The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jul 2002
Influence of comorbidity on self-assessment instrument scores of patients with idiopathic adhesive capsulitis.
The purpose of this study was to determine whether comorbid factors influence the results of self-assessment instruments completed by patients with idiopathic adhesive capsulitis of the shoulder. We hypothesized that an increased number of comorbidities would be correlated with greater pain and worse function as measured by general and shoulder-specific outcome tools. ⋯ Idiopathic adhesive capsulitis is a debilitating condition. Comorbid factors have a significant effect on the pain and dysfunction (as measured on shoulder-specific and general health instruments) experienced by patients with this disorder. These findings can be applied to the evaluation of these patients and may help to identify patients who potentially require a longer treatment course or those whose outcome will be less satisfactory.
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J Bone Joint Surg Am · Jun 2002
Bone-lengthening for symbrachydactyly of the hand with the technique of callus distraction.
Bone-lengthening in the hand and foot is a relatively new application for distraction osteogenesis. We present the operative treatment and postoperative outcome for four patients with M ller type-D symbrachydactyly of the hand who underwent metacarpal lengthening with use of a distraction device to establish pinch function. ⋯ On the basis of our limited experience, we found that distraction osteogenesis of the metacarpals was an effective technique for the establishment of pinch function. We also found that an intramedullary Kirschner wire could maintain the alignment of the osteotomized bone. Although distraction requires a longer treatment period, it is apparently more effective than bone-grafting in terms of achieving adequate bone length. Simultaneous lengthening of two metacarpals also was found to be an effective technique.
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J Bone Joint Surg Am · Jun 2002
Comparative StudyPeriprosthetic femoral fractures around well-fixed implants: use of cortical onlay allografts with or without a plate.
Periprosthetic femoral fractures around hip replacements are increasingly common. When the femoral component is stable, open reduction and internal fixation is recommended in all but exceptional cases. The purpose of this study was to evaluate the outcome of treatment of fractures around stable implants with cortical onlay strut allografts with or without a plate. ⋯ Cortical onlay strut allografts act as biological bone plates, serving both a mechanical and a biological function. The use of cortical struts, either alone or in conjunction with a plate, led to a very high rate of fracture union, satisfactory alignment, and an increase in femoral bone stock at the time of short-term follow-up. Although this study did not address the potential for later allograft remodeling, our findings suggest that cortical strut grafts should be used routinely to augment fixation and healing of a periprosthetic femoral fracture.
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J Bone Joint Surg Am · Jun 2002
Femoral lengthening over a humeral intramedullary nail in preadolescent children.
Femoral lengthening over an intramedullary nail has been described in adults. A technique of femoral lengthening over a humeral intramedullary nail in children is described, and the results and complications are presented. ⋯ The technique is effective but has a high rate of complications, including osteomyelitis, which developed in two of the nine patients. No avascular necrosis or proximal femoral valgus was noted.