The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Oct 2008
Randomized Controlled Trial Comparative StudyFemoral nerve block for diaphyseal and distal femoral fractures in the emergency department. Surgical technique.
Diaphyseal and distal femoral fractures are painful injuries that are frequently seen in patients requiring a trauma work-up in the hospital emergency department prior to definitive management. The purpose of this study was to determine whether a femoral nerve block administered in the emergency department could provide better pain relief for patients with femoral fractures than currently used pain management practices. ⋯ The acute pain of a diaphyseal or distal femoral fracture can be significantly decreased through the use of a femoral nerve block, which can be administered safely in the hospital emergency department.
-
J Bone Joint Surg Am · Oct 2008
Randomized Controlled TrialUse of a postoperative lumbar corset after lumbar spinal arthrodesis for degenerative conditions of the spine. A prospective randomized trial.
Lumbosacral corsets and braces have been used to treat a variety of spinal disorders. Although their use after lumbar arthrodesis for degenerative conditions has been reported, there is a lack of evidence on which to base guidelines on their use. The purpose of this study was to evaluate the effect of a postoperative corset on the outcome of lumbar arthrodesis. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Oct 2008
Surgical treatment of main thoracic scoliosis with thoracoscopic anterior instrumentation. a five-year follow-up study.
The surgical outcomes in patients with scoliosis at two years following anterior thoracoscopic spinal instrumentation and fusion have been reported. The purpose of this study was to evaluate the results at five years. ⋯ Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Oct 2008
Randomized Controlled Trial Multicenter StudyComparison of autogenous bone graft and endothermic calcium phosphate cement for defect augmentation in tibial plateau fractures. A multicenter, prospective, randomized study.
Bone graft augmentation is often selected to treat defects associated with unstable tibial plateau fractures. This prospective, randomized, multicenter study was undertaken to determine the efficacy of bioresorbable calcium phosphate cement compared with standard autogenous iliac bone graft in the treatment of these osseous defects. ⋯ Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
-
J Bone Joint Surg Am · Oct 2008
Design and implementation of a system-based course in musculoskeletal medicine for medical students.
The amount of time devoted to musculoskeletal medicine in the typical undergraduate curriculum is disproportionately low compared with the frequency of musculoskeletal complaints that occur in a general practice. Consequently, whether because of the quantity or quality of the education, the competence level of graduating physicians regarding musculoskeletal problems is inadequate. Our purposes were to design a self-contained, system-based course in musculoskeletal medicine for medical students in the preclinical years and to measure the level of competence achieved by a class of first-year medical students who took the course. ⋯ The main features of the course were: (1) an emphasis on both cognitive and process-based knowledge; (2) more contact hours and broader content than in previously described courses in musculoskeletal medicine; (3) the use of small groups to focus on problem-solving and physical examination competencies; (4) basic-science content directly related to clinical goals. These features might be used at other institutions that employ a system-based curriculum for the preclinical years to help improve competence in musculoskeletal medicine.