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Cast-Saw Burns: Evaluation Of Skin, Cast, And Blade Temperatures Generated During Cast Removal, Franklin D. Shuler MD, Frank N. Grisafi 2010 Marshall University

Cast-Saw Burns: Evaluation Of Skin, Cast, And Blade Temperatures Generated During Cast Removal, Franklin D. Shuler Md, Frank N. Grisafi

Orthopaedics

Background: The use of an oscillating saw for cast removal creates a potential for iatrogenic injury and patient discomfort. Burns and abrasions can occur from the heat created by frictional forces and direct blade contact. With use of a cadaver model system, skin temperature measurements were recorded during cast removal with an oscillating saw.

Methods: Casts of uniform thickness were applied to cadavers equilibrated to body temperature. The casts were removed by a single individual while simultaneously measuring temperatures at the skin-padding interface, cast-padding interface, and the blade. Variables tested include two removal techniques, two casting materials (fiberglass and plaster ...


Physician’S Ability To Manually Detect Isolated Elevation In Leg Intracompartmental Pressure., Franklin D. Shuler MD, Matthew J. Dietz 2010 Marshall University

Physician’S Ability To Manually Detect Isolated Elevation In Leg Intracompartmental Pressure., Franklin D. Shuler Md, Matthew J. Dietz

Orthopaedics

Background: Serial physical examination is recommended for patients for whom there is a high index of suspicion for compartment syndrome. This examination is more difficult when performed on an obtunded patient and relies on the sensitivity of manual palpation to detect compartment firmness—a direct manifestation of increased intracompartmental pressure. This study was performed to establish the sensitivity of manual palpation for detecting critical pressure elevations in the leg compartments most frequently involved in clinical compartment syndrome.

Methods: Reproducible, sustained elevation of intracompartmental pressure was established in fresh cadaver leg specimens. Pressures tested included 20 and 40 mm Hg (negative ...


Prophylactic Radiation Therapy Is Safe And Effective Treatment For The Prevention Of Recurrent Heterotopic Ossification In Elbow And Knee Joints, M. V. Mishra, L. Austin, J. Parvisi, M. Ramsey, T. N. Showalter 2010 Thomas Jefferson University and Hospitals

Prophylactic Radiation Therapy Is Safe And Effective Treatment For The Prevention Of Recurrent Heterotopic Ossification In Elbow And Knee Joints, M. V. Mishra, L. Austin, J. Parvisi, M. Ramsey, T. N. Showalter

Bodine Journal

Background: Background Prophylactic radiation therapy (RT) is an established adjuvant therapy for heterotopic ossification (HO) of the hip when delivered in the immediate pre- or post-operative setting. Its role in prevention of recurrence after excision of HO is supported by randomized trials for HO of the hip, but there is scant evidence to support a similar approach in non-hip joints. In the current study, we evaluate radiologic and functional outcomes after prophylactic radiation therapy (RT) for prevention of HO of the knee and upper extremity [elbow and metacarpophalangeal (MCP) joints].

American Society for Therapeutic Radiation Oncology (ASTRO) 52nd Annual Meeting ...


Injection Treatment And Back Pain Associated With Degenerative Lumbar Spinal Stenosis In Older Adults, Virginia G. Briggs, Wenjun Li, Mark S. Kaplan, Mark S. Eskander, Patricia D. Franklin 2010 University of Massachusetts Medical School

Injection Treatment And Back Pain Associated With Degenerative Lumbar Spinal Stenosis In Older Adults, Virginia G. Briggs, Wenjun Li, Mark S. Kaplan, Mark S. Eskander, Patricia D. Franklin

GSBS Student Publications

BACKGROUND: Lower back pain is one of the most common health-related complaints in the adult population. Thirty percent of Americans 65 years and older reported symptoms of lower back pain in 2004 (NCHS, 2006). Injection treatment is a commonly used non-surgical procedure to alleviate lower back pain in older adults. However, the effectiveness of injection treatment, particularly in older adults, has not been well documented.

OBJECTIVE: This study quantified the effectiveness of injection treatment on pain relief among adults 60 years and over who were diagnosed with degenerative lumbar spinal stenosis, a common cause of lower back pain in older ...


