Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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To establish a patient-oriented outcome measure for cervical myelopathy, a subcommittee of the Japanese Orthopaedic Association (JOA) developed a new scoring system to evaluate the overall clinical status of patients, which could be completed by patients themselves. The subcommittee completed three large-scale studies to select and modify questions derived from various preexisting outcome measures including Short Form-36, and then finalized and validated the questionnaire, which comprised 24 questions. ⋯ We have successfully established a questionnaire that is able to demonstrate the status of patients suffering cervical myelopathy from five different aspects represented by five intuitive numerical scores. The final issue to be confirmed is the responsiveness of this questionnaire to changes in patients' status after various surgical and nonsurgical treatments.
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Fractures of the proximal humerus are common and the repair of displaced fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have developed a new intramedullary nail (pin lock nail) for the repair of surgical neck fractures of the proximal humerus in patients with osteoporotic bones. A retrospective review is presented of the cases of 19 elderly patients with two-part or three-part fractures of the proximal humerus treated using the pin lock nail. ⋯ Our data show that using the pin lock nail for the treatment of two-part and three-part humeral fractures is a reliable procedure, providing good results with careful postoperative management.
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Bleeding pelvic fracture patients with severe associated injuries have a high mortality rate that is exacerbated by several factors. To gain deeper etiological insights into this injury, we investigated the specific risk factors associated with the high mortality rate. ⋯ Statistically significant risk factors were brain injuries and shock symptoms on arrival. Brain injuries should be heavily weighted when evaluating the prognosis of bleeding pelvic fracture patients.
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In shoulders with multidirectional instability, translation of the humeral head on the glenoid is increased in the midrange because of the following three reasons: the increased retroversion, a hypoplastic posteroinferior rim, and decreased scapular abduction during arm elevation. This study aimed to clarify the relationship between glenoid inclination and glenohumeral joint stability. ⋯ The posterior and inferior stability increased with an anterior tilt of more than 5 degrees and with a superior tilt of 10 degrees , respectively. The anterior and posterior stability decreased with an anterior tilt of 5 degrees and with a posterior tilt of 15 degrees , respectively.