Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2016
Comparative StudyGreater Tuberosity Fractures: Does Fracture Assessment and Treatment Recommendation Vary Based on Imaging Modality?
For greater tuberosity fractures, 5-mm displacement is a commonly used threshold for recommending surgery; however, it is unclear if displacement can be assessed with this degree of precision and reliability using plain radiographs. It also is unclear if CT images provide additional information that might change decision making. ⋯ Level III, diagnostic study.
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Clin. Orthop. Relat. Res. · May 2016
ReviewVascularized versus Nonvascularized Bone Grafts: What Is the Evidence?
There is a general perception in practice that a vascular supply should be used when large pieces of bone graft are used, particularly those greater than 6 cm in length for long-bone and large-joint reconstructions. However, the scientific source of this recommendation is not clear. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2016
Is there an Increase in Valgus Deviation in Tibial Distraction Using the Lengthening Over Nail Technique?
During tibial lengthening, the soft tissues of the posterolateral compartment produce distraction-resisting forces causing valgus angulation. Although this occurs with the classic Ilizarov method, whether a valgus deformity develops with the lengthening over nail (LON) technique is questioned, because the intramedullary nail is thought to resist deforming forces and adequately maintain alignment of the distracted bone. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2016
Comparative StudyIs Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?
Arthroscopic double-row suture-anchor fixation and open reduction and internal fixation (ORIF) are used to treat displaced greater tuberosity fractures, but there are few data that can help guide the surgeon in choosing between these approaches. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2016
Comparative StudyUniversal Health Insurance Coverage in Massachusetts Did Not Change the Trajectory of Arthroplasty Use or Costs.
The state of Massachusetts enacted universal health insurance in 2006. However it is unknown whether the increased access to care resulted in changes to surgical use or costs. ⋯ The enactment of universal health insurance coverage in Massachusetts appears to have been a nonevent insofar as the use and cost of total hip and knee surgeries is concerned in the state. Factors other than health insurance reform appear to be driving the growth in demand for arthroplasties in Massachusetts and are likely to do so as well in the United States under the Affordable Care Act of 2010.