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141. Orthopaedic aspects of paediatric non-accidental injury. Full Text available with Trip Pro

Orthopaedic aspects of paediatric non-accidental injury. Non-accidental injury (NAI) in children includes orthopaedic trauma throughout the skeleton. Fractures with soft-tissue injuries constitute the majority of manifestations of physical abuse in children. Fracture and injury patterns vary with age and development, and NAI is intrinsically related to the mobility of the child. No fracture in isolation is pathognomonic of NAI, but specific abuse-related injuries include multiple fractures (...) and psychological morbidity, with wide- ranging effects from deviations in normal developmental progression to death. Orthopaedic surgeons must systematically assess, recognise and act on the indicators for NAI in conjunction with the paediatric multidisciplinary team.

2010 The Journal of Bone and Joint Surgery British Volume

142. Assessment of hip and knee muscle function in orthopaedic practice and research. (Abstract)

Assessment of hip and knee muscle function in orthopaedic practice and research. Isometric evaluation of hip and knee muscle strength can be a useful objective assessment tool in the clinic and may be preferred over other forms of dynamic muscle testing, such as isokinetic assessment or variable-resistance weight-lifting. Assessment of isometric strength with use of a handheld dynamometer requires little skill and is easily administered, relatively inexpensive, valid, reliable, and functional (...) ; thus, it could be easily integrated into routine clinical examinations. Surface electrical stimulation, electromyography, and ultrasonography can be used in conjunction with isometric muscle testing for the identification of neuromuscular factors influencing muscle force generation. Further research is warranted to investigate the neural and/or muscular impairments associated with hip and knee muscle weakness in orthopaedic populations, with the ultimate goal of improving rehabilitation strategies.

2010 The Journal of Bone and Joint Surgery. American Volume

143. Leading 20 at 20: top cited articles and authors in the Journal of Orthopaedic Trauma, 1987-2007. (Abstract)

Leading 20 at 20: top cited articles and authors in the Journal of Orthopaedic Trauma, 1987-2007. To determine the 20 most cited articles and authors in the Journal of Orthopaedic Trauma during the first 20 years of publication, 1987 to 2007.Review.We used Web of Science "cited reference search" to determine the most cited articles originating in the Journal of Orthopaedic Trauma from 1987 to 2007, the first 20 years of publication. The characteristics of each article were recorded. Next, we (...) with the most common topic being tibia fractures (shaft, plateau, and pilon). The top cited authors ranged for 111 to 566 citations, whereas the citations per lead authorship ratio for the authors on that list ranged from 9.5 to 566 citations per lead authorship. The number of citations to the Journal of Orthopaedic Trauma overall over the last 20 years has increased from 181 in 1997 to 3050 in 2007.The influence of the Journal of Orthopaedic Trauma, its articles, and its authors is readily apparent

2010 Journal of Orthopaedic Trauma

144. Origins of Eponymous Orthopaedic Equipment. Full Text available with Trip Pro

Origins of Eponymous Orthopaedic Equipment. Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation.We explored the origins of common and eponymous orthopaedic equipment.We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants (...) and instruments owing to the overwhelming number of these devices.The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop

2010 Clinical Orthopaedics and Related Research

145. B-type natriuretic peptide in patients undergoing orthopaedic surgery: a prospective cohort study. (Abstract)

B-type natriuretic peptide in patients undergoing orthopaedic surgery: a prospective cohort study. Postoperative cardiac complications pose a substantial risk to patients undergoing orthopaedic surgery.B-type natriuretic peptide (BNP) was determined preoperatively in 270 patients undergoing scheduled orthopaedic surgery. The accuracy of BNP to predict the occurrence of in-hospital cardiac events was evaluated as the primary endpoint. Cardiac events at 1 year of follow-up were considered (...) % confidence interval 0.57-0.84).In patients undergoing orthopaedic surgery, preoperative BNP levels can predict short-term and long-term postoperative cardiac events. Despite the paucity of endpoint events observed in this study, our results are in agreement with all prior investigations. BNP used in addition to an American College of Cardiology/American Heart Association guideline-based risk assessment might, therefore, be a useful tool in the preoperative evaluation of patients undergoing orthopaedic

