Abstract:
OBJECTIVE:This study tests the bone debridement efficacy and damage to cancellous bone produced by different wound irrigation methods. METHODS:Cancellous bone slices of bovine distal femurs (3 cm x 3 cm) were divided into eight test groups and scored with a saw in a latticed pattern. Four test groups were contaminated with 1.0 g rock dust and four were not. The specimens were then treated as follows: no treatment (control), bulb irrigation, brush-suction irrigation, or high-pressure pulsatile lavage (HPPL). Runoff from the irrigation was collected, filtered, lyophilized, and ashed to allow for quantitative determination of organic and inorganic material removed from the bone by each irrigation method. The bone samples were subjected to blinded grading on two five-point scales to assess: 1) macroscopic tissue damage and 2) amount of contaminant remaining following treatment. RESULTS:Significantly more (P < or = 0.05) mean organic material was removed from samples treated with HPPL (744.8 +/- 120.0 mg) than with bulb syringe (115.2 +/- 11.9 mg) or brush-suction irrigation (95.1 +/- 9.2 mg). Brush-suction irrigation removed statistically significantly more (P < or = 0.05) of the 1.0 g of initial inorganic contaminant (937.7 +/- 6.3 mg) than bulb syringe irrigation (866.2 +/- 30.1 mg), while HPPL (900.2 +/- 19.0 mg) did not. CONCLUSIONS:Past studies have shown HPPL to damage both soft tissue and bone structure. The tissue damage that HPPL produces has been accepted in the past in exchange for its presumed superiority in contaminant removal. In this study, HPPL damaged samples more than other irrigation methods by removing significantly more organic material from them. However, HPPL and bulb syringe removed a statistically similar amount of inorganic contaminant, while brush-suction irrigation removed a significantly greater amount of inorganic contaminant than bulb syringe. It is proposed that HPPL may drive some contaminants deeper into the tissue rather than removing them, rendering HPPL not only more deleterious to bone structure and healing, but also less efficacious at removing contaminant than brush-suction irrigation.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Draeger RW,Dirschl DR,Dahners LEdoi
10.1097/BOT.0b013e31802b41e2subject
Has Abstractpub_date
2006-11-01 00:00:00pages
692-8issue
10eissn
0890-5339issn
1531-2291pii
00005131-200611000-00007journal_volume
20pub_type
杂志文章abstract::Four acute cases of volar carpometacarpal dislocations of the medial four metacarpals were treated in our hospital's emergency room. Our initial diagnosis after clinical examination was confirmed by routine x-rays of the hand. Closed reduction was followed by percutaneous fixation of the carpometacarpal joints with Ki...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199809000-00019
更新日期:1998-09-01 00:00:00
abstract::Although Kirschner wires are useful implants in many situations, migration of the wire and irritation of the surrounding soft tissues are common complications. Seven steps are described herein, which result in a Kirschner wire that is bent 180° angle, providing a smooth anchor into bone. Use of this technique produces...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318290f818
更新日期:2013-11-01 00:00:00
abstract::Fracture compression can be achieved in many ways intraoperatively using either screws in compression plates, compression devices, or using intramedullary nails. The use of locked intramedullary nails combines the advantages of indirect fracture fixation and compression with minimal soft tissue disruption. This articl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31819f2779
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVE:To measure the dimensions of the narrowest portion of the sacral ala for safe insertion of iliosacral lag screws. DESIGN:Computed tomography (CT) model. SETTING:Level One trauma center. PATIENTS:Thirteen adult patients underwent pelvic CT imaging. MAIN OUTCOME MEASURE:Axial CT scans of intact pelves were ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200001000-00007
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVE:To study the effect of tourniquet control on intramedullary reaming. DESIGN:An experimental prospective nonsurvival animal study was performed using 5 mongrel dogs. A pneumatic tourniquet was randomized to either the right or left hind limb. Tibial intramedullary reaming was performed with progressively larg...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200411000-00004
更新日期:2004-11-01 00:00:00
abstract:OBJECTIVES:To assess the treatment preferences of orthopaedic surgeons for displaced three- and four-part proximal humerus fractures. DESIGN:Cross-sectional survey. SETTING:Academic and nonacademic institutions across Canada. PATIENTS/PARTICIPANTS:Members of the Canadian Orthopedic Trauma Society and the Joint Ortho...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181bdc46a
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine the clinical relevant accuracy of CT-based navigation for drilling. DESIGN:Experimental model. SETTING:Laboratory. METHODS:Twelve drills of varying lengths and diameters were tested with 2 different set-ups. Group 1 used free-hand navigated drilling technique with foam ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract::Twenty-six patients with major anterior-posterior pelvic disruptions not involving the acetabulum were reevaluated an average of 8 years (minimum 5 years) after injury. All pelvic injuries were treated nonoperatively. Subjective complaints at the time of follow-up included frequent or daily low back discomfort (50%), ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198903010-00008
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVE:To determine the rate of pelvic vein thrombosis following acetabular or pelvic fracture identified by enhanced computed tomography venography or magnetic resonance venography. DESIGN:Prospective evaluation of computed tomography venography and magnetic resonance venography in patients with pelvic and acetabu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200210000-00001
更新日期:2002-10-01 00:00:00
abstract:PURPOSE:The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries. METHODS:A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers-Danlos synd...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001212
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31815cf6e9
