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Tuesday, August 16, 2011

Journal of Rehabilitation Research and Development (from the Veterans Administration)

JRRD, the Journal of Rehabilitation Research and Development, has been a leading research journal for more than 45 years. Formerly the Bulletin of Prosthetics Research (BPR), JRRD debuted in 1983 to include cross-disciplinary findings in rehabilitation. JRRD, a scientifically indexed journal, publishes original research papers from U.S. and international researchers on all rehabilitation research disciplines.
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Monday, August 15, 2011

Ultrasound-Guided Sclerosing Treatment in Patients With Patellar Tendinopathy (Jumper's Knee): 44-Month Follow-up

A randomized controlled study has shown good clinical results after treatment with sclerosing injections into the area with neovessels in patients with patellar tendinopathy, but no study has investigated medium- or long-term outcomes. Hoksrud A, Bahr R. Am J Sports Med August 12, 2011 Published online before print. PDF

NYU Langone experts find MRI techniques can detect early osteoarthritis

Researchers from NYU Langone Medical Center's Departments of Orthopaedic Surgery and Radiology found that advanced MRI techniques can be used to detect subtle changes in joint cartilage microstructure – and provide physicians a diagnostic tool for finding key markers of early osteoarthritis (OA). By using these techniques during patient exams to identify OA earlier, clinicians can shift the management of the disease from eventual joint reconstruction to long-term preservation. The study was published in the July issue of the Journal of the American Academy of Orthopaedic Surgeons. Eurekalert!  PDF

History, clinical findings, magnetic resonance imaging, and arthroscopic correlation in meniscal lesions.

The aim of this prospective study was to compare the accuracy of clinical examination and magnetic resonance imaging (MRI) versus arthroscopic findings and to determine the value of an experienced examiner in clinical decision making. Ercin E, Kaya I, Sungur I, Demirbas E, Ugras AA, Cetinus EM. Knee Surg Sports Traumatol Arthrosc. 2011 Aug 11. [Epub ahead of print] PMID: 21833511

65 Outstanding Shoulder Surgeons and Specialists

The following shoulder surgeons and specialists were selected for this list based on the awards they have received from major organizations in the field, leadership in those organizations, work on professional publications and positions of service held at hospitals and practices. The surgeons are listed in alphabetical order by last name. All physicians placed on this list have undergone substantial review from our editorial staff. Physicians do not pay and cannot pay to be selected as an outstanding leader. This list is not an endorsement of any individual's or organization's clinical abilities. Becker's Orthopedic, spine & Pain Management Review

'Windmill of War' about pain, moving forward

"(It) is called ‘Windmill of War,' because no matter what's going on with the outside world these men are like a windmill, they just keep turning and moving and going to wherever they're needed," Gehrig said of her patient and all war veterans.

Thanks to medical advancements in the field and orthopedic surgeons like Gehrig, orthopedic patients across the country are able to move forward in their lives as normally as possible.

"The role an orthopedic surgeon plays in all this is the fact that we put their limbs together and they can then function after they heal," Gehrig said.

The American Academy of Orthopaedic Surgeons strives to showcase stories like Gehrig's patient's through the "Wounded in Action" art exhibit. Shown across the country, the exhibit has pieces from orthopedic surgeons and veterans who know what it is like to undergo such a life-changing experience.

Though Gehrig says that "Windmill of War" is a personal expression of how she feels toward her patients, it also is a call for all to take another look at those who have put their lives on the line for Americans.

"You can't really appreciate it until you hear some of the stories and see some of the residue of war and miracles happen with some of these injuries," Gehrig said. Bismarck Tribune

To see the entire "Wounded in Action" exhibit, visit woundedinactionart.org

Sailors can wear ‘toe shoes’ despite military medical warnings

The Navy has reversed its policy banning minimalist 'toes shoes', Military Times reported. According to a fleetwide message released Aug. 5, sailors can wear the popular glove-like shoes, even during physical readiness tests, the newspaper reported.

However, the Navy Bureau of Medicine and Surgery has expressed concerns about the bare-bones Vibram Fivefingers shoes and warned against their use, according to Military Times.

While the Army banned soldiers from wearing the shoes during training earlier this summer, according to The Washington Post, the military school system endorsed them in March.
Read more on the toe shoe debate from Military Times.

Sunday, August 14, 2011

Interventions for treating chronic ankle instability.

Neuromuscular training alone appears effective in the short term but whether this advantage would persist on longer-term follow-up is not known. While there is insufficient evidence to support any one surgical intervention over another surgical intervention for chronic ankle instability, it is likely that there are limitations to the use of dynamic tenodesis. After surgical reconstruction, early functional rehabilitation appears to be superior to six weeks immobilisation in restoring early function.  de Vries JS, Krips R, Sierevelt IN, Blankevoort L, van Dijk CN. Cochrane Database Syst Rev. 2011 Aug 10;(8):CD004124. PMID: 21833947

Clinical and Ultrasonographic Results of Ultrasonographically Guided Percutaneous Radiofrequency Lesioning in the Treatment of Recalcitrant Lateral Epicondylitis.

The authors present a newly developed minimally invasive procedure, ultrasonographically guided percutaneous radiofrequency thermal lesioning (RTL), and its clinical efficacy in treating recalcitrant lateral epicondylitis. Lin CL, Lee JS, Su WR, Kuo LC, Tai TW, Jou IM. Am J Sports Med. 2011 Aug 11. [Epub ahead of print] PMID: 21836121

Recent PubMed Entries for the European Journal of Trauma and Emergency Surgery (2007 to present). Not currently indexed for MEDLINE.

