The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2011
Comparative StudyVolar locking plate implant prominence and flexor tendon rupture.
Flexor tendon injury is a recognized complication of volar plate fixation of distal radial fractures. A suspected contributing factor is implant prominence at the watershed line, where the flexor tendons lie closest to the plate. ⋯ Flexor tendon rupture after volar plating of the distal part of the radius is an infrequent but serious complication. The plate used in Group 1 is prominent at the watershed line of the distal part of the radius, which may increase the risk of tendon injury. We found no ruptures in Group 2, perhaps as a result of the lower profile of the plate. Further studies are needed before recommending one plate over another. Regardless of plate selection, surgeons should avoid implant prominence in this area.
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This update summarizes recent research pertaining to the subspecialty of orthopaedic foot and ankle surgery that was published or presented between August 2009 and July 2010. The sources of these studies include The Journal of Bone and Joint Surgery (American and British Volumes), Foot & Ankle International, and the proceedings of Specialty Day at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS), held on March 13, 2010, in New Orleans, Louisiana, and the summer meeting of the American Orthopaedic Foot & Ankle Society (AOFAS), held on July 7 through 10, 2010, in National Harbor, Maryland.
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J Bone Joint Surg Am · Feb 2011
How much varus is optimal with proximal femoral osteotomy to preserve the femoral head in Legg-Calvé-Perthes disease?
Although proximal femoral varus osteotomy is an established operative treatment for Legg-Calvé-Perthes disease, there is a lack of data on how much varus at the osteotomy is optimal for preserving the spherical shape of the femoral head. The purpose of this study was to determine if there is a correlation between the amount of varus used and the Stulberg radiographic outcome at maturity and to determine if the varus angulation improved over time. ⋯ Contrary to the conventional belief, greater varus angulation does not necessarily produce better preservation of the femoral head following proximal femoral varus osteotomy. Given the results, our recommendation is to achieve 10° to 15° of varus correction when performing proximal femoral varus osteotomy on hips that are in the early stages of Legg-Calvé-Perthes disease.
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J Bone Joint Surg Am · Feb 2011
Comparative StudyLyme arthritis in children presenting with joint effusions.
The present study was designed to evaluate the prevalence of Lyme arthritis in children who had a joint aspiration at a tertiary care children's hospital in an endemic area and to identify clinical factors useful to differentiate Lyme arthritis from septic arthritis at the time of the initial presentation. ⋯ For any child presenting with a joint effusion in a Lyme-endemic area of the Northeastern United States, the likely prevalence of Lyme arthritis is 31% overall and 45% in the presence of knee effusion. Children with joint effusions resulting from Lyme disease are more likely to have knee involvement, a lower peripheral white blood-cell count, and a lower joint fluid cell count, and they are less likely to have fever or complete refusal to bear weight, when compared with children with septic arthritis.