The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2010
Internal fixation of type-C distal femoral fractures in osteoporotic bone.
Fixation of distal femoral fractures remains a challenge, especially in osteoporotic bone. This study was performed to investigate the biomechanical stability of four different fixation devices for the treatment of comminuted distal femoral fractures in osteoporotic bone. ⋯ The findings of this study support the concept that, for intramedullary nails, the kind of distal interlocking pattern affects the stabilization of distal femoral fractures. Four-screw distal locking provides the highest axial stability and nearly comparable torsional stability to that of the angular stable plate; the four-screw distal interlocking construct was found to have the best combined (torsional and axial) biomechanical stability.
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The outcomes of combined arthroscopic repairs of a SLAP (superior labral anterior-posterior) lesion and a rotator cuff tear are not known. We compared the outcomes in a cohort of patients who had undergone concomitant arthroscopic repairs of a SLAP lesion and a rotator cuff tear with those in a cohort of patients with a stable biceps anchor who had undergone an isolated rotator cuff repair. We hypothesized that the results would be similar between the two cohorts with respect to the range of motion and preoperative and postoperative function. ⋯ Controversy surrounds the treatment of a SLAP lesion with concomitant treatment of a full-thickness rotator cuff tear. This study suggests that, in middle-aged patients, the results of combined SLAP lesion and rotator cuff repair can be comparable with those achieved with rotator cuff repair alone.
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J Bone Joint Surg Am · Jun 2010
Evaluation of the modified Albee arthroplasty for femoral head loss secondary to septic arthritis in young children.
Surgical treatment options for femoral head deficiency in infants secondary to septic arthritis of the hip are varied and associated with uncertain long-term outcomes. The modified Albee arthroplasty has been considered an acceptable procedure; however, the long-term outcomes of this procedure have not been reported, to our knowledge. We evaluated the long-term outcomes of the modified Albee arthroplasty in young patients with severe sequelae of septic arthritis of the hip. ⋯ The modified Albee arthroplasty is a feasible and clinically useful procedure for the treatment of severe sequelae of septic arthritis of the hip, particularly in children who are two years of age or younger.
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J Bone Joint Surg Am · May 2010
Role of early surgical decompression of the intradural space after cervical spinal cord injury in an animal model.
The role of decompressing the intradural space through a durotomy as a treatment option for acute traumatic cervical spinal cord injury has not been explored in an animal model, to our knowledge. We sought to determine the role of durotomy and duraplasty in the treatment of acute cervical spinal cord injury and its effects on inflammation, scar formation, and functional recovery. ⋯ Functional recovery after acute cervical spinal cord injury was better in animals treated with decompression of the intradural space and placement of a dural allograft than it was in animals treated with decompression alone. These functional data correlated directly with histological evidence of a decrease in spinal cord cavitation, inflammation, and scar formation.
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J Bone Joint Surg Am · May 2010
Comparative Study Clinical TrialQuality of life after volar plate fixation of articular fractures of the distal part of the radius.
Outcome measurement following surgery is increasingly the focus of attention in current health-care debates because of the rising costs of medical care and the large variety of operative options. The purpose of the present study was to correlate quality of life after volar locked plate fixation of unstable intra-articular distal radial fractures with functional and radiographic results as well as with quality-of-life data from population norms. ⋯ The results of the present single-center study show that, following distal radial fracture fixation, wrist arthritis may affect the patient's subjective well-being, as documented with the Short Form-36, without influencing the functional outcome. Well-designed longitudinal clinical trials are needed to confirm the findings of the present investigation in terms of quality of life after surgical treatment of intra-articular distal radial fractures.