Antibiotic prophylaxis in primary hip and knee arthroplasty: comparison between cefuroxime and two specific antistaphylococcal agents.

This is a prospective randomized study comparing cefuroxime to 2 antistaphylococal agents (fusidic acid and vancomycin), for prophylaxis in total hip arthroplasty (THA) and total knee arthroplasty (TKA) in an institute, where methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus epidermidis (MRSE) prevalence exceeds 25% of orthopedic infections. There were 3 patient groups. Group A included the patients who received cefuroxime, group B those who received fusidic acid, and group C those who received vancomycin.

Dosimetry during intramedullary nailing of the tibia.

Background: Intramedullary nailing under fluoroscopic guidance is a common operation. We studied the intraoperative radiation dose received by both the patient and the personnel.

Patients And Methods: 25 intramedullary nailing procedures of the tibia were studied.

Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: effectiveness and timing.

This retrospective, multicentre study aimed to evaluate reamed intramedullary nailing (IMN) for the treatment of 30 cases of aseptic femoral shaft non-union after plating failure. Following nailing, 29 non-unions had healed by a mean 7.93 months.

Treatment of unstable lower cervical spine injuries by anterior instrumented fusion alone.

Study Design: Retrospective study of a prospectively followed cohort.

Objective: To summarize the complications after instrumented stabilization of cervical spine injuries in a single-institution series, and to discuss management of unstable injuries with respect to the complication rate between the 2 approaches (anterior and posterior).

Summary Of Background Data: The anterior approach to the cervical spine has been criticized for destruction of the anterior elements in the presence of posterior instability.

The adult spinal cord injury without radiographic abnormalities syndrome: magnetic resonance imaging and clinical findings in adults with spinal cord injuries having normal radiographs and computed tomography studies.

Background: Spinal cord injury without radiographic abnormalities (SCIWORA) is thought to represent mostly a pediatric entity and its incidence in adults is rather underreported. Some authors have also proposed the term spinal cord injury without radiologic evidence of trauma, as more precisely describing the condition of adult SCIWORA in the setting of cervical spondylosis. The purpose of the present study was to evaluate adult patients with cervical spine injuries and radiological-clinical examination discrepancy, and to discuss their characteristics and current management.

A Phase II Study of Docetaxel and Epirubicin in Advanced Adult Soft Tissue Sarcomas (STS).

Purpose: The aim of this study was to determine the efficacy and safety of docetaxel plus epirubicin combination as first-line chemotherapy in patients with locally advanced and/or metastatic adult STS.

Patients And Methods: Eighteen patients were treated with epirubicin 30 mg/m(2) on days 1 to 3 and docetaxel 100 mg/m(2) on day 1 every 3 weeks.

Results: Fifteen out of 18 patients (83.

Current Concepts: Aseptic Nonunion of Femoral Shaft Diaphysis.

In spite of increased understanding of biomechanics and improvements of implant design, nonunion of femoral shaft fractures continues to hinder the treatment of these injuries. Femoral nonunion presents a difficult treatment challenge for the surgeon and a formidable personal and economic hardship for the patient. In most series of femoral fractures treated with intramedullary nailing techniques, the incidence of this complication is estimated to be 1%.

Anterior traumatic shoulder dislocation associated with displaced greater tuberosity fracture: the necessity of operative treatment.

Objective: To evaluate the radiographic and clinical outcome, including the incidence of recurrence, in patients with displaced greater tuberosity (GT) fractures associated with a traumatic anterior shoulder dislocation.

Design: Retrospective study.

Setting: University Hospital (Level 1 trauma center).

Long-term results in surgically treated acetabular fractures through the posterior approaches.

Background: The long-term results of surgically treated displaced acetabular fractures using the posterior approaches and the possible role of the greater trochanteric osteotomy in the development of heterotopic ossification (HO) are still somehow controversial despite extensive publications.

