The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Oct 2012
Review Historical ArticlePlaster: our orthopaedic heritage: AAOS exhibit selection.
Plaster has been used for centuries as a stiffening agent to treat fractures and other musculoskeletal conditions that require rest, immobilization, or correction of a deformity. Despite modern metallurgy and internal stabilization, plaster casts and splints remain an important means of external stabilization. Casting is a dying art as modern internal and external fixation replace external immobilization. Proper casting technique is paramount. This manuscript outlines the history and chemistry of immobilization materials and techniques as well as the differences among them and the advantages and disadvantages of each. ⋯ Plaster casts and splints remain an important treatment method for acute and chronic orthopaedic conditions.
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J Bone Joint Surg Am · Oct 2012
Transient soft-tissue edema associated with implantation of increasing doses of rhBMP-2 on an absorbable collagen sponge in an ectopic rat model.
Recombinant human bone morphogenetic protein-2 (rhBMP-2) is an osteoinductive protein. However, soft-tissue edema adjacent to the site of rhBMP-2 implantation has been reported. This animal study was designed to examine soft-tissue edema associated with increasing rhBMP-2 doses with implantation on an absorbable collagen sponge (ACS) and with injection directly into muscle. ⋯ Transient peri-implant soft-tissue edema occurred in a dose-dependent manner following implantation of rhBMP-2/ACS in this rat model. The normal dose of rhBMP-2/ACS produced edema similar to that in the controls. Finally, rhBMP-2 solutions injected directly into muscle resulted in minimal soft-tissue edema.
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J Bone Joint Surg Am · Oct 2012
Randomized Controlled Trial Multicenter Study Comparative StudyPrognostic factors for predicting outcomes after intramedullary nailing of the tibia.
Prediction of negative postoperative outcomes after long-bone fracture treatment may help to optimize patient care. We recently completed the Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT), a large, multicenter trial of reamed and unreamed intramedullary nailing of tibial shaft fractures in 1226 patients. Using the SPRINT data, we conducted an investigation of baseline and surgical factors to determine any associations with an increased risk of adverse events within one year of intramedullary nailing. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2012
Randomized Controlled Trial Comparative StudyDoes subacromial injection of a local anesthetic influence strength in healthy shoulders?: a double-blinded, placebo-controlled study.
Subacromial injection of a local anesthetic is used to eliminate pain as a confounding factor in clinical assessment of abduction strength in shoulders with a suspected rotator cuff tear. If strength remains diminished despite pain relief, a rotator cuff tear is likely. The effect of injecting local anesthetic into the subacromial space on the strength of a normal shoulder is unknown, although it could affect strength by impairing suprascapular or axillary nerve function. We hypothesized that subacromial injection of a local anesthetic could decrease shoulder abduction and/or external rotation strength, resulting in physical examination findings that could mislead the clinician. ⋯ Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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J Bone Joint Surg Am · Oct 2012
Comparative StudyPeriprosthetic fractures associated with primary total shoulder arthroplasty and primary humeral head replacement: a thirty-three-year study.
The objective of this study was to assess the frequency of, and risk factors for, periprosthetic fractures during and after shoulder arthroplasty. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.