Open Access Articles Link

1. Outcomes following operative and non-operative management of humeral midshaft fractures: a prospective, observational cohort study of 47 patients. van Middendorp JJ, Kazacsay F, Lichtenhahn P, Renner N, Babst R, Melcher G. Eur J Trauma Emerg Surg. 2011 Jun;37(3):287-296. Epub 2011 Apr 1. PMID: 21837261
2. Bilateral proximal tibia fracture. Andriessen MJ, Mattens EC, Sleeboom C, Heij HA. Eur J Orthop Surg Traumatol. 2011 Apr;21(3):199-201. Epub 2010 Aug 29. PMID: 21837233
3. Results of 131 consecutive operated patients with a displaced proximal humerus fracture: an analysis with more than two years follow-up. Faraj D, Kooistra BW, Vd Stappen WA, Werre AJ. Eur J Orthop Surg Traumatol. 2011 Jan;21(1):7-12. Epub 2010 Jun 15. PMID: 21837232

Impact of AOA Status and Perceived Lifestyle on Career Choices of Medical School Graduates.

Based upon student ratings of such factors as predictable work hours and personal time, medical specialties have been identified as lifestyle friendly, intermediate, or unfriendly. Lifestyle friendly programs may be more desirable, more competitive, and for students elected to the Alpha Omega Alpha (AOA) Honor Medical Society, more attainable.  Grayson MS, Newton DA, Patrick PA, Smith L. J Gen Intern Med. 2011 Aug 12. [Epub ahead of print]PMID: 21837375

European Journal of Orthopaedic Surgery & Traumatology (1991 to present). Not currently indexed in MedLine

Open Access Articles Link

Most Recent:

1.  Technical Note. Technical details of using sural flap in pes equinovarus surgery: a preliminary report on the technique  Daghan Isik, M. Fethi Ceylan, Savas Guner, M. Ata Gokalp and Bekir Atik
Online First™, 10 August 2011 Show Summary 



4. Up-to date Review and Case Report. Distal fracture clavicle and acromioclavicular dislocation: a case report and review the literature Antonio Zarza Pérez, J. L. González Montane and A. D. Delgado Martínez Online First™, 4 August 2011  Show Summary 

5. Original Article. Pedicle screw diameter selection for safe insertion in the thoracic spine
Online First™, 4 August 2011 Show Summary 

6. Original Article. Tranexamic acid reduces blood loss in simultaneous bilateral total knee arthroplasty: a randomized control trial A. Raviraj, Ashish Anand, Murali Chakravarthy, S. Kumarswamy and Ajith Prabhu, et al. Online First™, 2 August 2011 Show Summary

Friday, August 12, 2011

Mobile Devices and Medical Liability: Some Important Considerations

As mobile devices become more and more integrated into clinical practice, our health system will have to not only figure out how this technology will change the face of medicine, but also how it will change the system of medical liability. Physicians and administrators alike shudder at the thought of malpractice, but considering the fact that 60% of physicians over the age of 55 have been sued at least once during their career, we have to carefully think about how all of our new tools fit into the liability picture. Michelle Mello, a Harvard health law professor, offered some insight at the World Congress Leadership Summit on mHealth. iMedicalApps

Kienböck Disease

Article in Press: Treatment of Kienböck Disease by Lunate Core Decompression  Mehrpour S, Kamrani S, Aghamirsalim M, Sorbi R, Kaya A. The Journal of Hand Surgery , Corrected Proof  PDF

1 - 3 From PubMed: 
1. Arthroscopic core decompression of the lunate in early stage Kienbock disease of the lunate. Bain GI, Smith ML, Watts AC. Tech Hand Up Extrem Surg. 2011 Mar;15(1):66-9. PMID:  21358528
2. Systematic review of the treatment of Kienböck's disease in its early and late stages. Innes L, Strauch RJ. J Hand Surg Am. 2010 May;35(5):713-7, 717.e1-4. Review. PMID: 20438990 PDF
3. Core decompression of the distal radius for the treatment of Kienböck's disease: a biomechanical study. Sherman GM, Spath C, Harley BJ, Weiner MM, Werner FW, Palmer AK. J Hand Surg Am. 2008 Nov;33(9):1478-81. PMID: 18984326 PDF

Surgical treatment of syndesmotic diastasis: emphasis on effect of syndesmotic screw on ankle function.

Fifty-two consecutive adult patients with syndesmotic diastasis (SD) were treated with closed anatomical reduction and stable fixation by a trans-syndesmotic cancellous screw. A short leg splint was prescribed for a six week postoperative period. Treatment outcomes of syndesmotic screw removal at various time points were studied and compared (group 1 at six weeks, group 2 at three months and group 3 at an average of nine months).  Hsu YT, Wu CC, Lee WC, Fan KF, Tseng IC, Lee PC. Int Orthop. 2011 Mar;35(3):359-64. Epub 2010 Nov 11. PMID: 21069524

Thursday, August 11, 2011

Associations between repeated deployments to OEF/OIF/OND, October 2001-December 2010, and post-deployment illnesses and injuries, active component, U.S. Armed Forces.

Since 2001, 1,347,731 U.S. military members have deployed to Afghanistan or Iraq; of these, approximately 40% deployed to Afghanistan or Iraq more than once. We assessed relationships between multiple deployments and diagnoses of diseases and injuries (as defined by 3-digit ICD-9-CM codes) among all male and female deployers within one year after returning from first through fifth deployments. For most illnesses and injuries, the proportions of deployers affected within one year post-deployment hardly varied in relation to the number of prior deployments. Back and joint disorders, sleep disorders, hypercholesterolemia, hypertension, chronic sinusitis, and allergic rhinitis were "excessive" among repeat compared to first-time deployers. Some conditions may be caused or exacerbated by repeat wartime deployments. On the other hand, repeat deployments may select for the most inherently resilient service members and/or incrementally increase the resilience of repeat deployers. Armed Forces Health Surveillance Center (AFHSC). MSMR. 2011 Jul;18(7):2-11. PMID: 21815709 PDF

Effectiveness of the Saline Load Test in Diagnosis of Traumatic Elbow Arthrotomies.

The purpose of this study was to investigate the amount of fluid required and the sensitivity of the saline load test to identify an intra-articular arthrotomy of the elbow. Feathers T, Stinner D, Kirk K, Kirby J, Hsu JR; Skeletal Trauma Research Consortium (STReC); Brooke Army Medical Center. J Trauma. 2011 Jul 15. [Epub ahead of print] PMID: 21768902 PDF

The Modern "Deck-Slap" Injury-Calcaneal Blast Fractures From Vehicle Explosions.

