The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Apr 2008
Nail or plate fixation of intertrochanteric hip fractures: changing pattern of practice. A review of the American Board of Orthopaedic Surgery Database.
A new method of fixation for intertrochanteric hip fractures that involves the use of an intramedullary nail that interlocks proximally into the femoral head was introduced in the early 1990s. Anecdotal observation of practice patterns during the Part II (oral) American Board of Orthopaedic Surgery examination suggested that the use of this method had increased substantially in recent years in comparison with the more traditional sliding compression screw technique. A study of the Part II database was undertaken to detect changing patterns of care for intertrochanteric fractures. ⋯ From 1999 to 2006, a dramatic change in surgeon preference for the fixation device used for the treatment of intertrochanteric fractures has occurred among young orthopaedic surgeons. This change has occurred despite a lack of evidence in the literature supporting the change and in the face of the potential for more complications.
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J Bone Joint Surg Am · Apr 2008
Comparative StudyAnterior cruciate ligament reconstruction in patients who have excessive joint laxity.
The purpose of the present study was to compare the clinical results of anterior cruciate ligament reconstruction with use of different grafts in patients with or without excessive joint laxity. ⋯ In patients who have excessive joint laxity, the two-year outcomes of anterior cruciate ligament reconstruction with bone-patellar tendon-bone grafts are better than those with four-bundle hamstring grafts in terms of both side-to-side anterior laxity and clinical results.
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J Bone Joint Surg Am · Apr 2008
Randomized Controlled TrialPrimary arthroscopic stabilization for a first-time anterior dislocation of the shoulder. A randomized, double-blind trial.
Anterior dislocation of the glenohumeral joint in younger patients is associated with a high risk of recurrence and persistent functional deficits. The aim of this study was to assess the efficacy of a primary arthroscopic Bankart repair, while controlling for the therapeutic effects produced by the arthroscopic intervention and joint lavage. ⋯ Following a first-time anterior dislocation of the shoulder, there is a marked treatment benefit from primary arthroscopic repair of a Bankart lesion, which is distinct from the so-called background therapeutic effect of the arthroscopic examination and lavage of the joint. However, primary repair does not appear to confer a functional benefit to patients with a stable shoulder at two years after the dislocation.