Subject(s)
Physician's Role , Physician-Patient Relations , Religion and Medicine , Religion , Humans , United StatesABSTRACT
This 20-year study of avascular necrosis of the patella indicates that the patella can regain its blood supply and normal joint surface over time. Significant changes in the patella and operative treatment are noted.
Subject(s)
Joint Dislocations/complications , Osteonecrosis/etiology , Patella/injuries , Child , Epiphyses/injuries , Epiphyses/surgery , Femoral Fractures/surgery , Follow-Up Studies , Humans , Male , Patella/blood supply , Patella/pathology , Range of Motion, ArticularABSTRACT
Symptomatic bowlegs and knock-knees are common in the aging person and aging athlete secondary to knee trauma. Diagnosis is made by observation and in mild degrees by a standing alignment x-ray that shows narrowing of the joint surface on the appropriate side. The patients complained of pain on the convexity side of the deformity. Treatment consisted of a simple exercise program, non-steroidal anti-inflammatory drugs and appropriate 1/8-inch wedges on the lateral side of the heel for bowlegs or on the medial side of the heel for knock-knees. The effect of a simple heel wedge formed the basis for conservative treatment of symptomatic knee deformities.
Subject(s)
Knee Joint , Orthotic Devices , Osteoarthritis/therapy , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Humans , Knee Joint/pathology , Locomotion , Osteoarthritis/pathology , PainABSTRACT
Ninety-six patients (63 females and 33 males) who underwent total joint arthroplasty or spinal reconstructive surgery were randomized to receive either a Solcotrans Plus or a Stryker-CBC ConstaVAC closed-wound drainage system. A binomial test showed that the Stryker-CBC ConstaVAC system was significantly preferred over the Solcotrans Plus system for ease of use, as reported by nurses. However, Solcotrans Plus was more cost-effective because a larger volume of blood shed by a patient could be reinfused while maintaining the standards of the American Association of Blood Banks. The difference in the occurrence of side effects between the two systems was not statistically significant.
Subject(s)
Blood Transfusion, Autologous/instrumentation , Orthopedics/methods , Postoperative Care , Suction/instrumentation , Adolescent , Adult , Aged , Aged, 80 and over , Attitude of Health Personnel , Blood Transfusion, Autologous/economics , Blood Transfusion, Autologous/nursing , Cost-Benefit Analysis , Evaluation Studies as Topic , Female , Humans , Maintenance , Male , Middle Aged , Nursing Staff, Hospital/psychology , Safety , Suction/economics , Suction/nursing , Surveys and QuestionnairesABSTRACT
Closed reduction techniques using a countersupport vector on an extension table, which minimize intraoperative reduction effort as well as surgeon radiation hazards, are described that are particularly suited for the polytrauma patient.
Subject(s)
Femoral Fractures/surgery , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/instrumentation , Humans , Supine Position , Traction/instrumentation , Traction/methodsABSTRACT
Seven different reduction techniques have been tested in the treatment of displaced femoral neck fractures using the fracture table. Wellmerling's technique is preferred because of its utility, predictable results, and flexibility in treatment alternatives.
Subject(s)
Femoral Neck Fractures/therapy , Manipulation, Orthopedic/methods , HumansABSTRACT
Ninety-six open tibial shaft fractures in 93 patients were examined to determine the incidence of amputation, nonunion and infection in each of three types of open fractures. Amputation occurred in four patients, who had type III fractures. Nonunion developed in two of 20 type II fractures, and 16 of 59 patients with type III fractures did not result in amputation (three of 62 total type III open fractures resulted in immediate amputation). Infection occurred in one of the 20 type II open fractures and 14 of 59 type III fractures. The distribution of infection and nonunion in the three grades of open fractures proved to be statistically significant, whereas the occurrence of amputation did not.
Subject(s)
Fractures, Open/complications , Tibial Fractures/complications , Adolescent , Adult , Aged , Amputation, Surgical , Bacterial Infections/complications , Female , Fracture Fixation , Fractures, Open/classification , Fractures, Open/surgery , Fractures, Ununited/complications , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Tibial Fractures/classification , Tibial Fractures/surgeryABSTRACT
A study was done of ninety-eight patients who had supracondylar and intercondylar fractures of the femur that were treated by the insertion of Rush pins. A system of classification relating the type of fracture to the method of Rush-pin fixation is described, and the importance of proper surgical technique is emphasized. The patients were followed for periods ranging from one to seventeen years (mean, 3.5 years) and 84 per cent of them had either excellent or good results, as evaluated by both radiographic and clinical examination. There were two non-unions and one deep infection. Angulation at the fracture site, the development of significant degenerative arthritis, and metal failure were not encountered. Properly performed, the Rush-pin supracondylar technique offers enough stability to allow early knee motion and has the advantages of both open and closed techniques in managing this type of fracture of the femur.
