Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Mar 2013
Joint-preserving tumor resection and reconstruction using image-guided computer navigation.
Joint-preserving surgery is performed in select patients with bone sarcomas of extremities and allows patients to retain the native joint with better joint function. However, recurrences may relate to achieving adequate margins and there is frequently little room for error in tumors close to the joint surface. Further, the tumor margin on preoperative CT and/or MR images is difficult to transpose to the actual extent of tumor in the bone in the operating room. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2013
Lateralized reverse shoulder arthroplasty maintains rotational function of the remaining rotator cuff.
Humeral rotation often remains compromised after nonlateralized reverse shoulder arthroplasty (RSA). Reduced rotational moment arms and muscle slackening have been identified as possible reasons for this impairment. Although several clinical studies suggest lateralized RSA may increase rotation, it is unclear whether this is attributable to preservation of rotational moment arms and muscle pretension of the remaining rotator cuff. ⋯ Our findings could explain clinically improved rotation in lateralized RSA in comparison to nonlateralized RSA.
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Clin. Orthop. Relat. Res. · Mar 2013
Multicenter Study Comparative StudyGiant cell tumor with pathologic fracture: should we curette or resect?
Approximately one in five patients with giant cell tumor of bone presents with a pathologic fracture. However, recurrence rates after resection or curettage differ substantially in the literature and it is unclear when curettage is reasonable after fracture. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2013
Comparative StudyFee-based care is important for access to prompt treatment of hip fractures among veterans.
Hip fracture is a medical emergency for which delayed treatment increases risk of disability and death. In emergencies, veterans without access to a Veterans Administration (VA) hospital may be admitted to non-VA hospitals under fee-based (NVA-FB) care paid by the VA. The affect of NVA-FB care for treatment and outcomes of hip fractures is unknown. ⋯ Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Mar 2013
Locking buttons increase fatigue life of locking plates in a segmental bone defect model.
Durability of plate fixation is important in delayed union. Although locking plates result in stronger constructs, it is not known if locking affects the fatigue life of a plate. Two locking screws on either side of the nonunion could decrease working length and increase strain in the plate. However, the reinforcing effect of the locking head on the plate may compensate, so that it is unclear whether locking reduces fatigue life. ⋯ Locking buttons in holes adjacent to a defect may improve durability, which is important when delayed union is a possibility.