Limitations Of The Knee Society Score In Evaluating Outcomes Following Revision Total Knee Arthroplasty., Elie Ghanem, Ian Pawasarat, Adam Lindsay, Lauren May, Khalid Azzam, Ashish Joshi, Javad Parvizi 2010 The Rothman Institute of Orthopaedics, Thomas Jefferson University Hospital

Limitations Of The Knee Society Score In Evaluating Outcomes Following Revision Total Knee Arthroplasty., Elie Ghanem, Ian Pawasarat, Adam Lindsay, Lauren May, Khalid Azzam, Ashish Joshi, Javad Parvizi

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Traditionally, the results of revision total knee arthroplasty have been determined with use of surgeon-based measures such as the Knee Society rating system. Recently, outcome and quality-of-life measures have shifted toward a greater emphasis on patient-based evaluation. The aim of our study was to determine the validity and responsiveness of the Knee Society rating system compared with the Short Form-36 health survey (SF-36), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a four-question 4-point Likert scale satisfaction questionnaire following revision total knee arthroplasty.

METHODS: A total of 152 patients underwent revision total knee arthroplasty at our institution, between ...


Biomechanical Investigation Of A Novel Ratcheting Arthrodesis Nail, Jeremy J. McCormick, Xinning Li, Douglas R. Weiss, Kristen L. Billiar, John J. Wixted 2010 University of Massachusetts Medical School

Biomechanical Investigation Of A Novel Ratcheting Arthrodesis Nail, Jeremy J. Mccormick, Xinning Li, Douglas R. Weiss, Kristen L. Billiar, John J. Wixted

Orthopedics and Physical Rehabilitation Publications and Presentations

BACKGROUND: Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails.

METHODS: A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model ...


Developmental Dysplasia Of The Hip., Shahryar Noordin, Masood Umer, Kamran Hafeez, Haq Nawaz 2010 Aga Khan University

Developmental Dysplasia Of The Hip., Shahryar Noordin, Masood Umer, Kamran Hafeez, Haq Nawaz

Department of Surgery

Developmental dysplasia of the hip (DDH) is a spectrum of anatomical abnormalities of the hip joint in which the femoral head has an abnormal relationship with the acetabulum. Most studies report an incidence of 1 to 34 cases per 1,000 live births and differences could be due to different diagnostic methods and timing of evaluation. Risk factors include first born status, female sex, positive family history, breech presentation and oligohydramnios. Clinical presentations of DDH depend on the age of the child. Newborns present with hip instability, infants have limited hip abduction on examination, and older children and adolescents present ...


High-Intensity Mechanical Therapy For Loss Of Knee Extension For Worker's Compensation And Non-Compensation Patients, Amanda L. Dempsey, Thomas P. Branch, Timothy Mills, Robert M. Karsch 2010 University of Kentucky

High-Intensity Mechanical Therapy For Loss Of Knee Extension For Worker's Compensation And Non-Compensation Patients, Amanda L. Dempsey, Thomas P. Branch, Timothy Mills, Robert M. Karsch

Orthopaedic Surgery and Sports Medicine Faculty Publications

BACKGROUND: Knee flexion contractures have been associated with increased pain and a reduced ability to perform activities of daily living. Contractures can be treated either surgically or conservatively, but these treatment options may not be as successful with worker's compensation patients. The purposes of retrospective review were to 1) determine the efficacy of using adjunctive high-intensity stretch (HIS) mechanical therapy to treat flexion contractures, and 2) compare the results between groups of worker's compensation and non-compensation patients.

METHODS: Fifty-six patients (19 women, 37 men, age = 51.5 ± 17.0 years) with flexion contractures were treated with HIS mechanical ...


