Abstract：
:Failure of bone grafting in scaphoid nonunion presents the hand surgeon a perplexing set of problems. Controversy remains as to the best course of treatment in this difficult situation. The authors have retrospectively reviewed during a 5-year period the patients treated at the Mayo Clinic who have gone on to a second nonunion after a failed initial bone grafting procedure. Twenty-five patients were identified, 19 of whom had a second bone grafting procedure. Depending on the preoperative evaluation, 4 types of bone grafting procedures were performed: conventional Russe procedure, 4; Maltese cross bone graft procedure, 6; interpositional wedge graft, 5; and vascularized pedicle bone graft, 4. Twenty-two of 25 united (88%). Average followup at 57 months (range, 25-90 months), shows satisfactory results (16% very satisfied and 8% moderately satisfied), but varying degrees of pain. Results using a modification of the Mayo Wrist Score are somewhat disappointing with 3 excellent, 5 good, 10 fair, and 7 poor. It must be remembered, however, these wrists have had at least 2 surgeries, multiple long periods of immobilization, and often a delay in treatment with a prolonged period of abnormal carpal mechanics. It is thought that a second bone grafting attempt should be strongly considered. The key to success is matching the type of bone graft procedure to the specific unique features of scaphoid shortening, carpal instability, and proximal pole vascularity that each patient's wrist displays. A treatment algorithm is presented to help decision making in this difficult problem.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Smith BS,Cooney WPdoi
10.1097/00003086-199606000-00015subject
Has Abstractpub_date
1996-06-01 00:00:00pages
98-109issue
327eissn
0009-921Xissn
1528-1132pub_type
杂志文章abstract：:The micromovements of 18 ribbed femoral prostheses were measured for two years postoperatively. Repeated roentgen stereophotogrammetric examinations (RSA) were used to measure distal migration of the center of the prostheses and movements of the prosthetic hump and tip. During the first six postoperative months, an in...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-02-01 00:00:00
abstract：BACKGROUND:Patients with severe lower extremity trauma have significant disability 2 years after injury that worsens by 7 years. Up to 15% seek late amputation. Recently, an energy-storing orthosis demonstrated improved function compared with standard orthoses; however, the effect when integrated with rehabilitation ov...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3609-7
更新日期：2014-10-01 00:00:00
abstract：:Eleven intraoperative femur fractures occurred during 605 total hip replacements at Rancho Los Amigos Hospital, an incidence of 1.8%. Fractures occur more often in women, are usually located in the proximal femur, and mostly occur during femoral reaming. The main predisposing factors were osteoporosis and previous hip...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteropost...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0452-8
更新日期：2008-11-01 00:00:00
abstract：:Some patients who had cervical laminoplasty with subsequent substantial loss of cervical lordosis have shown failed healing of a repaired semispinalis cervicis. We also have identified some patients in whom it is difficult to repair the C2 spinous process during laminoplasty. We therefore quantitatively analyzed the m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/01.blo.0000160710.11991.33
更新日期：2005-07-01 00:00:00
abstract：:Of 19 patients (24 hips) with LCPD treated between 1968 and 1974, 18 hips were treated by nonoperative methods (the abduction weight-bearing program as described by Petrie), and six hips were treated by Salter innominate osteotomy. Using Catterall's classification of the roentgenographic changes, 14 cases were rated g...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-07-01 00:00:00
abstract：:In this series of 62 free flap transfers, 48 (80%) have been successful. There have been a significant number of vascular complications, 39% of which the majority were arterial thrombosis. Fifty per cent of those which thrombosed were salvaged on exploration and revision of the vessels. The frequency of complications ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-06-01 00:00:00
abstract：:Fifty-two patients with subtalar joint involvement secondary to os calcis fractures have been treated with a surgical technique designed by George F. Pennal. There were 23 tongue-type fractures and 33 joint depression fractures in this series. All were treated by open reduction and internal fixation, and occasionally ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:A retrospective analysis of 75 consecutive cases of massive allograft implantations performed from July 1976 to October 1986 was conducted. Seventy percent of these patients had malignant bone tumors. Of the total group, 10 (13.3%) patients developed a deep infection of the allograft and are the subject of this review...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：:Fourteen patients with separation of the distal clavicular metaphysis from the epiphysis were reviewed. These injuries, especially in the older child and adolescent, mimic acromioclavicular separation. However, they are really growth-plate injuries in which the epiphysis and physis maintain their normal anatomic relat...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-09-01 00:00:00
abstract：:Femoroacetabular impingement due to metaphyseal prominence is associated with the slippage in patients with slipped capital femoral epiphysis (SCFE), but it is unclear whether the changes in femoral metaphysis morphology are associated with range of motion (ROM) changes or type of impingement. We asked whether the fem...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0477-z
更新日期：2009-03-01 00:00:00
abstract：:A committee was appointed by the American Academy of Orthopaedic Surgeons in 1981 to continue the orthopaedic workforce studies begun by D. Kay Clawson a decade earlier. The committee found that the rapid increase in orthopaedists graduating from residency programs between 1970 and 1982 had resulted in a workforce in ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200104000-00013
更新日期：2001-04-01 00:00:00
