The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Mar 2003
Treatment of distal femoral nonunion with internal fixation, cortical allograft struts, and autogenous bone-grafting.
The purpose of this retrospective study was to analyze the results of treatment of nonunions of the distal part of the femur with internal fixation combined with cortical allograft struts and autogenous bone-grafting. ⋯ Therapeutic study, Level IV (case series [no, or historical, control group]). See Instructions to Authors for a complete description of levels of evidence.
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Until recently, wrong-site surgery had received little attention and had been considered a random, infrequent event. In 1997, the American Academy of Orthopaedic Surgeons (AAOS) Task Force on Wrong-Site Surgery was formed to determine the incidence of wrong-site surgery and to initiate the "Sign Your Site" campaign. The purpose of our study was to determine the incidence of wrong-site surgery among hand surgeons, elucidate surgeons' practice habits and measures taken to prevent its occurrence, and evaluate the effectiveness of the AAOS "Sign Your Site" campaign. ⋯ Prior to the AAOS "Sign Your Site" campaign, the issue of wrong-site surgery by hand surgeons had not been addressed. Although wrong-site surgery is rare, 21% of hand surgeons reported performing it at least once during their careers. Since the institution of the "Sign Your Site" campaign, 45% of orthopaedic hand surgeons have changed their practice habits, and almost all routinely take some action to prevent wrong-site surgery.
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J Bone Joint Surg Am · Feb 2003
Comparative StudyExperimental tibial plateau fractures augmented with calcium phosphate cement or autologous bone graft.
Depression fractures of the tibial plateau are often managed with use of internal fixation and autologous bone-grafting to maintain an anatomical reduction. Bone-grafting, however, provides only limited stability. As calcium phosphate cements have appropriate mechanical properties, they may provide a more suitable alternative. The objective of this study was to compare the effect of a calcium phosphate cement with that of impacted cancellous autograft for maintaining an anatomical reduction in an experimental model of a tibial plateau fracture. ⋯ Cancellous autograft did not maintain an anatomical reduction of the tibial plateau fractures in this model. In contrast, augmentation with calcium phosphate cement prevented subsidence of the fracture fragment and maintained articular congruency as the fracture healed. The improved articular congruency reduced the prevalence and severity of degenerative changes in the joint.
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J Bone Joint Surg Am · Feb 2003
Total hip arthroplasty in adult patients who had childhood infection of the hip.
Adult patients with a history of infection of the hip in childhood present a challenge as candidates for total hip arthroplasty because of abnormal bone development, soft-tissue contractures, the possibility of reinfection, and their relative youth. The purpose of this study was to analyze the mid-term results of primary total hip arthroplasty in adult patients who had had infection of the hip in childhood. ⋯ There was no recurrence of infection after total hip arthroplasty in the patients with a quiescent period of infection of more than ten years. These young, active patients with technically difficult arthroplasties were at considerable risk for aseptic loosening. The prevalence of polyethylene wear and osteolysis was attributable to the less than optimal prosthetic designs and materials used during the time-period of this study.