High Rate of Studies with Level 1 and 2 Evidence among the 100 Most Cited Articles in Lumbar Spinal Stenosis.

BACKGROUND: To date, no study has used bibliometric analysis to review the most influential articles in lumbar spinal stenosis. The objective of this study was to identify and analyze the characteristics and the level of evidence of the 100 most cited articles on lumbar spinal stenosis METHODS: The Thomson Reuters Web of Science was accessed to find the 100 most cited articles on lumbar spinal stenosis. For each article, we recorded the number and density of citations, authors, country, journals and years, department, level of evidence, type of study, and if it was part of any multicenter studies. RESULTS: Until January 2017, the 100 most cited articles accumulated 11,136 citations (average: 259.05/y), ranging individually between 442 and 50 (average: 111.36). The first reference was published in 1974 in Clinical Orthopaedics and Related Research. Therapeutic studies (n = 40), the 1990s (n = 46), United States as country of origin (n = 51), Harvard University as institution (n = 16), Katz JN as author (n = 10), and Spine as journal (n = 48) have the hegemony. Many were multicenter (n = 42) and using level 2 evidence (n = 49). There is an inverse relationship between citation index and long-standing studies, maintenance of those most cited, and a temporary advance toward better levels of evidence. CONCLUSION: This bibliometric analysis reveals a good level of evidence in the published clinical series and includes 100 articles useful for the approach of lumbar spinal stenosis.

Occupational risk factors for shoulder chronic tendinous pathology in the Spanish automotive manufacturing sector: a case-control study.

BACKGROUND: Musculoskeletal Diseases (MSDs) are among the most prevalent health problems encountered in the workforce in Europe. Multiple risk factors contribute to their onset. In the present study, different individual risk factors for chronic tendinous pathology affecting the shoulder were analysed in a sample of workers from the automotive manufacturing sector. METHODS: An observational retrospective study was conducted with 73 cases of officially recognised and compensated occupational diseases and 94 aleatory cases of healthy workers from the same car assembly company. The experimental group comprised individuals with tendinous chronic pathology of the rotator cuff. Multiple variables that identified the risks present in the job were assessed along with participants clinical evaluation. Furthermore, two standardised guidelines for risk factors assessment were also used: the Spanish National Institute of Social Security (INSS) and the American Occupational Information Network (O*Net). Both descriptive statistical analysis and Odds ratios calculations considering the occupational disease as a dependent variable were performed. RESULTS: The use of hand tools, exposure to mechanical pressure in the upper limbs and awkward postures were the most prevalent risk factors. Pressure on the palm of the hand and the hand tool impacting the hand were also important risk factors. Some psychosocial factors such as lack of autonomy and mental workload were also associated shoulder tendinous diseases. The association of age, load handling, and awkward postures were the core risk factors responsible for most of the tendinous chronic injuries of the shoulder in this sample of car assembly workers. CONCLUSIONS: Both ergonomic and psychosocial factors were present and increased the risk of developing occupational chronic tendinopathies at the shoulder in this sample of workers. Aging, load handling, and awkward postures showed the strongest predictive values. Greater knowledge of how risk factors interact would facilitate the design of better preventive workplace strategies.

Predominance of Studies With Poor Level of Evidence Among the Top 100 Most Cited Studies on Idiopathic Scoliosis: A Bibliometric and Content Analysis.