Cell Therapy In Bone Healing Disorders, Marcus Jager, Philippe Hernigou, Christoph Zilkens, Monika Herten, Xinning Li, Johannes Fischer, Rudiger Krauspe 2010 Heinrich-Heine-Universitat Dusseldorf

Cell Therapy In Bone Healing Disorders, Marcus Jager, Philippe Hernigou, Christoph Zilkens, Monika Herten, Xinning Li, Johannes Fischer, Rudiger Krauspe

Orthopedics and Physical Rehabilitation Publications and Presentations

In addition to osteosynthetic stabilizing techniques and autologous bone transplantations, so-called orthobiologics play an increasing role in the treatment of bone healing disorders. Besides the use of various growth factors, more and more new data suggest that cell-based therapies promote local bone regeneration. For ethical and biological reasons, clinical application of progenitor cells on the musculoskeletal system is limited to autologous, postpartum stem cells. Intraoperative one-step treatment with autologous progenitor cells, in particular, delivered promising results in preliminary clinical studies. This article provides an overview of the rationale for, and characteristics of the clinical application of cell-based therapy to treat ...


Medial Pelvic Migration Of The Lag Screw In A Short Gamma Nail After Hip Fracture Fixation: A Case Report And Review Of The Literature, Xinning Li, Michael J. Heffernan, Christina Kane, Walter J. Leclair 2010 University of Massachusetts Medical School

Medial Pelvic Migration Of The Lag Screw In A Short Gamma Nail After Hip Fracture Fixation: A Case Report And Review Of The Literature, Xinning Li, Michael J. Heffernan, Christina Kane, Walter J. Leclair

Open Access Articles

Hip fractures are a common injury among the elderly. Internal fixation with an intramedullary (IM) system has gained popularity for the treatment of intertrochanteric femur fractures. Multiple complications associated with IM fracture fixation have been described, however, we report a rare complication of medial pelvic migration of the lag screw of a short IM nail in a stable construct ten weeks post surgery. The patient was subsequently treated with Lag Screw removal and revision surgery with a shorter Lag Screw and an accessory cannulated screw acting as a de-rotational device. The patient did well with the revision surgery and was ...


Use Of Orthogonal Or Parallel Plating Techniques To Treat Distal Humerus Fractures., Joshua M. Abzug, Phani K. Dantuluri 2010 Thomas Jefferson University

Use Of Orthogonal Or Parallel Plating Techniques To Treat Distal Humerus Fractures., Joshua M. Abzug, Phani K. Dantuluri

Department of Orthopaedic Surgery Faculty Papers

Distal humerus fractures continue to be a complex fracture to treat. This article describes two surgical techniques that can be used to tackle these difficult fractures: Parallel plating and orthogonal plating. Both techniques have yielded excellent outcomes after open reduction and internal fixation; yet each has its own set of unique considerations. However, the key to successful treatment of these difficult fractures regardless of technique remains obtaining anatomic reduction with stable fixation and the implementation of early motion.


Current Concepts: Neonatal Brachial Plexus Pals, Joshua M. Abzug, MD, Scott H. Kozin, MD 2010 Thomas Jefferson University

Current Concepts: Neonatal Brachial Plexus Pals, Joshua M. Abzug, Md, Scott H. Kozin, Md

Department of Orthopaedic Surgery Faculty Papers

Neonatal brachial plexus palsy may be decreasing in incidence; however, conflicting reports exist. Regardless, neonatal brachial plexus palsy has an incidence of 1 to 2 per 1000 live births making this a frequent occurrence. The majority of infants with brachial plexus palsy spontaneously recover in the first 2 months of life and subsequently progress to near complete recovery of motion and strength. However, those infants who do not have substantial recovery by age 3 months will have permanent limited range of motion, less strength, and a decrease in size and girth of the involved extremity. Currently, debate continues about the ...


Correlation Of C2 Fractures And Vertebral Artery Injury., Tao Ding, Mitchell Maltenfort, Huilin Yang, Harvey Smith, John Ratliff, Alexander Vaccaro, D Greg Anderson, James Harrop 2010 First Affiliated Hospital of Soochow University, Suzhou, China

Correlation Of C2 Fractures And Vertebral Artery Injury., Tao Ding, Mitchell Maltenfort, Huilin Yang, Harvey Smith, John Ratliff, Alexander Vaccaro, D Greg Anderson, James Harrop

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective review of prospectively collected data.

SUMMARY OF BACKGROUND DATA: Vertebral artery injuries (VAI) occur commonly after cervical spine trauma. No study has yet examined the association between VAI and specific variants of C2 fractures.

