The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jan 2010
Should an ulnar styloid fracture be fixed following volar plate fixation of a distal radial fracture?
Ulnar styloid fractures often occur in association with distal radial fractures. The purpose of this study was to determine whether an associated ulnar styloid fracture following stable fixation of a distal radial fracture has any effect on wrist function or on the development of chronic distal radioulnar joint instability. ⋯ An accompanying ulnar styloid fracture in patients with stable fixation of a distal radial fracture has no apparent adverse effect on wrist function or stability of the distal radioulnar joint.
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J Bone Joint Surg Am · Jan 2010
Cytotoxic effect of zoledronic acid-loaded bone cement on giant cell tumor, multiple myeloma, and renal cell carcinoma cell lines.
Local recurrence with subsequent osteolysis is a problem after intralesional curettage of giant cell tumor of bone, myeloma, and metastatic carcinoma. The bisphosphonate zoledronic acid (zoledronate) has been shown to reduce osteoclast activity, and its local administration is a potentially attractive therapy, especially for the osteoclast-rich giant cell tumor. The aim of this study was to analyze the elution dynamics of zoledronic acid release from acrylic bone cement and its in vitro antitumor efficacy. ⋯ The method presented in our study is a reproducible technique for evaluating zoledronic acid elution from bone cement and determining its impact on tumor growth. Zoledronic acid is released from bone cement, remains biologically active despite the polymerization of cement, and inhibits the in vitro growth of cell lines from giant cell tumor of bone, myeloma, and renal cell carcinoma.
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J Bone Joint Surg Am · Jan 2010
Amplified inflammatory response to sequential hemorrhage, resuscitation, and pulmonary fat embolism: an animal study.
The objective of this study was to assess the role of pulmonary fat embolism caused by intramedullary pressurization of the femoral canal in the development of acute lung injury in the setting of acute hemorrhagic shock and resuscitation. ⋯ Fat embolism from canal pressurization alone did not activate a pulmonary inflammatory response. The combination of hemorrhagic shock, resuscitation, and fat embolism elicited neutrophil activation, infiltration of alveoli by polymorphonuclear leukocytes, and inflammatory cytokine expression in bronchoalveolar lavage fluid.
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J Bone Joint Surg Am · Dec 2009
Comparative StudyComparison of self-reports and parent proxy-reports of function and quality of life of children with below-the-elbow deficiency.
The agreement between children's self-reports and parent proxy-reports has not been established for function and quality-of-life measures for children with musculoskeletal diagnoses, including unilateral congenital below-the-elbow deficiency. Factors influencing parent-child agreement in this population have yet to be determined. ⋯ Although the absolute differences are small, children with a unilateral congenital below-the-elbow deficiency report better upper-extremity function and quality of life than their parents perceive, but they may also be experiencing more pain. Factors influencing parent-child agreement on measures of quality of life include age and use of a prosthesis. Parents' reports of function may provide a helpful counterbalance to children's and adolescents' reports, but because quality of life is subjective by nature, the child's or adolescent's report is the gold standard. As a result of variability in agreement, PODCI and PedsQL parent reports cannot be considered true proxies for the self-reports of children or adolescents with unilateral congenital below-the-elbow deficiency or, possibly, of those with other musculoskeletal diagnoses.
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Higher levels of tourniquet pressure and higher pressure gradients beneath tourniquet cuffs are associated with a higher risk of nerve-related injury. Measurement of limb occlusion pressure can help to minimize tourniquet pressure levels and pressure gradients for individual patients and individual surgical procedures. Selective use of pneumatic, wider, and contoured tourniquet cuffs reduces tourniquet pressure levels and the applied pressure gradients.