The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2013
Current and future use of surgical skills training laboratories in orthopaedic resident education: a national survey.
Acquisition of surgical skills through laboratory-based training and simulation is appealing to surgical training programs. The purpose of this study was to provide baseline information on the current use of surgical skills training laboratories in orthopaedic resident education and to determine the interest in expansion of these facilities and training techniques. ⋯ There was strong agreement among both program directors and residents that surgical skills laboratories and simulation technology should be a required component of orthopaedic resident training. At the present time, the most substantial barrier to adoption of surgical skills laboratories and a formalized surgical skills curriculum is the lack of funding.
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J Bone Joint Surg Am · Jan 2013
Risk factors for nonunion in patients with intracapsular femoral neck fractures treated with three cannulated screws placed in either a triangle or an inverted triangle configuration.
Intracapsular femoral neck fractures are associated with high rates of nonunion. We aimed to identify risk factors for nonunion in patients with both displaced and nondisplaced intracapsular femoral neck fractures treated with three 7-mm parallel cannulated screws, placed in either a triangle or an inverted triangle configuration, using failure of fixation as the primary outcome. ⋯ Screw fixation with a triangle configuration, a displaced fracture, and poor reduction are risk factors for nonunion in intracapsular femoral neck fractures treated with fixation with multiple screws.
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J Bone Joint Surg Am · Jan 2013
CommentThe Spine Patient Outcomes Research Trial (SPORT): a continuing return on investment: commentary on an article by Jeffrey A. Rihn, MD, et al.: "The influence of obesity on the outcome of treatment of lumbar disc herniation. analysis of the Spine Patient Outcomes Research Trial (SPORT)".
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J Bone Joint Surg Am · Jan 2013
Quality in orthopaedic surgery--an international perspective: AOA critical issues.
Quality is a hallmark of health care, although it is difficult to come to a consensus on who gets to define what "quality health care" is. Most health-care workers enter this field with the goal of improving the health of their patients (and the community), and while everyone tries to do the best job possible, we must continuously seek better methods and techniques for achieving better outcomes. The passion for continuous improvement is fundamental, but passion is not sufficient by itself. ⋯ While health-care entities strive to focus on quality of care, measuring and reporting such care in a meaningful way are difficult. The best chance of improving overall care for patients is through the adoption of systems that improve coordination and continuity, not by health-care staff working harder. Only through collaboration and integration can health care incorporate a culture for improving quality and patient safety.
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J Bone Joint Surg Am · Jan 2013
Randomized Controlled Trial Multicenter StudyThe influence of obesity on the outcome of treatment of lumbar disc herniation: analysis of the Spine Patient Outcomes Research Trial (SPORT).
Questions remain as to the effect that obesity has on patients managed for symptomatic lumbar disc herniation. The purpose of this study was to determine if obesity affects outcomes following the treatment of symptomatic lumbar disc herniation. ⋯ Obese patients realized less clinical benefit from both operative and nonoperative treatment of lumbar disc herniation. Surgery provided similar benefit over nonoperative treatment in obese and nonobese patients.