar pull of the intrinsics and provides a stronger construct. The implant provides firm fixation in the juxta-articular fragment with minimal space requirements. Therefore, the purpose of this study was to examine the outcomes following the use of a minicondylar blade plate for the treatment of distal metacarpal fractures.
Twenty-two distal metacarpal fractures in 20 patients treated with a minicondylar blade plate were retrospectively reviewed. Outcome measures collected included postoperative grip strength, range of motion, return to work, and radiographic evidence of osseous union. Average range of motion of the metacarpophalangeal joint was 62° postoperatively. Eighty-two percent (18/22) of fractures were able to flex their digits to their distal palmar crease. Seventy-one percent (12/17) of patients had at least 75% return to grip strength compared with the contralateral side. Seventeen patients returned to full activity at a mean of 2.5 months (range, 1–3 months) postoperatively; 1 patient was on disability, and data were not available for the final 2 patients. No major complications occurred.
The minicondylar blade plate is a safe and effective technique for stabilizing unstable periarticular metacarpal fractures. Stable fixation allows for early range of motion, rapid return to strength, and a relatively quick return to full work duty.
Morphological Characteristics of Posterolateral Articular Fragments in Tibial Plateau Fractures
Authors: Xiang Gao , Zhi-Jun Pan , Qiang Zheng , Hang Li 
Published: August 2014

Treatment of posterolateral tibial plateau fractures is controversial, and information regarding this specific fracture pattern is lacking. The purpose of this study was to elucidate the frequency and morphological features of posterolateral articular fragments in tibial plateau fractures.
A retrospective radiographic and chart review was performed on a consecutive series of patients who sustained tibial plateau fractures between May 2008 and August 2012. The articular surface area, maximum posterior cortical height, sagittal fracture angle, and amount of displacement were measured on computed tomography scans using the Picture and Archiving Communication System. Thirty-six (15%) of 242 injuries demonstrated a posterolateral fracture fragment comprising a mean 14.3% of the articular surface of the total tibial plateau (range, 8% to 32%). Mean major articular fragment angle was 23° (range, 62° to −43°), mean maximum posterior cortical height was 29 mm (range, 18 to 42 mm), and mean sagittal fracture angle was 77° (range, 58° to 97°).
The posterolateral plateau articular fracture fragment has morphological characteristics of a conically shaped fragment with a relatively small articular surface area and sagittal fracture angle. Recognizing these morphological features will help the clinician formulate an effective surgical plan.
Anatomy and Histology of the Transverse Humeral Ligament
Authors: Snow Brian J. , Narvy Steven J. , Omid Reza , Atkinson Roscoe D. , Vangsness C. Thomas 
Published: August 2014

The classic literature describes the transverse humeral ligament (THL) as a distinct anatomic structure with a role in biceps tendon stability; however, recent literature suggests that it is not a distinct anatomic structure. The purpose of this study was to evaluate the gross and microscopic anatomy of the THL, including a specific investigation of the histology of this ligament.
Thirty frozen, embalmed cadaveric specimens were dissected to determine the gross anatomy of the THL. Seven specimens were evaluated histologically for the presence of mechanoreceptors and free nerve endings. Two tissue layers were identified in the area described as the THL. In the deep layer, fibers of the subscapularis tendon were found to span the bicipital groove with contributions from the coracohumeral ligament and the supraspinatus tendon. Superficial to this layer was a fibrous fascial covering consisting of distinct bands of tissue. Neurohistology staining revealed the presence of free nerve endings but no mechanoreceptors.
This study’s findings demonstrate that the THL is a distinct structure continuous with the rotator cuff tendons and the coracohumeral ligament. The finding of free nerve endings in the THL suggests a potential role as a shoulder pain generator.
Anterior Interosseous Nerve Palsy as a Complication of Proximal Humerus Fracture
Authors: Tanagho Andy , Elgamal Tarek , Ansara Sameh 
Published: August 2014

