Journal of surgical orthopaedic advances
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Comparative Study
Role of diabetes type in perioperative outcomes after hip and knee arthroplasty in the United States.
The objective of this study was to determine whether the type of diabetes mellitus (DM) affected the incidence of immediate perioperative complications following joint replacement. From 1988 to 2003, the Nationwide Inpatient Sample recognized 65,769 patients with DM who underwent total hip and knee arthroplasty in the United States. ⋯ Type 1 patients also had significant increases in the incidence of myocardial infarction, pneumonia, urinary tract infection, postoperative hemorrhage, wound infection, and death (p < .02). Perhaps because of the differences in the duration of disease and their underlying pathologies, patients with type 1 diabetes carry more significant overall perioperative risks and require more health care resources compared with patients with type 2 diabetes following hip and knee arthroplasty.
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The late sequela of a simple elbow dislocation includes loss of motion or recurrent instability. This case report involves a patient with a 4-year history of recurrent elbow instability following multiple closed traumatic posterior elbow dislocation, who underwent the simultaneous reconstruction of both medial and lateral collateral ligament complexes, for both varus and valgus instability. The patient was informed and consented that data concerning his case would be submitted for publication.
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This report presents a rare case of a child who presented with neglected intra-articular entrapment of the median nerve, ulnar nerve palsy, and intra-articular incarceration of the medial epicondyle following closed reduction of an elbow dislocation. In the present case, as in most other cases, the diagnosis and treatment were delayed. Careful initial and postreduction neurological examination, as well as careful interpretation of the plain radiographs, is necessary for early detection of any nerve complications and associated fractures of an elbow dislocation. The authors' opinion is that a child with an elbow dislocation, which is initially neurologically intact but advances to a median or ulnar nerve deficit after the reduction, must undergo early surgical exploration, especially when the dislocation is associated with a medial epicondyle fracture.
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Many research abstracts presented at orthopaedic conferences do not undergo a formal editorial, or peer-review process; however, abstracts are frequently referenced in textbooks and influence clinical practice. The purpose of this study was to determine the publication rate of abstracts formally presented at the Society of Military Orthopaedic Surgeons (SOMOS) annual meetings from 1998 to 2006 that went to full-text publication. Using Google Scholar and PubMed, a literature search was performed for each abstract presented at the annual SOMOS meeting in the years 1998-2006, to calculate the overall full-text publication rate, the average duration from presentation to publication, and the distribution of publications in the various journals. ⋯ The published articles appeared in 65 peer-reviewed journals, with notable distribution in Spine (10.0%), The American Journal of Sports Medicine (9.4%), and The Journal of Bone and Joint Surgery (9.4%). The full-text publication rate of abstracts presented at the annual SOMOS meetings compares favorably with that of other major orthopaedic conferences in the United States. Nonetheless, more than half of abstracts presented at the SOMOS meetings remain unpublished.
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This case report presents a 28-year-old man with foot drop 48 hours after a grade I inversion ankle sprain. Clinical examination and electrodiagnostic studies showed common peroneal nerve palsy. ⋯ Function of the peroneal nerve should be evaluated in all patients with inversion ankle sprain as part of initial and follow-up evaluations. Early electrodiagnostic studies are helpful to localize and provide indications of the severity of the injury.