Bulletin of the Hospital for Joint Diseases 

About: Bulletin of the Hospital for Joint Diseases is an academic journal published by J.Michael Ryan Publishing. The journal publishes majorly in the area(s): Medicine & Femur. It has an ISSN identifier of 2328-4633. Over the lifetime, 1167 publications have been published receiving 13392 citations.

The principles of the Ilizarov method.

Abstract: The author was the 1987 Sir Robert Jones Lecturer of the Hospital for Joint Diseases Orthopaedic Institute. This article is based on the speech he delivered in that capacity on October 30, 1987, at the Annual Scientific Program of the Alumni Association, supplemented by material he presented at a three-day International Conference on the Ilizarov Techniques for the Management of Difficult Skeletal Problems which was sponsored by HJDOI November 1-3, 1987.

The incidence of full thickness rotator cuff tears in a large cadaveric population.

Abstract: The incidence of full thickness rotator cuff tears was determined after careful dissection and inspection of 235 male and female cadavers ranging in age from 27-102 years with an average age of 64.7 years. A total of 456 shoulders were examined. Partial thickness tears were excluded from the study. Seventy-eight shoulders, 17% (53 female, 26 male) were found to have full thickness tears. The average age of those cadavers with tears was 77.8 years as compared to 64.7 years in the intact group. The incidence of full thickness tears was also found to increase with increasing age. In cadavers under 60 years of age the incidence of rotator cuff tears was 6% as opposed to 30% in those over 60 years of age.

The economics of treating tibia fractures. The cost of delayed unions.

Abstract: The tibia, being the most commonly fractured long bone, is associated with a high incidence of delayed union and non-union. A previously published prospective, randomized, double-blind and placebo-controlled tibia study demonstrated that pulsed, low-intensity ultrasound shortened the time to a healed fracture and significantly reduced the incidence of delayed union. The economics of treating tibia fractures has never been calculated. We have reviewed the literature pertaining to the tibia, the results of the above published tibia study, and stratified the data from that study for those patient and fracture co-morbidity factors that can influence healing of tibia fractures. Three economic models are presented with the total costs of treating a pool of 1,000 patients with tibial shaft fractures divided into two treatment paths - operative and conservative. These costs include surgery and recovery, outpatient costs, and Workers' Compensation costs for both the primary and secondary procedures, and emergency room and disability costs. The first model does not use low-intensity ultrasound and provides a summary of the costs associated with fracture treatment for each treatment path. The second model uses low-intensity ultrasound adjunctively with the conservatively treated group while the third model uses ultrasound adjunctively in both the operative and conservative groups. When comparing the conservative treatment path of Model 2 to Model 1 a cost savings of over $15,000 per case (40%) is realized by dramatically lowering secondary procedures and Workers' Compensation costs when pulsed low-intensity ultrasound is used adjunctively with conservative treatment. A similar savings of over $13,000 per case results from the use of ultrasound in the operative treatment path of Model 3 when compared with the standard operative care of Model 1. The total savings realized is over $14.6 million when adjunctively using low-intensity ultrasound in both the conservative and operative treatment paths. These analyses demonstrate that reduced healing time could yield substantial cost savings for third party payors, employers, and government agencies by lessening the need for secondary procedures and reducing the amount of Workers' Compensation payments.

A comparison of nonoperative and operative treatment of type II distal clavicle fractures

Abstract: A retrospective study was performed to compare nonoperative and operative treatments of Type II distal clavicle fractures. From a total of 30 diagnosed patients, 16 were identified as receiving nonoperative treatment and 14 open reduction and coracoclavicular stabilization. The average follow-up was 53.5 months for the nonoperative group and 59.8 months for the operative group. All patients were evaluated postoperatively for pain, range of motion, function, and fracture healing as well as for isokinetic strength. Fractures treated surgically achieved union within six to ten weeks. Nonoperative treatment resulted in seven nonunions. There were no significant differences between the two groups in the mean UCLA, Constant, and ASES scores. Nonunion had no significant effect on functional outcome or strength. This study suggests that Type II distal clavicle fractures can be successfully managed nonoperatively. The high incidence of nonunion does not impede a clinical outcome comparable to that achieved by surgical treatment.

A new suggestion for the treatment of minimally displaced fractures of the greater tuberosity of the proximal humerus.

Abstract: Fourteen shoulders in 14 patients with minimally displaced fractures of the greater tuberosity of the proximal humerus were evaluated, at an average of 3 years, 7 months (range: 1 year to 6 years, 1 month) after the operation. For comparison this portion of the proximal humerus was measured using 100 Korean adult cadaveric humeri. The results of these preliminary studies suggest that the patients presenting with a one-part fracture of the greater tuberosity of the proximal humerus should be evaluated individually. In most patients in whom the displacement of the fragment is less than 5 mm, good results can be obtained with non-operative treatment. If the displacement of the fragment is more than 5 mm in young active patients, and more than 3 mm in individuals (especially athletes and heavy laborers) involved in overhead activity, the fragment should be mobilized, repaired, and fixed into its original bed or slightly inferolaterally.