Bulletin (Hospital for Joint Diseases (New York, N.Y.))
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Fracture-dislocations of the elbow remain a complex problem in orthopaedics. The myriad of treatment protocols and methodologies focuses on precise articular alignment and restoration of the skeletal architecture. ⋯ Surgical management, primarily reconstruction of the secondary stabilizers of the elbow joint as well as preserving soft tissue structures, subsequently provides the possibility of a speedier recovery. If proper skeletal alignment does not confer enough stability, hinged external fixation becomes an integral part of the treatment strategy for the reconstructive and trauma surgeon.
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Comparative Study
An analysis of orthopaedic residency selection criteria.
The lack of literature on residency selection criteria used by orthopaedic program directors has left medical students in the position of relying on rumor and anecdotal information as to what program directors value most highly when sorting through large candidate pools. The purpose of this study was to compare the perspectives on resident selection criteria solicited from orthopaedic program directors and residency applicants. A power analysis was done to determine adequate sample size. ⋯ This study provides the most comprehensive empirical data to date as to the factors which orthopaedic program directors consider most important during the residency selection process. To our knowledge, this is the first study in the orthopaedic literature that compares the program directors 'and residency applicants' views on resident selection criteria. Significant differences were found between applicant and program director views on resident selection criteria.
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Although Achilles tendon ruptures are a common occurrence, bilateral ruptures of the Achilles tendon are not. We present the case of a 33-year-old female who sustained metasynchronous (i.e., very close in time) bilateral ruptures of her Achilles tendons with no obvious predisposing factors. She was treated using a percutaneous technique and six months following surgery has returned to her normal activities.
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The value of caudal epidural steroid injections (CEI) in treatment of low back pain and sciatica is controversial. It is believed that CEI are mainly effective in treating acute radiculopathy at intermediate term follow up and have no long-term benefit. The objective of this study was to evaluate the role of CEI in the management of low back pain. ⋯ We found that the outcome of CEI was unpredictable. The clinical value of CEI remains unproven. The decision to perform the procedure may well remain a matter of personal choice and experience.