Methods: Seventy-five patients with an acetabular fracture and displacement of at least 3 mm were surgically treated during a 6-year period. The duration of the follow-up was from 10 to 15 years, with a mean of 12.

Functional outcome of surgical treatment for multilevel lumbar spinal stenosis.

Background: There is no consensus regarding the best treatment of patients with multilevel lumbar stenosis. We evaluated the clinical and radiological findings in 41 patients with complex degenerative spinal stenosis of the lumbar spine who were treated surgically.

Methods: Between 1997 and 2003, 41 patients suffering from degenerative lumbar spinal stenosis were included in a prospective clinical study.

Graft-supplemented, augmented external fixation in the treatment of intra-articular distal radial fractures.

This article compares the functional and radiographic outcomes of intraarticular distal radial fractures treated with augmented external fixation in which autologous cancellous bone grafting or Norian SRS (Norian Corp, Cupertino, Calif) was used for filling the metaphyseal void. Thirty non-randomized patients, 15 in each group, with AO type C distal radius fractures (20 men and 10 women; average age: 48 years) were operatively treated between 1998-2000 and retrospectively evaluated. Radial inclination, radial length, volar tilt, and Modified Mayo Wrist Score were assessed at the most recent follow-up evaluation (average: 33.

Double-loop suture repair for acute acromioclavicular joint disruption.

Background: Although it has been established that surgical treatment for acromioclavicular joint disruption (types IV-VI and type III in overhead throwing athletes and heavy laborers) is preferred, the literature is inconclusive about the best type of surgery.

Purpose: With the goal of avoiding the potential complications of hardware use, the authors present a coracoclavicular functional stabilization technique with the intention to restore the anteroposterior and superior displacement of the clavicle.

Study Design: Case series; Level of evidence, 4.

Sexual function in females with severe cervical spinal cord injuries: a controlled study with the Female Sexual Function Index.

The objective of this study was to identify the sexual adjustment of females with severe cervical spinal cord injuries (SCI) using the Female Sexual Function Index (FSFI). The 19-item questionnaire of the FSFI concerns sexual function and satisfaction in sex life. This study, conducted by the Orthopaedic and Psychiatry Departments of Patras University, used a sample of a series of 39 consecutive female patients with severe traumatic SCI.

Alteration in serum leptin correlates with alterations in serum N-telopeptide of collagen type I and serum osteocalcin during the progression of osteoporosis in ovariectomized rats.

The role of leptin during the progression of osteoporosis was investigated in ovariectomized rats by correlation of serum leptin levels with N-telopeptide of collagen type I (NTx) and osteocalcin levels before ovariectomy and 20, 40 and 60 days after the operation. Furthermore, peripheral quantitative computed tomography was used to confirm the development of severe osteoporosis in rats on day 60. The levels of NTx and osteocalcin were significantly increased on day 20 [61.

Herbert screw fixation and reverse guided drillings, for treatment of types III and IV osteochondritis dissecans.

We evaluated the outcome in 10 young patients, ages ranging from 15 to 26, with types III and IV osteochondritis dissecans of the knee, treated with Herbert screws fixation and reverse guided drillings. The disease involved the medial femoral condyle in eight patients and the lateral in two. Diagnosis and preoperative planning based on plain radiographs (AP, lateral and tunnel view) and MRI (in seven patients).

Minimal internal fixation augmented by small wire transfixion frames for high-energy tibial plateau fractures.

Purpose: To evaluate the outcome of bicondylar tibial plateau fractures treated with minimal internal fixation augmented by small wire external fixation frames and to assess the necessity of bridging the knee joint by extending the external fixation to the distal femur.

Methods: This is a retrospective study of 48 tibial plateau fractures. There were 40 (83.

Correlative radiological, self-assessment and clinical analysis of evolution in instrumented dorsal and lateral fusion for degenerative lumbar spine disease. Autograft versus coralline hydroxyapatite.

