The American journal of orthopedics
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Rupture of the extensor pollicis longus (EPL) tendon after nondisplaced fracture of the distal radius is a known complication, but can also occur in nonrheumatoid patients without a history of fracture. This study is a retrospective analysis of seven patients treated between 1985 and 1992. Five EPL ruptures occurred with nondisplaced Colles' fractures. ⋯ The causes of EPL rupture include mechanical irritation, attrition, and vascular impairment leading to delayed rupture. Synovitis of the extensor carpi radialis due to repetitive use may invade the EPL tendon and lead to rupture. Extensor indicis proprius transfer or free palmaris longus grafts yield good results after EPL rupture.
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Comparative Study
A comparison of blood loss and transfusion requirements in total knee arthroplasty with and without arterial tourniquet.
A retrospective study was undertaken to determine the intraoperative blood loss and the subsequent need for blood transfusion in primary total knee arthroplasty. Fifty-six patients were operated on with the use of an arterial tourniquet (group 1), and 50 patients, without the use of a tourniquet (group 2). The mean intraoperative blood loss was significantly different between the two groups (P = 0.001). ⋯ This difference was not significantly different. Although intraoperative blood loss was increased in the group when no tourniquet was used, the overall incidence of transfusion was the same between the two groups. It may therefore be justified to question the routine use of a tourniquet during total knee arthroplasty.
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Randomized Controlled Trial Clinical Trial
The effect of cold therapy on the postoperative course of total hip and knee arthroplasty patients.
Fifty total hip arthroplasty (THA) patients and 24 total knee arthroplasty (TKA) patients were randomized in a controlled study to examine the effects of cold therapy (via thermal blankets) in the postoperative period. The postoperative hospital stay was significantly shorter for the cold-therapy (50 degrees F) compared with control (70 degrees F) groups (by 1.4 days, P = 0.03) for THA patients. ⋯ Total knee arthroplasty patients using cold therapy achieved independent ambulation an average of 1 day sooner than TKA control patients, but this difference did not reach statistical significance (P = 0.08). There were no statistically significant differences between the control groups or the test groups for both THA and TKA patients in narcotic usage, postoperative range-of-motion (ROM), or rate of progression of ROM.
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Case Reports
Acute exercise-induced bilateral anterolateral leg compartment syndrome in a healthy young man.
While compartment syndrome after traumatic injury is a well-recognized entity, atraumatic or exercise-induced acute compartment syndrome is not as widely reported. This syndrome, usually unilateral, was first described as "march gangrene" in 1943, and can result in the loss of life or limb. ⋯ We wish to report a case of acute, bilateral, exercise-induced anterolateral leg compartment syndrome in a healthy young man. Early recognition and prompt treatment by decompressive fasciotomy is of vital importance if limb function is to be preserved and complications are to be avoided.