The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2014
Randomized Controlled TrialFusion may not be a necessary procedure for surgically treated burst fractures of the thoracolumbar and lumbar spines: a follow-up of at least ten years.
The surgical results of treating thoracolumbar and lumbar burst fractures were reported to be comparable between patients with and without fusion in an intermediate-term follow-up. To our knowledge, no prior report has compared the results of fusion and non-fusion with long-term follow-up. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2014
The effect of suture-button fixation on simulated syndesmotic malreduction: a cadaveric study.
The accuracy of reduction of distal tibiofibular syndesmosis disruptions has been associated with the clinical outcome. Suture-button fixation of the syndesmosis is a dynamic alternative mode of fixation. We hypothesized that with deliberate clamp-induced malreduction, suture-button fixation of the syndesmosis would allow a more anatomic post-fixation position compared with screw fixation. ⋯ Although the clinical relevance is unknown, dynamic syndesmotic fixation may mitigate clamp-induced malreduction.
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J Bone Joint Surg Am · Oct 2014
Neonatal brachial plexus palsy with neurotmesis of C5 and avulsion of C6: supraclavicular reconstruction strategies and outcome.
Nerve reconstruction strategies for restoration of elbow flexion and shoulder function in patients with neonatal brachial plexus palsy with neurotmesis of C5 and avulsion of C6 are not well defined and the outcomes are unclear. ⋯ 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 2014
Multicenter StudyTheT1 pelvic angle, a novel radiographic measure of global sagittal deformity, accounts for both spinal inclination and pelvic tilt and correlates with health-related quality of life.
Adult spinal deformity is a prevalent cause of pain and disability. Established measures of sagittal spinopelvic alignment such as sagittal vertical axis and pelvic tilt can be modified by postural compensation, including pelvic retroversion, knee flexion, and the use of assistive devices for standing. We introduce the T1 pelvic angle, a novel measure of sagittal alignment that simultaneously accounts for both spinal inclination and pelvic retroversion. The purpose of this study was to investigate the relationship of the T1 pelvic angle and other established sagittal alignment measures and to correlate these parameters with health-related quality-of-life measures. ⋯ Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2014
Cost-effectiveness analysis of fixation options for intertrochanteric hip fractures.
Intertrochanteric hip fractures are a major source of morbidity and financial burden, accounting for 7% of osteoporotic fractures and costing nearly $6 billion annually in the United States. Traditionally, "stable" fracture patterns have been treated with an extramedullary sliding hip screw whereas "unstable" patterns have been treated with the more expensive intramedullary nail. The purpose of this study was to identify parameters to guide cost-effective implant choices with use of decision-analysis techniques to model these common clinical scenarios. ⋯ Sliding hip screw fixation is likely more cost-effective for stable intertrochanteric fractures (A1) or those with questionable stability (A2), whereas intramedullary nail fixation is more cost-effective for reverse obliquity fractures (A3). These conclusions are highly sensitive to the fixation failure rate, which was the major influence on the model results.