Abstract:
:If the underlying pathology of the syndrome of fat embolism is the presence of circulating emboli of neutral fat with adherent platelets and red blood cells, then one could expect certain changes in normal vascular cellular elements and fat metabolism, with resultant alterations in pulmonary function. In our series of 118 patients with fractures of the lower limbs we found that more than half of them exhibited hypoxemia as well as a decrease in the hematocrit and platelet counts with a concomitant increase in platelet adhesiveness. In addition, those patients with hypoxemia showed increased fibrinogen degenerative product levels indicating an increased fibrinolysis. We found only a slight temporary rise in the serum triglycerides, but the nonesterified fatty acid levels rose sharply over the first three days following trauma associated with an increase in serum lipase. Our study demonstrated that this increase in serum lipase occurred slightly before the peaking tendency observed in the nonesterified fatty acids. Following trauma, fat emboli with adherent platelets and other vascular cellular elements are formed; we would expect that these emboli would lodge in the capillaries and small vessels of the lung, thereby producing a physiological shunt. An increase in the A-aDo2 confirmed this hypothesis and was associated with a decrease in the arterial oxygen level in over half the patients studied. Although 58 of our patients showed evidence of hypoxemia associated with a fall in hematocrit and platelet count, not one of them showed clinical signs and symptoms of the fat embolus syndrome. This study suggests that a subclinical form of fat embolism does exist. What causes a small percentage of those patients with subclinical fat embolism to progress to a clinical fat embolism is still unknown. The majority of our patients spontaneously returned to normal within 5 days. Reviewing the results of those patients who developed hypoxemia and the two patients who developed clinical fat embolism, there seems to be no indication of what causes the progression. Hypotension and shock do not seem to be relevant to the progression of the subclinical condition. Not one of 110 reviewed had evidence of shock or persistent hypotension, yet 58 of these patients developed changes in arterial saturation, vascular elements, and evidence of disseminated intravascular coagulation.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Riseborough EJ,Herndon JHsubject
Has Abstractpub_date
1976-03-01 00:00:00pages
248-67issue
115eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract:BACKGROUND:The main static stabilizers of the medial knee are the superficial medial collateral and posterior oblique ligaments. A number of reconstructive techniques have been advocated including one we describe here. However, whether these reconstructions restore function and stability is unclear. DESCRIPTION OF TEC...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2061-1
更新日期:2012-03-01 00:00:00
abstract::A large, well-encapsulated intraneural lipoma occurred within the sciatic nerve of a 34-year-old woman. In a review of the literature, significant differences were noted between the well-encapsulated and the diffusely infiltrative lipofibromatous hamartoma types of intraneural lipomas. The average age at the time of a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1987-08-01 00:00:00
abstract::The initial experience with the Freeman-Swanson (ICLH) total knee arthroplasty (1971-1975) led to changes of tibial component size, alignment, instruments, and surgical technique in 1975. Certain patients in this initial series, however, have shown excellent long-term (5 1/2-9 years) results. In patients with overall ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-03-01 00:00:00
abstract::To investigate if an intensive rehabilitation program has a positive influence on the late course of an old, isolated anterior cruciate ligament rupture, patients were evaluated at an average of 8 years after injury. Seventy-five percent had acquired the injury during sporting activities. After diagnostic arthroscopy,...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199607000-00025
更新日期:1996-07-01 00:00:00
abstract::The purpose of this two-part biomechanical study was to evaluate various fixation methods for transverse acetabular fractures in a synthetic pelvic model. In Part 1, 40 transverse acetabular fractures were repaired with anterior column plating using 10-hole curved reconstructions plates with one of four screw configur...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1998-07-01 00:00:00
abstract::In two cases of post-traumatic radioulnar synostosis occurring in a father and his adult son, the bony bridge was excised and a Silastic sheet interposed between the forearm bones. Both patients benefitted and had improved function of the hand following the procedure, although the range of forearm rotation restored wa...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-06-01 00:00:00
abstract::A method of surface replacement of the knee joint using an uncemented titanium-on-high-density-polyethylene prosthesis has been investigated in 61 patients. The results show that pain is relieved in the vast majority of cases. Overall, the joint range is marginally improved. Preoperative deformities can be considerabl...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-05-01 00:00:00
abstract::Elbow dislocations are relatively uncommon in children. Rupture of the brachial artery associated with closed elbow dislocations in children is rare. This is a report of an 8-year-old boy, the youngest patient ever to be reported to have a closed posterior dislocation of the elbow associated with a brachial artery lac...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1993-11-01 00:00:00
abstract::Release of antibiotics from antibiotic-loaded PMMA is dependent on its permeability. Loading PMMA with soluble particulate filler has been proposed to increase permeability and antibiotic release for beads and spacers. We therefore assessed particulate sucrose, xylitol, and erythritol as fillers to increase the permea...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e3181123e90
更新日期:2007-08-01 00:00:00
abstract::An aggressive and recurrent pigmented villonodular synovitis of the knee occurred in a 47-year-old man. Magnetic resonance imaging was an excellent noninvasive diagnostic aid that completely outlined the extent of the synovitis and correlated well with surgical findings. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1988-11-01 00:00:00
abstract:BACKGROUND:Cost-effectiveness research is an increasingly used tool in evaluating treatments in orthopaedic surgery. Without high-quality primary-source data, the results of a cost-effectiveness study are either unreliable or heavily dependent on sensitivity analyses of the findings from the source studies. However, to...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-015-4369-8
更新日期:2015-10-01 00:00:00
abstract::The Hoffmann external fixator has proved to be an effective means of stabilizing complex femoral fractures in patients in whom prolonged traction or internal fixation is not advisable. It provides for the prompt mobilization of multiple-trauma victims and assists in the evaluation of the "floating knee." Pin tract inf...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
