Abstract：
:Fracture-healing problems today occur predominantly in the weight-bearing tibia and femur. This review of 83 lower-limb nonunions out of a series of 100 fracture-healing problems identified avoidable causes in 30%. These included rigid fixation, which produced fracture gap, fibulectomy, which destabilized the tibia, and soft-tissue procedures, which impeded fracture management. The significance of these factors was evident when treatment to avoid the above-noted adverse factors did produce union. The fact that complications occur with certain techniques does not interdict their proper use. However, critical analysis of a large number of cases suggests the following three principles for avoiding nonunion: (1) Rigid fixation eliminates the critical external callus response of the first six weeks after fracture. Consequently, less than rigid fixation obtained with functional fracture braces or intramedullary rods, which maximize external callus and avoid fracture distraction, is generally preferable for weight-bearing bones. (2) Fibulectomy may encourage impaction across a tibial fracture gap. However, the resection should be performed well away from the tibial fracture site, thereby avoiding tibial instability. (3) With the open fracture, priority of management should be given to achieving fracture union rather than to absolute soft-tissue coverage. No fracture in this series failed to heal because of exposed bone.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Connolly JFsubject
Has Abstractpub_date
1985-04-01 00:00:00pages
226-35issue
194eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：:Reduction of a posterior elbow dislocation can be accomplished by many methods and can require special positioning of the patient, trained assistants, and special equipment. A method that provides a simplified alternative is described. Leverage rather than forceful strength is the prerequisite. The maneuver is perform...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-11-01 00:00:00
abstract：:An improved method of closed irrigation-suction treatment of bone and joint infections is described. The method utilizes a crisscross flow-reversal system using a double tube which prevents obstruction of the tube. A series of 154 patients with acute and chronic bone and joint infections were treated with closed irrig...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-05-01 00:00:00
abstract：:Avulsion of the navicular tuberosity in association with fracture at the calcanecuboid joint is a characteristic pattern of injury resulting from an acute valgus and dorsiflexion stress. Only 22 cases of this unusual injury pattern have been reported, and confusion exists regarding treatment. Recommendations for manag...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1993-07-01 00:00:00
abstract：BACKGROUND:Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. QUESTIONS/PURPOSES:The aims of the stud...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3622-x
更新日期：2015-03-01 00:00:00
abstract：:There has been a substantial change in the population demographics of patients who potentially will require total joint replacements. We studied data regarding temporal trends in physical condition, life expectancy, education, and other population demographics of individuals most likely to receive total joint replacem...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000188066.01833.4f
更新日期：2006-02-01 00:00:00
abstract：:Isolated capitellar fractures are rare, intraarticular fractures requiring an aggressive management regimen. Several treatment options have been described for the Type 1 fracture. A new technique of direct anatomic reduction and fixation of the fracture using a maxillofacial plate is reported. Advantages of this new t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：2001-03-01 00:00:00
abstract：BACKGROUND:Osteoid osteomas consist of a nidus surrounded by reactive sclerotic bone. The diagnosis typically is based on imaging and clinical presentation involving nocturnal pain. Removal of the lesion is essential and currently is performed mainly with image-guided, minimally invasive techniques. We describe a case ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2772-y
更新日期：2013-05-01 00:00:00
abstract：:Orthopaedic surgery represents a specialty in which applicants are abundant, residency slots are limited, and all candidates presumably are qualified. Orthopaedic residency programs have members of the resident selection committee review medical school performance measures for the purpose of screening candidates to in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1999-05-01 00:00:00
abstract：:Because there is no consensus regarding the factors predicting femoral head collapse in asymptomatic osteonecrosis of the hip, we studied the risk factors for collapse. Between 1990 and 2000, we used MRI to confirm asymptomatic osteonecrosis of the femoral head in 81 patients (81 hips) whose other hip had nontraumatic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0191-x
更新日期：2008-05-01 00:00:00
abstract：:Periprosthetic osteolysis caused by wear debris released from the bearing surface of polyethylene components is the major problem in contemporary hip arthroplasty. Several types of metal on metal prostheses were developed in the 1960s, but by the mid 1970s they were completely displaced by polyethylene bearings. There...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199608001-00003
更新日期：1996-08-01 00:00:00
abstract：:During a 5 year period 50 patients with chronic low back pain, with or without sciatica due to a proven lumbosacral disk lesion, underwent a spinal fusion using the Boucher method of screw fixation of the facet joints. The L-4 spinous process was excised and fashioned into an H-shape to act as the bone graft between t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：BACKGROUND:When considering arthroscopic surgery for treatment of hip pain, it is important to understand the influence of joint degeneration on the likelihood of success. Previous research has shown poorer outcomes among patients with osteoarthritis but new arthroscopic techniques including femoroacetabular impingemen...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2594-y
更新日期：2013-02-01 00:00:00
abstract：:The role of local heat or cold therapy used in conjunction with exercise in the rehabilitation of total knee arthroplasty patients was investigated. Thirty-six osteoarthritic patients were analyzed. Parameters evaluated were range of motion, swelling about the knee, and pain. All patients received the total condylar k...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1983-09-01 00:00:00
