bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-Term Outcome of Retrograde Tibiotalocalcaneal Arthrodesis with a Curved Intramedullary Nail
Authors: Mückley Thomas , Klos Kajetan , Drechsel Thomas , Beimel Claudia , Gras Florian , Hofmann Gunther O. 
Published: February 2011

Background: The aim of this study was to investigate the potential clinical benefit of tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary nail with a valgus curve, two compression options, and angle-stable locking. Material and Methods: Patients who had undergone TTCA at two tertiary hospitals were eligible. Patients who had undergone TTCA before the beginning of the study were evaluated retrospectively, then all following patients were examined prospectively. There were 59 TTCAs; 55 patients were available for analysis. Twenty-eight were evaluated retrospectively, 27 prospectively. Main Outcome Measures were an SF-36, Mazur-, and AOFAS ankle-hindfoot rating scores and radiographic examination. Results: Bony union was obtained in 53 patients. Fifty-one patients were satisfied with the outcome. Fifty-one patients had marked subjective improvement in mobility. The mean AOFAS score of the 55 patients at the latest followup was 66.8 (range, 38 to 86). The mean Mazzur score was 68.0 (range, 30 to 83). In the prospective group, the scores were significantly improved: AOFAS score by an average of 39.6 points ( p < 0.001); Mazur score by an average of 43 points ( p < 0.001); SF-36 physical component summary score ( p < 0.001) and mental component summary score also improved ( p < 0.048). Radiology showed good hind-foot alignment. The complication rate was 25%. Conclusion: Compared with the literature, the data obtained in this study show a good outcome and a high rate of bony union, with comparable complication rates. Patient satisfaction was good. However, the patients still had limitations. The clinical benefit of the nail used was confirmed. Level of Evidence: IV, Case Series
Distinctive Pain Course during First Year after Total Ankle Arthroplasty: A Prospective, Observational Study
Authors: Pagenstert Geert , Horisberger Monika , Leumann André G. , Wiewiorski Martin , Hintermann Beat , Valderrabano Victor 
Published: February 2011

Background: Patients and health care professionals alike are often surprised by the course of pain after total ankle arthroplasty (TAA). The current study aimed to determine the baseline patterns of postoperative symptoms during the first year following uncomplicated TAA. Materials and Methods: In a prospective observational study 28 patients with unilateral posttraumatic osteoarthritis were tested for pain with a visual analogue scale, swelling (min grade, 0; max grade, 4), ankle range of motion, and AOFAS ankle score. Assessments were performed preoperatively and 6 weeks, 3, 6, 9, and 12 months after TAA. Results: At 6 weeks all variables had improved significantly. However, at 3 months a relapse with deterioration of mean variables was found. These improved asymptotically during assessments at 6, 9, and 12 months. Conclusion: Our data suggest patients undergoing uncomplicated TAA have to overpass what we believe is an adaptive inflammatory phase with increased periarticular pain and swelling about 3 months after surgery. This distinctive course may influence patient education and increase confidence of healthcare professionals involved in the rehabilitation of TAA patients. Level of Evidence: II, Prospective Observational Study
Outcomes of Ankle Fractures in Patients with Uncomplicated versus Complicated Diabetes
Authors: Wukich Dane K. , Joseph Alison , Ryan Michael , Ramirez Claudia , Irrgang James J. 
Published: February 2011

