The Journal of bone and joint surgery. American volume
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The sagittal diameter of the cervical spinal canal is of clinical importance in traumatic, degenerative, and inflammatory conditions. A small canal diameter has been associated with an increased risk of injury; however, there is a lack of reliable normative data on spinal canal diameters in different age groups in the United States population. The purpose of this study was to use direct measurement of skeletal specimens to determine the spectrum of the sagittal diameters of the cervical spinal canal, the frequency of cervical stenosis in the general population, and the prevalence of cervical stenosis for different age groups, races, and sexes. ⋯ Cervical spine stenosis appears to be very common. The radiographic finding of cervical stenosis should therefore be correlated with the clinical presentation prior to decision-making regarding treatment.
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The long-term results of surgical treatment of brachial plexus birth palsy have not been reported. We present the findings of a nationwide study, with a minimum five-year follow-up, of the outcomes of surgery for brachial plexus birth palsy in Finland. ⋯ Following surgical treatment of brachial plexus birth palsy, substantial numbers of the patients continued to need help performing activities of daily living and had pain in the affected limb, with the pain due to a clavicular nonunion in one-fourth of the patients. The strongest prognostic factor predicting outcome appears to be the extent of the primary plexus injury.
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J Bone Joint Surg Am · Jan 2007
Randomized Controlled Trial Multicenter Study Comparative StudyNonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial.
Recent studies have shown a high prevalence of symptomatic malunion and nonunion after nonoperative treatment of displaced midshaft clavicular fractures. We sought to compare patient-oriented outcome and complication rates following nonoperative treatment and those after plate fixation of displaced midshaft clavicular fractures. ⋯ Operative fixation of a displaced fracture of the clavicular shaft results in improved functional outcome and a lower rate of malunion and nonunion compared with nonoperative treatment at one year of follow-up. Hardware removal remains the most common reason for repeat intervention in the operative group. This study supports primary plate fixation of completely displaced midshaft clavicular fractures in active adult patients.