The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2011
Comparative StudyFixation of the coronoid process in elbow fracture-dislocations.
Terrible triad injuries consist of a posterior dislocation of the elbow, a coronoid fracture, and a radial head fracture. The coronoid plays a pivotal role as an anterior buttress, yet the optimal management of the coronoid fracture remains unknown. We hypothesize that suture lasso fixation of the coronoid fracture leads to fewer complications and improved outcomes compared with screw or suture anchor fixation techniques. ⋯ For terrible triad injuries, greater stability with fewer complications was achieved with use of the suture lasso technique for coronoid fracture fixation.
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J Bone Joint Surg Am · Oct 2011
Randomized Controlled Trial Comparative StudyA prospective randomized controlled trial comparing occupational therapy with independent exercises after volar plate fixation of a fracture of the distal part of the radius.
The effect of formal occupational therapy on recovery after open reduction and volar plate fixation of a fracture of the distal part of the radius is uncertain. We hypothesized that there would be no difference in wrist function and arm-specific disability six months after open reduction and volar plate fixation of a distal radial fracture between patients who receive formal occupational therapy and those with instructions for independent exercises. ⋯ Prescription of formal occupational therapy does not improve the average motion or disability score after volar locking plate fixation of a fracture of the distal part of the radius.
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J Bone Joint Surg Am · Oct 2011
The effects of spinal cord injury induced by shortening on motor evoked potentials and spinal cord blood flow: an experimental study in Swine.
Spinal cord injury due to spinal shortening is disastrous, but the amount that the spine can be shortened without injury is unknown. We assessed spinal cord injury and changes in spinal cord blood flow after spinal shortening in swine. ⋯ Spinal shortening of =104.2% of one vertebral body height at the thoracolumbar level caused spinal cord injury, but shortening of =73.8% did not result in injury. swine.
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J Bone Joint Surg Am · Oct 2011
ReviewTherapy-resistant complex regional pain syndrome type I: to amputate or not?
Amputation for the treatment of long-standing, therapy-resistant complex regional pain syndrome type I (CRPS-I) is controversial. An evidence-based decision regarding whether or not to amputate is not possible on the basis of current guidelines. The aim of the current study was to systematically review the literature and summarize the beneficial and adverse effects of an amputation for the treatment of long-standing, therapy-resistant CRPS-I. ⋯ The previously published studies regarding CRPS-I as a reason for amputation all represent Level-IV evidence, and they do not clearly delineate the beneficial and adverse affects of an amputation performed for this diagnosis. Whether to amputate or not in order to treat long-standing, therapy-resistant CRPS-I remains an unanswered question.