Abstract:
OBJECTIVES:To determine whether there is a patient-reported functional difference between combat-related knee disarticulations (KDs) and transfemoral amputations (TFAs). SETTING:Role 3 Military Trauma Centers. PATIENTS:We identified and contacted all KDs and TFAs performed at the Walter Reed National Military Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center from January 2003 until July 2012 to participate in a retrospective functional cohort analysis. Ten KD patients were available for study completion and were matched against 18 patients in the TFA group. INTERVENTION:Knee disarticulation versus transfemoral amputation. MAIN OUTCOME MEASUREMENTS:The following surveys were obtained from the participants-AAOS Lower Limb Outcome Questionnaire (LLQ), Tegner Activity Scale, SF-36, and Prosthetic Evaluation Questionnaires (PEQs). RESULTS:Ten KD patients agreed to participate in the study, and 18 TFA matched controls were interviewed. Patients were followed up at an average of 66 months (interquartile range 50-79 months) after injury. There were no significant differences with regard to the SF-36, PEQ, LLQ, and Tegner Activity Scale scores. CONCLUSIONS:We detected no functional differences measured on the PEQ, LLQ, SF-36, and Tegner Activity Scale scores between KDs and TFAs. In the absence of a proven functional difference, we advocate performing trauma-related amputations at the most distal level the osseous and soft tissue injuries permit. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Polfer EM,Hoyt BW,Bevevino AJ,Forsberg JA,Potter BKdoi
10.1097/BOT.0000000000001440subject
Has Abstractpub_date
2019-06-01 00:00:00pages
308-311issue
6eissn
0890-5339issn
1531-2291pii
00005131-201906000-00008journal_volume
33pub_type
杂志文章abstract::Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluorosco...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828f89a9
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVES:To compare the outcomes of two different surgical treatments for the management of isolated closed Mason Type 2 radial head fractures. DESIGN:Retrospective study. The Student t test and McPearson chi-square test were used to evaluate whether there was a significance difference between the groups. PATIENTS:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318220a227
更新日期:2012-04-01 00:00:00
abstract::The application of a pelvic clamp for provisional stability of unstable pelvic fractures has been advocated in the orthopaedic literature. Although the technique has gained some supporters, problems with placement and associated complications have prevented widespread acceptance. We have modified the pelvic clamp (ACE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000175156.92743.db
更新日期:2006-01-01 00:00:00
abstract::Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000694
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVES:Iliosacral screw pathways in the first (S1) and second (S2) sacral segments are commonly used for adult pelvic ring stabilization. We hypothesize that radiographically "safe" pathways exist in pediatric patients. SETTING:Academic level I Trauma Center. PATIENTS:All patients between ages 2 and 16 years with...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000421
更新日期:2016-01-01 00:00:00
abstract::The indications for surgical stabilization of a pediatric diaphyseal femur fracture are expanding. Children with multiple system injuries, a head injury, and/or multiple fractures have fewer local and distant complications if the femur fracture is treated operatively. Other indications include a pathological fracture ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199212000-00011
更新日期:1992-01-01 00:00:00
abstract:PURPOSE:Comminuted iliac fractures are uncommon and difficult to treat. The purpose of this study is to further delineate the fractures, to present a management protocol, and to evaluate the results of treatment. DESIGN:Retrospective clinical study. SETTING:Level one trauma center at Harborview Medical Center. PATIE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200005000-00008
更新日期:2000-05-01 00:00:00
abstract:BACKGROUND:Accurate prediction of likelihood of reoperation in patients with tibial shaft fractures would facilitate optimal management. Previous studies were limited by small sample sizes and noncomprehensive examination of possible risk factors. OBJECTIVE:We conducted an observational study to determine which progno...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200305000-00006
更新日期:2003-05-01 00:00:00
abstract::Recent innovations have greatly increased the range of proximal humeral fractures that are amenable to open reduction and plate fixation.The optimum technique for some of the more complex fracture patterns is not yet fully refined.This article aims to describe the recent advances in the treatment of complex proximal h...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31821c0a2f
更新日期:2011-10-01 00:00:00
abstract::Marginal impaction of the acetabulum is typically accessible through fracture planes specific to the nature of the injury. Infrequently, however, incarcerated marginal impaction or free osteochondral fragments are not accessible through these existing fracture planes. As such, alternative methods to access these artic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000759
更新日期:2017-05-01 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::Our purpose was to determine the incidence of deep-vein thrombosis (DVT) in patients who have had early operative fixation of fractures of the lower extremity distal to the hip. There is a high incidence of distal thrombosis in patients who have undergone early operative fixation of lower-extremity fractures. The inci...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199605000-00002
更新日期:1996-01-01 00:00:00
