Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2010
Multiplanar osteotomy with limited wide margins: a tissue preserving surgical technique for high-grade bone sarcomas.
Limb-salvage surgery has been used during the last several decades to treat patients with high-grade bone sarcomas. In the short- and intermediate-term these surgeries have been associated with relatively good function and low revision rates. However, long-term studies show a high rate of soft tissue, implant, and bone-related complications. Multiplanar osteotomy with limited wide margins uses angled bone cuts to resect bone tumors with the goal of complete tumor removal while sparing host tissue although its impact on local recurrence is not known. ⋯ Level IV, therapeutic study. See the guidelines online for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2010
Comparative StudyLow-income countries' orthopaedic information needs: challenges and opportunities.
The Internet should, in theory, facilitate access to peer-reviewed scientific articles for orthopaedic surgeons in low-income countries (LIC). However, there are major barriers to access, and most full-text journal articles are available only on a subscription basis, which many in LIC cannot afford. Various models exist to remove such barriers. We set out to examine the potential, and reality, of journal article access for surgeons in LIC by studying readership patterns and journal access through a number of Internet-based initiatives, including an open access journal ("PLoS Medicine"), and programs from the University of Toronto (The Ptolemy Project) and World Health Organization (WHO) (Health InterNetwork Access to Research Initiative [HINARI]). ⋯ Free or low-cost Internet-based initiatives can improve access to the medical literature in LIC. Open access journals are a key component to providing clinically relevant literature to the regions and healthcare workers who need it most.
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Clin. Orthop. Relat. Res. · Oct 2010
Is closed-suction drainage necessary for single-level lumbar decompression?: review of 560 cases.
Closed-suction drainage is commonly used for prevention of postoperative hematoma and associated neurologic compromise after lumbar decompression, but it remains unclear whether suction drainage reduces postoperative complications. ⋯ Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Oct 2010
Pain relief, motion, and function after rotator cuff repair or reconstruction may not persist after 16 years.
Short- to medium-term rotator cuff repair reportedly relieves pain in 82% to 97% of patients and provides normal or almost normal shoulder function in 82% to 92%. However, it is unknown whether pain relief and function persist long term. ⋯ Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Rodent lumbar and caudal (tail) spine segments provide useful in vivo and in vitro models for human disc research. In vivo caudal models allow characterization of the effect of static and dynamic loads on disc mechanics of individual animals with time, but the lumbar models have required sacrifice of the animals for in vitro mechanical testing. ⋯ Improved methods to assess comparative models for disease or aging may permit enhanced clinical treatments and improved patient care.