The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Aug 2011
Randomized Controlled Trial Comparative StudyFunctional outcome following intramedullary nailing of the femur: a prospective randomized comparison of piriformis fossa and greater trochanteric entry portals.
The purpose of the study was to prospectively compare the functional outcome of intramedullary nailing of the femur performed with use of a trochanteric and a piriformis fossa entry portal. ⋯ Patients in our prospective randomized study who were treated with trochanteric nailing did not differ in hip function at one year postoperatively compared with patients treated with intramedullary nailing through the piriformis fossa. The values of several intraoperative parameters were significantly better in the trochanteric nailing group. Our data indicate that the functional hip outcome of femoral intramedullary nailing performed through the greater trochanter is equal to that of intramedullary nailing performed through the piriformis fossa.
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J Bone Joint Surg Am · Aug 2011
Prospective study of distal radial fractures treated with an intramedullary nail.
Intramedullary nailing for the treatment of unstable distal radial fractures is reported to provide stable fixation with minimal soft-tissue complications, but there is a paucity of data documenting the results of this technique. The purpose of this study was to prospectively determine the functional outcomes of treatment of unstable distal radial fractures with an intramedullary nail. ⋯ Intramedullary nailing can be a safe and effective treatment with minimal complications for dorsally displaced unstable extra-articular or simple intra-articular distal radial fractures.
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J Bone Joint Surg Am · Aug 2011
Mini-C-arm fluoroscopy for emergency-department reduction of pediatric forearm fractures.
Reduction of pediatric forearm fractures with the patient under sedation in the emergency department is a common practice throughout the United States. We hypothesized that the use of a mini-c-arm fluoroscopy device as an alternative to routine radiographs for evaluation of fracture reduction would (1) allow a more anatomic fracture reduction, (2) decrease the number of repeat reductions or subsequent procedures, (3) reduce overall radiation exposure to the patient, and (4) decrease the orthopaedic consultation time in the emergency department. ⋯ Use of the mini c-arm to assist in the closed reduction of pediatric forearm and wrist fractures in the emergency department can improve the quality of the reduction, decrease the radiation exposure to the patient, and decrease the need for repeat fracture reduction or additional procedures. Mini-c-arm imaging can also decrease the average orthopaedic consultation time for fracture reduction.
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J Bone Joint Surg Am · Aug 2011
Pyrolytic carbon resurfacing arthroplasty for osteoarthritis of the proximal interphalangeal joint of the finger.
Pyrolytic carbon resurfacing arthroplasty of the proximal interphalangeal joint has been reported to provide favorable results. The purpose of this study was to evaluate the effectiveness of pyrolytic carbon joint replacement at an average follow-up of fifty-five months. ⋯ Interphalangeal joint motion decreased significantly at the final follow-up evaluation, following short-term gains in the initial postoperative period. Complications were numerous, and implant loosening with migration was a major problem. Arthroplasty of the proximal interphalangeal joint with a pyrolytic carbon implant has a high complication rate, poor outcomes, and variable patient satisfaction. On the basis of these findings, we no longer use this implant in our practice.