Background: Patients with diabetes who sustain an ankle fracture are at increased risk for complications including higher rates of in hospital mortality, in-hospital postoperative compli-cations, length of stay and non-routine discharges. The purpose of this study was to retrospectively compare the complications associated with operatively treated ankle fractures in a group of patients with uncomplicated diabetes versus a group of patients with complicated diabetes. Complicated diabetes was defined as diabetes associated with end organ damage such as peripheral neuropathy, nephropathy and/or PAD. Uncomplicated diabetes was defined as diabetes without any of these associated conditions. Our hypothesis was that patients with uncomplicated diabetes would experience fewer complications than those patients with complicated diabetes. Materials and Methods: We compared the complication rates of ankle fracture repair in 46 patients with complicated diabetes and 59 patients with uncomplicated diabetes and calculated odds ratios (OR) for significant findings. Results: At a mean followup of 21.4 months we found that patients with complicated diabetes had 3.8 times increased risk of overall complications 3.4 times increased risk of a non-infectious complication (malunion, nonunion or Charcot arthropathy) and 5 times higher likelihood of needing revision surgery/arthrodesis when compared to patients with uncomplicated diabetes. Open ankle fractures in this diabetic population were associated with a three times higher rate of complications and 3.7 times higher rate of infection. Conclusion: Patients with complicated diabetes have an increased risk of complications after ankle fracture surgery compared to patients with uncomplicated diabetes. Careful preoperative evaluation of the neurovascular status is mandatory, since many patients with diabetes do not recognize that they have neuropathy and/or peripheral artery disease. Level of Evidence: III, Retrospective, Case Control Study
Stability Criteria for Nonoperative Ankle Fracture Management
Authors: Pakarinen Harri J. , Flinkkilä Tapio E. , Ohtonen Pasi P. , Ristiniemi Jukka Y. 
Published: February 2011

Background: This study was designed to see if stability based criteria are useful in choosing between nonoperative and operative treatment of ankle fractures. Materials and Methods: One hundred sixty ankle fractures in skeletally mature patients were retrospectively analyzed to obtain an epidemiological profile in a population of about 130,000. One hundred thirty patients had followup of more than 2 years. A decision between operative and nonoperative treatment was made by the surgeon-on-duty, based on accepted stability criteria. Fractures were classified according to Weber and Lauge-Hansen systems. Clinical outcome was assessed using the scoring systems of Olerud-Molander, the RAND 36-Item Health Survey and the Visual Analogue Scale (VAS), measuring pain and function. Results: The overall incidence of ankle fractures was 154/100,000. Nonoperatively treated patients had more displacement of the distal fibula after treatment, but less pain and better Olerud-Molander (good or excellent, 89% vs. 71%) and VAS functional scores. Independent factors for worse outcome were female gender, older age, unstable fracture and co-morbidity. No nonoperatively treated patients needed operative fixation during followup. Conclusion: Stability-based fracture classification was a simple and useful tool in decision-making for the treatment of ankle fractures. We found lateral malleolar fractures could be treated nonoperatively with success if the ankle mortise was stable. Displacement of the distal fibula after treatment did not affect functional scores or pain. Level of Evidence: III, Comparative Case Series
Fixation of First Tarsometatarsal Arthrodesis: A Retrospective Comparative Cohort of Two Techniques
Authors: DeVries J. George , Granata Jaymes D. , Hyer Christopher F. 
Published: February 2011

Background: Presently, indications for the Lapidus procedure include patients with many pathologies of the first metatarsocuneiform joint. Currently the standard in many areas is that of two or three crossed screws through the first tarsometatarsal region. This type of fixation requires an extended period of nonweightbearing and may be difficult for patient compliance. Materials and Methods: The present study is a retrospective comparison of crossed screw fixation to locking plate fixation without a lag screw on union rates, time to weightbearing, and complications. Results: One hundred forty-three first TMT fusions met the inclusion criteria. There were 96 fused by crossed screw construct (CS) and 47 by the locked plate with or without compression screw (LP). There was a significant difference in time to full weightbearing and union rate. Time to full weightbearing was 8.8 (range, 3 to 16) weeks and 7.8 (range, 1.5 to 34) weeks in the CS and LP groups, respectively ( p < 0. 001). Union rate was 89.4% (88 of 96 joints) and 98.5% (46 of 47 joints) in the CS and LP groups, respectively ( p < 0. 001). Conclusions: We found that when using a dorsal-medial locked plate with or without lag screw lead to a superior rate of union compared to standard crossed screw constructs even while allowing earlier return to full weightbearing. Level of Evidence: III, Retrospective Comparative Analysis
Peripheral Nerve Sheath Tumors of the Foot and Ankle
Authors: Carvajal Jaime A. , Cuartas Esteban , Qadir Rabah , Levi Allan D. , Temple H. Thomas 
Published: February 2011

