Clinical orthopaedics and related research
-
Clin. Orthop. Relat. Res. · Mar 2013
Does valgus femoral osteotomy improve femoral head roundness in severe Legg-Calvé-Perthes disease?
Many surgeons perform a varus femoral or Salter pelvic osteotomy in patients with Legg-Calvé-Perthes (LCP) disease. However, more severely deformed femoral heads show greater congruency in adduction rather than in abduction. Therefore, a valgus-(flexion) femoral osteotomy (VFO) seems preferable rather than a varus femoral or Salter pelvic osteotomy. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Mar 2013
Multicenter Study Comparative StudyGiant cell tumor with pathologic fracture: should we curette or resect?
Approximately one in five patients with giant cell tumor of bone presents with a pathologic fracture. However, recurrence rates after resection or curettage differ substantially in the literature and it is unclear when curettage is reasonable after fracture. ⋯ Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Mar 2013
Comparative StudyStaples equal sutures for skin closure after soft tissue tumor resection.
Wound closure accounts for a relatively constant portion of the time required to complete a surgical case. Both longer closure times and wound infections contribute to higher medical costs and patient morbidity. ⋯ Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Mar 2013
Comparative StudyFee-based care is important for access to prompt treatment of hip fractures among veterans.
Hip fracture is a medical emergency for which delayed treatment increases risk of disability and death. In emergencies, veterans without access to a Veterans Administration (VA) hospital may be admitted to non-VA hospitals under fee-based (NVA-FB) care paid by the VA. The affect of NVA-FB care for treatment and outcomes of hip fractures is unknown. ⋯ Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.
-
Clin. Orthop. Relat. Res. · Mar 2013
Joint-preserving tumor resection and reconstruction using image-guided computer navigation.
Joint-preserving surgery is performed in select patients with bone sarcomas of extremities and allows patients to retain the native joint with better joint function. However, recurrences may relate to achieving adequate margins and there is frequently little room for error in tumors close to the joint surface. Further, the tumor margin on preoperative CT and/or MR images is difficult to transpose to the actual extent of tumor in the bone in the operating room. ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.