The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2013
Displacement of the sustentacular fragment in intra-articular calcaneal fractures.
The sustentacular fragment in displaced intra-articular calcaneal fractures has historically been portrayed as a "constant fragment," bound to the talus by the interosseous and deltoid ligament complex. Operative treatment typically occurs through a lateral approach, with the remaining calcaneus being reconstructed back to the sustentaculum. We hypothesized that the sustentacular fragment in displaced intra-articular calcaneal fractures does not maintain its relationship to the talus. The purpose of this study was to characterize the frequency, magnitude, and mode of displacement of the sustentacular fragment. ⋯ Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2013
Comorbidities and perioperative complications in HIV-positive patients undergoing primary total hip and knee arthroplasty.
Highly active antiretroviral therapy has prolonged the lifespan of individuals infected with human immunodeficiency virus (HIV). We hypothesized that the number of primary total joint arthroplasties performed in this population has been increasing and that HIV infection is not an independent risk factor for postoperative complications. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2013
Reporting and methodological quality of systematic reviews in the orthopaedic literature.
Properly designed and conducted systematic reviews can reliably produce valid pooled treatment-effect estimates and are an important resource for clinical decision-making. The purpose of this report was to assess the reporting and methodological quality of systematic reviews in orthopaedic journals. ⋯ The validity of published systematic reviews in orthopaedics is questionable, and their contribution to clinical decision-making is suboptimal. Clinicians should be careful when interpreting and applying findings of current orthopaedic systematic reviews.
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J Bone Joint Surg Am · May 2013
Heterotopic ossification after surgery for fractures and fracture-dislocations involving the proximal aspect of the radius or ulna.
The objectives of this study were to (1) determine the prevalence of heterotopic ossification after surgery for fractures and fracture-dislocations involving the proximal aspect of the radius or ulna, (2) identify risk factors associated with the development of heterotopic ossification in these injuries, and (3) characterize the severity and location of the heterotopic ossification and the associated range of elbow motion. ⋯ Thirty-seven percent of elbows treated surgically for fractures involving the proximal aspect of the radius and/or ulna developed heterotopic ossification. In twenty percent of elbows, heterotopic ossification was associated with clinically relevant motion deficits. More severe heterotopic ossification was encountered in patients presenting with an associated distal humeral fracture, terrible triad injury, transolecranon fracture-dislocation, or Monteggia fracture-dislocation. Patients with an open injury, instability, severe chest trauma, or delay in definitive surgical treatment had a higher prevalence of heterotopic ossification.
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J Bone Joint Surg Am · May 2013
Comparative StudyComparison of functional outcomes of reverse shoulder arthroplasty with those of hemiarthroplasty in the treatment of cuff-tear arthropathy: a matched-pair analysis.
Rotator cuff-tear arthropathy has traditionally represented a challenge to the shoulder arthroplasty surgeon. The poor results of conventional total shoulder arthroplasty in rotator-cuff-deficient shoulders due to glenoid component loosening have led to hemiarthroplasty being the traditional preferred surgical option. Recently, reverse total shoulder arthroplasty has gained increasing popularity because of a clinical perception of an improved functional outcome, despite the lack of comparative data. The aim of this study was to compare the early functional results of hemiarthroplasty with those of reverse shoulder arthroplasty in the management of cuff-tear arthropathy. ⋯ In this unselected population with rotator cuff-tear arthropathy, controlled for age, sex, and ASA score, reverse shoulder arthroplasty resulted in a functional outcome that was superior to that of hemiarthroplasty. Longer-term follow-up is needed to confirm these findings.