Background: Peripheral nerve sheath tumors (PNSTs) are soft tissue neoplasms found in intimate association with a peripheral nerve. They are rarely seen in the foot and ankle where they have an innocuous appearance, but these tumors have the potential to become malignant. This study reports a large series of foot and ankle PNSTs surgically treated at a single institution. Materials and Methods: Retrospectively, all cases of PNSTs confirmed by biopsy and surgically treated from 1992 to 2008 were included in the study. Preoperative, perioperative and postoperative variables were collected. Foot and ankle tumors were compared with the overall group of PNSTs. Fisher's test and Student's t-test were implemented to address the significance of the findings ( p< 0. 05). Results: From all PNSTs identified ( n= 137), there were 14 (10.2%) foot and ankle. A painful mass was the most common presenting symptom. Schwannoma represented the most common histologic type. Two cases of malignant foot and ankle PNSTs were identified. Foot and ankle PNSTs were significantly smaller in size and showed fewer postoperative neurologic deficits than the overall group of PNSTs. No differences were found in terms of histologic type distribution, age at diagnosis, duration of symptoms and postoperative tumor recurrence, but there was a preponderance of females in this series of foot and ankle tumors. Conclusion: PNSTs of the foot and ankle usually present as innocuous, slow-growing masses leading to misdiagnosis and suboptimal surgical treatment of a potentially malignant lesion. A comprehensive diagnostic evaluation, preoperative planning and meticulous surgical excision are required to prevent tumor recurrence and minimize the incidence of postoperative sequelae, thus improving postoperative functional outcomes. Level of Evidence: IV, Retrospective Case Series
Correction of Severe Foot Deformities Using the Taylor Spatial Frame
Authors: Floerkemeier Thilo , Stukenborg-Colsman Christina , Windhagen Henning , Waizy Hazibullah 
Published: February 2011

Background: This study was conducted to evaluate the treatment of severe foot deformities using the Taylor spatial frame. Materials and Methods: The treatment of seven patients with nine severe foot deformities was reviewed. The mean age of the patients at surgery was 16 years with a mean followup of 21.5 months. The following parameters were assessed: etiology of deformity, date of surgery, surgical procedure, age at surgery, previous surgical or conservative treatments, preoperative symptoms, preoperative and postoperative deformity and affected side, complications during correction, duration of TSF, duration of hospital stay, occurrence of secondary osteoarthritis, recurrence of deformity, surgical revisions or subsequent surgeries. The pre- and postoperative deformity was assessed clinically. The final outcome was categorized as good, fair, or poor. Results: The results were good in eight feet and poor in one foot. Early complications included pin tract infection, temporary hypoesthesia and temporary shortening of the tendon of the flexor digitorum longus. Recurrence of deformity occurred in no patient. One patient required a subtalar arthrodesis for symptomatic, secondary osteoarthritis in one foot. Conclusion: The present study showed that TSF is a viable solution to correct severe foot deformities but we believe a surgeon should be aware of the possible complications. Level of Evidence: IV, Retrospective Case Series
Definition of Coordinate System for Three-Dimensional Data Analysis in the Foot and Ankle
Authors: Green Connor , Fitzpatrick Clare , FitzPatrick David , Stephens Michael , Quinlan William , Flavin Robert 
Published: February 2011

Background: Three-dimensional data is required to have advanced knowledge of foot and ankle kinematics and morphology. However, studies have been difficult to compare due to a lack of a common coordinate system. Therefore, we present a means to define a coordinate frame in the foot and ankle and its clinical application. Materials and Methods: We carried out ten CT scans in anatomically normal feet and segmented them in a general purpose segmentation program for grey value images. 3D binary formatted stereolithography files were then create and imported to a shape analysis program for biomechanics which was used to define a coordinate frame and carry out morphological analysis of the forefoot. Results: The coordinate frame had axes standard deviations of 2.36 which are comparable to axes variability of other joint coordinate systems. We showed a strong correlation between the lengths of the metatarsals within and between the columns of the foot and also among the lesser metatarsal lengths. Conclusion: We present a reproducible method for construction of a coordinate system for the foot and ankle with low axes variability. Clinical Relevance: To conduct meaningful comparison between multiple subjects the coordinate system must be constant. This system enables such comparison and therefore will aid morphological data collection and improve preoperative planning accuracy. Level of Evidence: III, Retrospective Case Control Study
Invoking Experience as Evidence
Authors: Sangster Joan 
Published: February 2011