2010 European Journal of Anaesthesiology

146. Foot and ankle experience in orthopedic residency: an update. (Abstract)

Foot and ankle experience in orthopedic residency: an update. In 2003, a limited survey regarding the number of dedicated foot and ankle faculty and foot and ankle rotations at orthopaedic surgery residency programs was published. The purpose of this paper was to update the results of that previous survey and provide additional, more in-depth information.A survey questionnaire was emailed to the program directors and chairpersons of the 150 ACGME-accredited orthopaedic residency training (...) programs in the United States.Responses were obtained from all programs. One hundred thirty-seven (91.3%) programs had one or more orthopaedic surgeon faculty members with a predominantly foot and ankle practice (at least 50%), an increase of 5.5 percentage points from the survey performed 6 years previously. One hundred forty three (95.3%) programs had one or more orthopaedic surgeon faculty members with a practice consisting of at least 25% foot and ankle. One hundred twenty programs (80%) had one

2010 Foot & Ankle International

147. Sedimentation method for preparation of postoperatively salvaged unwashed shed blood in orthopaedic surgery. Full Text available with Trip Pro

Sedimentation method for preparation of postoperatively salvaged unwashed shed blood in orthopaedic surgery. Salvage and return of unwashed shed blood (USB) after total knee replacement (TKR) is an established blood-saving technique, but some authors question its efficacy and safety and suggest that the shed blood be washed before returning. We evaluated a colloid-based sedimentation method for improving and standardizing the quality of USB collected after TKR without the need

2010 British Journal of Anaesthesia

148. Prospective audit on the use of the LMA-SupremeTM for airway management of adult patients undergoing elective orthopaedic surgery in prone position. Full Text available with Trip Pro

Prospective audit on the use of the LMA-SupremeTM for airway management of adult patients undergoing elective orthopaedic surgery in prone position. The LMA-Supreme (SLMA) is a single-use, latex-free, supraglottic airway device with a drain tube which allows immediate assessment of correct positioning of the device at insertion and throughout the procedure and provides access to gastric contents. The anatomically shaped airway tube facilitates easy insertion in anaesthetized patients (...) orthopaedic surgery with spontaneous (n=6) or positive pressure ventilation (PPV) (n=199).First-pass success was achieved in 184 insertions. Forty-two SLMA insertions were performed by anaesthesia trainees with first-pass success achieved in 38 insertions. All problems encountered during insertion were minor, and no patient had to be turned to the supine position for an airway problem. Problems during insertion were independent of patients' BMI. There were no failures of SLMA insertion or of maintenance

2010 British Journal of Anaesthesia

149. Orthopaedic training: 'RUN THROUGH' OR UNCOUPLED. (Abstract)

Orthopaedic training: 'RUN THROUGH' OR UNCOUPLED. The Postgraduate Medical Education and Training Board wants either 'run through' or 'uncoupled' orthopaedic training to be adopted throughout the United Kingdom but it is not willing to let both continue together as is the current situation. This annotation explores the argument for and against 'run through' training.

2010 The Journal of Bone and Joint Surgery British Volume

150. Low-income Countries' Orthopaedic Information Needs: Challenges and Opportunities. Full Text available with Trip Pro

Low-income Countries' Orthopaedic Information Needs: Challenges and Opportunities. The Internet should, in theory, facilitate access to peer-reviewed scientific articles for orthopaedic surgeons in low-income countries (LIC). However, there are major barriers to access, and most full-text journal articles are available only on a subscription basis, which many in LIC cannot afford. Various models exist to remove such barriers. We set out to examine the potential, and reality, of journal article

2010 Clinical Orthopaedics and Related Research

151. Developing guidelines for venous thromboembolism for The National Institute for Clinical Excellence: involvement of the orthopaedic surgical panel. Full Text available with Trip Pro