STUDY DESIGN: Bibliometric review of current literature. OBJECTIVE: To identify and analyze the characteristics of the 100 most cited articles on idiopathic scoliosis focusing on the level of evidence. SUMMARY OF BACKGROUND DATA: The scientific literature on idiopathic scoliosis has been constantly evolving, but many aspects of its true etiology, natural history, and response to treatment continue to be discussed. To date, no study has used bibliometric analysis to review the most influential articles about idiopathic scoliosis. METHODS: The Thompson Reuters Web of Science was accessed to find the 100 most cited articles on idiopathic scoliosis. The number and citation density, authorship, institutions, country of origin, year of publication, source journals, type of study, topic, study design, and level of evidence were analyzed. RESULTS: The 100 most frequently cited articles accumulated 13,749 citations. The number of citations ranged between 616 and 80. The 10 most cited articles represent 24.6% of all citations. The treatment of idiopathic scoliosis is the most commonly studied issue (n = 46), and specifically surgical correction (n = 36). Most studies originated in the United States (n = 62) and were published in Spine (n = 56). Almost half of the papers (n = 49) were published between 2000 and 2008. The majority of studies have a case series design (n = 35). Most of the cited articles have low levels of evidence (Level III = 36; Level IV = 35). CONCLUSION: This bibliometric analysis includes the 100 most cited articles on idiopathic scoliosis, recognizing its importance as a basic milestone in today's spine knowledge. The results indicate that the evolution of the knowledge on idiopathic scoliosis has been through case reports and case series, which analyzed retrospectively today are considered to have a poor level of evidence. This observation seems to be paradoxical because they are the most influential articles on IS and had been published in the top, leading journals of spine surgery.

Lesiones deportivas de la muñeca y mano / Sports injuries of the wrist and hand

El objetivo de este trabajo es exponer de un modo sistemático, las lesiones deportivas más frecuentes o más graves de la mano y la muñeca, presentando los tratamientos basados en métodos sencillos y seguros. Las lesiones de la mano representan una gran proporción de todas las lesiones que acuden a los servicios de urgencias (aproximadamente un tercio). En los deportistas, son particularmente frecuentes las lesiones por avulsión del flexor profundo, el dedo en martillo (lesión cerrada más común del deportista), las roturas de la placa volar, o las lesiones de los ligamentos colaterales. Se revisan además las tendinitis y tendinosis, luxaciones tendineas a distintos niveles, neuropatías de los nervios mediano, cubital y colaterales digitales, síndrome de impactación cubito carpiano, esguinces, fracturas y luxaciones articulares, deformidades más comunes de los dedos (Boutonnière, Jersey finger, mallet finger y dedo caído), los esguinces e inestabilidades carpianas y las lesiones del fibrocartílago triangular. La evaluación de las lesiones óseas debe iniciarse con unas radiografías simples. La TAC debe reservarse para la comprensión de las lesiones óseas complejas. La ecografía y la resonancia para el estudio de los tejidos blandos. Se exponen los tratamientos más comunes con la idea de que sirva como una guía rápida para enfocar estas lesiones a pie de pista. La mayoría de mecanismos de lesión de las manos relacionados con el deporte se pueden prevenir. La literatura actual sugiere que los esfuerzos dirigidos al cambio de reglas en los distintos deportes para conseguir entornos de juego más seguros, así como los cambios en la educación y formación de entrenadores, deportistas y personal sanitario minimizan los riesgos de lesión

The aim of this work is to expose systematically the most frequent or severe sports injuries of the hand, presenting treatments based on simple and safe. Hand injuries account for a large proportion of injuries treated in the emergency departments (approximately one third). In athletes, particularly frequent avulsion injuries are deep flexor, mallet finger (closed most common injury of the athlete), the volar plate ruptures, or collateral ligament injuries. Tendinitis and tendinosis, tendinous dislocations at different levels, neuropathy of median, ulnar and digital collateral, impactation ulnar carpal syndrome, sprains, fractures and joint dislocations, common deformities of the fingers (Boutonnière, Jersey finger, mallet finger and thumb down), carpal instabilities, sprains and injuries of the triangular fibrocartilage are reviewed. The evaluation of bone lesions should start with a plain radiographs. The CT-scan should be reserved for the understanding of complex bone lesions. Ultrasound and MRI are recommended for the study of soft tissue injuries. The most common treatment protocols are addressed that constitutes a rapid guide to assess all these lesions at the course. Most injury mechanisms related to the different hand lesions in sports are preventable. The current literature suggests that some efforts should be done to change rules in different sports to get safer playing environments. Changes in the education and training of coaches, athletes and healthcare personnel are needed to minimize the risk of injury