Clinical orthopaedics and related research
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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.
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Clin. Orthop. Relat. Res. · Mar 2013
A novel imaging system permits real-time in vivo tumor bed assessment after resection of naturally occurring sarcomas in dogs.
Treatment of soft tissue sarcoma (STS) includes complete tumor excision. However, in some patients, residual sarcoma cells remain in the tumor bed. We previously described a novel hand-held imaging device prototype that uses molecular imaging to detect microscopic residual cancer in mice during surgery. ⋯ The ability to assess the tumor bed intraoperatively for residual disease has the potential to improve local control.
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The ability to apply casts and splints is a technical skill that requires practice and understanding of basic principles of musculoskeletal medicine. A video in which a given procedure is simulated on a dummy can represent reality under controlled conditions. A decrease in physician competency in musculoskeletal medicine is the result of educational deficiencies at the medical school level. ⋯ Our observations suggest a supplemental video instructional program improved the performance of musculoskeletal clinical skills in comparison to only a traditional lecture series.
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Clin. Orthop. Relat. Res. · Feb 2013
Randomized Controlled TrialParecoxib added to ropivacaine prolongs duration of axillary brachial plexus blockade and relieves postoperative pain.
Cyclooxygenase (COX)-2 antagonist is widely used for intravenous postoperative pain relief. Recent studies reported COX-2 in the spinal dorsal horn could modulate spinal nociceptive processes. Epidural parecoxib in rats showed no neurotoxicity. These findings suggested applying a COX-2 antagonist directly to the central or peripheral nerve might provide better analgesia. ⋯ Level I, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.