Calcaneal injuries following under-vehicle explosions are commonly associated with significant multiple injuries including severe lower limb injury. The frequency of associated spinal injuries mandates radiologic evaluation of the spine in all such patients. The severity of the hindfoot injury is reflected by the high infection rate and amputation rate. Only a small proportion of casualties were able to return to preinjury military duties.
 Ramasamy A, Hill AM, Phillip R, Gibb I, Bull AM, Clasper JC. J Trauma. 2011 Jul 29. [Epub ahead of print] PMID: 21808204 PDF

Impact of Stress on Resident Performance in Simulated Trauma Scenarios.

In trainees, some aspects of performance and immediate recall appear to be impaired in complex clinical scenarios in which they exhibit elevated subjective and physiologic stress responses. The findings of this study highlight a potential threat to patient safety and demand further investigation. Future studies should strive to further elucidate the effects of stress on specific components of performance and investigate ways to reduce its negative impact.  Harvey A, Bandiera G, Nathens AB, Leblanc VR. J Trauma. 2011 Jul 29. [Epub ahead of print] PMID: 21808212  PDF

Died of wounds on the battlefield: causation and implications for improving combat casualty care.

Understanding the epidemiology of death after battlefield injury is vital to combat casualty care performance improvement. The current analysis was undertaken to develop a comprehensive perspective of deaths that occurred after casualties reached a medical treatment facility.  Eastridge BJ, Hardin M, Cantrell J, Oetjen-Gerdes L, Zubko T, Mallak C, Wade CE, Simmons J, Mace J, Mabry R, Bolenbaucher R, Blackbourne LH. J Trauma. 2011 Jul;71(1 Suppl):S4-8. PMID: 21795876

The Role of Platelet-rich Plasma in Rotator Cuff Repair.

Injections of platelet-rich plasma (PRP) have led to reduced pain and improved recovery in other degenerate pathologies areas together with the restoration of function. This study reviews the current literature on PRP and in particular discusses its relevance in the treatment of rotator cuff tears. Mei-Dan O, Carmont MR. Sports Med Arthrosc. 2011 Sep;19(3):244-50. PMID: 21822108

Treatment of femur fractures in school-aged children using elastic stable intramedullary nailing: a systematic review.

Femur fractures are common long-bone injuries in school-aged children (6-12 years). Among the various acceptable treatment options, elastic stable intramedullary nailing (ESIN) has gained popularity over recent years although the level of evidence for ESIN is low. This study was a systematic review of the literature to examine the outcomes and complications of ESIN in school-aged children and to critically evaluate the quality of the available literature.  Baldwin K, Hsu JE, Wenger DR, Hosalkar HS. J Pediatr Orthop B. 2011 Sep;20(5):303-8. PMID: 21829144

Meniscal Repair Versus Partial Meniscectomy: A Systematic Review Comparing Reoperation Rates and Clinical Outcomes

Whereas meniscal repairs have a higher reoperation rate than partial meniscectomies, they are associated with better long-term outcomes. E. Scott Paxton, Michael V. Stock, Robert H. Brophy, Arthroscopy: The Journal of Arthroscopic and Related Surgery - 08 August 2011 (10.1016/j.arthro.2011.03.088)

Platelet-Rich Plasma Intra-Articular Injection Versus Hyaluronic Acid Viscosupplementation as Treatments for Cartilage Pathology: From Early Degeneration to Osteoarthritis

Autologous PRP injections showed more and longer efficacy than HA injections in reducing pain and symptoms and recovering articular function. Better results were achieved in younger and more active patients with a low degree of cartilage degeneration, whereas a worse outcome was obtained in more degenerated joints and in older patients, in whom results similar to those of viscosupplementation have been observed.
Elizaveta Kon, Bert Mandelbaum, Roberto Buda, Giuseppe Filardo, Marco Delcogliano, Antonio Timoncini, Pier Maria Fornasari, Sandro Giannini, Maurilio Marcacci, Arthroscopy: The Journal of Arthroscopic and Related Surgery - 11 August 2011 (10.1016/j.arthro.2011.05.011) PDF

Long-term results of the surgical treatment of type III acromioclavicular dislocations: AN UPDATE OF A PREVIOUS REPORT.

 According to the Imatani and UCLA scores, there was no difference between the operated shoulder and the opposite shoulder (p > 0.05). Given the same situation, 35 (92.1%) patients would opt for the same surgical treatment again. Operative treatment of type III acromioclavicular joint injuries produces satisfactory long-term results.  Lizaur A, Sanz-Reig J, Gonzalez-Parreño S. J Bone Joint Surg Br. 2011 Aug;93(8):1088-92. PMID: 21768634

Wednesday, August 10, 2011

Clinical Orthopaedics and Related Research: [Epub ahead of print]

1. Risk Factors for Peroneal Nerve Injury and Recovery in Knee Dislocation. Peskun CJ, Chahal J, Steinfeld ZY, Whelan DB. Clin Orthop Relat Res. 2011 Aug 6. [Epub ahead of print] PMID: 21822573 PDF
2. Lateral Unicompartmental Knee Arthroplasty Through a Lateral Parapatellar Approach Has High Early Survivorship. Berend KR, Kolczun MC 2nd, George JW Jr, Lombardi AV Jr. Clin Orthop Relat Res. 2011 Aug 6. [Epub ahead of print] PMID: 21822570 PDF
3. A More Reliable Method to Assess Acetabular Component Position. Tiberi JV, Pulos N, Kertzner M, Schmlazried TP. Clin Orthop Relat Res. 2011 Aug 6. [Epub ahead of print] PMID: 21822569 PDF
4. Can Stress Radiography of the Knee Help Characterize Posterolateral Corner Injury? Gwathmey FW Jr, Tompkins MA, Gaskin CM, Miller MD. Clin Orthop Relat Res. 2011 Aug 6. [Epub ahead of print] PMID: 21822568 PDF
5. Can Surgeons Predict What Makes a Good TKA?: Intraoperative Surgeon Impression of TKA Quality Does Not Correlate With Knee Society Scores. Lee GC, Lotke PA. Clin Orthop Relat Res. 2011 Aug 6. [Epub ahead of print] PMID: 21822567 PDF

Position of shoulder arthroplasty and clinical outcome in proximal humerus fractures.