Anterior interosseous nerve palsy subsequent to proximal humerus fracture is rare compared with an axillary nerve injury. This article presents a case of anterior interosseous nerve palsy secondary to such a fracture in an 87-year-old woman after a simple fall onto her outstretched hand.
The patient had no sensory involvement but was unable to form an O with her thumb and index finger. She had a positive pointing index test on attempting to clasp her hand. The fracture and nerve palsy were treated conservatively. At 3-month follow-up, the patient had partial recovery; therefore, electromyography was not performed. By 6 months, she had complete recovery of anterior interosseous nerve palsy.
This case highlights the possibility of sustaining anterior interosseous nerve palsy with proximal humerus fracture with a classical clinical presentation. Because most nerve lesions after proximal humerus fracture are neurapraxia, symptoms usually resolve either partially or completely after a few months.
It is recommended that cases with proximal humerus fracture be evaluated carefully for median nerve and axillary nerve injury. In addition, it is recommended to perform electromyography if no signs of recovery are evident at 3-month follow-up.
Dislocated Double-layered Lateral Meniscus Mimicking the Bucket-handle Tear
Authors: Lee Kwang Won , Yang Dae Suk , Choy Won Sik 
Published: August 2014

Various shapes of congenital abnormalities of the meniscus have been reported. Among them, the double-layered meniscus is rare. This article describes a 22-year-old man with a double-layered lateral meniscus who reported right knee pain with no history of trauma.
The double-layered lateral meniscus included both the upper and lower meniscus. The anterior and posterior edge of the upper meniscus was attached to the lower lateral meniscus, and its periphery was not connected to the capsule and the lower meniscus. In addition, the upper meniscus was dislocated into the intercondylar notch, mimicking a bucket-handle tear. However, the lower meniscus was normal in appearance, so a bucket-handle or horizontal tear of the meniscus was ruled out of the differential diagnosis.
Although this is a rare case, clinicians should be aware of this anomaly due to the potential for a double-layered meniscus to contribute to a bucket-handle or horizontal tear of the lower meniscus. Therefore, early diagnosis and proper treatment of a double-layered meniscus are needed before an additional injury occurs to a normal meniscus.
Determinants of Ocular Deviation in Esotropic Subjects Under General Anesthesia
Authors: Daien Vincent , Turpin Chloé , Lignereux François , Belghobsi Riadh , Le Meur Guylene , Lebranchu Pierre , Pechereau Alain 
Published: August 2014

Purpose:
The authors attempted to identify the determinants of ocular deviation in a population of patients with esotropia under general anesthesia.

Methods:
Forty-one patients with esotropia were included. Horizontal ocular deviation was evaluated by the photographic Hirschberg test both in the awakened state and under general anesthesia before surgery. Changes in ocular deviation were measured and a multivariate analysis was used to assess its clinical determinants.

Results:

The mean age (± standard deviation [SD]) of study subjects was 13 ± 11 years and 51% were females. The mean spherical equivalent refraction of the right eye was 2.44 ± 2.50 diopters (D), with no significant difference between eyes (
P
= .26). The mean ocular deviation changed significantly, from 33.5 ± 12.5 prism diopters (PD) at preoperative examination to 8.8 ± 11.4 PD under general anesthesia (
P
= .0001). The changes in ocular deviation positively correlated with the pre-operative ocular deviation (correlation coefficient r = 0.59,
P
= .0001) and negatively correlated with patient age (correlation coefficient r = −0.53,
P
= .0001). These two determinants remained significant after multivariate adjustment of the following variables: preoperative ocular deviation; age; gender; spherical equivalent refraction; and number of previous strabismus surgeries (model r
2
= 0.49,
P
= .0001).

Conclusions:
The ocular position under general anesthesia was reported as a key factor in the surgical treatment of subjects with esotropia; therefore, its clinical determinants were assessed. The authors observed that preoperative ocular deviation and patient age were the main factors that influenced the ocular position under general anesthesia.

[J Pediatr Ophthalmol Strabismus 2013;50(3):155–160.]
Long-term Outcomes of Photorefractive Keratectomy for Low to High Myopia: 13 to 19 Years of Follow-Up
Authors: Vestergaard Anders H. , Hjortdal Jesper Ø. , Ivarsen Anders , Work Kresten , Grauslund Jakob , Sjølie Anne Katrin 
Published: August 2014

PURPOSE:
To evaluate long-term outcomes after photorefractive keratectomy (PRK).