Abstract: This paper uses the hundreds of private letters that women sent to the Royal Commission on the Status of Women in 1968–9 to explore women's changing interpretations of paid work in the twenty-five years after the Second World War. These working women often invoked their own experiences as evidence the commission should heed, although its staff tended to see the letters as subjective and personal, and thus less useful than official briefs. The letters offer us insight into how women negotiated and interpreted changing patterns of paid work, as the number of working mothers increased significantly in this era. An analysis of the letters revisits feminist debates about the concept of experience: while some feminist writers have become increasingly skeptical of using women's words as ‘authentic’ evidence from the past, others remain committed to the ‘retrieval of experience,’ arguing that we can use the concept in a way that does not reify experience, gloss over differences between women, or ignore the way in which it is interpreted by historical actors using the cultural resources at hand. Following from the second line of argument, the paper also suggests that the letters offer us a sense of connection to and feeling for the past, which should remain important aspects of feminist history.
Entre nationalismes irlandais et canadien-français : Les intrigues québécoises de la Self Determination for Ireland League of Canada and Newfoundland
Authors: Jolivet Simon 
Published: February 2011

Abstract: In May of 1920, the Self Determination for Ireland League of Canada and Newfoundland (SDIL), an Irish republican organization, was founded in Montreal. The League opposed the actions of the British government of David Lloyd George at the time of the Anglo-Irish War (1919–1921), but it primarily presented itself as a Canadian organization. This article will describe the founding and evolution of this association still neglected by Irish-Canadian historiography. Deliberately focused on the experience of the SDIL in Quebec, the article highlights that two former Irish nationalist traditions clashed in the province: one, constitutional autonomist, and the other, republican. Despite this division of Irish-Quebec nationalist forces, the involvement of French-Canadian elites in the SDIL contributed to making the League a success in Quebec. At the time, journalists and politicians like Omer Héroux, Armand Lavergne and Henri Bourassa effectively supported the goals of the SDIL. This pragmatic agreement between Irish and French-Canadian coreligionsists who had often clashed at the beginning of the twentieth century (especially on the subject of French education in Canadian schools) incidentally constituted one of the original elements of the business of the SDIL.
Climbing the Pinnacle of Art: Learning Vacations at the Banff School of Fine Arts, 1933–1959
Authors: Wall Karen , Reichwein PearlAnn 
Published: February 2011

Abstract: Learning tourism at the Banff School of Fine Arts in Banff National Park, Alberta, was historically rooted in a combination of mass tourism, public education, and cultural politics. Initiated by the University of Alberta, the School offered summer programs premised on the traditions and ideals of rational recreation and adult extension. This study focuses on the School's visual arts programs from the mid-1930s to the late 1950s, discussing administration, teaching and learning within a broader circuit of culture. Mediating between state agendas of cultural development and popular taste in landscape art, the School's production of visual art also contributed to the production of Banff National Park as a tourist commodity. In coordinating temporary tourist communities of artistic production and wilderness consumption, the Banff School contributed to shaping twentieth-century concepts of the human-nature relationship as mediated through practices of tourism and art.
Egas Moniz (1874–1955) and the “invention” of modern psychosurgery: a historical and ethical reanalysis under special consideration of Portuguese original sources
Authors: Gross Dominik , Schäfer Gereon 
Published: February 2011