Four-part proximal humeral fractures are frequently treated with shoulder replacement. Outcome of this procedure has not been standardized, and there are controversy data on range of motion (ROM) and active function of the shoulder. The aim of this study is to compare shoulder prosthesis position (SPP) in terms of version of humeral head and height of stem with clinical subjective and objective outcome. Padua R, Padua L, Galluzzo M, Ceccarelli E, Alviti F, Castagna A. Musculoskelet Surg. 2011 Jul;95 Suppl :55-8. PMID: 21479866

Skeletal Radiology: Osteochondral Lesions

1. Limitations of radiographs in evaluating non-displaced osteochondral lesions of the talus. Dheer S, Khan M, Zoga AC, Morrison WB. Skeletal Radiol. 2011 Aug 9. [Epub ahead of print]  PMID: 21826614
2. High-resolution MR imaging of talar osteochondral lesions with new classification. Griffith JF, Lau DT, Yeung DK, Wong MW. Skeletal Radiol. 2011 Aug 9. [Epub ahead of print] PMID: 21826613

Tuesday, August 9, 2011

Lawson scientist presents joint pain treatment 2.0

When patients have OA in the knee, the fluid in their joint breaks down, causing pain and preventing natural shock absorption. To treat this condition, gel-like substances called "viscosupplements" are injected into the knee. This acts as a supplement for the fluid loss and provides temporary pain relief. In the COR1.0 study, Dr. Petrella and his colleagues compared Synvisc-One, the leading market viscosupplement for OA in the knee, to Hydros-TA Joint Therapy. Hydros-TA is a unique dual-action treatment combining steroids within a viscosupplement. It is believed to provide faster acting, longer lasting pain relief than either treatment alone. Eurekalert!

Curry spice could offer treatment hope for tendinitis

A derivative of a common culinary spice found in Indian curries could offer a new treatment hope for sufferers of the painful condition tendinitis, an international team of researchers has shown.  In a paper due to be published in the Journal of Biological Chemistry, the researchers at The University of Nottingham and Ludwig Maximilians University in Munich have shown that curcumin, which also gives the spice turmeric its trademark bright yellow colouring, can be used to suppress biological mechanisms that spark inflammation in tendon diseases. Eurekalert!

The Dedicated Orthopedic Trauma Operating Room

The development and implementation of a dedicated orthopedic trauma operating room (OTOR) that is used for the treatment of orthopedic trauma patients has changed and improved the practice of orthopedic trauma surgery. Advantages noted with OTOR implementation include improvements in morbidity and complication rates, enhancements in the professional and personal lifestyles of the on-call surgeon, and increased physician recruitment and retention in orthopedic traumatology. However, the inappropriate use of the OTOR, which can waste valuable resources and delay the treatment of emergent cases, must be monitored and avoided.

Telemedicine to a moving ambulance improves outcome after trauma in simulated patients.

TM to a moving ambulance improved the care of simulated trauma patients. Furthermore, procedurally naïve EMTs were able to perform needle thoracostomy and pericardiocentesis with TM guidance. Charash WE, Caputo MP, Clark H, Callas PW, Rogers FB, Crookes BA, Alborg MS, Ricci MA. J Trauma. 2011 Jul;71(1):49-55. PMID: 21818014  PDF

Wayne State researcher discovers antibiotic useful for localized treatment of bone wear

Total joint replacement surgeries can help relieve joint pain common in people with conditions like osteoarthritis. But sometimes, the debris from prosthetic joints leads to aseptic loosening, or disintegration of surrounding bones. In 2009, a Wayne State University researcher determined that the anti-inflammatory antibiotic erythromycin can prevent and treat such disintegration. There was one caveat, however: there are side effects associated with long-term usage of erythromycin. Eurekalert!

The Plate-Joystick Technique to Reduce Proximal Humeral Fractures and Nonunions With a Varus Deformity Through the Extended Deltoid-Splitting Approach.

Fractures and nonunions in which there is a varus deformity of the humeral head producing posterinferior subluxation of the articular surface are increasingly recognized as an important subgroup of proximal humeral fractures. Operative open reduction and internal fixation of these injuries is often recommended when the varus deformity is severe. We describe a simple technique to assist in the open reduction and locking plate stabilization of this challenging and complex fracture subtype using tools and implants that are readily available in most modern orthopaedic trauma operating rooms. Robinson CM, Inman D, Phillips SA. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID:  21804419  PDF

Arthroscopic Treatment of Rotator Cuff Disease (article in press)

The goal of this article is to summarize the current concepts on rotator cuff disease with an emphasis on arthroscopic treatment. Most rotator cuff tears are the result of an ongoing attritional process. Once present, a tear is likely to gradually increase in size. Partial thickness and subscapularis tears can both be successfully treated arthroscopically if conservative management fails. Partial tears involving greater than 50% of tendon thickness should be repaired. Articular sided partial tears involving less than 50% of the rotator cuff can reliably be treated with debridement. A more aggressive approach should be considered for low-grade tears (<50%) if they occur on the bursal side. Biomechanical and anatomic studies have shown clear superiority with dual-row fixation compared with single-row techniques. However, current studies have yet to show clear clinical advantage with dual-row over single-row repairs. Biceps tenotomy or tenodesis can reliably provide symptomatic improvement in patients with irreparable massive tears. True pseudoparalysis of the shoulder is a contraindication to this procedure alone and other alternatives should be considered. Jarrett CD, Schmidt CC. J Hand Surg Am. 2011 Aug 6. [Epub ahead of print] PMID: 21821368  PDF


