The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2012
Review Historical ArticlePlaster: our orthopaedic heritage: AAOS exhibit selection.
Plaster has been used for centuries as a stiffening agent to treat fractures and other musculoskeletal conditions that require rest, immobilization, or correction of a deformity. Despite modern metallurgy and internal stabilization, plaster casts and splints remain an important means of external stabilization. Casting is a dying art as modern internal and external fixation replace external immobilization. Proper casting technique is paramount. This manuscript outlines the history and chemistry of immobilization materials and techniques as well as the differences among them and the advantages and disadvantages of each. ⋯ Plaster casts and splints remain an important treatment method for acute and chronic orthopaedic conditions.
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J Bone Joint Surg Am · Oct 2012
Transient soft-tissue edema associated with implantation of increasing doses of rhBMP-2 on an absorbable collagen sponge in an ectopic rat model.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein. However, soft-tissue edema adjacent to the site of rhBMP-2 implantation has been reported. This animal study was designed to examine soft-tissue edema associated with increasing rhBMP-2 doses with implantation on an absorbable collagen sponge (ACS) and with injection directly into muscle. ⋯ Transient peri-implant soft-tissue edema occurred in a dose-dependent manner following implantation of rhBMP-2/ACS in this rat model. The normal dose of rhBMP-2/ACS produced edema similar to that in the controls. Finally, rhBMP-2 solutions injected directly into muscle resulted in minimal soft-tissue edema.
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J Bone Joint Surg Am · Oct 2012
Randomized Controlled Trial Multicenter Study Comparative StudyPrognostic factors for predicting outcomes after intramedullary nailing of the tibia.
Prediction of negative postoperative outcomes after long-bone fracture treatment may help to optimize patient care. We recently completed the Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT), a large, multicenter trial of reamed and unreamed intramedullary nailing of tibial shaft fractures in 1226 patients. Using the SPRINT data, we conducted an investigation of baseline and surgical factors to determine any associations with an increased risk of adverse events within one year of intramedullary nailing. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2012
Comparative StudyComparison of ten-year survivorship of hip prostheses with use of conventional polyethylene, metal-on-metal, or ceramic-on-ceramic bearings.
To improve the long-term performance of hip prostheses, alternative bearings with metal-on-metal (MoM) and ceramic-on-ceramic (CoC) couples have been introduced. Although currently the results from the use of these bearings are in the midterm stage, there have been few comparative studies of these different bearings. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2012
Comparative StudyTreatment algorithm for dens fractures: non-halo immobilization, anterior screw fixation, or posterior transarticular C1-C2 fixation.
The appropriate treatment of dens fractures is unclear. We established a staged treatment protocol for dens fractures and conducted a prospective study to evaluate the outcome of treatment based on this protocol. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.