Developing guidelines for venous thromboembolism for The National Institute for Clinical Excellence: involvement of the orthopaedic surgical panel. Following the publication in 2007 of the guidelines from the National Institute for Health and Clinical Excellence (NICE) for prophylaxis against venous thromboembolism (VTE) for patients undergoing surgery, concerns were raised by British orthopaedic surgeons as to the appropriateness of the recommendations for their clinical practice. In order (...) to address these concerns NICE and the British Orthopaedic Association agreed to engage a representative panel of orthopaedic surgeons in the process of developing expanded VTE guidelines applicable to all patients admitted to hospital. The functions of this panel were to review the evidence and to consider the applicability and implications in orthopaedic practice in order to advise the main Guideline Development Group in framing recommendations. The panel considered both direct and indirect evidence

2010 The Journal of Bone and Joint Surgery British Volume

152. Examining the ethical implications of an orthopaedic joint registry. (Abstract)

Examining the ethical implications of an orthopaedic joint registry. R.P., a fifty-seven-year-old man, underwent a total hip replacement with a newly designed, cementless hip system. Within the first several months after surgery, he had persistent thigh pain. Radiographs made at one year indicated progressive radiolucent lines surrounding the femoral component. He required revision surgery for aseptic loosening of the femoral component. Several months following the revision, a single journal

2010 The Journal of Bone and Joint Surgery. American Volume

153. Effect of General Anesthesia and Orthopedic Surgery on Serum Tryptase. Full Text available with Trip Pro

Effect of General Anesthesia and Orthopedic Surgery on Serum Tryptase. Mast cell tryptase is used clinically in the evaluation of anaphylaxis during anesthesia, because symptoms and signs of anaphylaxis are often masked by the effect of anesthesia. No larger studies have examined whether surgery and anesthesia affect serum tryptase. The aim of this study was to investigate the effect of anesthesia and surgery on serum tryptase in the absence of anaphylaxis.The study included 120 patients (...) (median age, 54 yr; range, 19-94 yr) undergoing elective orthopedic surgery in general anesthesia. Exclusion criteria were allergic reactions during this or previous anesthesia, hematologic disease, or high-dose corticosteroid treatment. Blood samples for tryptase analysis (ImmunoCAP; Phadia, Uppsala, Sweden) were drawn shortly before anesthesia and after anesthesia and surgery.Median duration of anesthesia was 105 min (range, 44-263 min). Median interval between blood samples was 139 min (range, 39

2010 Anesthesiology

154. Health-related quality of life (EQ-5D) before and after orthopedic surgery. Full Text available with Trip Pro

Health-related quality of life (EQ-5D) before and after orthopedic surgery. Population data on mortality and life expectancy are generally available for most countries. However, no longitudinal data based on the health-related quality of life outcome from the EQ-5D instrument have been reported for orthopedic patients. We assessed the effect of orthopedic surgery as measured by EQ-5D.We analyzed EQ-5D data from 2,444 patients who were operated at the Department of Orthopedic Surgery

2010 Acta Orthopaedica

155. Europium Stearate Additives Delay Oxidation of UHMWPE for Orthopaedic Applications: A Pilot Study. Full Text available with Trip Pro

Europium Stearate Additives Delay Oxidation of UHMWPE for Orthopaedic Applications: A Pilot Study. Ultrahigh-molecular-weight polyethylene (UHMWPE) is used as an articulating surface in prosthetic devices. Its failure under various mechanisms after oxidation is of utmost concern. Free radicals formed during the sterilization process using high-energy irradiation result in oxidation. Europium, an element of the lanthanide family, has a unique electron configuration with an unusual lack

2010 Clinical Orthopaedics and Related Research

156. The Prevalence of Intimate Partner Violence across Orthopaedic Fracture Clinics in Ontario. Full Text available with Trip Pro

