Abstract：
BACKGROUND:Strict criteria have been used before removing cervical collars in patients with injuries who have midline pain or are unable to be reliably examined. This sometimes leads to prolonged immobilization in cervical collars or use of MRI to rule out injury. Several studies suggest a collar may be removed in the absence of fractures, dislocation, or pathologic subluxation on a cervical CT scan. This may avoid the morbidity of prolonged cervical immobilization or cost of advanced imaging study but risks devastating consequences from missing injuries. CASE DESCRIPTION:We report a patient with a cervical spinal cord injury after removal of a collar after a CT scan was misinterpreted as normal. Retrospective review of the CT showed subtle signs of widening between the spinous processes of the injured level, a finding easily missed without the use of further imaging studies. LITERATURE REVIEW:Several articles suggest cervical collars may be safely removed from awake and alert patients and in patients who cannot be reliably examined after a negative CT scan without the need for further imaging. PURPOSES AND CLINICAL RELEVANCE:CT scans are excellent at detecting bony injuries but not ligamentous injuries. Removing cervical collars based on CT scans alone may be expeditious, but some injuries may be missed without further imaging. Our case demonstrates the catastrophic consequences of missing a cervical spine injury and emphasizes the need for maintaining the cervical collar in high-risk patients until proper imaging can be obtained.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Gebauer G,Osterman M,Harrop J,Vaccaro Adoi
10.1007/s11999-012-2286-7subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1652-7issue
6eissn
0009-921Xissn
1528-1132journal_volume
470pub_type
杂志文章abstract：:Posttraumatic avascular humeral head necrosis may require salvage shoulder arthroplasty in symptomatic cases. We tested the hypothesis that associated tuberosity malunion negatively influences the final clinical outcome after shoulder arthroplasty. Thirty-eight patients with posttraumatic avascular necrosis of the hum...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318159cb7a
更新日期：2007-12-01 00:00:00
abstract：:Successful outcome of total shoulder arthroplasty depends on a well-designed and a well-executed physical therapy program. For maximal benefit, the program is usually initiated immediately after surgery and follows a logical pattern of joint mobilization followed by muscle strengthening. The process proceeds through a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：:From 1972 to 1982, 455 patients had arthrodesis and other operations with screw-plate internal fixation of the lumbosacral spine. Of these 455 patients, 440-413 of whom had had spinal fusion and 27 of whom had undergone pars interarticularis reconstruction--were evaluated for a mean follow-up period of 31.6 months. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-02-01 00:00:00
abstract：:Because it is difficult to predict which patients may sustain a pulmonary embolism after total hip or knee arthroplasty, we assessed multiple thrombophilic and hypofibrinolytic parameters to identify risk factors. Twenty-nine patients who survived a known pulmonary embolism after total knee or total hip arthroplasty w...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000128971.35014.31
更新日期：2004-05-01 00:00:00
abstract：:Joint synovia and fluids taken from patients with various stages of rheumatoid arthritis (RA) were injected into embryonated chicken eggs, resulting in characteristic joint abnormalities ("crooked toes") in the extremities of the embryos and chicks. There was a direct correlation between the number of the induced lesi...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-10-01 00:00:00
abstract：:The formation of heterotopic bone within soft connective tissue is a common feature of at least three distinct genetic disorders of osteogenesis in humans: fibrodysplasia ossificans progressiva; progressive osseous heteroplasia; and Albright hereditary osteodystrophy. The pathobiologic characteristics of osteogenic in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-200005000-00028
更新日期：2000-05-01 00:00:00
abstract：:Electron microscopic evaluation was investigated in surgical specimens of interdigital neuroma. Edema of the endoneureum, fibrosis beneath the perineurium, axonal degeneration and necrosis suggest nerve damage occurs secondary to mechanical impingement in the etiology of interdigital neuroma. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-10-01 00:00:00
abstract：:Arthrodesis of the carpometacarpal joint of the thumb is useful in reconstruction of hand deficiencies and in eliminating pain at this site. The author has speculated that fusion of the carpometacarpal joint might lead to pantrapezial arthritis in later years. No patients with painful arthritis received this operation...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：:A treatment program for chronic pain is reported which focuses on modification of patient pain behavior. After an outpatient pain clinic screening by a multidisciplinary team, the patient with chronic pain (duration of 6 months or longer) is admitted for a 7--8 week inpatient program followed by a 4-week outpatient pe...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1977-11-01 00:00:00
abstract：:Our research group developed an implant retrieval program to study in vivo degradation of polyethylene. We now have evidence to support our hypothesis that degradation of radiation-sterilized polyethylene occurs in the body for not only historical gamma air sterilized liners, but also for conventional gamma inert ster...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000246547.18187.0b
更新日期：2006-12-01 00:00:00
abstract：BACKGROUND:Recent popularity of intramedullary nails over sliding hip screws for treatment of intertrochanteric fractures is concerning given the absence of evidence for clinical superiority for nailing yet the presence of reimbursement differences. QUESTIONS/PURPOSES:We describe the change in outcomes of both procedu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2694-8
更新日期：2013-04-01 00:00:00
abstract：:The purpose of this study is to clarify the clinical features of the knee affected by multiple epiphyseal dysplasia. Thirty-one cases of multiple epiphyseal dysplasia were reviewed. Of the patients, 11 were male and 20 were female. The average age at onset of symptoms was 22.5 years. The average age at initial visit t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200011000-00025
