The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2011
Fresh osteochondral allograft for the treatment of cartilage defects of the talus: a retrospective review.
Osteochondral lesions of the talar dome can cause substantial functional impairment and present a difficult treatment dilemma. Interest has recently focused on fresh osteochondral allografts as a promising treatment alternative. The purpose of this study was to evaluate the clinical outcome of osteochondral lesions of the talus treated with a fresh osteochondral allograft. ⋯ In our experience, transplantation of fresh osteochondral allograft is a viable and effective method for the treatment of osteochondral lesions of the talus as evidenced by improvements in pain and function.
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J Bone Joint Surg Am · Sep 2011
Comparative StudyClinical outcomes of corrective osteotomy for distal radial malunion: a review of opening and closing-wedge techniques.
Radial corrective osteotomy is an established but challenging treatment for distal radial malunion. There is ongoing discussion over whether an opening or closing-wedge osteotomy should be employed. The purpose of the present study was to retrospectively compare the clinical and radiographic results of conventional opening-wedge osteotomy with those of our closing-wedge technique. ⋯ The closing-wedge osteotomy technique is an effective reconstructive procedure for the treatment of extra-articular distal radial malunion. It is significantly better than the opening-wedge osteotomy technique in terms of the restoration of ulnar variance, the extension-flexion arc of wrist motion, and the Mayo wrist score.
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J Bone Joint Surg Am · Sep 2011
Risk factors for postoperative infection following posterior lumbar instrumented arthrodesis.
Surgical site infection in the spine is a serious postoperative complication. Factors such as posterior surgical approach, arthrodesis, use of spinal instrumentation, age, obesity, diabetes, tobacco use, operating-room environment, and estimated blood loss are well established in the literature to affect the risk of infection. The goal of this study was to analyze and identify independent risk factors for surgical site infection among spine patients undergoing posterior lumbar instrumented arthrodesis. ⋯ This analysis confirms previously demonstrated risk factors for postoperative infection while reporting on new potential independent risk factors of osteoporosis, chronic obstructive pulmonary disease, and dural tears in the setting of posterior lumbar instrumented arthrodesis. Areas of new research can focus on the roles these novel factors may play in the pathogenesis of surgical site infections in the spine.
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J Bone Joint Surg Am · Sep 2011
The epidemiology, risk of recurrence, and functional outcome after an acute traumatic posterior dislocation of the shoulder.
Posterior glenohumeral dislocation is less common than anterior dislocation, and less is known about its epidemiology, functional outcome, and complications. The purposes of this study were to determine the epidemiology and demographics of posterior dislocations and to assess the risk of recurrence and the functional outcome after treatment. ⋯ The prevalence of posterior dislocation is low. The most common complication after this injury is recurrent instability, which occurs at an early stage in 17.7% of shoulders within the first year after dislocation. The risk is highest in patients who are less than forty years old, sustain the dislocation during a seizure, and have a large humeral head defect. The risk is lower for most patients who sustain the injury from a traumatic accident, especially if they are older and have a small anterior humeral head defect. There are persistent deficits of shoulder function within the first two years after the injury.
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J Bone Joint Surg Am · Sep 2011
Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program.
This investigation sought to identify risk factors for immediate postoperative morbidity and mortality among a large series of patients undergoing spine surgery who were prospectively entered into a national registry. ⋯ Patient age, female sex, longer procedural times, and several types of medical comorbidities influenced the risk of postoperative complications or mortality. This information enhances estimates of morbidity and mortality following spine surgery and may improve patient selection for spine surgery as well as preoperative discussions related to the risks of spine surgery.