Abstract:
OBJECTIVES:To determine preoperative factors predictive of improvement in pain and function following elective implant removal. We hypothesized that patients undergoing orthopaedic implant removal to relieve pain would have significant improvements in both pain and function. DESIGN:Prospective Cohort Study SETTING:: Level I Trauma Center PATIENTS/PARTICIPANTS:: 189 patients were enrolled after consenting for orthopaedic implant removal to address residual pain. 163 were available for 3-month follow-up. MAIN OUTCOME MEASUREMENT:Preoperative and postoperative outcome measures including Patient Reported Outcomes Measurement Information System (PROMIS) scores were compared. Preoperative scores, surgeon prediction of pain improvement, and palpable implants were analyzed as predictors of outcomes. RESULTS:Median PROMIS physical function and pain interference (PI) scores and VAS significantly improved by 6, 8, and 2 points, respectively (p<0.001 for all). Worse preinjury scores predicted improvement in respective postoperative outcomes (p<0.001 for all). Surgeon prediction of improvement was associated with improved PROMIS PI (p=0.005), patient subjective assessment of pain improvement (p=0.03), and subjective percent of pain remaining at 3 months (p=0.02). Implant superficial palpability was not predictive for any postoperative outcomes. CONCLUSIONS:Although the primary indication for implant removal in this population was pain relief, many patients also had a clinically relevant improvement in physical function. Additionally, patients who start with worse global indices of pain and function are more likely to improve after HWR. This suggests that implant-related pain directly contributes to global dysfunction. LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Kempton LB,Gaski GE,Brown K,McKinley TO,Virkus WWdoi
10.1097/BOT.0000000000001920subject
Has Abstractpub_date
2020-10-13 00:00:00eissn
0890-5339issn
1531-2291pub_type
杂志文章abstract::Leg length discrepancies can occur despite successful union of femur fractures after intramedullary nailing (IMN). Often, the leg length discrepancy can result in significant disability to the patient, altered gait biomechanics, pelvic obliquity, and pain. Therefore, a successful clinical result for such deformities a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f92d6e
更新日期:2011-11-01 00:00:00
abstract::A study was undertaken to review the results of donor site morbidity of cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred six patients who underwent 230 proximal tibial bone graft harvestings were reviewed. Patients with lower-extremity fractures or nonunions who required cancellous bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199112000-00014
更新日期:1991-01-01 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::A case history of a trauma patient who developed a palsy of the marginal mandibular nerve from compression by a cervical spine hard collar is presented. After clinical and radiographic screening found no evidence of occult cervical spine pathology, the collar was removed; the palsy resolved uneventfully during the nex...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199504000-00015
更新日期:1995-04-01 00:00:00
abstract::The maximum pullout force in the distal metaphysis of cadaver femurs was investigated using a commercially available, pneumatically inserted staple. In paired studies, a significantly greater pullout force was required in the power-driven staples than in an almost identical sized hand-driven staple. A nonlinear relati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004020-00009
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To observe the results and describe the technique of closed reduction and placement of a two-pin supra-acetabular external fixator, followed by immediate weight bearing, in the treatment of displaced vertically stable lateral compression pelvic fractures. DESIGN:Prospective, consecutive. SETTING:Regional tr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:Far cortical locking (FCL) constructs have been shown to increase axial interfragmentary displacement while limiting shear and have been specifically recommended in the treatment of distal femur fractures. However, there is no available data regarding their mechanical behavior within the range of bridge span...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001341
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:Anatomic reduction of the fibula with regard to the tibia is the goal when treating syndesmotic injuries. No objective method exists to describe the distal tibiofibular relationship. The primary and secondary objectives of this study was to describe and validate radiologic measurements of the syndesmosis and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318284785a
更新日期:2013-11-01 00:00:00
abstract::Standard 5-mm AO Schanz pedicle screws were biomechanically compared with a new design, featuring 6-mm threads with a 5-mm core diameter continuous with the shaft. One each of the two screw designs was surgically inserted into the matching pedicles of 32 cadaveric vertebrae. The pull-out strengths of the screws were t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00015
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To determine the effect of retrograde femoral reaming on the blood flow of the distal femur and the cruciate ligaments. DESIGN:Canine experimental study. SETTING:Tertiary referral and teaching hospital in Toronto, Canada. PARTICIPANTS:Thirteen skeletally mature, cross-bred dogs. MAIN OUTCOME MEASURE:Red c...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199805000-00007
更新日期:1998-05-01 00:00:00
abstract::We conducted a prospective, randomized study on 84 consecutive patients with 88 acute, traumatic femoral shaft fractures using 32 Grosse-Kempf nails, 29 Russell-Taylor nails, and 27 Synthes nails. Although total operative times and proximal and distal locking times were similar for the three groups, the procedure was ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000000185
更新日期:2014-08-01 00:00:00
