The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2008
Randomized Controlled Trial Comparative StudyThe efficacy of combined popliteal and ankle blocks in forefoot surgery.
Postoperative pain following forefoot surgery can be difficult to control with oral analgesia. The aim of this study was to compare the efficacy of a combined popliteal and ankle block with that of an ankle block alone in providing postoperative analgesia following forefoot surgery. ⋯ A popliteal block in conjunction with an ankle block provides significantly better pain relief than does an ankle block alone in patients undergoing forefoot surgery.
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J Bone Joint Surg Am · Jul 2008
Large osteochondral fractures of the lateral femoral condyle in the adolescent: outcome of bioabsorbable pin fixation.
Large osteochondral fractures of the lateral femoral condyle of the knee in adolescent patients can be diagnostically and therapeutically challenging. Historically, management has involved removal of the fragment, leaving a large area of bone devoid of articular cartilage on the weight-bearing surface of the lateral femoral condyle. This study assessed open reduction and internal fixation of the osteochondral fragments with use of multiple polyglycolic acid rods. ⋯ Osteochondral fracture of the lateral femoral condyle is an injury to which adolescents with ligamentous laxity of the knee are prone. Our results show that internal fixation of these osteochondral fragments with bioabsorbable implants is possible and is a worthwhile option.
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J Bone Joint Surg Am · Jul 2008
Osmolarity influences chondrocyte death in wounded articular cartilage.
Mechanical injury results in chondrocyte death in articular cartilage. The purpose of the present study was to determine whether medium osmolarity affects chondrocyte death in injured articular cartilage. ⋯ Medium osmolarity significantly affects chondrocyte death in wounded articular cartilage. The greatest chondrocyte death occurs at 0 mOsm. Conversely, increased medium osmolarity (480 mOsm) is chondroprotective. The majority of cell death occurs within 2.5 hours, with no significant increase over seven days.
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J Bone Joint Surg Am · Jun 2008
The epidemiology of neonatal brachial plexus palsy in the United States.
The nationwide incidence of neonatal brachial plexus palsy in the United States is unknown. The purpose of this study was to determine the incidence of this condition in the United States and to identify potential risk factors for neonatal brachial plexus palsy. ⋯ This nationwide study of neonatal brachial plexus palsy in the United States demonstrates a decreasing incidence over time. Shoulder dystocia poses the greatest risk for brachial plexus injury, and having a twin or multiple birth mates and delivery by cesarean section are associated with a protective effect against injury. Most children with neonatal brachial plexus palsy did not have known risk factors.