1.
The Utility of DXA Assessment at the Forearm, Proximal Femur, and Lateral Distal Femur, and Vertebral Fracture Assessment in the Pediatric Population: 2019 ISCD Official Position.
Weber, DR, Boyce, A, Gordon, C, Högler, W, Kecskemethy, HH, Misra, M, Swolin-Eide, D, Tebben, P, Ward, LM, Wasserman, H, et al
Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry. 2019;(4):567-589
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Abstract
Dual-energy X-ray absorptiometry (DXA) is widely used in the evaluation of bone fragility in children. Previous recommendations emphasized total body less head and lumbar spine DXA scans for clinical bone health assessment. However, these scan sites may not be possible or optimal for all groups of children with conditions that threaten bone health. The utility of DXA scans of the proximal femur, forearm, and radius were evaluated for adequacy of reference data, precision, ability of predict fracture, and applicability to all, or select groups of children. In addition, the strengths and limitations of vertebral fracture assessment by DXA were evaluated. The new Pediatric Positions provide guidelines on the use of these additional measures in the assessment of skeletal health in children.
2.
Osteochondral Autograft Transplantation Surgery for Metacarpal Head Defects.
Kitay, A, Waters, PM, Bae, DS
The Journal of hand surgery. 2016;(3):457-63
Abstract
Post-traumatic osteonecrosis of the metacarpal head is a challenging problem, particularly in younger patients in whom arthroplasty may not be a durable option. Although several osteochondral reconstructive options have been proposed, some are associated with considerable donor site morbidity and/or require the use of internal fixation. We present an application of osteochondral autograft transplantation surgery as a treatment option for focal metacarpal head lesions. An osteochondral plug from the non-weight-bearing articular surface of the knee is transferred and press-fit to resurface a focal metacarpal head defect. The technical pearls and pitfalls are reviewed, and an illustrative case is presented.
3.
Cement fixation of the femoral component in older patients.
Lachiewicz, PF
Instructional course lectures. 2008;:261-5
Abstract
Polymethylmethacrylate cement fixation of the femoral component in total hip arthroplasty is still a reasonable option in a select group of patients. Cement fixation is indicated in sedentary patients older than 75 years, certain older patients with rheumatoid arthritis, and patients with femoral neck fractures or conversion surgery. Hips with severe osteopenia or a "stove-pipe" femur (Dorr type C) may also be considered for cement fixation. The cemented femoral component should be fabricated of a cobalt-chromium alloy with a modern geometry and offset. Third-generation cementing techniques should be used to obtain a grade A or B cement mantle. Antibiotic cement may be used in patients at higher risk for infection. The 10-year results of cemented femoral components in these patient populations are excellent.