The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2006
Prospective measurement of function and pain in patients with non-neoplastic compression fractures treated with vertebroplasty.
There has been an increasing number of reports regarding the benefits of vertebroplasty for the treatment of vertebral compression fractures. In this investigation, validated outcome tools were utilized to document the impact of vertebroplasty on pain and function. ⋯ Vertebroplasty is an effective treatment for patients with intractable pain due to osteoporotic vertebral compression fractures. Improvement in pain scores and functional capabilities that were found at one month were maintained at one year.
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J Bone Joint Surg Am · Feb 2006
Randomized Controlled TrialTreatment of external fixation pins about the wrist: a prospective, randomized trial.
Pin-track infection remains one of the most troublesome complications of external fixation, in some cases compromising otherwise successful fracture treatment. ⋯ We found a high rate of local wound complications around external fixation pin sites; however, most complications were minor and could be observed or treated with oral antibiotics. The prevalence of these complications was not decreased in association with the use of hydrogen peroxide wound care or chlorhexidine-impregnated dressings. On the basis of these results, we do not recommend additional wound care beyond the use of dry, sterile dressings for pin-track care after external fixation for the treatment of distal radial fractures.
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J Bone Joint Surg Am · Feb 2006
Comment Letter Comparative StudyComparison of soap and antibiotic solutions for irrigation of lower-limb open fracture wounds.
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J Bone Joint Surg Am · Feb 2006
Randomized Controlled TrialA multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.
Although numerous methods of postoperative analgesia have been investigated in an attempt to improve pain control after total knee arthroplasty, parenteral narcotics still play a major role in postoperative pain management. Local anesthetics have the advantage of blocking pain conduction at its origin and minimizing the systemic side effects associated with postoperative narcotic use. This study was performed to evaluate the benefits and safety of a multimodal analgesia protocol that included periarticular injection of large doses of local anesthetics in patients undergoing total knee arthroplasty. ⋯ This multimodal perioperative analgesia protocol that included infiltration of a local anesthetic offered improved pain control and minimal side effects to patients undergoing total knee arthroplasty. Our study also confirmed the safety of the protocol.
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J Bone Joint Surg Am · Feb 2006
Direct percutaneous gene delivery to enhance healing of segmental bone defects.
Healing of segmental bone defects can be induced experimentally with genetically modified osteoprogenitor cells, an ex vivo strategy that requires two operative interventions and substantial cost. Direct transfer of osteogenic genes offers an alternative, clinically expeditious, cost-effective approach. We evaluated its potential in a well-established, critical-size, rat femoral defect model. ⋯ A single, percutaneous, intralesional injection of Ad.BMP-2 induces healing of critical-size femoral bone defects in rats within eight weeks. At this time, the repair tissue is predominantly trabecular bone, has normal bone mineral content, and has gained mechanical strength.