See also:
Arthroscopic treatment of rotator cuff disease GM Gartsman - Journal of Shoulder and Elbow Surgery, 1995 - Elsevier Rotator cuff disease represents a spectrum of tendon lesions including inflammation of an intrinsically normal tendon, tendon fibrosis, partial-thickness tears, complete tears, and cuff tear arthropathy. An in-depth analysis of the entire subject is beyond the scope of this ...
Cited by 59 (drill up) - Related articles - All 3 versions - Import into EndNote

Visible Body is a complete, fully interactive 3D rendering of the human body and may one day replace traditional anatomy texts

Visible Body  3D Human Anatomy Atlas for iPad 2 is a huge breath of fresh air. While we at iMedicalApps have been reviewing anatomy apps that constantly improved on previous ones, Visible Body simply blew me away. After using Visible Body for mere minutes, it felt as if someone had read my previous review and made it a goal to silence my past quibbles. Not only does it take full advantage of the iPad’s touchscreen interface, it does so in such a gorgeous manner that there are not enough superlatives in my vocabulary to adequately describe it. But since a picture is worth a thousand words (especially when it comes to anatomy), I will include plenty of pictures to rectify my speechlessness and for you to judge for yourself. iMedicalApps

Have you tried the Google Translate App with your patients?

he Google Translate app for Android translates speech in real time. It works best if you don't have a heavy accent. Google Translate is a free mobile app (developed by Google) and you can instantly translate text between more than 50 languages. It includes:
Text-to-speech
and
Voice input
Soon, we won't need interpreters because we'll be using our technology, right? Maybe. MedicalSmartphones

Monday, August 8, 2011

New Ortho Books (via Amazon)

Knee Arthroscopy by Brian McKeon, James V. Bono and John C. Richmond (Aug 29, 2011)

New Advances in Wrist and Small Joint Arthroscopy, An Issue of Hand Clinics (The Clinics: Orthopedics) by David J. Slutsky (Aug 28, 2011)

The Poly-Traumatized Patient with Fractures: A Multi-Disciplinary Approach by Hans-Christoph Pape, Roy Sanders and Joseph Borrelli Jr. (Aug 28, 2011)

Tribology in Total Hip Arthroplasty by Karl Knahr (Aug 28, 2011)

Fundamentals of Revision Hip Arthroplasty: Diagnosis, Evaluation, and Treatment by David J. Jacofsky MD and Anthony K. Hedley MD (Aug 15, 2011)

Oxford Textbook of Trauma and Orthopaedics by Christopher Bulstrode, James Wilson-MacDonald,
Jeremy Fairbank and Tim Briggs (Aug 11, 2011)

Manual of INTERNAL FIXATION: Techniques Recommended by the AO-ASIF Group by Maurice E. Müller, Robert Schneider, Hans Willenegger and Martin Allgöwer (Jul 29, 2011)

FOOT AND ANKLE ARTHROSCOPY, An Issue of Clinics in Podiatric Medicine and Surgery (The Clinics: Orthopedics) by Lawrence G. Rubin DPM (Jul 28, 2011)

Concepts and Cases in Nonunion Treatment by Rene Marti and Peter Kloen (Jul 27, 2011)

Armed Conflict Injuries to the Extremities: A Treatment Manual by Alexander Lerner and Michael Soudry (Jul 18, 2011)

Sunday, August 7, 2011

Multidrug-resistant chronic osteomyelitis complicating war injury in iraqi civilians.

War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission.  Murphy RA, Ronat JB, Fakhri RM, Herard P, Blackwell N, Abgrall S, Anderson DJ.
J Trauma. 2011 Jul;71(1):252-4. PMID: 21818032

Above- or below-elbow casts for distal third forearm fractures in children? A meta-analysis of the literature.

Fractures of the distal third forearm are common fractures in childhood. Most of these fractures can be treated non-operatively by means of closed reduction and immobilization. The purpose of this meta-analysis is to investigate whether above- or below-elbow cast should be considered the first-choice for conservative treatment.  Hendrickx RP, Campo MM, van Lieshout AP, Struijs PA, van den Bekerom MP. Arch Orthop Trauma Surg. 2011 Aug 5. [Epub ahead of print] PMID: 21818587

Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy.

Our radiographic results indicated that a preoperative hallux valgus angle >40° can be a risk factor for hallux valgus recurrence. Decreased risk factors for recurrence included hallux valgus angle ≤15° and an intermetatarsal angle <10° at the early follow-up. These risk factors may be helpful for modifying surgical procedures, improving surgical outcome, and predicting hallux valgus recurrence.  Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. J Orthop Sci. 2011 Aug 5. [Epub ahead of print] PMID: 21818604

Reconstructive osteotomy of fibular malunion: review of the literature.

The treatment of ankle fractures has a primary goal of restoring the full function of the injured extremity. Malunion of the fibula is the most common and most difficult ankle malunion to reconstruct. The most frequent malunions of the fibula are shortening and malrotation resulting in widening of the ankle mortise and talar instability, which may lead to posttraumatic osteoarthritis. The objective of this article is to review the literature concerning the results of osteotomies for correcting fibular malunions and to formulate recommendations for clinical practice. van Wensen RJ, van den Bekerom MP, Marti RK, van Heerwaarden RJ. Strategies Trauma Limb Reconstr. 2011 Aug;6(2):51-7. Epub 2011 Apr 6. PMID: 21818702 PDF

Saturday, August 6, 2011

Tornier Announces First Implant in U.S. Trial of Its Simpliciti Stemless Shoulder Joint Replacement System

Tornier N.V. (Amsterdam, The Netherlands), an orthopedic surgical solutions company, has announced the first implant of its Simpliciti stemless shoulder joint replacement system as part of an FDA -approved, investigational device exemption (IDE) study. The Simpliciti system is designed to allow surgeons to carry out total shoulder replacements without the complications, additional bone removal and time associated with conventional stemmed implants.

Functional reconstruction of ischemic contracture in the lower limb.

Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Tang H, Zhang SC, Tan ZY, Zhu HW, Zhang QL, Li M. Chin J Traumatol. 2011 Apr 1;14(2):96-9. PMID: 21453575

Management of Grade III Open Dislocated Ankle Fractures: Combined Internal Fixation with Bioabsorbable Screws/Rods and External Fixation.

Isolated dislocation of the ankle with grade III open fracture has been scarcely reported. These ankle injuries usually involved mortise fractures, complete dislocation of the tibial astragaloid joint, capsuloligamentous structure disruption, and severe soft-tissue damage. There is no well-recognized regimen that would result in desirable outcomes. Ye T, Chen A, Yuan W, Gou S. J Am Podiatr Med ssoc. 2011 Jul-Aug;101(4):307-15. PMID: 21816999

Friday, August 5, 2011

Mechanical Comparison of Two Types of Fixation for Ludloff Oblique First Metatarsal Osteotomy.

The use of a medially applied supplementary mini locking plate offers a simple and effective method to improve the mechanical stability of the Ludloff oblique osteotomy.  Tsilikas SP, Stamatis ED, Kourkoulis SK, Mitousoudis AS, Chatzistergos PE, Papagelopoulos PJ. J Foot Ankle Surg. 2011 Aug 1. [Epub ahead of print] PMID: 21813302

American Journal of Sports Medicine [Epub ahead of print]

1. Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis: A Randomized Controlled Clinical Trial. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813443 PDF
2. Patellar Tendon Ruptures in National Football League Players. Boublik M, Schlegel T, Koonce R, Genuario J, Lind C, Hamming D. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813442 PDF
3. Factors Affecting Rotator Cuff Healing After Arthroscopic Repair: Osteoporosis as One of the Independent Risk Factors. Chung SW, Oh JH, Gong HS, Kim JY, Kim SH. Am J Sports Med. 2011 Aug 3. [Epub ahead of print] PMID: 21813440 PDF

Stem cells in bone diseases: current clinical practice.

Introduction Bone is an obvious candidate tissue for stem cell therapy. This review provides an update of existing stem cell-based clinical treatments for bone pathologies. Sources of data A systematic computerized literature search was conducted. The following databases were accessed on 10 February 2011: NIH clinical trials database, PubMed, Ovid and Cochrane Reviews. Areas of agreement Stem cell therapy offers new options for bone conditions, both acquired and inherited. Areas of controversy There is still no agreement on the exact definition of 'mesenchymal stem cells'. Consequently, it is difficult to appreciate the effect of culture expansion and the feasibility of allogeneic transplantation. Growing points Based on the sound foundations of pre-clinical research, stem cell-based treatments and protocols have recently emerged. Areas timely for developing research Well-designed prospective clinical trials are needed in order to establish and develop stem cell therapy for bone diseases. Beyth S, Schroeder J, Liebergall M. Br Med Bull. 2011 Aug 3. [Epub ahead of print] PMID:  21813557

Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review.

Efficacy among surgical techniques varied depending on the clinical outcome measure, but all were superior to corticosteroid therapy and physical therapy according to the VAS and HHS in both comparison studies and between studies. This systematic review found that traditional nonoperative treatment helped most patients, SWT was a good alternative, and surgery was effective in refractory cases. Lustenberger DP, Ng VY, Best TM, Ellis TJ. Clin J Sport Med. 2011 Aug 2. [Epub ahead of print] PMID: 21814140

Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant.

Use of the anterolateral approach and endosteal augment of a lateral locking plate can minimize avascular necrosis following proximal humerus fracture Neviaser AS, Hettrich CM, Dines JS, Lorich DG. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814772

Intra-articular injection of hyaluronic acid (MW 1,500-2,000 kDa; HyalOne(®)) in symptomatic osteoarthritis of the hip: a prospective cohort study.

The study treatment reduced pain and improved mobility in osteoarthritis of the hip. These results in daily clinical practice demonstrate a beneficial effect and the safety of the study product and suggest adding intra-articular injections of HyalOne(®) to the armamentarium of conservative management of symptomatic hip osteoarthritis. Alberto M, Umberto M, Emanuele B, Bruno L, Valentina G, Prisco P, Mauro G, Sandro T. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814776

Thursday, August 4, 2011

Recent Military Related Ortho Trauma in PubMed

1. Combat-related pelvis fractures in nonsurvivors. Bailey JR, Stinner DJ, Blackbourne LH, Hsu JR, Mazurek MT. J Trauma. 2011 Jul;71(1 Suppl):S58-61. PMID: 21795891
2. Infections complicating the care of combat casualties during operations iraqi freedom and enduring freedom. Murray CK, Wilkins K, Molter NC, Li F, Yu L, Spott MA, Eastridge B, Blackbourne LH, Hospenthal DR. J Trauma. 2011 Jul;71(1 Suppl):S62-73. PMID: 21795880
3. Infectious complications and soft tissue injury contribute to late amputation after severe lower extremity trauma. Huh J, Stinner DJ, Burns TC, Hsu JR; Late Amputation Study Team. J Trauma. 2011 Jul;71(1 Suppl):S47-51. PMID: 21795878
Eastridge BJ, Hardin M, Cantrell J, Oetjen-Gerdes L, Zubko T, Mallak C, Wade CE, Simmons J, Mace J, Mabry R, Bolenbaucher R, Blackbourne LH. J Trauma. 2011 Jul;71(1 Suppl):S4-8. PMID:  21795876
J Trauma. 2011 Jul;71(1 Suppl):S147-50. PMID: 21795872
Ramasamy A, Hill AM, Phillip R, Gibb I, Bull AM, Clasper JC. J Trauma. 2011 Jul 29. [Epub ahead of print] PMID: 21808204 
8. Posterior distal tibial fracture in a military trainee. Miller J, Gerber JP. J Orthop Sports Phys Ther. 2011;41(8):615. Epub 2011 Aug 1. PMID: 21808103
9. Multiple limb compartment syndromes in a recruit with sickle cell trait. Way A, Ganesan S, McErlain M. J R Army Med Corps. 2011 Jun;157(2):182-3. PMID: 21805771 
10. rhBMP-2 not alendronate combined with HA-TCP biomaterial and distraction osteogenesis enhance bone formation. Ni M, Li G, Tang PF, Chan KM, Wang Y. Arch Orthop Trauma Surg. 2011 Jul 31. [Epub ahead of print] PMID: 21805359
11. Use of an "Antibiotic Plate" for Infected Periprosthetic Fracture in Total Hip Arthroplasty. Liporace FA, Yoon RS, Frank MA, Gaines RJ, Maurer JP, Polishchuk DL, Choung EW. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID:  21804411
12. Surface wound mapping of battlefield occulo-facial injury. Breeze J, Allanson-Bailey LS, Hunt NC, Midwinter MJ, Hepper AE, Monaghan A, Gibbons AJ. Injury. 2011 Jul 28. [Epub ahead of print] PMID: 21802684
13. Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures. Tong DK, Ji F, Cai XB. Chin J Traumatol. 2011 Aug 1;14(4):233-6. PMID: 21801668