abstract::Intracapsular femoral neck fractures are common in the elderly population after a simple fall. However, femoral neck fractures in the physiologically young are less common. Regardless, femoral neck fractures can be a source of significant morbidity and mortality if not treated correctly. Multiple management strategies...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000288
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVES:This study was designed to evaluate the frequency of intraoperative problems and complications involved with Less Invasive Stabilization System (LISS) plate removal. DESIGN:Retrospective study. SETTING:Single academic level I trauma center. METHODS:Medical records were reviewed for demographics, surgical ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c29bf5
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral ne...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001934
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:To determine whether uncemented implants would provide similar outcomes while avoiding the complications associated with cement in the treatment of elderly patients with proximal humerus fractures (PHFs) with primary reverse total shoulder arthroplasty (RTSA). DESIGN:Case series. SETTING:A single Level I t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001465
更新日期:2019-07-01 00:00:00
abstract::Business intelligence in the field of medicine, particularly with physicians, has been an abstract concept at best with no objective metric. Furthermore, in many arenas, it was taboo for medical students, residents, and physicians to discuss the business and finances of their work for fear that it would interfere with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000177
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. DESIGN:Standardized proximal tibial fractures (AO classificati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200409000-00010
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To determine whether knee arthrodesis with simultaneous lengthening using the Ilizarov method for a nonreconstructable knee joint with bone loss and infection is a successful salvage procedure. DESIGN:Retrospective review of patients. SETTING:University hospital-based orthopaedic practice. PATIENTS:From 19...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200503000-00004
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To assess the recovery of ankle function and general health status at multiple time points during the first 24 months after an isolated tibial plafond fracture treated with joint-spanning external fixation and to determine factors that affect a rapid versus a slow recovery and factors that influence patient ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c8ad52
更新日期:2010-08-01 00:00:00
abstract::Pilon and ankle fractures and ligamentous injuries about the ankle often require external fixation to allow for soft tissue stabilization before definitive surgery. Often used external fixator constructs can cause obscuring of the site of injury on radiographs, pin tract infections, loosening of calcaenal pin fixation...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182604639
更新日期:2013-02-01 00:00:00
abstract::Lateral condyle fractures are second only to supracondylar humeral fractures when it comes to pediatric elbow fractures. Whether minimally displaced or substantially displaced, these growth plate fractures may present significant treatment challenges. These include nonunion, malunion, avascular necrosis, and growth di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001543
更新日期:2019-08-01 00:00:00
abstract::A 14 cm deficit of the tibia with a soft tissue deficit was resolved using the apparatus of Ilizarov. The apparatus was applied using a double corticotomy of the proximal and distal remainder of the tibia. The fragments were moved until they met each other in the central part of the deficit. Afterwards, a part of the ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
abstract::Tibial shaft fractures distal to total knee arthroplasty are rare, but they are likely to become more common with the increasing number of arthroplasty procedures being performed. These fracture patterns have been treated in the past either with closed reduction and casting/bracing or with open reduction internal fixa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000096
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the experience of a single tertiary care teaching hospital with the association between use of bisphosphonates and atypical femoral fractures, and to identify potential risk factors and chronologic incidence. DESIGN:Retrospective review. SETTING:Tertiary-care teaching hospital. PATIENTS:Thirty-...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000539
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000015
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:To determine whether the superior sensitivity of computed tomography (CT) results in changes in treatment plans for cervical spine fractures that have been diagnosed on plain films alone. DESIGN:Retrospective review of radiographic studies for cervical spine trauma. SETTING/PARTICIPANTS:An orthopaedic spine...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199906000-00003
更新日期:1999-06-01 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::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::We reviewed 21 cases of humeral nonunion following the failure of "locking" humeral nails. The nails had been inserted as the primary operative procedure following humeral fracture in fifteen cases or after the failure of closed treatment in six cases. Reconstruction after the failure of these implants was complicated...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199610000-00008
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws. DESIGN:Retrospective. SETTING:Level I trauma center. PARTICIPANTS:Thirty patients with thirty-two acetabular fractures. INTERVENTION:Patients were evaluated with fluor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199908000-00004
更新日期:1999-08-01 00:00:00