abstract：:Moiré topography, a simple technique for three-dimensional quantitation, was used to provide interference fringe photographs of the human back with sufficient accuracy to be used for detecting children with asymmetry due to scoliosis. Experimental equipment, built and tested at the National Research Council of Canada,...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-197711000-00019
更新日期：1977-11-01 00:00:00
abstract：:Postoperative infection of elective surgical wounds with Clostridium species has been linked to gastrointestinal tract lesions. A 55-year-old man with a history of peptic ulcer disease was treated by open reduction and internal fixation with autogeneic cancellous bone grafting from an anterior iliac crest donor site f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:Rotator cuff repair is one of the most common surgical procedures done in the shoulder. Traditionally, repair has required an open incision with release of a portion of the deltoid from the acromion. In the past decade, an arthroscopically-assisted, mini-open approach has gained popularity. This has been facilitated b...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：2001-09-01 00:00:00
abstract：:Pathologic fractures of the proximal femur secondary to benign bone tumors often are difficult to treat because of specific anatomic features of this region and the aggressiveness of the tumors. Between 1986 and 1996, 11 patients presented with a pathologic fracture of the proximal femur secondary to a benign bone tum...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200112000-00032
更新日期：2001-12-01 00:00:00
abstract：UNLABELLED:To determine whether inferior vena cava (IVC) filter placement protects patients with musculoskeletal tumors from fatal pulmonary embolisms (PE), we retrospectively analyzed the records of 81 patients who underwent surgery for pelvic and lower extremity malignancies. All 81 patients received an IVC filter an...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0607-7
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Reverse shoulder arthroplasty has been proven to improve function in shoulders with cuff-tear arthropathy, but existing studies are primarily single-center studies with a small number of patients, which limits their ability to identify patients who have an increased risk of revision or a worse functional out...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/CORR.0000000000001114
更新日期：2020-05-01 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：:Disabling back pain plagues industrialized societies. Generally redress adheres to a Prussian paradigm that those injured at work are more deserving than those who have worked but can no longer do so because of diseases not related to work. Those who never have worked are least entitled. A comparison of the way the Pr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199703000-00012
更新日期：1997-03-01 00:00:00
abstract：:Juvenile rheumatoid arthritis (JRA) involves a wide range of joint tissues. Tissue changes include proliferation of synovial cells, alterations in synovial fluid, and degradation of articular cartilage. Synovial cell proliferation results in increased numbers of fibroblasts and lymphocytes. Changes in the synovial flu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：
更新日期：1990-10-01 00:00:00
abstract：:This study evaluated the quality and quantity of osseointegration of two thicknesses of hydroxyapatite coating on press-fit, porous-coated titanium implants in a canine hip model. In 12 dogs, titanium press-fit porous-coated prostheses were implanted. The stems had a 50-microm thickness hydroxyapatite coating, 100-mic...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200111000-00058
更新日期：2001-11-01 00:00:00
abstract：UNLABELLED:Giant cell tumors of bone are sometimes locally aggressive and may metastasize, although uncommonly. We attempted to identify associations of clinical and histopathologic parameters with metastasis, the long-term outcome with metastases, and the best treatment. We identified distant metastases in 24 of 470 p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-009-0966-8
更新日期：2010-03-01 00:00:00
abstract：:Multiple myeloma and solitary plasmacytoma are common reticuloendothelial diseases. They involve primarily the bone marrow but have occasional extramedullary components. Numerous complications have been reported with these diseases. Despite modern modes of therapy, the prognosis remains grim. Myeloma and plasmacytoma ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-03-01 00:00:00
abstract：BACKGROUND:Child abuse and neglect (CAN) is a serious problem that has major implications for the welfare of the child involved. Unexplained fractures are of particular concern to the orthopaedic surgeon, who must often consider alternative diagnoses to CAN. QUESTIONS/PURPOSES:We therefore (1) determined which bone di...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1007/s11999-010-1578-z
更新日期：2011-03-01 00:00:00
abstract：BACKGROUND:Disruption of the periosteum has been used to explain overgrowth after long bone fractures. Clinically, various periosteal procedures have been reported to accelerate growth with varied results. Differences between procedures and study populations, in these prior studies, make drawing conclusions regarding t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-015-4646-6
更新日期：2016-04-01 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：:Regional cortical blood flow was measured in 23 adult mongrel dogs using the hydrogen washout technique. Cortical blood flow in the rib was found to be 4.7 +/- 0.8 ml/min/100 ml (n=21). The concept of a dual blood supply to cortical bone is supported since eliminating the medullary supply did not affect the measurable...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-05-01 00:00:00
abstract：:A 27-year-old manual laborer presented with dislocation of the right elbow, complete separation of the radial head at the neck level, and avulsion of the coronoid process. Closed reduction of the elbow resulted in ulnohumeral instability. As an alternative to silastic implant, the radial head was reduced, internally f...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-03-01 00:00:00
abstract：:The authors report the results of a consecutive series of 37 total condylar prostheses inserted between 1975 and 1977 in 31 osteoarthritic and six rheumatoid arthritic knees. Prostheses were inserted in 33 usually low-activity patients with an average age of 65 years. There was a five-year minimum follow-up period for...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-06-01 00:00:00
