The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2011
Randomized Controlled Trial Comparative StudyLocking intramedullary nails and locking plates in the treatment of two-part proximal humeral surgical neck fractures: a prospective randomized trial with a minimum of three years of follow-up.
locking intramedullary nails and locking plates specially designed for proximal humeral fractures are widely used. The purpose of our study was to compare the outcomes between these two types of implants in patients with a two-part surgical neck fracture. The advantages and shortcomings of each method were analyzed. ⋯ therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2011
Randomized Controlled Trial Comparative StudyInternet-based outpatient telerehabilitation for patients following total knee arthroplasty: a randomized controlled trial.
total knee arthroplasty is an effective means for relieving the symptoms associated with degenerative arthritis of the knee. Rehabilitation is a necessary adjunct to surgery and is important in regaining optimum function. Access to high-quality rehabilitation services is not always possible, especially for those who live in rural or remote areas. The aim of this study was to evaluate the equivalence of an Internet-based telerehabilitation program compared with conventional outpatient physical therapy for patients who have had a total knee arthroplasty. ⋯ therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2011
Comparative StudyTrends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly.
the treatment of proximal humeral fractures in the elderly remains controversial. Options include nonoperative treatment, open reduction with internal fixation (ORIF), and hemiarthroplasty. Locking plate technology has expanded the indications for ORIF for certain fracture types in osteoporotic bone. This study was performed to characterize the incidence, treatment, and revision surgery of proximal humeral fractures according to geographic region both before (1999 to 2000) and after (2004 to 2005) the introduction of locking plates. ⋯ therapeutic Level II. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2011
Review Meta AnalysisEarly effects of resident work-hour restrictions on patient safety: a systematic review and plea for improved studies.
since the inception of the eighty-hour work week, work hour restrictions have incited considerable debate. Work hour policies were designed to prevent medical errors and to reduce patient morbidity and mortality. It is unclear whether work hour restrictions have been helpful in medicine in general and in orthopaedic surgery specifically. This systematic review of the literature was designed to determine the success of these restrictions in terms of patient mortality, medical errors, and complications. ⋯ therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jan 2011
ReviewOperative treatment of chest wall injuries: indications, technique, and outcomes.
Most injuries to the chest wall with residual deformity do not result in long-term respiratory dysfunction unless they are associated with pulmonary contusion. Indications for operative fixation include flail chest, reduction of pain and disability, a chest wall deformity or defect, symptomatic nonunion, thoracotomy for other indications, and open fractures. Operative indications for chest wall injuries are rare.