Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Sep 2014
Multicenter StudyWhat is the frequency of vascular injury after knee dislocation?
Vascular injury secondary to an acute knee dislocation is a known complication. However, there exist wide discrepancies in the reported rate of vascular injury in this setting. ⋯ Level IV, prognostic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Sep 2014
Posterior tibial tendon transfer improves function for foot drop after knee dislocation.
Knee dislocation may be associated with an injury to the common peroneal nerve with a subsequent foot drop. Previous studies have demonstrated good functional results after posterior tibial tendon transfer in patients with foot drop. No studies, to our knowledge, have focused exclusively on knee dislocation as the cause of common peroneal nerve injury leading to foot drop. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Sep 2014
Comparative StudyMedial injury in knee dislocations: what are the common injury patterns and surgical outcomes?
When associated with a knee dislocation, management of the medial ligamentous injury is challenging, with little literature available to guide treatment. ⋯ Medial ligament injury is common in knee dislocations. Females who sustain these injuries and patients who have an ultra-low-velocity mechanism should be counseled at the time of injury about the likelihood of inferior outcomes. As ROM deficits are the most commonly encountered complication, postoperative rehabilitation should focus on early ROM exercises as stability and wound healing allow. Future prospective studies are needed to definitively determine whether operative or nonoperative management is appropriate for particular medial ligamentous injury patterns.
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Clin. Orthop. Relat. Res. · Sep 2014
Assessing leg length after fixation of comminuted femur fractures.
Nailing comminuted femur fractures may result in leg shortening, producing significant complications including pelvic tilt, narrowing of the hip joint space, mechanical and functional changes in gait, an increase in energy expenditures, and strains on spinal ligaments, leading to spinal deformities. The frequency of this complication in patients managed with an intramedullary (IM) nail for comminuted diaphyseal fractures is unknown. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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Clin. Orthop. Relat. Res. · Sep 2014
Increased complication rates after hip and knee arthroplasty in patients with cirrhosis of the liver.
Risk stratification is critical in patients with cirrhosis undergoing THAs and TKAs, as they may be more likely to have serious medical and surgical complications. As opposed to the Child-Pugh scoring system, which has limited use for orthopaedic surgeons inexperienced in assessing ascites and hepatic encephalopathy, the Model for End-stage Liver Disease (MELD) is an easily calculated, validated scoring system for severity of liver disease based on common laboratory values; however, its usefulness for predicting complications after elective arthroplasty has not been studied. ⋯ Level III, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.