Arthroscopic excision of wrist ganglions: does trans-cystic or cystic-sparing portal technique affect clinical outcomes?

Introduction: The preliminary results of arthroscopic wrist ganglionectomy were contradictory. The approach used for the arthroscopic excision of wrist ganglions may play an important role. We analyzed two surgical approaches for arthroscopic excision of wrist ganglions.

Kirschner Wire and Bone Cement is a Viable Alternative to Reconstruction of Large Iliac Bone Defects After Strut Bone Graft Harvesting.

Study Design: A retrospective study.

Objective: To assess the safety and efficacy of iliac crest defect reconstruction using Kirschner wire (K-wire)/polymethylmethacrylate (PMMA) versus traditional autologous rib graft reconstruction.

Summary Of Background Data: The iliac crest has been the preferred donor site for strut bone graft for various spinal fusion surgeries.

Minimally invasive endoscopic treatment for lumbar infectious spondylitis: a retrospective study in a tertiary referral center.

Background: Spinal infections remain a challenge for clinicians because of their variable presentation and complicated course. Common management approaches include conservative administration of antibiotics or aggressive surgical debridement. The purpose of this study was to evaluate the efficacy of percutaneous endoscopic debridement with dilute betadine solution irrigation (PEDI) for treating patients with lumbar infectious spondylitis.

Extended indications of percutaneous endoscopic lavage and drainage for the treatment of lumbar infectious spondylitis.

Purpose: The treatment of spinal infection remains a challenge for spinal surgeons because of the variable presentations and complicated course. The diagnostic and therapeutic value of percutaneous endoscopic lavage and drainage (PELD) has been proved in some recent studies. The purpose of this study is to evaluate the efficacy of PELD in patients with advanced infectious spondylitis which may traditionally require open surgery.

Subpedicle decompression and vertebral reconstruction for thoracolumbar Magerl incomplete burst fractures via a minimally invasive method.

Study Design: Retrospective.

Objective: To evaluate the clinical and radiographical results.

Summary Of Background Data: The evolution of posterior approach for burst fractures was from long-segment to short-segment and then to monosegmental fixation.

Radiographic and clinical results of posterior dynamic stabilization for the treatment of multisegment degenerative disc disease with a minimum follow-up of 3 years.

Background: This study aims to compare radiographic and clinical outcomes of Dynesys and posterior lumbar interbody fusion (PLIF) for the treatment of multisegment disease.

Methods: Thirty-five consecutive patients who received Dynesys implantation at three levels from L1 to S1 from November 2006 to July 2007 were studied. A retrospective analysis of the medical records of 25 patients with the same indications who received 3-level PLIF (L1-S1) was also conducted.

Specialty differences in the association between health care climate and patient trust.

Context: Previous studies have suggested that there is a positive correlation between doctors' emotional intelligence (EI) and patients' trust in their attending physicians; however, there is only limited evidence of specialty differences between internists and surgeons for such an association.

Objectives: This study examined the association of nursing director assessments of doctors' EI, outside observer assessments of doctors' health care climate (HCC) in the examining room and patient-rated trust in internists and surgeons. Health care climate refers to a key component in communication and reflects the extent to which patients perceive their health care providers as supporting patient autonomy rather than controlling the provision of treatment.

Locked plating for proximal humeral fractures: differences between the deltopectoral and deltoid-splitting approaches.

Background: Locking proximal humerus plate (LPHP) fixation has recently become available for the treatment of proximal humeral fractures. However, the preliminary results were contradictory. The technical requirements for success when using LPHP remain to be defined.

The effect of surgeon empathy and emotional intelligence on patient satisfaction.

We investigated the associations of surgeons' emotional intelligence and surgeons' empathy with patient-surgeon relationships, patient perceptions of their health, and patient satisfaction before and after surgical procedures. We used multi-source approaches to survey 50 surgeons and their 549 outpatients during initial and follow-up visits. Surgeons' emotional intelligence had a positive effect (r = .

RNA interference-mediated gene silence of the NR1 subunit of the NMDA receptor by subcutaneous injection of vector-encoding short hairpin RNA reduces formalin-induced nociception in the rat.

There is accumulating evidence to implicate the importance of N-methyl-d-aspartate (NMDA) receptors to the induction and maintenance of central sensitization during pain states. However, the use of NMDA receptor antagonists can often be limited by serious central nervous system side effects. The development of peripheral NMDA receptor antagonists that do not interfere with central glutamate processing can avoid adverse effects of the central nervous system.

Reverse LISS plates for unstable proximal femoral fractures.

The best treatment for unstable proximal femoral fractures is controversial. In this prospective study, we assessed the outcomes of reverse less invasive stabilisation system (LISS) plates for treatment of unstable proximal femoral fractures that are expected to be difficult to nail. From April 2004 to January 2007, 20 patients with unstable proximal femoral fractures that were assessed to be difficult to nail were managed with reverse less invasive stabilisation system-distal femur (LISS-DF) plates, which included (1) subtrochanteric fractures with extension into the piriform fossa, (2) short skeletons with narrow femoral canals, (3) adolescents with open physes and (4) severely bowed or deformed femurs.

