ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

In the specialty of orthopedic surgery, most conditions impact tremendously on patients' quality of life but not on the length of their life. Therefore, it only makes sense to consider the measurement of health-related quality of life when assessing the relative efficacies of the treatments that are available. Traditional objective measures of patient outcome have included range of motion, strength, and radiographic variables. These measures are usually very poor indicators of the functional and psychological aspects of patient health. Subjective measures of quality of life, when rigorously developed, have been found to be more reliable and valid. Additionally, it has been found that older instruments reflect the fact that they were developed at a time when little information was available on the appropriate methodology for instrument development. However, it is clear that much progress has been made in the area of orthopedic surgery, and currently there is an appropriate instrument for each of the main conditions of the shoulder. Investigators planning clinical trials should select one of the modern instruments developed with appropriate patient input for item generation and reduction, established validity, and reliability. All things being equal, the most responsive instrument available should be used to minimize the sample size for the proposed study. The shoulder instruments reviewed in this article include the Rating Sheet for Bankart Repair (Rowe); ASES Shoulder Evaluation Form; UCLA Shoulder Score; The Constant Score; Disabilities of the Arm, Shoulder, and Hand (DASH) Outcome Measure; the Shoulder Rating Questionnaire; the Western Ontario Osteoarthritis of the Shoulder Index (WOOS); the Western Ontario Rotator Cuff Index (WORC); the Western Ontario Shoulder Instability Index (WOSI); and the Rotator Cuff Quality of Life (RC-QOL).

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Optimal outcomes when managing fractures of the proximal humerus are contingent on the surgeon's knowledge of the fracture geometry, the quality of the bone, the patient's lifestyle, and an organized rehabilitation protocol. To assess the fracture pattern, the treating physician must know the anatomy of the proximal humerus and the appropriate imaging studies that need to be obtained. Proximal humerus fractures in elderly and young patients are very different. A patient's age, lifestyle, bone quality, and overall health impact heavily on treatment. Patients must be educated with regard to what a successful outcome means and the rehabilitation program that will help them reach that goal.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The proximal humerus is a common location for malignant lesions of the bone. With the advent of limb-sparing approaches, several reconstructive options have been developed. Although allograft reconstructions are technically difficult and fraught with potential complications, they may provide a better functional outcome. One major drawback to using allografts is the articular degeneration that almost universally occurs. One recently developed method for avoiding this problem is the use of endoprosthesis-allograft composites. This article will relate the specific indications and the appropriate preoperative assessment for performing allograft or endoprosthesis-allograft reconstructions for malignant lesions of the proximal humerus. The focus will be on the specifics of the operative technique and the critically important postoperative rehabilitation. Finally, the limited results that have been reported on this topic to date will be discussed.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

In the course of clinical practice, surgeons who care for patients with disorders of the upper extremity will encounter some whose signs and symptoms depart from the list of conditions that immediately come to mind. Some of these patients will actually be suffering from proximal neurovascular compression within the thoracic outlet. This article presents an explanation of the pathogenesis, diagnosis, and treatment of this uncommon, yet important entity.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Brachial plexus surgical treatment, though complex, has evolved substantially over the past 40 years as technology and microsurgical techniques have continued to improve. Options for repair, depending on the type and level of injury, include neurolysis, direct repair, nerve grafting, nerve transfer, arthrodesis, and muscle and tendon transfer. A comprehensive review of the indications, preoperative work-up, and surgical approach is presented, along with outcomes, complications, and postoperative management. We conclude with a discussion of the evaluation and management of patients with thoracic outlet syndrome.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

Despite being the largest rotator cuff tendon of the shoulder, the function and clinical relevance of subscapularis pathology has been largely ignored in the literature. Although more recent studies have focused on subscapularis tears, all have reported on techniques of open repair. The advent of arthroscopy and arthroscopic repair techniques has opened new frontiers for the diagnosis and repair of torn rotator cuff tendons, including the subscapularis. In this article, the authors review the senior author's surgical rationale, technique, and preliminary results of arthroscopic subscapularis repair.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID

摘要:

The Ilizarov method for fracture management has historically been reserved for complex deformities, recalcitrant nonunions, and high-grade open fractures. Advances in the understanding of fracture healing and the importance of the soft tissue envelope have led to the use of external fixation for routine fracture management. Application of the Ilizarov method provides stable fixation by allowing early range of motion while minimizing soft tissue trauma and preserving the fracture fragment blood supply. The authors present a technique and illustrative case describing the use of the Ilizarov method for acute extraarticular distal humerus fracture management.

ISSN:1523-9896    

出版商:OVID    

年代:2002

数据来源: OVID