The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Feb 2010
Minimal clinically important differences in ASES and simple shoulder test scores after nonoperative treatment of rotator cuff disease.
The minimal clinically important difference is the smallest difference in an outcome score that a patient perceives as beneficial. The purpose of this study was to determine the minimal clinically important difference in the American Shoulder and Elbow Surgeons (ASES) score and in the Simple Shoulder Test (SST) score for patients treated nonoperatively for rotator cuff disease. ⋯ Patients with rotator cuff disease who are treated without surgery and have a 2-point change in the SST score or a 12 to 17-point change in the ASES score experience a clinically important change in self-assessed outcome. These minimal clinically important differences can provide the basis for determining if significant differences in outcomes after treatment are clinically relevant.
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J Bone Joint Surg Am · Feb 2010
Physicians' ability to manually detect isolated elevations in leg intracompartmental pressure.
Serial physical examination is recommended for patients for whom there is a high index of suspicion for compartment syndrome. This examination is more difficult when performed on an obtunded patient and relies on the sensitivity of manual palpation to detect compartment firmness-a direct manifestation of increased intracompartmental pressure. This study was performed to establish the sensitivity of manual palpation for detecting critical pressure elevations in the leg compartments most frequently involved in clinical compartment syndrome. ⋯ Manual detection of compartment firmness associated with critical elevations in intracompartmental pressure is poor.
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J Bone Joint Surg Am · Jan 2010
Clinical TrialPredictability of the fulcrum bending radiograph in scoliosis correction with alternate-level pedicle screw fixation.
The fulcrum bending radiograph accurately predicts scoliosis curve correction in patients with thoracic adolescent idiopathic scoliosis who are managed with hooks. We assessed the predictive value of the fulcrum bending radiograph in the context of alternate-level pedicle screw fixation of the scoliotic spine. ⋯ To our knowledge, this is the first study to demonstrate the predictive value of the fulcrum bending radiograph in the context of alternate-level pedicle screw fixation in patients with adolescent idiopathic scoliosis. Curve flexibility may dictate the degree of the fulcrum bending correction index, whereby a curve that is less flexible may achieve a greater fulcrum bending correction index. The fulcrum bending radiograph has potential predictive utility. In addition, pedicle screw constructs appear to have a better ability to correct scoliosis in comparison with hooks and hybrid constructs.