Surgical treatment of displaced medial clavicle fractures using a small T-shaped plate and tension band sutures.

The surgical treatment of medial clavicle nonunion is associated with high complication and failure rates, particularly with regard to metal work migration. Therefore, we describe a simple surgical procedure for displaced medial clavicle fractures using a small T-shaped plate and multiple tension band sutures. After stabilizing the medial clavicle fracture using a small nonunion for the distal radius, our simple technique for preventing high complication and failure rates is performed easily and effectively, with sufficient tension band sutures. Kim KC, Shin HD, Cha SM. Arch Orthop Trauma Surg. 2011 Aug 3. [Epub ahead of print] PMID: 21811810

Proximal Sural Traction Neurectomy During Transtibial Amputations

Symptomatic neuroma formation after trauma-related transtibial amputations remains a clinical problem. The sural nerve is frequently overlooked in its vulnerable subcutaneous location in the posterior myofasciocutaneous flap and commonly leads to chronic pain and decreased prosthesis use.
Tintle SM, Donohue MA, Shawen S, Forsberg JA, Potter BK. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID: 21804416

Strategies in Trauma and Limb Reconstruction (Open Access)

1. Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface-experience in eight adult patients. Livani B, Castro G, Filho JR, Morgatho TR, Mongon ML, Belangero WD, Davitt M, Carvalho JA. Strategies Trauma Limb Reconstr. 2011 Jul 26. [Epub ahead of print] PMID: 21789589 PDF
Mesa PA. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785911 PDF
3. Guided growth for correction of knee flexion deformity: a series of four cases. Macwilliams BA, Harjinder B, Stevens PM. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785910 PDF
Pretell-Mazzini J, Rodriguez-Martin J, Auñon-Martin I, Zafra-Jimenez JA. Strategies Trauma Limb Reconstr. 2011 Jul 22. [Epub ahead of print] PMID: 21785909 PDF
5. Reconstruction nailing for ipsilateral femoral neck and shaft fractures. Tsarouhas A, Hantes ME, Karachalios T, Bargiotas K, Malizos KN. Strategies Trauma Limb Reconstr. 2011 Jul 21. [Epub ahead of print] PMID: 21779894 PDF
Ramesh S, Lim YJ. Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773776 PDF
7. Distal radioulnar joint prosthesis for the treatment of giant cell tumor of the distal ulna: a case report and literature review. Gracia I, Proubasta IR, Trullols L, Peiró A, Moya E, Cortés S, Buezo O, Majó J.
Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773775 PDF
Strategies Trauma Limb Reconstr. 2011 Jul 20. [Epub ahead of print] PMID: 21773774 PDF

Descending Geniculate Artery: The Ideal Recipient Vessel for Free Tissue Transfer Coverage of Below-the-Knee Amputation Wounds.

The descending geniculate artery has received notoriety as the source vessel of the medial femoral condyle vascularized bone flap in recent years. Its size and location enable it to serve as a useful recipient vessel in free flap reconstruction about the knee. It is particularly useful in coverage of unstable below-the-knee amputation stumps when recipient vessels are limited. It provides the ease and convenience of two-team surgery in the supine position and its distal position permits convenient and distal insetting of the transferred flap of choice. A discussion of its use in this setting and exemplary cases are provided. Higgins JP. J Reconstr Microsurg. 2011 Aug 2. [Epub ahead of print] PMID: 21811968

A meta-analysis of open versus arthroscopic Bankart repair using suture anchors

Purpose of this study is to conduct a meta-analysis comparing the results of open and arthroscopic Bankart repair using suture anchors in recurrent traumatic anterior shoulder instability. Using Medline Pubmed, Cochrane and Embase databases we performed a search of all published articles. We included only studies that compared open and arthroscopic repair using suture anchors. Database of Abstracts of Reviews of Effects ( DARE )

Wednesday, August 3, 2011

IT solution to improve hospital workflow and schedules (including the OR)

"The benefit of this system, over a human-run system, is that it is more accurate, efficient and quicker and is able to adapt to any changes in the availability of staff, equipment, or delays immediately.

"For example, surgical procedures can go overtime, staff can be off sick and equipment can fail, all of which can cause delays. This system is able to automatically revise the schedule of tasks in a way that maintains efficiency and assists in the decision making process." MedicalXpress

Orthopedic Reviews Vol 3, No 1 (2011) (open access)

1. Does improved instrumentation result in better component alignment in total knee arthroplasty?Hassaballa M, Budnar V, Gbejuade H, Learmonth I. Orthop Rev (Pavia). 2011 Mar 17;3(1):e3. PMID: 21808715 PDF
2. Enlarged transacromial superior approach with reverse shoulder arthroplasty for fractures. Poignard A, Bouhou M, Homma Y, Hernigou P. Orthop Rev (Pavia). 2011 Mar 17;3(1):e2. PMID: 21808714 PDF
3. Oxidative stress in secondary osteoarthritis: from cartilage destruction to clinical presentation? Ziskoven C, Jäger M, Zilkens C, Bloch W, Brixius K, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e23. PMID:  21808712 PDF
Orthop Rev (Pavia). 2010 Sep 23;2(2):e21. PMID: 21808711 PDF
5. Cell therapy in bone healing disorders. Jäger M, Hernigou P, Zilkens C, Herten M, Li X, Fischer J, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e20. PMID:  21808710  PDF
6. Arthroplasty of a Charcot knee. Babazadeh S, Stoney JD, Lim K, Choong PF. Orthop Rev (Pavia). 2010 Sep 23;2(2):e17. PMID: 21808708 PDF
7. Surgical management of complex humerus head fractures. El-Sayed MM. Orthop Rev (Pavia). 2010 Sep 23;2(2):e14. PMID: 21808705 PDF

Proximal humeral fractures.