OBJECTIVE: To evaluate the incidence of VAI (as defined by magnetic resonance imaging/angiography [MRI/A]) in subtypes of C2 fractures. To define the association between the incidence, morphology, and severity of C2 fractures, based on fracture angulation and comminution, and the occurrence of VAI.

METHODS: Patients admitted to the hospital with C2 fractures between October 2006 and December 2008 to a tertiary ...


Operative Management Of Unstable Thoracolumbar Burst Fractures, Mujahid Jamil Khattak, Shakir Syed, Riaz Hussain Lakdawala 2010 Russell’s Hall Hospital NHS Foundation Trust, UK

Operative Management Of Unstable Thoracolumbar Burst Fractures, Mujahid Jamil Khattak, Shakir Syed, Riaz Hussain Lakdawala

Department of Surgery

Operative management of unstable burst vertebral fractures is challenging and debatable. This study of such cases was conducted at the Aga Khan Hospital, Karachi from January 1998 to April 2003. All surgically managed spine injuries were reviewed from case notes and operative records. Clinical outcome was assessed by Hanover spine score and correction of kyphosis was measured for radiological assessment. The results were analyzed by Wilcoxon sign rank test for two related samples and p-value < 0.05 was considered significant. Ten patients were identified by inclusion criteria. There was statistically significant difference between mean pre-and postoperative Hanover spine score (p=0.008). Likewise, there was significant difference between mean immediate postoperative and final follow-up kyphosis. (p=0.006). Critical assessment of neurologic and structural extent of injury, proper pre-operative planning and surgical expertise can optimize the outcome of patients


Extraskeletal Osteosarcoma: Clinico-Pathologic Features And Results Of Multimodal Management, Nicola Fabbri, Akshay Tiwari, masood umer 2010 Aga Khan University

Extraskeletal Osteosarcoma: Clinico-Pathologic Features And Results Of Multimodal Management, Nicola Fabbri, Akshay Tiwari, Masood Umer

Department of Radiology

. Extraskeletal Osteosarcoma: Clinico-pathologic Features and Results of Multimodal
Management N. Fabbri, A. Tiwari, M. Umer, D. Vanel, M. Alberghini, P. Ruggieri, S. Ferrari, P.
Picci, M. Mercuri Department of Musculoskeletal Oncology Istituto Ortopedico Rizzoli, Bologna,
Italy 23rd EMSOS Meeting Birmingham, UK 5th-7th May 2010 Page 2. Extraskeletal Osteosarcoma
Background .About 1% of all soft tissue sarcomas .First described by Wilson in 1941 .Few large
series then reported .Older individuals & usually worse survival


Effects Of Reamer-Femoral Component Offset On Cement Mantle Penetration In Hip Resurfacing Arthroplasty, Mark Lloyd Paulick 2010 California Polytechnic State University, San Luis Obispo

Effects Of Reamer-Femoral Component Offset On Cement Mantle Penetration In Hip Resurfacing Arthroplasty, Mark Lloyd Paulick

Master's Theses and Project Reports

Hip resurfacing arthroplasty has changed the treatment of end stage arthritis without severe deformity for young, active adults. Presently, there are varying clinical approaches to implant design selection and cementation techniques. The purpose of this project is to determine what amount of reamer-femoral component offset allows for the best cement penetration into the femoral head.

Rapid prototyped femoral component models were produced with reamer femoral component offsets of 0.0 mm, 0.5 mm, and 1.0 mm. After implantation onto models of reamed femoral heads made from high-density open-cell reticulated carbon foam, cement penetration was assessed from cross-sections of ...


Lower-Limb Alignment And Posterior Tibial Slope In Pakistanis: A Radiographic Study, Mujahid Jamil Khattak, Masood Umer, Edward T Davis, Munira Habib, Mehmood Ahmed 2010 Russell’s Hall Hospital NHS Foundation Trust, UK

Lower-Limb Alignment And Posterior Tibial Slope In Pakistanis: A Radiographic Study, Mujahid Jamil Khattak, Masood Umer, Edward T Davis, Munira Habib, Mehmood Ahmed

Department of Surgery

Abstract

PURPOSE:

To assess the lower-limb alignment and posterior tibial slope in Pakistanis.

