The Journal of bone and joint surgery. American volume
-
J Bone Joint Surg Am · Oct 2011
Randomized Controlled Trial Comparative StudyA prospective randomized controlled trial comparing occupational therapy with independent exercises after volar plate fixation of a fracture of the distal part of the radius.
The effect of formal occupational therapy on recovery after open reduction and volar plate fixation of a fracture of the distal part of the radius is uncertain. We hypothesized that there would be no difference in wrist function and arm-specific disability six months after open reduction and volar plate fixation of a distal radial fracture between patients who receive formal occupational therapy and those with instructions for independent exercises. ⋯ Prescription of formal occupational therapy does not improve the average motion or disability score after volar locking plate fixation of a fracture of the distal part of the radius.
-
J Bone Joint Surg Am · Oct 2011
The effects of spinal cord injury induced by shortening on motor evoked potentials and spinal cord blood flow: an experimental study in Swine.
Spinal cord injury due to spinal shortening is disastrous, but the amount that the spine can be shortened without injury is unknown. We assessed spinal cord injury and changes in spinal cord blood flow after spinal shortening in swine. ⋯ Spinal shortening of =104.2% of one vertebral body height at the thoracolumbar level caused spinal cord injury, but shortening of =73.8% did not result in injury. swine.
-
J Bone Joint Surg Am · Oct 2011
ReviewTherapy-resistant complex regional pain syndrome type I: to amputate or not?
Amputation for the treatment of long-standing, therapy-resistant complex regional pain syndrome type I (CRPS-I) is controversial. An evidence-based decision regarding whether or not to amputate is not possible on the basis of current guidelines. The aim of the current study was to systematically review the literature and summarize the beneficial and adverse effects of an amputation for the treatment of long-standing, therapy-resistant CRPS-I. ⋯ The previously published studies regarding CRPS-I as a reason for amputation all represent Level-IV evidence, and they do not clearly delineate the beneficial and adverse affects of an amputation performed for this diagnosis. Whether to amputate or not in order to treat long-standing, therapy-resistant CRPS-I remains an unanswered question.
-
J Bone Joint Surg Am · Oct 2011
Femoral fracture fixation in developing countries: an evaluation of the Surgical Implant Generation Network (SIGN) intramedullary nail.
The Surgical Implant Generation Network (SIGN) intramedullary nailing system was designed to treat femoral fractures in developing countries where real-time imaging, power equipment, and fracture tables are often not available. We performed a retrospective analysis of prospectively collected data on femoral shaft fractures treated with the SIGN intramedullary nailing system. ⋯ The SIGN intramedullary nailing system promotes predictable healing of femoral fractures in settings with limited resources including lack of real-time imaging, lack of power reaming, and delayed presentation to the operating room.
-
J Bone Joint Surg Am · Sep 2011
Patient activation and functional recovery in persons undergoing spine surgery.
Despite advances in surgical techniques, outcomes after spine surgery are highly variable. Recent research has highlighted the importance of individuals participating in, and taking responsibility for, their health and recovery. Patient activation, defined as an individual's propensity to engage in adaptive health behaviors leading to improved health outcomes, has been identified as a potentially important factor in this process. Our goal was to determine the association between preoperative patient activation and functional recovery after lumbar spine surgery. ⋯ High patient activation was associated with better recovery after surgery. Increased patient activation may lead to improved functional recovery through increased physical therapy adherence after spine surgery in adults.