Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Dec 2010
Transtrochanteric rotational osteotomy for a subchondral insufficiency fracture of the femoral head in young adults.
While subchondral insufficiency fracture of the femoral head is most frequently seen in elderly patients, this fracture has also been reported in some young individuals. ⋯ Anterior rotational osteotomy seems a useful surgical option for treating young patients with subchondral insufficiency fracture of the femoral head if symptoms persist.
-
Clin. Orthop. Relat. Res. · Dec 2010
Delayed foreign-body reaction to absorbable implants in metacarpal fracture treatment.
First-generation bioabsorbable implants have been associated with a high complication rate attributable to weak mechanical properties and rapid degradation. This has led to the development of stronger devices with improved durability. However, the modern implants have raised concerns about potential late-occurring adverse reactions. ⋯ Our results indicate these absorbable implants for metacarpal fractures achieved adequate bone healing but simply postponed the problem of foreign-body reactions. Patients treated with bioabsorbable implants should be advised of potential late complications and should be followed for at least 2 years, possibly longer.
-
Clin. Orthop. Relat. Res. · Dec 2010
Comparative StudyEthnic and gender differences in the functional disparities after primary total knee arthroplasty.
The benefits of TKA have been well documented. Whether these benefits apply equally across gender and ethnic groups is unclear. Given the underuse of TKA among certain demographic groups, it is important to understand whether gender or ethnicity influence pain and function after TKA. ⋯ Gender and race affected functional KSS and ROM variables. The worse results experienced by African-American women may be attributable to a longer delay to presentation. However, the scores and motion were high for all subgroups, and underuse of TKA in women and African-Americans cannot be justified based on a perception of lesser functional gains.
-
Carpal tunnel syndrome causes numbness, weakness, and atrophy. Pain without numbness is not characteristic of this disease. ⋯ Illness behavior (specifically depression and misinterpretation of nociception) predicts pain intensity in patients with carpal tunnel syndrome.
-
Clin. Orthop. Relat. Res. · Nov 2010
Comparative StudySite-dependent replacement or internal fixation for postradiation femur fractures after soft tissue sarcoma resection.
High-dose radiation retards bone healing, compromising the surgical results of radiation-induced fractures. Prosthetic replacement has traditionally been reserved as a salvage option but may best achieve the clinical goals of eliminating pain, restoring function and avoiding complications. ⋯ Radiation-induced fractures have poor healing potential. Our data suggest an aggressive approach to fracture treatment with a prosthetic replacement can minimize complications and the need for revision surgery.