The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Nov 2014
Clinical TrialStability assessment of the ankle mortise in supination-external rotation-type ankle fractures: lack of additional diagnostic value of MRI.
This prospective diagnostic study assessed the utility of MRI (magnetic resonance imaging) findings for the deep aspect of the deltoid ligament in evaluating the stability of the ankle mortise in patients who have an SER (supination-external rotation)-type lateral malleolar fracture with no widening of the medial clear space. ⋯ On the basis of the study results, we do not recommend the use of MRI when choosing between operative and nonoperative treatment of an SER-type ankle fracture.
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J Bone Joint Surg Am · Nov 2014
The presence of a negative sacral slope in patients with ankylosing spondylitis with severe thoracolumbar kyphosis.
Pelvic retroversion is one of the mechanisms for regulating sagittal balance in patients with a kyphotic deformity. This retroversion is limited by hip extension, which prevents the pelvis from becoming excessively retroverted, achieving a sacral slope of <0°. However, a negative sacral slope can be found in some patients with ankylosing spondylitis with thoracolumbar kyphosis. The purpose of this study was to analyze this finding. ⋯ Negative sacral slope does exist in Chinese Han patients with ankylosing spondylitis with thoracolumbar kyphosis. This appears to be caused by severe kyphosis, an initially small sacral slope, and pronounced tilting of the femoral shaft as a result of knee flexion, resulting in the pelvis becoming further retroverted.
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J Bone Joint Surg Am · Nov 2014
Randomized Controlled TrialImproving residency training in arthroscopic knee surgery with use of a virtual-reality simulator. A randomized blinded study.
There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room. ⋯ We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs.
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J Bone Joint Surg Am · Nov 2014
Management of thoracic insufficiency syndrome in patients with Jarcho-Levin syndrome using VEPTRs (vertical expandable prosthetic titanium ribs).
Jarcho-Levin syndrome represents a spectrum of clinical and radiographic irregularities including abnormal vertebral segmentation or formation defects, rib deformities, and short-trunk dwarfism. These abnormalities cause reduced thoracic capacity for lung development, resulting in thoracic insufficiency syndrome. In the present study, we reviewed outcome measures related to scoliotic curve correction, thoracic growth, and respiratory function following VEPTR treatment in patients with Jarcho-Levin syndrome. ⋯ VEPTR treatment improved thoracic symmetry, controlled spinal deformity, and was associated with improved clinical respiratory function.