The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2009
Randomized Controlled Trial Comparative StudyEarly recovery after total knee arthroplasty performed with and without patellar eversion and tibial translation. A prospective randomized study.
Proponents of minimally invasive total knee arthroplasty claim that patellar eversion and anterior tibial translation during total knee arthroplasty have a deleterious effect on early patient rehabilitation and the early clinical outcome. Our purpose was to identify differences in knee preference and clinical outcome measures in a series of patients who had undergone bilateral total knee arthroplasty with each knee randomized to one of two different surgical approaches: patellar eversion and anterior tibial translation, or patellar subluxation and no tibial translation. ⋯ We found no significant differences between the two treatment groups (patellar eversion and anterior tibial translation compared with patellar subluxation and no tibial translation) at six weeks, twelve weeks, or six months after the surgery. We concluded that patellar eversion and anterior tibial translation appear to have no adverse effects on the range of motion, quadriceps strength, or patient's knee preference during the early postoperative recovery period after total knee arthroplasty.
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J Bone Joint Surg Am · Jun 2009
Comparative StudyDistal radial fracture treatment: what you get may depend on your age and address.
Distal radial fractures are common and confer a considerable financial burden on the health-care system; however, controversy surrounds the optimal treatment of these injuries. This study was performed to determine (1) the rate of distal radial fractures in the U.S. Medicare population stratified by hospital referral region and (2) whether the type of fracture treatment is affected by patient age, race, sex, comorbidity, or hospital referral region. ⋯ There is wide variation in the rate of distal radial fractures across sex, age, race, and geographic region in the United States. There is also significant variation in the treatment of these fractures, driven mainly by age and region. Between 1998 and 2004, a strong trend toward more frequent operative fixation was apparent. While white individuals had more than twice as many fractures as did non-white individuals, there did not appear to be significant racial variation in the treatment of this injury.
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J Bone Joint Surg Am · Jun 2009
Comparative StudyComparison of arthroscopic and open treatment of septic arthritis of the wrist.
Open irrigation and débridement is the standard of treatment for septic arthritis of the wrist. Although isolated cases of arthroscopic irrigation and débridement have been reported, a comparison of arthroscopic and open techniques has not been performed, to our knowledge. The purpose of this study was to compare the two methods of management. ⋯ Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2009
Multicenter StudyOpen reduction and internal fixation of proximal humeral fractures with use of the locking proximal humerus plate. Results of a prospective, multicenter, observational study.
The treatment of unstable displaced proximal humeral fractures, especially in the elderly, remains controversial. The objective of the present prospective, multicenter, observational study was to evaluate the functional outcome and the complication rate after open reduction and internal fixation of proximal humeral fractures with use of a locking proximal humeral plate. ⋯ Surgical treatment of displaced proximal humeral fractures with use of the locking proximal humeral plate that was evaluated in the present study can lead to a good functional outcome provided that the correct surgical technique is used. Because many of the complications were related to incorrect surgical technique, it behooves the treating surgeon to perform the operation correctly to avoid iatrogenic errors.
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J Bone Joint Surg Am · Jun 2009
Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children.
There have been few reports on the long-term outcomes after the operative treatment of missed Monteggia fracture-dislocations in children. The purpose of the present study was to evaluate the long-term clinical and radiographic outcomes after open reduction for the treatment of a missed Monteggia fracture-dislocation. ⋯ If open reduction for the treatment of a missed Monteggia fracture is performed when the patient is less than twelve years of age or within three years after the injury, good long-term clinical and radiographic outcomes can be expected.