METHODS:

40 male and 19 female healthy Pakistanis aged 20 to 45 years were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb of each subject was obtained. The axial alignment was measured based on the centres of the femoral head, knee, and ankle. The tibiofemoral (TF) angle, knee joint line obliquity angle (angle J), and posterior tibial slope were determined.

RESULTS:

The mean TF angle was more varus in men than women (178.4 degrees vs. 180.0 degrees, p<0.001). The mean angle J was more medially inclined in men than women (93.4 degrees vs. 91.4 degrees, p=0.007). The mean medial tibial slope was greater in women than men (16.0 degrees vs. 12.5 degrees, p<0.001). The posterior tibial slope was greater in women than men (14.1 degrees vs. 12.5 degrees, p=0.02), and was greater than the 5 degrees to 10 degrees commonly reported.

CONCLUSIONS:

Knee alignment and ...


Acellular Dermal Regeneration Template For Soft Tissue Reconstruction Of The Digits., John S. Taras, Anthony Sapienza, Josh B. Roach, John P. Taras 2010 Thomas Jefferson University

Acellular Dermal Regeneration Template For Soft Tissue Reconstruction Of The Digits., John S. Taras, Anthony Sapienza, Josh B. Roach, John P. Taras

Department of Orthopaedic Surgery Faculty Papers

PURPOSE: Trauma to the digits often leaves soft tissue defects with exposed bone, joint, and/or tendon that require soft tissue replacement. The objective of this study was to evaluate the effectiveness of acellular dermal regeneration template combined with full-thickness skin grafting for soft tissue reconstruction in digital injuries with soft tissue defects.

METHODS: Acellular dermal regeneration template was used to reconstruct digital injuries with exposed bone, joint, tendon, and/or hardware not amenable to treatment with healing by secondary intention, rotation flaps, or primary skin grafts. Acellular dermal regeneration template was applied to 21 digits in 17 patients. Nineteen ...


Management Of Type Ii Superior Labrum Anterior Posterior Lesions: A Review Of The Literature, Xinning Li, Timothy J. Lin, Marcus Jager, Mark D. Price, Nicola Deangelis, Brian D. Busconi, Michael A. Brown 2010 University of Massachusetts Medical School

Management Of Type Ii Superior Labrum Anterior Posterior Lesions: A Review Of The Literature, Xinning Li, Timothy J. Lin, Marcus Jager, Mark D. Price, Nicola Deangelis, Brian D. Busconi, Michael A. Brown

Orthopedics and Physical Rehabilitation Publications and Presentations

Superior labrum anterior and posterior lesions were first described in 1985 by Andrews et al. and later classified into four types by Synder et al. The most prevalent is type II which is fraying of the superior glenoid labrum with detachment of the biceps anchor. Superior labrum anterior posterior (SLAP) lesions can also be associated with other shoulder pathology. Both MRI and MRA can be utilized in making the diagnosis with the coronal images being the most sensitive. The mechanism of injury can be either repetitive stress or acute trauma with the superior labrum most vulnerable to injury during the ...


The Power Of Empowerment: An Icf-Based Model To Improve Self-Efficacy And Upper Extremity Function Of Survivors Of Breast Cancer, Mary Insana Fisher, Dana Howell 2010 University of Dayton

The Power Of Empowerment: An Icf-Based Model To Improve Self-Efficacy And Upper Extremity Function Of Survivors Of Breast Cancer, Mary Insana Fisher, Dana Howell

Physical Therapy Faculty Publications

Breast cancer is one of the most frequently diagnosed cancers among women. Breast cancer treatments often negatively impact the function of the arm, and quality of life and upper extremity function does not always return to a prediagnosis level. Survivors of breast cancer may also experience feelings of diminished self-efficacy related to functional deficits resulting from their physical limitations. The International Classification of Functioning (ICF) provides a framework for rehabilitation practitioners to address physical and psychological impairments, activity limitations, and participation restrictions. Patient outcomes may be improved by fostering self-efficacy through empowerment. This paper explores how the ICF model and ...


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