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:To compare the efficacy of anesthetic type on clinical outcomes after operative treatment of distal radius fractures. DESIGN:Retrospective review of prospectively collected data. SETTING:Academic medical center. PATIENTS:One hundred eighty-seven patients with a distal radius fracture (OTA type 23) were ide...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238becb
更新日期:2012-09-01 00:00:00
abstract::Road traffic accidents are a leading cause of global mortality. In March 2010, the United Nations General Assembly and the World Health Organization (WHO) officially proclaimed 2011-2020 as the "Decade of Action for Road Safety." Researchers must focus on vulnerable road users and low- and middle-income countries (LMI...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000103
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To report the results from functional bracing of isolated ulnar shaft fractures. DESIGN:Retrospective review. SETTING:Two university hospitals. PATIENTS:Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. INTERVENTION:Prefa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00
abstract:OBJECTIVES:Misperception on the fluoroscopic image showing a well-placed iliosacral (IS) screw can occur, when the screw is in reality misplaced. The purpose of this study was to demonstrate and highlight examples of misperception and suggest alternative inlet and outlet views to confirm adequate IS screw placement. M...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000426
更新日期:2016-01-01 00:00:00
abstract::A rare case of bilateral atlantoaxial rotatory dislocation (Fielding type V) in an adult is presented. The diagnosis was rapidly made by computed axial tomography. Prior reports of this entity have not clearly defined the pathoanatomy, which in our case was confirmed by three-dimensional tomographic reconstruction. We...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199402000-00015
更新日期:1994-01-01 00:00:00
abstract::The induced membrane technique for reconstruction of bone defects has proved its effectiveness and is now widely accepted. The 2 stages procedure, implying a cement spacer in the first stage and a huge bone graft in the second stage, responds to rigorous technical details involving each phase of the procedure. Prerequ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000979
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200211000-00001
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:To compare the hospital costs, charges, and reimbursement for treatment of pediatric femur fractures by two treatment methods: external fixation and 90-90 traction with spica casting. DESIGN:Retrospective clinical review. SETTING:Department of Orthopaedic Surgery, Children's Hospital Oakland, regional pedi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199811000-00006
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:In the distal femur, locked plating is efficacious when coronal fractures preclude the use of a conventional fixed-angle device. However, minimal comparative data exist for supracondylar fracture patterns, which could be treated with other devices. The purpose of this study was to compare the 95-degree angle...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318234d460
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:To review and critically assess trends observed regarding the levels of evidence in published articles in orthopaedic traumatology literature. DATA SOURCES:The Journal of Orthopaedic Trauma, Journal of Bone and Joint Surgery-American, and Clinical Orthopaedics and Related Research. STUDY SELECTION:All artic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000557
更新日期:2016-07-01 00:00:00
abstract:OBJECTIVES:Because locked plates as a neutralization device for lag screw fracture fixation have different biomechanics than that of unlocked plates, we investigated how this would affect lag screw load at the fracture site. The purpose of this study was to assess the load at a fracture site compressed with a lag screw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31823b3dd1
更新日期:2012-09-01 00:00:00
abstract::Tibial plateau fractures can involve planes that require reduction and stabilization from a posterior approach. This includes posteromedial, posterolateral, and posterior column shear type injuries. This video outlines the prone posteromedial approach to the tibial plateau for posterior column fracture exposure, reduc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001826
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To determine if the addition of a dorsal ulnar pin plate provides improved stability characteristics in the management of intra-articular distal radius fractures with an associated dorsal ulnar fragment. METHODS:OTA/AO type C3 fractures, with a dorsal ulnar fragment of one-third or one-half the width of the ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001776
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:Hand dominance has been reported to be an important factor affecting outcomes after upper extremity trauma but remains unstudied after hemiarthroplasty for fracture. This study determined whether dominance affected outcomes after hemiarthroplasty for proximal humerus fractures. DESIGN:Retrospective cohort s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000294
更新日期:2015-08-01 00:00:00
abstract::The first known reported case of volar radiocarpal dislocation with ulnar translocation is described with a review of previous literature on the isolated components of these injuries. Radiographic criteria for their diagnosis are presented with recommendations for early operative intervention to minimize the risk of s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-198802040-00009
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this prospective cohort study was to determine if a new patella fracture fixation construct resulted in improved outcomes compared with traditional tension band techniques. DESIGN:Comparative cohort study. SETTING:Academic level I trauma center. PATIENTS/PARTICIPANTS:Patients with isolated, ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000787
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries. DATA SOURCES:The English language literature was searched using PubMed, E...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000937
更新日期:2018-01-01 00:00:00
abstract:SUMMARY:Convergent type radioulnar translocation is an extremely rare form of injury occurring in a growing child. We report a case of convergent radioulnar translocation along with a radial head fracture in a young child. Open reduction of the elbow and internal fixation of the radial head fragment helped in achieving...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31821d7fd5
更新日期:2012-04-01 00:00:00