Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · May 2015
Low-intensity pulsed ultrasound enhances bone repair in a rabbit model of steroid-associated osteonecrosis.
Steroids are a leading cause of femoral head osteonecrosis. Currently there are no medications available to prevent and/or treat steroid-associated osteonecrosis. Low-intensity pulsed ultrasound (LIPUS) was approved by the FDA for treating delayed union of bone fractures. Some studies have reported that LIPUS can enhance bone formation and local blood flow in an animal model of fracture healing. However, whether the effect of osteogenesis and neovascularization by LIPUS can enhance the repair progress in steroid-associated osteonecrosis is unknown. ⋯ LIPUS may be a promising modality for the treatment of early-stage steroid-associated osteonecrosis. Further research, including clinical trials to determine whether LIPUS has a therapeutic effect on patients with early-onset steroid-associated osteonecrosis may be warranted.
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Clin. Orthop. Relat. Res. · May 2015
Randomized Controlled Trial Comparative StudyAntegrade intramedullary pinning versus retrograde intramedullary pinning for displaced fifth metacarpal neck fractures.
Severe angulation or shortening can be a surgical indication for fifth metacarpal neck fracture. In a previous meta-analysis, antegrade intramedullary pinning was shown to produce better hand function outcomes than percutaneous transverse pinning or miniplate fixation for treatment of fifth metacarpal neck fractures. However, the outcomes of retrograde intramedullary pinning, to our knowledge, have not been compared with those of antegrade intramedullary pinning. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · May 2015
ReviewWhat effects have resident work-hour changes had on education, quality of life, and safety? A systematic review.
More than 15 years ago, the Institute of Medicine (IOM) identified medical error as a problem worthy of greater attention; in the wake of the IOM report, numerous changes were made to regulations to limit residents' duty hours. However, the effect of resident work-hour changes remains controversial within the field of orthopaedics. ⋯ There is a paucity of high-level or clear evidence evaluating the effect of the changes to resident work hours. Future research in this area should focus on objective measures that include patient safety as a primary outcome.