The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2003
Clinical TrialThe Lapidus procedure as salvage after failed surgical treatment of hallux valgus: a prospective cohort study.
Recurrent hallux valgus is a relatively common, yet challenging, condition for both the patient and the surgeon. The literature on the treatment of recurrent hallux valgus is sparse. The purpose of this study was to evaluate prospectively the functional outcome and patient satisfaction following the Lapidus procedure for the treatment of recurrent hallux valgus deformity. ⋯ Therapeutic study, Level IV (case series [no, or historical, control group]). See p. 2 for complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2003
Comparative StudyCentral placement of the screw in simulated fractures of the scaphoid waist: a biomechanical study.
Recent reports on internal fixation of acute fractures of the scaphoid waist have demonstrated higher rates of central placement of the screw when cannulated screws were used than when noncannulated screws were used. This cadaveric study was designed to determine whether central placement in the proximal fragment of the scaphoid offers a biomechanical advantage. ⋯ Central placement of the screw in the proximal fragment of the scaphoid offers a biomechanical advantage in the internal fixation of an osteotomy of the scaphoid waist. Clinical efforts and techniques that facilitate central placement of the screw in the fixation of fractures of the scaphoid waist should be encouraged.
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J Bone Joint Surg Am · Jan 2003
Long-term follow-up of fresh tibial osteochondral allografts for failed tibial plateau fractures.
The management of large posttraumatic full-thickness osteochondral defects in the proximal part of the tibia remains a challenge. The goal of treatment is a pain-free range of motion of the knee that provides enduring function and enables a young patient to participate in a wide range of activities. The use of fresh osteochondral allograft transplantation for tibial plateau lesions has been well documented. The purpose of the present study was to assess the survivorship and the long-term functional outcome following fresh osteochondral transplantation for unipolar posttraumatic tibial plateau defects in young, high-demand patients. ⋯ Fresh osteochondral allografts for large traumatic defects of the tibial plateau have provided a long-lasting and reliable reconstructive solution for a high-demand population. Meniscal allografts should be used when clinically warranted. In the present study, all grafts were protected with a coincident realignment osteotomy when preoperative radiographs suggested that the allograft would be placed under increased load. Conversion to knee arthroplasty was required for approximately one-third of the patients at an average of ten years.