abstract::Osteochondritis dissecans of the elbow mainly involves the capitellum; however, no authors have reported the condition in the radial head with subluxation of the radial head. We report four cases in which osteochondritis dissecans involved the radial head and was accompanied by radial head subluxation. All patients we...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318214d678
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To determine the effects of various suture patterns on cutaneous blood flow (CBF) at the wound edge as increasing tension is applied through the suture. METHODS:Four different suture patterns commonly used for wound closure (simple, vertical mattress, horizontal mattress, and Allgower-Donati) were placed ind...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318169074c
更新日期:2008-03-01 00:00:00
abstract::The effect of antibiotic bead chains on the evolution of infection cannot be studied entirely in man due to the ethical problems of obtaining valid controls. Therefore, a model of musculoskeletal injury was devised in rabbits by making a paraspinal wound, fracturing a spinous process, and contaminating the wound with ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199212000-00001
更新日期:1992-01-01 00:00:00
abstract::Several clinical trials have examined the safety and efficacy of recombinant human bone morphogenic protein-7 (rhBMP-7) for osseous repair in clinical trauma. This article summarizes the results obtained from three recent clinical trials, which suggest that rhBMP-7 is useful in the treatment of tibial nonunion, long b...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200511101-00008
更新日期:2005-11-01 00:00:00
abstract::When attempting to remove an intramedullary nail, the extraction device can fail. This can occur due to stripping of the proximal threads or, more rarely, due to entrapped broken metal devices (impacted cap screws; broken introducers, extractors, or taps). This latter situation is particularly problematic if access to...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199702000-00012
更新日期:1997-02-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract::Compression screws, Ender rods, and Zickel nails were evaluated mechanically to determine their resulting stability in the fixation of experimental subtrochanteric femur osteotomies. Twenty-five pairs of human cadaver femurs were used. Experimental osteotomies were created and a random member of each pair was fixed wi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199003000-00010
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:Evaluate the ability of osteogenic protein-1 to induce formation of de novo bone in the presence of bacterial infection and metal in an intramuscular osteoinduction model in the rat. DESIGN:Prospective experimental design with assessment time points of up to 4 weeks. SETTING:Intramuscular pocket surgically ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200408000-00008
更新日期:2004-08-01 00:00:00
abstract::The treatment of war wounds poses many unique challenges to all healthcare providers (surgeons, flight medics, nurses, etc.), whether they are located at the far forward trauma hospitals located in or near areas of conflict, at regional hospitals such as Landstuhl Medical Center in Germany, or the larger military hosp...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e318188e27d
更新日期:2008-11-01 00:00:00
abstract::A disaster is a catastrophic event that disrupts normal infrastructure to such a degree that normal response mechanisms and capabilities cannot manage what is required to respond appropriately to the event. Launched after the largest urban disaster in modern history--the 2010 Haiti Earthquake--the American Academy of ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000405
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study is to evaluate the predictive ability of the Orthopedic Trauma-Open Fracture Classification (OTA-OFC) system in regards to short-term (90 days) outcomes of amputation, infection necessitating intravenous antibiotics, and wound healing in clinical practice across multiple centers. D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000648
更新日期:2016-11-01 00:00:00
abstract::Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, ther...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001126
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study is to evaluate the change in quantitatively scored knee pain during union. DESIGN:This is a retrospective review of prospectively collected data over a 15-year period. SETTING:Academic medical center. PATIENTS:All patients treated with an intramedullary nail were evaluated for kn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318213f587
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:To quantify the obliquity and dimensions of the upper and second sacral segment iliosacral screw safe zones and to determine the differences between normal and dysmorphic sacral morphology. DESIGN:Retrospective cohort. SETTING:University Level I trauma center. PATIENTS/PARTICIPANTS:Fifty patients with pel...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181cf0404
更新日期:2010-10-01 00:00:00
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...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31802b41e2
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00
abstract::We describe a previously unreported problem of a patient who underwent errant 4-cortex syndesmotic screw fixation with resultant posterior tibial tendon tear necessitating removal of hardware and repair of a tendon tear. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31821e127f
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The open reduction and internal fixation of radial shaft fractures and osteotomies with standard 3.5-mm plates can be complicated by tendon irritation, hardware prominence, and fracture through the screw holes. With the advent of locking plate technology, implant companies and some surgeons have recommended e...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f8bf9b
更新日期:2011-06-01 00:00:00