METHODS:
A retrospective follow-up study of patients who received PRK at 5.0- to 6.5-mm optical zones, using the Summit broad beam excimer laser (Summit Technology, Inc., Waltham, MA) at Odense University Hospital, Odense, Denmark, between 1992 and 1998. One randomly selected eye of each patient was used in the statistical analyses. Re-treated eyes were excluded.

RESULTS:
One hundred sixty eyes were included. Mean follow-up time was 16 years (range: 13 to 19 years). Mean preoperative spherical equivalent was −4.84 ± 2.95 diopters (D) (range: −20.25 to −1.25 D). At last follow-up examination, achieved refraction was −1.00 ± 1.56 D (range: −10.75 to +1.00 D) from attempted refraction, and the change in mean refractive error from 6 months postoperatively was less than 1.00 D. Results from a subgroup of unilateral treated patients indicated that myopic progression was the main reason for the residual refractive error. For eyes with low myopia (n = 124), the proportion of eyes within ±1.0 D of attempted refraction was 72%, and for eyes with high myopia (−6.00 D or more, n = 36) it was 47%. Forty-five percent had uncorrected distance visual acuity of 20/20 or better at last follow-up examination. Three eyes (2%) lost two or more lines and 13 eyes (8%) gained two or more lines of corrected distance visual acuity. Fourteen percent had haze (grade 0.5 to 2). Eighty-one percent were satisfied with the surgery.

CONCLUSION:
PRK for low degrees of myopia seemed safe and effective up to 19 years after surgery with conventional broad beam laser ablation. Refractive predictability was significantly lower and the occurrence of haze was higher in eyes with high myopia.

[
J Refract Surg
. 2013;29(5):312–319.]
Intraocular Straylight After Thin-Flap LASIK With a Femtosecond Laser Versus a Mechanical Microkeratome
Authors: Wang Yan , Li Jing , Liu Yangchen , Xie Lili 
Published: August 2014

PURPOSE:
To investigate characteristics of straylight before and after thin-flap LASIK performed with femtosecond laser versus with mechanical microkeratome and assess changes at 1 day, 1 week, 1 month, 6 months, and 1 year postoperatively.

METHODS:
One hundred twenty-eight consecutive eyes from 66 patients were included in this prospective study. Sixty-one eyes of 31 patients had thin-flap LASIK with femtosecond laser. In addition, 67 eyes from 35 patients underwent thin-flap LASIK with mechanical microkeratome were included for comparison. Following flap creation, all eyes were ablated using the VIXS S4 excimer laser system (Visx USA, Inc., Santa Clara, CA). Straylight values were measured using the C-Quant straylight meter (Oculus Optikgeräte GmbH, Wetzlar, Germany) preoperatively and 1 day, 1 week, 1 month, 6 months and 1 year postoperatively.

RESULTS:

Preoperatively, the mean straylight values were 0.93 ± 0.11. After femtosecond laser-assisted thin-flap LASIK, the values were 1.00 ± 0.11, 0.98 ± 0.10, and 0.99 ± 0.12 at 1 day, 1 week, and 1 month, respectively, and significantly increased (F = 7.62,
P
> .0001) compared to preoperative values. However, these values decreased and returned to preoperative levels at 6 months and 1 year postoperatively (0.92 ± 0.09 and 0.89 ± 0.13, respectively;
P
> .05). The postoperative-preoperative increases in straylight were reduced in the femtosecond laser group compared to the mechanical microkeratome group (0.05 ± 0.13 vs 0.10 ± 0.13 at 1 month postoperatively;
P
< .05). This difference was statistically significant at 1 month postoperatively (
P
= .04). A negative significant correlation was also found between preoperative straylight values and postoperative-preoperative increases.

CONCLUSIONS:
Straylight increased significantly in the early stages after femtosecond laser-assisted thin-flap LASIK. However, these values improved over time and gradually returned to preoperative levels, which may be related to the progression of corneal healing.

[
J Refract Surg.
2013;29(8):534–539.]