The Prevalence of Intimate Partner Violence across Orthopaedic Fracture Clinics in Ontario. from 1999 to 2004, an estimated 653,000 women in Canada were either physically or sexually abused by their current or previous intimate partners. We aimed to determine the proportion of women presenting to orthopaedic fracture clinics for the treatment of musculoskeletal injuries who had experienced intimate partner violence, defined as physical, sexual, or emotional abuse, within the past twelve (...) months.we completed a cross-sectional study of 282 injured women attending two Level-I trauma centers in Canada. Female patients presenting to the orthopaedic fracture clinics anonymously completed two previously developed self-reported written questionnaires, the Woman Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS), to determine the prevalence of intimate partner violence. The questionnaire also contained questions that pertain to the participant's demographic characteristics

2010 The Journal of Bone and Joint Surgery. American Volume

157. Review of successful litigation against english health trusts in the treatment of adults with orthopaedic pathology: clinical governance lessons learned. (Abstract)

Review of successful litigation against english health trusts in the treatment of adults with orthopaedic pathology: clinical governance lessons learned. Reviewing litigation brought against health institutions is a clinical governance issue and can help to prevent further cases. While large-scale databases are rare, the British National Health Service Litigation Authority deals with claims brought against all public health trusts in England.We reviewed all 2312 successful cases pertaining (...) to adult orthopaedic claims between 2000 and 2006 in an effort to establish trends of litigation and highlight specific areas of concern such that orthopaedic health care could be potentially improved. A total of 1473 entries had sufficient detail to be considered in our study.There were 4,847,841 elective and trauma-related orthopaedic procedures performed between 2000 and 2006 in the United Kingdom. Compared with the number of cases performed, the frequency of successful litigation is relatively low

2010 The Journal of Bone and Joint Surgery. American Volume

158. Hemodynamic Changes During a Combined Psoas Compartment-Sciatic Nerve Block for Elective Orthopedic Surgery. (Abstract)

Hemodynamic Changes During a Combined Psoas Compartment-Sciatic Nerve Block for Elective Orthopedic Surgery. Hemodynamic variables can theoretically be influenced by a combined psoas compartment-sciatic nerve block (CPCSNB) owing to a relatively high systemic absorption of local anesthetics and extended vasodilatation in the anesthetized limb (hemisympatectomy). In this study we assessed and documented hemodynamic changes during CPCSNB for elective orthopedic surgery.Twenty consecutive patients

2010 Anesthesia and Analgesia

159. A Resident Survey Study of Orthopedic Fellowship Specialty Decision Making and Views on Arthroplasty as a Career. (Abstract)

A Resident Survey Study of Orthopedic Fellowship Specialty Decision Making and Views on Arthroplasty as a Career. A dramatic shortage of total hip arthroplasty (THA) and total knee arthroplasty (TKA) surgeons has been projected because fewer residents enter arthroplasty fellowships, and the demand for THAs/TKAs is rising. The purposes of this study were to ascertain the future supply of THA/TKA surgeons, to identify the criteria residents use to choose their fellowship specialty, and to assess

2010 Journal of Arthroplasty

160. Does stress-induced hyperglycemia increase the risk of perioperative infectious complications in orthopaedic trauma patients? (Abstract)

Does stress-induced hyperglycemia increase the risk of perioperative infectious complications in orthopaedic trauma patients? To determine if hyperglycemia in postoperative orthopaedic trauma patients with no known history of diabetes mellitus is associated with an increased rate of infectious complications.Retrospective review.University Level I trauma center.One hundred ten consecutive orthopaedic trauma patients,Perioperative pneumonia, urinary tract infection, sepsis, or wound (...) infection. This difference was significant (P = 0.0056).Mean perioperative glucose levels greater than 220 mg/dL (HGI greater than 3.0) were associated with a seven times higher risk of infection in orthopaedic trauma patients with no known history of diabetes mellitus. Further prospective studies are needed to study the effects of stress-induced hyperglycemia and to determine whether this physiological response is protective or detrimental to the postoperative trauma patient.

2010 Journal of Orthopaedic Trauma

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