This prospective longitudinal randomized clinical and radiological study compared the evolution of instrumented posterolateral lumbar and lumbosacral fusion using either coralline hydroxyapatite (CH), or iliac bone graft (IBG) or both in three comparable groups, A, B and C, which included 19, 18 and 20 patients, respectively, who suffered from symptomatic degenerative lumbar spinal stenosis and underwent decompression and fusion. The patients were divided randomly according to the graft used and the side that it was applied. The spines of group A received autologous IBG bilaterally; group B, IBG on the left side and hydroxyapatite mixed with local bone and bone marrow on the right side; group C, hydroxyapatite mixed with local bone and bone marrow bilaterally.

Midterm results of treatment with a retrograde nail for supracondylar periprosthetic fractures of the femur following total knee arthroplasty.

Objectives: Although the short-term results of supracondylar periprosthetic fractures treated with retrograde nailing have been satisfactory, there is always a concern about the long-term survival of the prosthesis. The aim of the study was to evaluate fracture healing and knee functional outcome with a follow-up time of at least 2 years in periprosthetic fractures of the knee treated with a supracondylar nail.

Design: Cohort study.

Modified extra rotator-cuff entry point in antegrade humeral nailing.

Introduction: We describe an extra-articular, extra-rotator cuff entry point for antegrade humeral nailing, which preserves the articular surface and rotator cuff integrity.

Material And Methods: Thirty-two patients with humeral shaft fractures underwent antegrade intramedullary nailing using a modified insertion point located 1 cm below the crest of the greater tuberosity, in a region outside the articular surface and rotator cuff area.

Results: In all cases, nailing was done successfully, without any perforation of the humeral inner cortex by the nail.

The role of rigid vs. dynamic instrumentation for stabilization of the degenerative lumbosacral spine.

Purpose Of The Study: This is a prospective comparative randomised study to compare the immediately postoperative effects of a rigid versus dynamic instrumentation for degenerative spine disease and stenosis on the standing sagittal lumbar spine alignment and to investigate if a dynamic spine system can replace the commonly used rigid systems in order to avoid the above mentioned disadvantages of rigid fixation.

Material & Methods: 15 randomly selected patients received the rigid instrumentation SCS and an equal number of randomly selected patients the dynamic TWINFLEX device for spinal stenosis associated degenerative lumbar disease. The age of the patients, who received rigid and dynamic instrumentation was 65 +/- 9 years and 62 +/- 10 years respectively.

The significance of correlation of radiographic variables and MOS short-form health survey for clinical decision in symptomatic low back pain patients.

Objectives: To assess any correlation between SF-36 scores and several lateral roentgenographic variables of the lumbar spine, both in low back pain patients and asymptomatic volunteers. The clinical relevance of the method proposed in this study to make a surgical strategy on the basis of distinct lateral roentgenographic parameters and conversely was assessed by independent radiologists and physicians.

Methods: One hundred asymptomatic male volunteers, used as controls and an equal number of age-, height- and weight- comparable consecutive patients with chronic low back pain were examined both roentgenographically and with the SF-36 questionnaire.

Secondary intramedullary nailing after distraction osteogenesis: 30 patients followed for 2-12 years.

Background: There is no consensus about replacement of an external fixator by reamed intramedullary nailing in fracture cases.

Patients And Methods: We evaluated the outcome in 30 patients (33 segments) of secondary intramedullary nailing during the consolidation phase after callus distraction using an external device. The main reasons for nailing were docking site nonunion (17 patients), angular deformity or fracture of the lengthened area (8 patients) or intolerance of the external device (5 patients), in 11 patients combined with a delayed distracted callus maturation.

Does graded reaming affect the composition of reaming products in intramedullary nailing of long bones?

Reaming products taken during intramedullary nailing were examined to identify possible differences in their composition depending on the reaming percentage. Reaming products were taken from 39 fresh closed tibial and femoral diaphyseal fractures in patients with an average age of 29 years. According to histology, reaming products mainly consisted of bone trabeculae, viable or nonviable, and bone marrow stroma.