The Portuguese neurologist Egas Moniz (1874–1955) is often regarded as the founder of psychosurgery. He performed the first prefrontal leukotomy in 1935—about 75 years ago—with the help of neurosurgeon Almeida Lima (1903–1985). In contrast to the psychosurgical interventions performed by the Swiss psychiatrist Gottlieb Burckhardt (1836–1907), Moniz's interventions on the white brain substance caught great attention worldwide. As a matter of fact, it was this repercussion that led to the award of the Nobel Prize for Medicine in 1949, an award that is still highly controversial today.
The goal of the present article is to reconstruct the historical background of the first leukotomies, the tangible expert debate since 1935 on the indication and legitimacy of these interventions, and their contemporary and recent (ethical) evaluation. Special focus will be set on the original Portuguese literature, which has been given too little attention thus far in the English-language literature.
Surgical approaches to hypothalamic hamartomas
Authors: Wait Scott D. , Abla Adib A. , Killory Brendan D. , Nakaji Peter , Rekate Harold L. 
Published: February 2011

Object
Hypothalamic hamartomas (HHs) are devastating lesions causing refractory epilepsy, rage attacks, social ineptitude, and precocious puberty. Microsurgical and/or endoscopic resection offers an excellent risk/benefit profile for cure or improvement of epilepsy.

Methods
The authors reviewed a prospective database maintained during the first 7 years of the Barrow Hypothalamic Hamartoma program. They describe and illustrate their surgical methods, and they review data from several previous publications regarding surgical outcome.

Results
To date, the authors have performed surgery in 165 patients for symptomatic HHs. Patients underwent an endoscopic, transcallosal, or skull base approach, or multiple approaches. Twenty-six patients (15.8%) required more than 1 treatment for their HH.

Conclusions
Microsurgical and endoscopic resection of symptomatic HHs are technically demanding but can be performed safely with excellent results and an acceptable risk profile. Meticulous attention to the subtleties of surgical management helps optimize outcomes.
Analysis of the risk of shunt failure or infection related to cerebrospinal fluid cell count, protein level, and glucose levels in low-birth-weight premature infants with posthemorrhagic hydrocephalus
Authors: Fulkerson Daniel H. , Vachhrajani Shobhan , Bohnstedt Bradley N. , Patel Neal B. , Patel Akash J. , Fox Benjamin D. , Jea Andrew , Boaz Joel C. 
Published: February 2011

Object
Premature, low-birth-weight infants with posthemorrhagic hydrocephalus have a high risk of shunt obstruction and infection. Established risk factors for shunt failure include grade of the hemorrhage and age at shunt insertion. There is anecdotal evidence that the amount of red blood cells or protein levels in the CSF may affect shunt performance. However, this has not been analyzed specifically for this cohort of high-risk patients. Therefore, the authors performed this study to examine whether any statistical relationship exists between the CSF constituents and the rate of shunt malfunction or infection in this population.

Methods
A retrospective cohort study was performed on premature infants born at Riley Hospital for Children from 2000 to 2009. Inclusion criteria were a CSF sample analyzed within 2 weeks prior to shunt insertion, low birth weight (< 1500 grams), prematurity (birth prior to 37 weeks estimated gestational age), and shunt insertion for posthemorrhagic hydrocephalus. Data points included the gestational age at birth and shunt insertion, weight at birth and shunt insertion, history of CNS infection prior to shunt insertion, shunt failure, shunt infection, and the levels of red blood cells, white blood cells, protein, and glucose in the CSF. Statistical analysis was performed to determine any association between shunt outcome and the CSF parameters.

Results
Fifty-eight patients met the study entry criteria. Ten patients (17.2%) had primary shunt failure within 3 months of insertion. Nine patients (15.5%) had shunt infection within 3 months. A previous CNS infection prior to shunt insertion was a statistical risk factor for shunt failure (p = 0.0290) but not for shunt infection. There was no statistical relationship between shunt malfunction or infection and the CSF levels of red blood cells, white blood cells, protein, or glucose before shunt insertion.

Conclusions
Low-birth-weight premature infants with posthemorrhagic hydrocephalus have a high rate of shunt failure and infection. The authors did not find any association of shunt failure or infection with CSF cell count, protein level, or glucose level. Therefore, it may not be useful to base the timing of shunt insertion on CSF parameters.