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:The alpha-defensin test has been previously demonstrated to be highly accurate in the diagnosis of prosthetic joint infection (PJI), nearly matching the Musculoskeletal Infection Society definition for PJI. However, the relationship between alpha-defensin levels and differing infecting organism has not yet b...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4152-x
更新日期：2015-07-01 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 study, the authors investigated enhancing the results of autoclaved autograft bone by combining it with a vascularized bone graft and supplementing it with autogenous bone marrow for replacement of a 2-cm tibial defect in the rabbit model. The study was divided into 4 groups. Group I consisted of autoclaved au...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-11-01 00:00:00
abstract：:With the use of a stereoscopic microscope, observations were made on the course of the proper digital nerve of the thumb on ten upper limbs in adult cadavers. By observation from the dorsal side after removal of the bone, it was possible to clearly see the ramification of the digital nerve from the subcutaneous tissue...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:Fifteen consecutive total hip arthroplasties (THAs) in 14 patients considered at risk for developing significant heterotopic ossification (HO) were treated postoperatively with 7.5 Gy of external beam radiation in three fractions. Eight hips in eight of the patients (Group I) had developed previous Brooker Class III o...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
abstract：:In 1941, Bosworth introduced a new method of repairing acute complete acromioclavicular dislocations in which a noncannulated coracoclavicular lag-screw was inserted by a blind technique. The author reintroduces the percutaneous coracoclavicular fixation concept. A cannulated screw was specially designed, and the tech...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-06-01 00:00:00
abstract：:Wrist arthrodesis is a reliable procedure that, although it sacrifices motion for stability, provides the patient with relief from pain. This review of 26 wrist arthrodeses performed in 24 patients using the AO technique, with plate and screw fixation and iliac crest bone graft, shows a 100% union rate and high patien...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1997-08-01 00:00:00
abstract：:Contemporary knee designs differ considerably in the conformity that exists between the articulating surfaces of the femoral and tibial components. The thickness of the polyethylene components also varies from design to design. Conformity and thickness affect the stresses associated with surface damage and the subsequ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
abstract：BACKGROUND:Pasteurized autograft is regarded as a biologic reconstructive option for managing bone defects after tumor resection; however, reports on long-term outcomes from large patient series are scarce. Contrary to previous favorable reports, we have observed many patients with failures, in particular as the durati...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999.0000000000000100
更新日期：2018-09-01 00:00:00
abstract：:Malposition of the acetabular component during hip arthroplasty increases the occurrence of impingement, reduces range of motion, and increases the risk of dislocation and long-term wear. To prevent malpositioned hip implants, an increasing number of computer-assisted orthopaedic systems have been described, but their...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000141903.08075.83
更新日期：2004-09-01 00:00:00
abstract：:Radiocarpal fracture-dislocation was associated with fracture of the distal articular surface of the radius in five patients (six extremities). Closed manipulation resulted in satisfactory reduction of both the dorsal dislocation of the carpus on the distal radius and displaced articular fracture fragment(s) in two of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-07-01 00:00:00
abstract：:The etiology of the foot deformity in patients with Charcot-Marie-Tooth disease has not previously been discussed in relation to the extrinsic muscle function around the foot and ankle. Eight adult patients with a strong familial history were evaluated, and their foot findings were remarkably similar. All demonstrated...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1988-09-01 00:00:00
abstract：:The effects of polymethylmethacrylate (PMMA) on DNA, protein, and sulfated-proteoglycan synthesis by rabbit articular chondrocytes were observed in monolayer cultures. PMMA pellets in ratios of 1:1 and 1:2 (liquid monomer:powder) significantly reduced [3H]thymidine incorporation into DNA during the first 24 h of cultu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:To determine the vascular architecture of nontraumatic avascular necrosis of the femoral head (ANFH), 38 femoral heads procured from 31 ANFH patients were studied by microangiographic and histologic methods. Microangiography showed that the head was consistently stratified into three zones: the normal vascular, the re...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-04-01 00:00:00
abstract：BACKGROUND:Outcomes after intrasynovial tendon repair are highly variable. An intense inflammatory cascade followed by a delayed healing response can cause adhesion formation and repair-site failure that severely impair the function of repaired digits. No effective remedies exist to fully address these issues. Cell- an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-017-5369-7
更新日期：2017-09-01 00:00:00
abstract：:Comparable groups of patients with osteoarthritic knees who had either a St. Georg sledge unicompartmental arthroplasty or an upper tibial osteotomy were reviewed in 1985, five to ten years after operation. The results of unicompartmental arthroplasty were better, but it was uncertain whether the superior results woul...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-05-01 00:00:00
abstract：:Failed surgery at the hallux metatarsophalangeal joint may present substantial difficulties in treatment, especially when complicated by infection. This retrospective study reviews the staged treatment of 5 patients with complications of hallux valgus surgery associated with sepsis of the metatarsophalangeal joint. Th...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-10-01 00:00:00
abstract：BACKGROUND:The incidence of acetabular fractures in osteoporotic patients is increasing. Immediate total hip arthroplasty (THA) has potential advantages, but achieving acetabular component stability is challenging and, at early followup, reported revision rates for loosening are high. QUESTIONS/PURPOSES:This study mea...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4460-1
更新日期：2015-12-01 00:00:00
