Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Oct 2001
Review Case ReportsPatellar metastasis from a squamous carcinoma of the lung: a case report.
Bone is a common site of metastasis from lung cancer. Metastasis to the patella, however, is rare. ⋯ Treatment was delayed secondary to delay in diagnosis. In cases of bone pain that are unexplained or out of proportion to a traumatic event, more extensive diagnostic studies should be done.
-
Clin. Orthop. Relat. Res. · Oct 2001
Review Case ReportsDifferentiation of psoas muscle abscess from septic arthritis of the hip in children.
A 20-year review was conducted of children presenting with psoas abscess at two major pediatric hospitals. Eleven children with psoas abscesses were identified. The extreme variability in the clinical presentation of this condition is shown. ⋯ This study also shows the often circuitous investigative route traversed before arriving at the diagnosis of psoas abscess. Atypical features, such as femoral nerve neurapraxia or bladder irritability in association with hip pain, should alert the clinician to consider psoas abscess. Based on this study, a diagnostic algorithm to differentiate between psoas abscess and septic hip was formulated.
-
Clin. Orthop. Relat. Res. · Oct 2001
ReviewPitfalls in the treatment of fractures of the ankle and talus.
Displaced fractures of the ankle are a common component of current orthopaedic practice, whereas displaced fractures of the talus are unusual. Ankle fractures generally are produced by indirectly applied, relatively low energy forces, whereas talus fractures are created by higher energy axial loading. ⋯ Complications and poor results can arise from the inherent characteristics of the injury, from failure to accomplish appropriate treatment objectives, from overzealous treatment goals, or from overlooking subtle clinical or radiographic signs. The goal of the current study is to provide a method of evaluating the characteristics of these injuries to optimize functional outcomes and avoid morbidity.
-
Clin. Orthop. Relat. Res. · Oct 2001
Mergers involving academic health centers: a formidable challenge.
Escalating economic pressures on the clinical enterprise threaten the missions of education and research in many of the most prestigious academic health centers. Following the model of industry, mergers of the healthcare delivery systems of teaching hospitals and clinics held promise for economies of scale and an improved operating margin. ⋯ Academic institutions and their respective governing boards need to exercise greater discipline in financial analysis and a willingness to make difficult decisions that show favor to one parent institution over another if mergers are to be effective in this setting. To date, an example of a vibrant and successful merger of academic health centers remains to be found.
-
Clin. Orthop. Relat. Res. · Sep 2001
ReviewKnotless suture anchor: arthroscopic bankart repair without tying knots.
Arthroscopic Bankart repair done using suture anchors most closely mimics open repair techniques. The challenge with the arthroscopic technique is tying consistent, good quality arthroscopic knots. A unique knotless suture anchor and method of use for arthroscopic Bankart repair is described. ⋯ This is attributable to the doubled suture configuration that is created with the Knotless Suture Anchor loop. To the author's knowledge, the current study describes the first knotless suture anchor. A secure, low-profile repair can be created without arthroscopic knot tying.