The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2014
Psychological factors predict disability and pain intensity after skeletal trauma.
The aims of this study were to (1) estimate the prevalence of clinical depression and posttraumatic stress disorder (PTSD) one to two months (Time 1) and five to eight months (Time 2) after musculoskeletal trauma and (2) determine the cross-sectional and longitudinal relationship of psychological variables (depression, PTSD, catastrophic thinking, and pain anxiety) at Time 1 to musculoskeletal disability and pain intensity at Time 1 and Time 2, after accounting for injury characteristics and demographic variables. ⋯ We found that psychological factors that are responsive to cognitive behavioral therapy--catastrophic thinking, in particular--are strongly associated with pain intensity and disability in patients recovering from musculoskeletal trauma.
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J Bone Joint Surg Am · Feb 2014
Behavior of scoliosis during growth in children with osteogenesis imperfecta.
Spinal deformities are common in patients with osteogenesis imperfecta, a heritable disorder that causes bone fragility. The purpose of this study was to describe the behavior of spinal curvature during growth in patients with osteogenesis imperfecta and establish its relationship to disease severity and medical treatment with bisphosphonates. ⋯ The prevalence of scoliosis in association with osteogenesis imperfecta is high. Progression rates of scoliosis in children with osteogenesis imperfecta are variable, depending on the Sillence type of osteogenesis imperfecta. High rates of scoliosis progression in type-III and type-IV osteogenesis imperfecta contrast with a benign course in type I. Bisphosphonate therapy initiated before the patient reaches the age of six years can modulate curve progression in type-III osteogenesis imperfecta.
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J Bone Joint Surg Am · Feb 2014
Obesity and its effects on pediatric supracondylar humeral fractures.
This study evaluates the effects of childhood obesity on fracture complexity and associated injuries in pediatric supracondylar humeral fractures. ⋯ Obesity is associated with more complex supracondylar humeral fractures, preoperative and postoperative nerve palsies, and postoperative complications. To our knowledge, this study is the first to assess the implications of obesity on supracondylar humeral fracture complexity and associated injuries and it validates public health efforts in combating childhood obesity.
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J Bone Joint Surg Am · Feb 2014
A new look at the Hawkins classification for talar neck fractures: which features of injury and treatment are predictive of osteonecrosis?
Osteonecrosis and posttraumatic arthritis are common after talar neck fracture. We hypothesized that delay of definitive fixation would not increase the rate of osteonecrosis, but that the amount of initial fracture displacement, including subtalar and/or tibiotalar dislocations, would be predictive. We investigated the possibility of dividing the Hawkins type-II classification into subluxated (type-IIA) and dislocated (type-IIB) subtalar joint subtypes. ⋯ Following talar neck fracture, osteonecrosis of the talar body is associated with the amount of the initial fracture displacement, and separating Hawkins type-II fractures into those without (type IIA) and those with (type-IIB) subtalar dislocation helps to predict the development of osteonecrosis as in this series. It never occurred when the subtalar joint was not dislocated. When it does develop, osteonecrosis often revascularizes without talar dome collapse. Delaying reduction and definitive internal fixation does not increase the risk of developing osteonecrosis.
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J Bone Joint Surg Am · Feb 2014
Thirty and ninety-day reoperation rates after shoulder arthroplasty.
The purpose of the present study was to assess thirty and ninety-day reoperation rates after shoulder arthroplasty from 2000 to 2010. ⋯ Short-term reoperation after shoulder arthroplasty was infrequent. Wound complications and shoulder instability were the most frequent causes for reoperation. Reoperation was twice as frequent after revision surgery as after primary shoulder arthroplasty.