Journal of the Southern Orthopaedic Association
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Delay or failure of healing in long bone fracture is a common clinical problem confronting the orthopaedic surgeon, and can have significant impact on the quality of life for patients who have it. One treatment option for this problem is the use of electrical or ultrasonic bone stimulation. Electrical signals can be delivered with an implantable direct current stimulator, or noninvasively using inductive or capacitive coupling to induce currents in the tissues. ⋯ In addition to dozens of retrospective reports, randomized, prospective, double-blind controlled trials have shown the efficacy of electrical stimulation for nonunion and ultrasound for speeding healing. Patients with unacceptable deformity, synovial pseudarthrosis, or large gaps are generally not good candidates for this treatment modality. This article is a review of the clinical literature regarding treatment of long bone nonunion with bone stimulators.
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J South Orthop Assoc · Jan 2000
ReviewImaging of the cervical spine and its role in clinical decision making.
Thorough imaging of the cervical spine often requires more than one test. The many available options from which to choose can often lead to redundancy and confusion regarding the best test series. In an effort to make the process of choosing the most effective imaging series more efficient, we review the current literature on cervical imaging and, from the information gathered, construct a diagnostic imaging algorithm for evaluating the cervical spine.
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J South Orthop Assoc · Jan 2000
ReviewDigital flexor sheath: repair and reconstruction of the annular pulleys and membranous sheath.
Rupture or transection of the digital pulley may necessitate repair or reconstruction to treat symptomatic flexor tendon bowstringing. When reconstruction is necessary, intrasynovial tendon grafts may provide superior gliding characteristics when compared with traditional extrasynovial tendon grafts. Lacerations of the membranous portion of the digital sheath and of noncritical annular pulleys usually do not require operative repair.
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J South Orthop Assoc · Jan 2000
ReviewIliac crest autogenous bone grafting: donor site complications.
Autogenous bone grafting is often done in orthopaedic surgery for a variety of conditions. The iliac crest is currently the most common donor site for obtaining autogenous bone graft. We searched the literature to summarize reported complications related to the donation of autogenous bone from the iliac crest. ⋯ Currently, autogenous bone grafting is a necessary part of the treatment of various orthopaedic conditions. Obtaining bone from the iliac crest can be associated with significant morbidity. As bone grafting technology emerges, the known complications of the current standard should be weighed against the risk of alternate therapies.
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J South Orthop Assoc · Jan 1998
ReviewPlate osteosynthesis of the distal femur: surgical techniques and results.
Over the past three decades, the techniques for internal fixation of the distal femur have evolved to provide reliably successful results. The improved outcomes of plate osteosynthesis of distal femur fractures are because of better implants, techniques of anatomic reduction and soft tissue handling, and post-fixation stability with early motion. We review the traditional Arbeitsgemeinschaft für Osteosynthesefragen (AO) surgical techniques for plate osteosynthesis of the distal femur and the results reported using these methods.