Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2012
Biography Historical ArticleBiographical sketch: Georg Clemens Perthes, MD (1869-1927).
This biographical sketch on Georg Perthes corresponds to the historic text, The Classic: On Juvenile Arthritis Deformans (1910), available at DOI 10.1007/s11999-012-2433-1.
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Clin. Orthop. Relat. Res. · Sep 2012
Review Meta AnalysisDo femoral or salter innominate osteotomies improve femoral head sphericity in Legg-Calvé-Perthes disease? A meta-analysis.
Recently, the authors of two prospective multicenter observational studies recommended surgery to improve head sphericity in older children, whereas large retrospective observational studies suggest that surgery does not improve head sphericity in older children. Thus, the treatment for Legg-Calvé-Perthes disease (LCPD) remains controversial. ⋯ The data suggest FVO or SIO in patients with LCPD disease who are older than 6 years of age during or before the fragmentation phase should be considered.
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Clin. Orthop. Relat. Res. · Sep 2012
What is the best way to apply the Spurling test for cervical radiculopathy?
A diagnosis of cervical radiculopathy is based largely on clinical examination, including provocative testing. The most common maneuver was described in 1944 by Spurling and Scoville. Since then, several modifications of the original maneuver have been proposed to improve its value in the diagnosis of cervical radiculopathy. ⋯ Whenever cervical radiculopathy is suspected our observations suggest the staged provocative maneuvers that should be included in the physical evaluation are extension and lateral bending first, followed by the addition of axial compression in cases with an inconclusive effect.
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Clin. Orthop. Relat. Res. · Sep 2012
Does carpal tunnel release provide long-term relief in patients with hemodialysis-associated carpal tunnel syndrome?
Carpal tunnel syndrome (CTS) is a common complication in patients receiving long-term hemodialysis. In the short-term however, these patients are less likely to have pain relief and restoration of function after carpal tunnel release. However, it is unclear whether patients who have release for hemodialysis-associated CTS have differing persisting relief of symptoms compared with patients with idiopathic CTS. ⋯ Patients with hemodialysis-associated CTS seem to remain impaired, unlike patients with idiopathic CTS, but the majority of them might have much improved CTS-related symptoms at 2 years after carpal tunnel release.
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Clin. Orthop. Relat. Res. · Sep 2012
Triple innominate osteotomy for Legg-Calvé-Perthes disease in children: does the lateral coverage change with time?
Triple innominate osteotomy (TIO) is one of the modalities of surgical containment in Legg-Calvé-Perthes disease (LCPD). However, overcoverage with TIO can lead to pincer impingement. ⋯ TIO resulted in femoral head containment in all cases. Lateral acetabular coverage changed during the growing years in all patients. Surgical correction beyond 44° of CE angle and -6° of ARA should be avoided to prevent pincer morphology later.