The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2012
Comparative StudySimple visual parameters for objective assessment of arthroscopic skill.
Restrictions placed on the working hours of doctors over the past decade have resulted in substantial changes to the training and assessment of orthopaedic surgical residents. Many who are responsible for training the surgeons of the future have become concerned that this reduced clinical exposure is having a detrimental impact on technical skill acquisition. Consequently, there is a need for surgical educators to develop more objective methods for assessing surgical skill. The primary aim of this study was to determine whether a novel set of visual parameters assessing visuospatial ability, fine motor dexterity, and gaze control could objectively discriminate among various levels of arthroscopic experience. The secondary aim was to evaluate the correlations between these new parameters and previously established technical skill assessment methods. ⋯ This study demonstrates the construct validity of three novel visual parameters for objectively assessing arthroscopic performance. These parameters are simple, can be used easily in the operating room, and are strongly correlated with current validated methods of technical skill assessment.
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J Bone Joint Surg Am · Jul 2012
Comparative StudyLong-term outcomes after arthroscopic capsular release for idiopathic adhesive capsulitis.
One management strategy for the treatment of idiopathic adhesive capsulitis, or frozen shoulder, is arthroscopic capsular release. While there are long-term data regarding nonoperative treatment and good short-term outcomes following a release for idiopathic adhesive capsulitis, little is known about the outcomes five years or more after arthroscopic capsular release. ⋯ Patients with idiopathic adhesive capsulitis treated with an arthroscopic capsular release had early significant improvements in shoulder range of motion, pain frequency and severity, and function. These improvements were maintained and/or enhanced at seven years. In contrast to results reported for nonoperative treatment, shoulder range of motion at seven years was equivalent to that in the contralateral shoulder.
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J Bone Joint Surg Am · Jul 2012
Randomized Controlled Trial Comparative StudySingle versus double-incision technique for the repair of acute distal biceps tendon ruptures: a randomized clinical trial.
This clinical trial was done to evaluate outcomes of the single and double-incision techniques for acute distal biceps tendon repair. We hypothesized that there would be fewer complications and less short-term pain and disability in the two-incision group, with no measureable differences in outcome at a minimum of one year postoperatively. ⋯ There were no significant differences in outcomes between the single and double-incision distal biceps repair techniques other than a 10% advantage in final flexion strength with the latter. Most complications were minor, with a significantly greater prevalence in the single-incision group.
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J Bone Joint Surg Am · Jul 2012
Comparative StudyThe Timed Up and Go test is an early predictor of functional outcome after hemiarthroplasty for femoral neck fracture.
The ability to predict the long-term physical function and prognosis of hip fracture patients during the early postoperative period is essential for surgeons and physical therapists as well as for patients and their families. The purpose of this study was to determine whether early functional assessment correlated with and/or predicted long-term function after surgery to treat a displaced femoral neck fracture. ⋯ The Timed Up and Go test was an early clinical indicator of future physical function in patients with a hip fracture treated with hemiarthroplasty. Innovative clinical approaches to anticipate future function will contribute to increasing the efficiency of overall management of this growing set of patients.
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J Bone Joint Surg Am · Jul 2012
Reconstruction of proximal humeral defects with shoulder arthrodesis using free vascularized fibular graft.
Treatment of proximal humeral bone loss resulting from tumor resection or from infection following shoulder arthroplasty represents a reconstructive challenge. Shoulder arthrodesis is an appropriate salvage procedure but is associated with a high rate of complications. The purpose of this report is to describe the surgical technique and report the functional outcomes in a series of patients treated with shoulder arthrodesis using free vascularized fibular graft. ⋯ Shoulder arthrodesis using free vascularized fibular graft with double plate fixation is a reliable salvage procedure in patients with major proximal humeral bone loss.