This article reviews the current literature on the classification and treatment options for proximal humeral fractures, while seeking to help the reader to define the most appropriate treatment plan for each individual patient with this type of fracture.  Mauro CS. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print] PMID:  21808995

Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment.

The glenohumeral joint is inherently predisposed to instability by its bony architecture. The incidence of traumatic shoulder instability is 1.7% in the general population. Associated injuries to the capsulolabral structures of the glenohumeral joint have been described and may play a role in predicting recurrent instability. Advanced imaging, computed tomography or MRI may be necessary to adequately evaluate for associated glenohumeral pathology. Treatment algorithms have traditionally included a period of non-operative management in all patients, however young athletic patients may often benefit from early operative treatment. Various open and arthroscopic surgical options exist to address anterior glenohumeral instability. Bony injuries including bony Bankart lesions and Hills Sachs lesion have been implicated in failed surgical management using techniques that address only the soft tissues. An individualized treatment approach, based upon the patient's injury pattern and expectations, will likely lead to the most successful outcome. Dumont GD, Russell RD, Robertson WJ. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print]PMID:  21808996

Operative Management of Flatfoot and Arthritis of the Ankle

OPERATIVE MANAGEMENT OF FLATFOOT AND ARTHRITIS OF THE ANKLE
Orthopaedics
Volume 34, Issue 16
August 21, 2011
Lateral column lengthening and midfoot fusion – Alastair S.E. Younger, MD
Managing valgus angle pes planus – Timothy Daniels, MD
Ankle options: fusion and replacement – Dr. Daniels
Arthroscopic ankle fusion – Kevin J. Wing, MD



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Monday, August 1, 2011

Apps for surgeons and the operating room

The explosive growth of medical applications for smartphones, launched by the  debut of the innovative Apple iTunes App store in 2008, promises to fundamentally change the physician’s tool set. While many specialties have always been heavily dependent on technology, such as radiology and cardiology, the ubiquity of these small, interconnected computers means that every physician will soon have access to a broad array of software and hardware to help them perform their daily work. iMedicalApps

New composite material may restore damaged soft tissue

Biomedical engineers at Johns Hopkins have developed a new liquid material that in early experiments in rats and humans shows promise in restoring damaged soft tissue relatively safely and durably. The material, a composite of biological and synthetic molecules, is injected under the skin, then "set" using light to form a more solid structure, like using cold to set gelatin in a mold. The researchers say the product one day could be used to reconstruct soldier's faces marred by blast injuries. Eurekalert!

Sunday, July 31, 2011

Accuracy of intra-articular injections of the glenohumeral joint through an anterior approach: arthroscopic correlation.

The results of this study show that an anterior injection into the glenohumeral joint can be accurately placed without radiographic assistance using standard landmarks. The technique used is similar to making a standard rotator interval portal during shoulder arthroscopy; therefore, it is most successful in the hands of experienced shoulder arthroscopists.  Kraeutler MJ, Cohen SB, Ciccotti MG, Dodson CC. J Shoulder Elbow Surg. 2011 Jul 27. [Epub ahead of print] PMID: 21798769

Journal of Pediatric Orthopaedics. Part B [Epub ahead of print]

J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799451 Related citations
3. Risk of redisplacement after first successful reduction in paediatric distal radius fractures: sensitivity assessment of casting indices. Devalia KL, Asaad SS, Kakkar R. J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799449 Related citations

Extensor pollicis longus rupture after distal radius fracture: Results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting.

Injury of the extensor pollicis longus tendon is one of the commonest extensor tendon injuries after distal radius fracture. In 2003-2005 we performed extensor indicis transfer in 31 patients with loss of function of the EPL tendon and postoperative dynamic splinting. In 25 patients, a distal radius fracture managed surgically led to the EPL rupture (wire internal fixation in 23 patients, plate internal fixation in 2 patients). In 6 patients, the cause was a distal radius fracture treated conservatively. Out of our 25 followed-up patients, 9 (36%) had a very good and 15 (60%) a good result in the Geldmacher score. We did not identify any re-rupture. In injuries of the extensor pollicis tendon, transposition of the extensor indicis tendon is a simple and uncomplicated procedure. Considerable improvement of thumb extension can be achieved through this substitution repair. Figl M, Mayer M, Lederer S, Bogner R, Leixnering M. Wien Klin Wochenschr. 2011 Aug 3. [Epub ahead of print] PMID: 21800046

Knee Surgery, Sports Traumatology, Arthroscopy [Epub ahead of print]

1.  Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R, Saito T. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800168
2.
Hardeman F, Londers J, Favril A, Witvrouw E, Bellemans J, Victor J. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800167
3. The painful knee after total knee arthroplasty. Becker R, Bonnin M, Hofmann S. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] No abstract available. PMID: 21800166
4. Medium to long-term follow-up after ACL revision. Lind M, Lund B, Faunø P, Said S, Miller LL, Christiansen SE. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800165

Insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures.

Insufficiency fractures are often overlooked, particularly when associated with greater trochanteric avulsion fractures. Here, we report magnetic resonance imaging (MRI) findings of insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures treated by internal fixation.  Suzuki K, Kawachi S, Nanke H. Arch Orthop Trauma Surg. 2011 Jul 29. [Epub ahead of print] PMID: 21800198