Abstract:
BACKGROUND:Fixation of unstable ankle fractures, including fixation of posterior malleolus fracture fragments with the attached, intact posteroinferior tibiofibular ligament (PITFL), reportedly provides more stable fixation than transsyndesmotic screws. QUESTIONS/PURPOSES:To confirm this observation we compared the Foot and Ankle Outcome Score (FAOS) and radiographic maintenance of fixation for fractures treated through direct posterior malleolar fixation versus syndesmotic screw fixation. METHODS:We prospectively followed 31 one patients with unstable ankle fractures treated with (1) open posterior malleolus fixation whenever the posterior malleolus was fractured, regardless of fragment size (PM group; n = 9); (2) locked syndesmotic screws in the absence of a posterior malleolar fracture (S group; n = 14); or (3) combined fixation in fracture-dislocations and more severe soft tissue injury (C group; n = 8). All patients had preoperative MRI confirming syndesmotic injury and an intact PITFL; postoperative and followup radiographs were evaluated for syndesmotic congruence. The minimum followup was 12 months (mean, 15 months; range, 12-31 months). RESULTS:Postoperative and followup FAOS scores were similar in the three groups. The tibiofibular clear space was greater in the S versus the PM group, but we found no other differences in the postoperative versus followup measurements between the PM, S, and C groups. CONCLUSIONS:Syndesmotic fixation through the posterior malleolus and PITFL is maintained at followup, and these patients have functional outcomes at least equivalent to outcomes for patients having syndesmotic screw fixation. LEVEL OF EVIDENCE:Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Miller AN,Carroll EA,Parker RJ,Helfet DL,Lorich DGdoi
10.1007/s11999-009-1111-4subject
Has Abstractpub_date
2010-04-01 00:00:00pages
1129-35issue
4eissn
0009-921Xissn
1528-1132journal_volume
468pub_type
杂志文章abstract:BACKGROUND:The ability of injection of corticosteroids into the subacromial space to relieve pain ascribed to rotator cuff tendinosis is debated. The number of patients who have an injection before one gets relief beyond what a placebo provides is uncertain. QUESTIONS/PURPOSES:We asked: (1) Do corticosteroid injection...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11999-016-5002-1
更新日期:2017-01-01 00:00:00
abstract::Although some patients experience a success rate greater than 90% after total hip arthroplasty, others require revision surgery within 5 years after the index procedure. The purpose of our study was to analyze the failure mechanisms in patients who had revision surgery within 5 years after index total hip arthroplasty...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/01.blo.0000203484.90711.52
更新日期:2006-06-01 00:00:00
abstract::A 60-year-old man had severe unilateral wrist flexion contracture associated with psoriatic arthritis mutilans. Proximal row carpectomy provided realignment of the carpus. Arthrodesis occurred spontaneously in functional position. ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1980-11-01 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::Segmentation and intramedullary rod fixation of the tibia have been found to be safe and effective procedures in osteogenesis imperfecta. An extensible rod is more difficult to insert than a solid rod due to the problem of obtaining an adequate fit distally, so the practical advantage of one type over the other is not...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-09-01 00:00:00
abstract::Increased attention and resources focused on women's health during the past decade have resulted in new offices, policies, and programs of the Federal government. The Office of Research on Women's Health, established by the National Institutes of Health in 1990, is a focal point for all National Institutes of Health-s...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-200003000-00003
更新日期:2000-03-01 00:00:00
abstract::A technique for ipsilateral femoral neck and shaft fracture using the sliding compression hip screw with plate combined with trochanteric antegrade Ender nailing of the femur was applied in two cases. Ender nails can be passed without difficulty past a compression hip screw and the bicortical plating screws. The hip a...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-12-01 00:00:00
abstract:UNLABELLED:Reorientation acetabular osteotomies can correct dysplastic deformities and provide marked improvement in hip function. Deformities of the proximal femur can produce suboptimal articulation or secondary impingement after acetabular reorientation, yet the incidence and characteristics of such deformities have...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-008-0481-3
更新日期:2009-01-01 00:00:00
abstract::A cellulose acetate membrane was fashioned into a cone to serve as a substratum for an outgrowth of connective tissue from normal neonatal muscle, and a container for diffusion of bone morphogenetic protein (BMP) of an aggregate of BMP and cold water insoluble noncollagenous protein (BMP/iNCP). The BMP/iNCP was prepar...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1986-06-01 00:00:00
abstract::Aneurysmal bone cysts are benign active or aggressive bone tumors that commonly arise in the long bones, especially the femur, tibia, and humerus and the posterior elements of the spine. Aneurysmal bone cysts affect all age groups but are more common before skeletal maturity (first two decades of life). They usually i...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-010-1228-5
更新日期:2010-04-01 00:00:00
abstract::The purpose of this study was to examine the mating surfaces of femoral heads and stems for evidence of corrosion, and to evaluate the quality of the taper lock of modular hip prostheses. Forty-eight implants with three different designs were evaluated. Group I (26 implants) had a cobalt alloy head and cobalt alloy st...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract::The purpose of this study was to determine trends and differences between various medical specialties with regard to the treatment of postmenopausal osteoporosis. The method used was a cross-sectional survey, and the authors' sample was composed of 116 physicians. There was an overall lack of consensus on choice of tr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::Shoulder motion has traditionally been described in reference to arbitrarily defined planes of motion (e.g., sagittal/flexion, coronal/abduction). This study examined shoulder muscle recruitment during conical arm movements, which include all planes of motion. Electromyographic (EMG) data was collected with intramuscu...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract::A quantitative three-dimensional measurement method, radiographic stereophotogrammetry (SPG), was employed to assess the relation between early subsidence of the femoral prosthesis after total hip arthroplasty (THA) and subsequent clinical course. The SPG technique and the authors' error control mechanisms are describ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1985-12-01 00:00:00
