The Journal of bone and joint surgery. American volume
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The purposes of this retrospective study were to review the results of isolated subtalar arthrodesis in adults and to identify factors influencing the union rate. The hypotheses were that (1) the overall outcome is acceptable but is not as favorable as previously reported, (2) complication rates, especially the nonunion rate, are higher than previously reported, and (3) factors contributing to a less favorable union rate can be identified. ⋯ To the best of our knowledge, the present study includes the largest reported series of isolated subtalar arthrodeses in adults. Our results suggest that the outcome following isolated subtalar arthrodesis is not as favorable as has been reported in previous studies. The rate of union was significantly diminished by smoking, the presence of more than two millimeters of avascular bone at the arthrodesis site, and the failure of a previous subtalar arthrodesis (p < 0.05 for all). Other factors that probably affect the union rate include the use of structural allograft and performance of the arthrodesis adjac
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J Bone Joint Surg Am · May 2000
Relationship of peak height velocity to other maturity indicators in idiopathic scoliosis in girls.
Our aim was to compare height velocity data, obtained from clinical height measurements, for girls who had idiopathic scoliosis with the data for adolescents who did not have scoliosis. We also compared the growth data with chronological age, menarchal age, and Risser sign in terms of their accuracy in the prediction of growth and progression of the scoliosis. ⋯ Height velocities generated from clinical height measurements for patients with idiopathic scoliosis document the growth peak and predict cessation of growth reliably. Knowing the timing of the growth peak provides valuable information on the likelihood of progression to a magnitude requiring spinal arthrodesis.
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J Bone Joint Surg Am · May 2000
Restoration of prehension with the double free muscle technique following complete avulsion of the brachial plexus. Indications and long-term results.
Recent interest in reconstruction of the upper limb following brachial plexus injuries has focused on the restoration of prehension following complete avulsion of the brachial plexus. ⋯ The double free muscle procedure can provide reliable and useful prehensile function for patients with complete avulsion of the brachial plexus.
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J Bone Joint Surg Am · Apr 2000
The safety and efficacy of Isola-Galveston instrumentation and arthrodesis in the treatment of neuromuscular spinal deformities.
Implant systems that realign and stabilize a deformed spine continue to evolve. The purpose of the study of this case series was to determine the safety and effectiveness of a system designed to integrate hook, wire, screw, and post anchors for the treatment of a wide spectrum of neuromuscular disorders associated with pelvic deformity or the potential for deformity. ⋯ Isola-Galveston instrumentation seems as safe and effective as other types of instrumentation that have been studied in comparable series in the literature. Isola-Galveston instrumentation is probably more effective for the correction of pelvic obliquity and the maintenance of correction. Only a posterior procedure is used, and the instrumentation appears to decrease the need for an additional anterior approach. Spinal hook, wire, screw, and post anchors have been successfully integrated into one posterior spinal implant system.
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J Bone Joint Surg Am · Apr 2000
Vascularized free fibular transfer combined with autografting for the management of fracture nonunions associated with radiation therapy.
The purpose of this study was to evaluate the functional results, rates of union, and complications associated with vascularized free fibular transfer combined with autografting for the treatment of nonunions in previously irradiated bone. ⋯ On the basis of this review, we suggest that microvascular fibular transfer combined with autografting is an appropriate treatment option for difficult nonunions associated with previously irradiated bone.