Staged external and internal locked plating for open distal tibial fractures.

Background And Purpose: Based on reported success with staged treatment of distal tibial fractures, we designed a 2-stage protocol including external/internal locked plating. We retrospectively assessed the outcome of open distal tibial fractures treated according to this protocol.

Patients And Methods: From March 2006 through July 2008, 16 patients who sustained open distal tibial fractures were treated by a two-stage protocol.

Impact of cement leakage into disks on the development of adjacent vertebral compression fractures.

Study Design: A retrospective study assessing new adjacent vertebral compression fracture (VCF) after percutaneous vertebroplasty (PV).

Objective: To evaluate the relationship between cement leakage into the disk during initial PV and development of subsequent new adjacent VCF.

Summary Of Background Data: Cement leakage outside the vertebral body during PV has been reported and usually responds to conservative treatment.

Staged external and internal less-invasive stabilisation system plating for open proximal tibial fractures.

High-energy proximal tibial fractures are complex injuries that may lead to significant complications. Staged treatment of these injuries using a spanning external fixator across the knee joint in the acute setting decreases the incidence of complications. This article is a prospective evaluation of outcomes using a two-stage procedure for treatment of 15 patients who sustained open proximal tibial fractures between April 2006 and January 2008.

Soft-tissue injury management and flap reconstruction for mangled lower extremities.

The treatment for mangled lower extremities poses a clinical challenge for orthopaedic surgeons. The complexities of soft-tissue injury combined with open fractures and osteomyelitis have frequently resulted in amputation of the lower extremity. The current advances in soft-tissue flap reconstruction techniques have significantly improved the results of limb-salvage attempts.

Reconstruction of upper extremity large soft-tissue defects using pedicled latissimus dorsi muscle flaps--technique illustration and clinical outcomes.

Reconstruction of large soft-tissue defects of an upper extremity is very challenging due to the unavailability of expendable local muscle. Appropriate soft-tissue restoration is an essential component of such reconstruction treatment protocols, and often requires a vascularised flap to protect the exposed neurovascular and musculotendinous structures. The latissimus dorsi muscle makes an ideal pedicled flap because of its long neurovascular pedicle, large size, ease of mobilisation and expendability.

Measurement of tibial endothelial cell function after cigarette smoking, cessation of smoking and hyperbaric oxygen therapy.

Cigarette smoking is hazardous to a range of human tissues. For instance, cigarette smoke inhalation has been proven to delay bone healing. This study analysed the effects of cigarette smoking on tibial vascular endothelium and blood flow using the bone-chamber model.

Inferior vena cava syndrome following percutaneous vertebroplasty with polymethylmethacrylate.

Study Design: A case of inferior vena cava syndrome following percutaneous vertebroplasty is described herein.

Objective: To alert clinicians to the potential occurrence of inferior vena cava syndrome following percutaneous vertebroplasty.

Summary Of Background Data: Vertebroplasty is a less invasive treatment solution for the osteoporotic compression fracture.

Revision strategies for complications and failure of vertebroplasties.

Percutaneous vertebroplasty is widely discussed in the management of osteoporotic spinal compression fracture, but few reports are available concerning salvage procedures after failure of this technique. We studied 22 percutaneous vertebroplasty patients who required revision surgery upon presentation of new symptoms postoperatively. The indications for revision surgery included recurrent intractable back pain with no response to medical treatment, infectious spondylitis, cement leakage with neurologic deficit, and cement dislodgement and/or fragmentation.

Open-door laminoplasty for multilevel cervical spondylotic myelopathy: good outcome in 12 patients using suture anchor fixation.

Background And Purpose: In the classic Hirabayashi procedure, the lamina door is tethered open by sutures between the spinous process and facet capsule or para-vertebral muscle. Our early experiences showed, however, that the loosened sutures result in dislodgement and reclosure of the lifted lamina. We present a modified method to ensure secure fixation and prevent restenosis due to hinge closure.

Biologic plating versus intramedullary nailing for comminuted subtrochanteric fractures in young adults: a prospective, randomized study of 66 cases.

Background: Published reports about treatment of comminuted subtrochanteric fractures in young patients are few. This study compared the effectiveness of biologic plating and intramedullary nailing in the treatment of such fractures.

Methods: A prospective, randomized, and nonblinded study was conducted.

Open-door laminoplasty with suture anchor fixation for cervical myelopathy in ossification of the posterior longitudinal ligament.

Expansive laminoplasty was developed to achieve posterior spinal cord decompression while preserving cervical spine stability. In the classic Hirabayashi procedure, the lamina door is tethered open by sutures between the spinous process and facet capsule or paravertebral muscle. The authors present a modified technique, which enhances secure fixation and prevents restenosis owing to hinge closure.