abstract::Internal fixation of oblique metacarpal fractures was studied in a cadaver model by impact loading. One hundred twenty fresh-frozen human metacarpals underwent compressive and bending impacts after oblique osteotomy and internal fixation. Dorsal plating with lag screws, 2 dorsal lag screws (2-screws), crossed Kirschne...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-199604000-00036
更新日期:1996-04-01 00:00:00
abstract::Numerous studies document vibrations emanating from joints during active or passive motion. It has been proposed these vibrations, termed vibroarthrographic signals, are associated with changes in the shape or quality of tissues in and around the joint. Vibroarthrographic signals in articular joints have been tested t...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/BLO.0b013e31802c3423
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Radiation-crosslinked UHMWPE has been used for joint implants since the 1990s. Postirradiation remelting enhances oxidative stability, but with some loss in strength and toughness. Vitamin E-stabilized crosslinked UHMWPE has shown improved strength and stability as compared with irradiated and remelted UHMWP...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-014-3850-0
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:While the primary objective of joint arthroplasty is to improve patient quality of life, pain, and function, younger active patients often demand a return to higher function that includes sporting activity. Knowledge of rates and predictors of return to sports will help inform expectations in patients antici...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2198-y
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Sacrectomy may offer curative potential for primary sarcomas of the sacrum. However, it is unclear whether and to what extent sacrectomies achieve local control. QUESTIONS/PURPOSE:We therefore determined the curative potential, walking ability, continence control, and quality of life for children after sacr...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-011-2199-x
更新日期:2012-05-01 00:00:00
abstract::This is a review of 13 patients with chronic osteomyelitis treated at the author's institution using techniques similar to the management of giant cell tumors of bone. This included aggressive serial debridements and appropriate antibiotic coverage and subsequent bone-grafting or soft-tissue coverage procedures. The n...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1994-01-01 00:00:00
abstract::Tumoral calcinosis is the deposition of calcium crystals and salts in the periarticular soft tissues. It commonly is seen as a complication of renal dialysis or in patients with a hereditary disposition. Occasionally, it is seen as an isolated condition with no known cause. Tumoral calcinosis usually affects adults an...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-01 00:00:00
abstract::The geometric total knee prosthesis was used in the reconstruction of 70 damaged knee joints in 56 patients from November 1973 through March 1979. The average follow-up period extended to six years and seven months. Eleven patients had died and four could not be located. Eighty-one percent of the remaining knees had l...
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:BACKGROUND:Compressive osseointegration is a promising modality for limb salvage in distal femoral oncologic tumors. However, few studies have explored short-term survival rates in a large patient cohort of distal femur compressive endoprostheses or highlighted the risk factors for spindle failures. QUESTIONS/PURPOSES...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1007/s11999-016-4839-7
更新日期:2016-07-01 00:00:00
abstract::Except in emergencies, the physician's obligation is not to relieve pain, but to diagnose and treat pathology. Psychological factors complicate organic pain, and make the diagnosis of "psychogenic" pain virtually impossible on the basis of psychological tests alone. In acute (short-term) pain, anti-anxiety agents are ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:10.1097/00003086-197711000-00017
更新日期:1977-11-01 00:00:00
abstract::The clinical and radiographic results of 160 primary, uncemented porous coated total hip replacements performed at 3 teaching hospitals were reviewed. Followup was obtained in 132 of 148 (89%) nondeceased patients. The acetabular component is a full hemisphere, fabricated of cobalt chrome with a sintered bead coating ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::A group of diseases--ankylosing spondylitis, psoriatic arthritis, Reiter's disease, ulcerative colitis, Crohn's disease, juvenile chronic arthritis (Still's disease), Whipple's disease, and Behçet's syndrome, which previously were thought to be variants of rheumatoid arthritis, now appear to be distinct from that dise...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1979-09-01 00:00:00
abstract::Forty-nine knees with osteochondritis dissecans were evaluated and in many cases, treated by arthroscopic means. The lesions were classified as to location and degree of separation. Arthroscopic treatment involved drilling, pinning, reduction of fragments, removal and replacement of fragments, and bone grafting. Of th...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1982-07-01 00:00:00
abstract::Of 254 adults admitted over a period of two years to the Head Trauma Service, 29 (11%) had ten previously undiagnosed fractures and/or dislocations and 29 had previously undetected peripheral neuropathies. The average delay in diagnosis was 57 days. Only one fracture, a fracture-dislocation of the thoracic spine, was ...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00
abstract::In this prospective, randomized, controlled study, we compared the performance of conventional and navigated total knee arthroplasties. Component alignment was measured in 60 patients operated on using navigation and in 60 patients operated on using the conventional technique. The groups then were divided into a subpo...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章,随机对照试验
doi:10.1097/BLO.0b013e3180316c92
更新日期:2007-04-01 00:00:00
abstract::The diagnosis of forearm compartment syndrome by clinical findings alone has been difficult and inconsistent. This study was designed to assist in the diagnosis and treatment of forearm compartment syndromes. We evaluated several forearm incisions and determined their effectiveness by measuring compartment pressures u...
journal_title:Clinical orthopaedics and related research
pub_type: 杂志文章
doi:
更新日期:1978-07-01 00:00:00