The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2013
Functional outcome thirty years after median and ulnar nerve repair in childhood and adolescence.
Age at injury is believed to be a factor that strongly influences functional outcome after nerve injury. However, there have been few long-term evaluations of the results of nerve repair and reconstruction in children. Our aim was to evaluate the long-term functional outcome of nerve repair or reconstruction at the forearm level in patients with a complete median and/or ulnar nerve injury at a young age. ⋯ At a median of thirty-one years after a median or ulnar nerve repair at the level of the forearm, nerve function is significantly better in those injured in childhood than in those injured in adolescence, with almost full sensory and motor recovery in individuals injured in childhood.
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J Bone Joint Surg Am · Feb 2013
Thickness of subcutaneous fat as a risk factor for infection in cervical spine fusion surgery.
Surgical site infections increase the incidence of morbidity and mortality as well as health-care expenses. The cost of care increases threefold to fourfold as a consequence of surgical site infection after spinal surgery. The aim of the present study was to determine the role of subcutaneous fat thickness in the development of surgical site infection following cervical spine fusion surgery. ⋯ The study demonstrated that the thickness of subcutaneous fat at the surgical site is a factor in the development of surgical site infection following cervical spine fusion and deserves assessment in the preoperative evaluation.
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J Bone Joint Surg Am · Feb 2013
Lessons regarding the safety of orthopaedic patient care: an analysis of four hundred and sixty-four closed malpractice claims.
An orthopaedic malpractice claim alleges that the patient sustained a preventable iatrogenic injury. The analysis of a representative series of malpractice claims provides a unique view of alleged orthopaedic adverse events, revealing what can potentially go wrong across a spectrum of practice settings and anatomic locations. The goal of this study was to identify high-impact targets in order to institute measures to reduce claims through efforts focused on patient safety. ⋯ Regarding clinical relevance, this analysis suggests risk areas for targeted efforts to improve patient safety and reduce malpractice claims.
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J Bone Joint Surg Am · Feb 2013
Multicenter StudyThe effect of pain after total knee arthroplasty on the contralateral, nonreplaced knee.
Osteoarthritis is associated with a strong biomechanical component. Persistent pain in the index knee after total knee arthroplasty could lead to pain in the contralateral knee. The purpose of the present study was to examine whether a change in the natural history of pain in the contralateral knee was related to postoperative pain in the index knee. ⋯ Pain in the index knee at three months after total knee arthroplasty did not appear to predict a symptomatic increase in pain in the contralateral knee over two years of follow-up in our cohort. The contralateral knee did not require any additional clinical surveillance over and above the patients' reports on their symptoms.