abstract::The collagens are products of a superfamily of closely related genes. Currently, there are 13 described collagens encompassing at least 25 separate genes. The collagen molecules can be categorized into four classes. Class I consists of molecules that form the banded collagen fibers that are readily seen by routine ele...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::Heterotopic ossification can impair the functional results of total hip arthroplasty. The causative role of trochanteric osteotomy in heterotopic ossification is uncertain. Postoperative radiographs of 100 total hip arthroplasties were analyzed for incidence of heterotopic ossification. Forty procedures were performed...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:UNLABELLED:Proximal tibia fractures present a difficult treatment challenge with historically high complication rates. In a prospective study, we asked whether the Less Invasive Stabilization System (LISS) plate can adequately treat extraarticular and complex intraarticular proximal tibia fractures and provide low comp...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000203467.58431.a0
更新日期:2006-04-01 00:00:00
abstract::Fixed flexion contracture can present a technical challenge in total knee arthroplasty. Various techniques of addressing these deformities have been described including additional bony resection, ligamentous releases, and the use of increasing constraint. We retrospectively reviewed the clinical outcomes of 40 patient...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000238801.90090.59
更新日期:2006-11-01 00:00:00
abstract::A technique of partial resection of the distal ulna ("wafer" procedure) for the treatment of patients with symptomatic tears of the triangular fibrocartilage complex or mild ulnar impaction syndrome or both is described. The distal 2-4 mm of the distal ulna is resected while preserving the distal radioulnar joint and ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-02-01 00:00:00
abstract:BACKGROUND:A femoral implant with a modular sleeve and stem has been designed to allow independent and complete metaphyseal-diaphyseal fit and fill as well as independent rotation to accommodate anteversion at the time of THA. QUESTIONS/PURPOSES:In a prospective study we asked whether such a modular femoral sleeve and...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1524-0
更新日期:2011-02-01 00:00:00
abstract::A study of 281 patients evaluated for a meniscus pathologic condition was performed to assess the accuracy of the clinical diagnosis and arthrogram and delineate the role of arthroscopy. Following the clinical examination, the surgeon stated his level of confidence in his diagnosis, as did the radiologist in his inter...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-03-01 00:00:00
abstract::Two hundred and eight skin knives and 374 deep knives were evaluated in 153 clean orthopedic cases with and without a horizontal wall-less laminar air-flow system. There was no statistical difference in contamination frequency between the skin and the deep knives with and without the laminar air-flow. However, the kni...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197505000-00024
更新日期:1975-05-01 00:00:00
abstract::Mechanically the wrist is the most complex joint in the body, providing a large range of motion in the flexion-extension and radial-ulnar deviation planes. By virtue of the constraints at the radiocarpal level, strong torque may be delivered to the grasping hand for work in the grasping mode through the rotational axi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-01-01 00:00:00
abstract::An 11-year-old boy sustained complete brachial artery disruption following closed posterior elbow dislocation. This is the first documentation in the English-language literature of this type of arterial transection following closed elbow dislocation in a child. It is also the first report of surgical repair of the bra...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract::Percutaneous pelvic fixation is possible because intraoperative fluoroscopic imaging and other technologies have been refined. Anterior and posterior unstable pelvic ring disruptions are amenable to percutaneous fixation after closed manipulation or open reduction. Stable and safe fixation is achieved only after an ac...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:10.1097/00003086-200006000-00004
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:MicroRNAs are small, noncoding RNAs that regulate the expression of posttranslational genes. The presence of some specific microRNAs has been associated with increased risk of both local recurrence and metastasis and worse survival in patients with osteosarcoma. Pathologic fractures in osteosarcoma are consi...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/CORR.0000000000000867
更新日期:2019-09-01 00:00:00
abstract::The medial collateral ligament is one of the most frequently injured ligaments in the knee. Although the medial collateral ligament is known to provide a primary restraint to valgus and external rotations, details regarding its precise mechanical function are unknown. In this study, strain in the medial collateral lig...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200110000-00031
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND:The antifibrinolytic tranexamic acid reduces surgical blood loss, but studies have not identified an optimal regimen. QUESTIONS/PURPOSES:We studied different dosages, timings, and modes of administration to identify the most effective regimen of tranexamic acid in achieving maximum reduction of blood loss i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11999-012-2310-y
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:The direct anterior approach for THA allows implantation through an internervous plane without muscle detachment from bone. However, the classic longitudinal skin incision does not follow the anatomic skin creases and can result in scar widening. We therefore modified our incision technique to a short obliqu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-013-2806-0
更新日期:2013-07-01 00:00:00
abstract::The overall biocompatibility characteristics of metallic implants are important considerations in orthopedic surgery. A review of the literature shows very few reports of neoplasms in association with metallic implants. This case report demonstrates osteogenic sarcoma at the site of a Smith-Petersen nail that had been...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Forty-two months follow-up examinations on 30 total knee arthroplasties revealed the following significant complications: phlebothrombosis, 13 knees (46%); pulmonary embolism 3 patients (11%); asymptomatic loosening, 8 knees (11.4%); symptomatic loosening, 3 knees (4.8%); superficial infections, 4 knees (5.4%); deep i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1976-11-01 00:00:00
abstract::Lyophilized radiation-sterilized bone graft operations were analyzed according to 27 variables in 1014 patients with two-year follow-up results. In 91.3% of patients, the result of treatment was "very good" (full-health restoration) or "satisfactory" (restoration with some small disorders). In 5.1%, the results were u...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1991-11-01 00:00:00