Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Apr 1988
Case ReportsSimultaneous bilateral avulsion fracture of the tibial tuberosity. A case report.
Bilateral avulsion fracture of the tibial tuberosity is a rare injury. A 14-year-old male gymnast sustained simultaneous tibial tuberosity displaced fractures while attempting a forward flip. The recommended treatment was open reduction and internal fixation. Functional results were excellent one year after surgical treatment.
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Clin. Orthop. Relat. Res. · Apr 1988
Comparative StudyHistologic and electrophysiologic changes following subepineurial hematoma induction in rat sciatic nerve.
The sciatic nerves of 34 rats were used to study the effects of intraneural, extrafascicular hematoma, exclusive of any other trauma. Electrodiagnostic, histologic, and electron microscopic techniques were used. The amount of nerve fiber damage was assessed using computerized planimetry. ⋯ Although there was a difference in the amount of nerve damage between the blood-injected and the hematoma-evacuated group (less damage), this difference was not statistically significant. These findings suggest that intraneural extrafascicular hematoma produces electrophysiologic and histologic evidence of axonal degeneration affecting nerve fibers in the vicinity of the hematoma. Early evacuation of the intraneural hematoma appears to slightly reduce the deleterious effects of the lesion.
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Clin. Orthop. Relat. Res. · Apr 1988
Biography Historical Article Classical ArticleA report of fifty-nine cases of scoliosis treated by the fusion operation. By Russell A. Hibbs, 1924.
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Clin. Orthop. Relat. Res. · Mar 1988
Case ReportsThe prevention of injuries of the brachial plexus secondary to malposition of the patient during surgery.
Brachial plexus injuries that occur secondary to malposition of the patient during general anesthesia have been described in the medical literature for nearly a century. However, little can be found in the orthopedic literature. ⋯ Pertinent anatomy, etiology, and pathogenesis of injury to the brachial plexus reveal that injury can occur from stretch or compression of nerves and is usually caused by a combination of the two. With awareness of risk factors and the positions which are likely to cause injury to the brachial plexus, careful positioning of the upper extremity can prevent injury and potential disability to the patient.
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Clin. Orthop. Relat. Res. · Mar 1988
A retrospective analysis of the efficacy of epidural steroid injections.
Forty patients were studied retrospectively to evaluate the effect of epidural steroid injections on low back pain and sciatica characteristic of spinal stenosis or a herniated lumbar disc. All but one of these patients had radicular symptoms. The average age was 55 years, and the average follow-up time was eight months. ⋯ Of those who had complete relief, there was no correlation between relief of pain, age, or number of injections. From this study, it appears that approximately 50% of patients with radicular symptoms may receive temporary relief with steroid injection. However, long-term relief occurs in less than 25% of patients.