Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 2003
Comparative StudyWrist injuries in guarded versus unguarded first time snowboarders.
In 1999, a study was done examining the injury risk and pattern in first time snowboarders versus first time skiers. Although these rates were similar, snowboarders sustained a higher percentage of injuries to the upper extremity, particularly wrist sprains and fractures. As an extension of this previous study, the protective value during snowboarding of an off-the-shelf wrist guard originally designed for inline skating was tested. ⋯ Five hundred fifty-one snowboarders wore wrist guards and a control group of more than 1800 snowboarders did not wear wrist guards. Forty wrist injuries were sustained in the control group (2.2%), compared with no injuries (0%) in the snowboarders who wore wrist guards. Importantly, there was no increase in more proximal or distal upper extremity injuries in the group of snowboarders who wore wrist guards.
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Clin. Orthop. Relat. Res. · Apr 2003
Laboratory monitoring in pediatric acute osteomyelitis and septic arthritis.
The purpose of the current study was to determine the usefulness of erythrocyte sedimentation rate and C-reactive protein in pediatric bone and joint infections treated with and without surgery. The medical records of 50 patients admitted for acute osteomyelitis, septic arthritis, or both were reviewed retrospectively. There were 22 patients with septic arthritis, 20 with osteomyelitis, and eight with osteomyelitis with adjacent septic arthritis. ⋯ The mean days to peak and normalization for erythrocyte sedimentation rate and C-reactive protein were twice as long in the surgical group as compared with the nonsurgical group. Complete recovery was achieved by all patients. This information should help the clinician in the diagnosis and treatment of children having surgery for acute osteomyelitis and septic arthritis.
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Although vehicular trauma traditionally has accounted for the majority of spinal cord injuries, gunshot wounds are the second most common cause. Furthermore, the proportion of spinal cord injuries caused by gunshot wounds are increasing although the proportion of injuries caused by high-speed vehicular trauma is decreasing. Gunshot wounds to the spine commonly are thought to be stable injuries. ⋯ Surgical decompression of bullets from the spinal canal has been shown to improve neurologic recovery below the T12 level. Improvement of neurologic recovery after bullet removal has not been shown in other regions of the spine. Rare instances of late neurologic decline because of retained bullet fragments have been documented.
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Clin. Orthop. Relat. Res. · Mar 2003
Case ReportsRecurrent anterior hip instability after a simple hip dislocation: a case report.
A 35-year-old woman sustained a simple anterior hip dislocation after a fall. Initial treatment involved a closed reduction under sedation with brace immobilization. Nine months after the initial dislocation, she began having recurrent anterior hip instability (four events) requiring closed reduction under anesthesia. ⋯ After this procedure she sustained five additional anterior dislocations requiring closed reduction under anesthesia. After nine anterior dislocations, she had periacetabular osteotomy retroverting her acetabulum with repair of the anterior hip capsule which has successfully solved the recurrent instability. To the author's knowledge this is the first reported case of recurrent anterior hip instability treated successfully with a periacetabular osteotomy.
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Clin. Orthop. Relat. Res. · Mar 2003
Recent advances in the treatment of gunshot fractures of the humeral shaft.
The increase in violent crime has lead to an increase in gunshot-induced fractures in the United States. Injuries to the upper extremity are common. The treatment of gunshot injuries depends on the extent of soft tissue disruption and the type and location of fracture. ⋯ Soft tissue disruption plays a more important role in high-energy gunshot-induced fractures. In these cases, external fixation is the treatment of choice for stabilization. Recent advances in the use of external fixation have led to quick fracture stabilization, stability for vascular repair, and access to the wound for debridement and subsequent soft tissue surgery.