The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · May 2012
Comparative StudyLong-term comparison of fixed-bearing and mobile-bearing total knee replacements in patients younger than fifty-one years of age with osteoarthritis.
There is limited information comparing the results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in patients with osteoarthritis who are younger than fifty-one years and who have a fixed-bearing implant in one knee and a mobile-bearing implant in the other. The purpose of this study was to compare our long-term clinical and radiographic results of fixed-bearing total knee replacement and mobile-bearing total knee replacement in a group of patients from this population. ⋯ Long-term results of both fixed and mobile-bearing total knee arthroplasties were encouraging in patients who were younger than fifty-one years of age with osteoarthritis. However, we found no superiority of the mobile-bearing total knee prosthesis over the fixed-bearing total knee prosthesis.
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The aims of this study were to document our experience with acute forearm compartment syndrome and to determine the risk factors for the need for split-thickness skin-grafting and the development of complications after fasciotomy. ⋯ Forearm compartment syndrome requiring fasciotomy predominantly affects males and can occur following either a fracture or soft-tissue injury. Age is an important predictor of undergoing split-thickness skin-grafting for wound closure. Complications occur in a third of patients and are associated with an increasing time from injury to fasciotomy.
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J Bone Joint Surg Am · May 2012
Comparative StudyIncreased use of intramedullary nails for intertrochanteric proximal femoral fractures in veterans affairs hospitals: a comparative effectiveness study.
Intramedullary nails for stabilizing intertrochanteric proximal femoral fractures have been available since the early 1990s. The nails are inserted percutaneously and have theoretical mechanical advantages over plates and screws, but they have not been demonstrated to improve patient outcomes. Still, use of intramedullary nails is becoming more common. The goal of this study was to examine trends in the use and associated outcomes of intramedullary nailing compared with sliding hip screws in Veterans Affairs (VA) hospitals. ⋯ Intramedullary nail use increased from 1998 through 2005 but did not decrease perioperative mortality or comorbidity compared with standard plate-and-screw devices for patients treated for intertrochanteric proximal femoral fractures in VA facilities.
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J Bone Joint Surg Am · May 2012
Multicenter StudyIs larger scoliosis curve magnitude associated with increased perioperative health-care resource utilization?: a multicenter analysis of 325 adolescent idiopathic scoliosis curves.
The treatment of patients with large adolescent idiopathic scoliosis curves has been associated with increased surgical complexity. The purpose of this study was to determine whether surgical correction of larger adolescent idiopathic scoliosis curves increased the utilization of health-care resources and to identify potential predictors associated with increased perioperative health-care resource utilization. ⋯ Correction of larger curves was associated with increased utilization of perioperative health-care resources, specifically longer operative time, a greater number of vertebral levels instrumented, and higher odds of receiving a blood transfusion.
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J Bone Joint Surg Am · May 2012
Economic impact of hand and wrist injuries: health-care costs and productivity costs in a population-based study.
Injuries to the hand and wrist account for approximately 20% of patient visits to emergency departments and may impose a large economic burden. The purpose of this study was to estimate the total health-care costs and productivity costs of injuries to the hand and wrist and to compare them with other important injury groups in a nationwide study. ⋯ Hand and wrist injuries not only constitute a substantial part of all treated injuries but also represent a considerable economic burden, with both high health-care and productivity costs. Hand and wrist injuries should be a priority area for research in trauma care, and further research could help to reduce the cost of these injuries, both to the health-care system and to society.