abstract：:Lead markers were placed on various osseous structures of the talus and calcaneus in fresh amputation specimens to analyze the radiographic anatomy of the hindfoot. Analysis of the talocalcaneal articulations revealed that only the central one-third of the posterior subtalar joint can be visualized on the lateral proj...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:Between 1974 and 1984 the Zickel supracondylar nail system was used to fix 82 femora. Sixty-nine femora had supracondylar fractures and 13 supracondylar osteotomies. A high rate of union (98%) was achieved in the fracture group, which included a variety of fracture types, but five supracondylar osteotomies failed to u...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:High wear rates and high patient ion levels have been associated with high (> 55 degrees) cup inclination angles for metal-on-metal surface replacements. Wear rates and patterns have been simulated for ceramic-on-ceramic bearings by applying microseparation to replicate head offset deficiency. We tested 39-mm metal-on...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0830-x
更新日期：2009-09-01 00:00:00
abstract：:The 2001 Institute of Medicine report entitled Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care pointed out extensive healthcare disparities in the United States even when controlling for disease severity, socioeconomic status, education, and access. The literature identifies several groups ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-009-0993-5
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documenta...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2719-3
更新日期：2013-06-01 00:00:00
abstract：BACKGROUND:Wound closure accounts for a relatively constant portion of the time required to complete a surgical case. Both longer closure times and wound infections contribute to higher medical costs and patient morbidity. QUESTIONS/PURPOSES:We therefore determined whether (1) biologic and treatment factors greater in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-012-2524-z
更新日期：2013-03-01 00:00:00
abstract：:Temperature sensors were placed in 50 knees in 25 patients who had one or both joints replaced. Temperature recordings were made before walking, after walking, and after cycling. The heat generated in healthy, arthritic, and replaced knees was measured. The knee replacements were done using eight different prostheses....
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000183739.50869.bb
更新日期：2006-01-01 00:00:00
abstract：:A modified Ilizarov external fixator was used to transfix the stifle joint in 13 dogs. A 1-cm cortical cancellous bone plug was outlined in the intracondylar notch of the femur after excising the anterior (cranial) cruciate ligament (ACL). Hardware attached to the plug allowed controlled distraction of the plug into a...
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：BACKGROUND:Controversy continues regarding the appropriate assessment of fracture risk in long bone lesions affected by disseminated malignancy. QUESTIONS/PURPOSES:The purpose of this ongoing Musculoskeletal Tumor Society-sponsored, multi-institutional prospective cross-sectional clinical study is to compare CT-based ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,多中心研究
doi：10.1007/s11999-015-4453-0
更新日期：2016-03-01 00:00:00
abstract：:The spike procedure is applicable as a substitute for a fixation device. In open tubular bone fractures, the spike procedure utilizes the open fracture bone ends to create an intrinsically stable situation in place of pins or extrinsic devices. One end of the tubular bone fracture is fitted into the medullary canal of...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：:Since the inception of adjuvant chemotherapy for osteogenic sarcoma (OS), 25 patients were treated for telangiectatic osteogenic sarcoma (TOS) from 1973 through 1980. This represented 12% of all patients with primary OS of an extremity seen during this time period. Tumors that demonstrated only focal areas of TOS with...
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：:Health care costs for inpatient care have been escalating. Homeless and indigent patients may be unable to have access to clean toilet facilities to perform adequate wound care. Evaluation of delayed primary closure of upper extremity soft tissue infections after incision and drainage in 34 patients was done. Patients...
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：BACKGROUND:Locking plate fixation of proximal humeral fractures improves biomechanical stability. It has expanded the indications of traditional open reduction internal fixation and become increasingly common for treating unstable, displaced proximal humeral fractures. Despite improved stability it is unclear whether t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1935-6
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:So-called "hazardous attitudes" (macho, impulsive, antiauthority, resignation, invulnerable, and confident) were identified by the Federal Aviation Administration and the Canadian Air Transport Administration as contributing to road traffic incidents among college-aged drivers and felt to be useful for the p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3966-2
更新日期：2015-05-01 00:00:00
abstract：:One thousand one hundred sixty-nine elderly Japanese patients who sustained a hip fracture were observed prospectively. Ninety-two percent had operative fracture treatment. Hospital length of stay averaged 67 days; 81% of patients were discharged to their place of residence where they resided before sustaining the fra...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1998-03-01 00:00:00
abstract：:The practice of medicine in rural Arizona has changed remarkably in 25 years. Although the delivery of care to the people of the San Carlos Apache Tribe has many challenges including geographic isolation and cultural differences, there are many rewards, such as knowing that some people would not receive care if the or...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200203000-00016
更新日期：2002-03-01 00:00:00
abstract：BACKGROUND:Mesenchymal stromal cells (MSCs) have been shown in rodent models to promote primary and pulmonary metastatic sarcoma growth when injected in the presence of gross tumor. In theory, this would limit their use in a clinical setting after limb salvage treatment for osteosarcoma. Although concerning, these mode...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4362-2
更新日期：2016-03-01 00:00:00
