The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Jun 2009
Comparative StudyDistal radial fracture treatment: what you get may depend on your age and address.
Distal radial fractures are common and confer a considerable financial burden on the health-care system; however, controversy surrounds the optimal treatment of these injuries. This study was performed to determine (1) the rate of distal radial fractures in the U.S. Medicare population stratified by hospital referral region and (2) whether the type of fracture treatment is affected by patient age, race, sex, comorbidity, or hospital referral region. ⋯ There is wide variation in the rate of distal radial fractures across sex, age, race, and geographic region in the United States. There is also significant variation in the treatment of these fractures, driven mainly by age and region. Between 1998 and 2004, a strong trend toward more frequent operative fixation was apparent. While white individuals had more than twice as many fractures as did non-white individuals, there did not appear to be significant racial variation in the treatment of this injury.
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J Bone Joint Surg Am · Jun 2009
Comparative StudyComparison of arthroscopic and open treatment of septic arthritis of the wrist.
Open irrigation and débridement is the standard of treatment for septic arthritis of the wrist. Although isolated cases of arthroscopic irrigation and débridement have been reported, a comparison of arthroscopic and open techniques has not been performed, to our knowledge. The purpose of this study was to compare the two methods of management. ⋯ Therapeutic Level III. See Instructions to Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Jun 2009
Long-term clinical and radiographic outcomes after open reduction for missed Monteggia fracture-dislocations in children.
There have been few reports on the long-term outcomes after the operative treatment of missed Monteggia fracture-dislocations in children. The purpose of the present study was to evaluate the long-term clinical and radiographic outcomes after open reduction for the treatment of a missed Monteggia fracture-dislocation. ⋯ If open reduction for the treatment of a missed Monteggia fracture is performed when the patient is less than twelve years of age or within three years after the injury, good long-term clinical and radiographic outcomes can be expected.
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J Bone Joint Surg Am · Jun 2009
Comparative StudyNear-infrared spectroscopy in lower extremity trauma.
Near-infrared spectroscopy measures the percentage of hemoglobin oxygen saturation in the microcirculation of tissue up to 3 cm below the skin. The purpose of this study was to describe the measurable response of normal tissue oxygenation in the leg after acute trauma with use of this technique. ⋯ Tibial fracture produces a predictable increase in tissue oxygenation as measured by near-infrared spectroscopy. The corresponding compartment of the contralateral leg can provide strong utility as an internal control value when evaluating the hyperemic response to injury.
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J Bone Joint Surg Am · Jun 2009
Uncemented grit-blasted straight tapered titanium stems in patients younger than fifty-five years of age. Fifteen to twenty-year results.
Total hip arthroplasty without cement is frequently performed in young active patients, but only limited outcomes data are available after durations of follow-up of more than fifteen years. ⋯ After a minimum duration of follow-up of fifteen years, the survival of this type of femoral component is excellent in individuals younger than fifty-five years. The main mode of stem failure was a periprosthetic fracture due to trauma, or late aseptic loosening in a small percentage of the hips in which the femoral implant was undersized. The high rate of failure of the acetabular components was attributable to a poor design that is no longer in use.