MAY 2008 VOLUME XXXVII NUMBER 5 pISSN:1078-4519 eISSN:1934-3418

E-PUBLISHING

92	Biofeedback Versus Physiotherapy in Patients With Partial Weight-Bearing Erel Hershko, MSc, PT, Chanan Tauber, MD, and Eli Carmeli, PhD, PT Mr. Hershko is Head, Department of Physical Therapy, Bet-Hadar Medical and Rehabilitation Center, Ashdod, Israel. Medical instructions for partial weight-bearing after lower limb surgery and fractures are commonly given. The techniques for instruction are mainly verbal cues. Our aim was to evaluate the efficiency of a new biofeedback device compared with traditional intervention for gait rehabilitation. After orthopedic surgery, 33 patients, randomly divided into a study group (n = 15) and a control group (n = 18), completed 10 days of a rehabilitation protocol. A significant difference (P<.05) was found between the groups. Study subjects were able to follow weight-bearing instructions better. We suggest that gait rehabilitation is more efficient when biofeedback is used to instruct patients regarding partial weight-bearing. Am J Orthop. 2008;37(5):E92-E96.
97	Asymmetric Bilateral Shoulder Dislocation Involving a Luxatio Erecta Dislocation Daniel A. Fung, MD, Marc Menkowitz, MD, and Kenneth Chern, MD Dr. Fung is Surgery Intern, University of California at San Diego, San Diego, California. Abstract not available. Introduction provided instead. We present the unusual case of posttraumatic asymmetric bilateral shoulder dislocations in a woman in her late 70s—an inferior dislocation of the glenohumeral joint (luxatio erecta) in the right shoulder and an anterior dislocation in the left shoulder. Bilateral shoulder dislocations and luxatio erecta dislocations are both rare by themselves, with only a few reported cases of each. To our knowledge, this is the first reported case of asymmetrical bilateral shoulder dislocations involving a luxatio erecta dislocation. Am J Orthop. 2008;37(5):E97-E98.
99	Endovascular Management of Pseudoaneurysms Following Lower Limb Orthopedic Surgery Umar Sadat, MRCS, Jagjeeth Naik, MD, FRCS, Parvesh Verma, MB BS, Teikchoon C. See, FRCS, FRCR, Claire Cousins, FRCP, FRCR, Jai P. Chitnavis, M Chir, FRCS, Kevin Varty, MD, FRCS, and Michael E. Gaunt, MD, FRCS Dr. Sadat is Clinical Research Associate, Vascular Imaging, and Fellow in Vascular Surgery, Addenbrooke’s Hospital, NHS Foundation Trust, Cambridge University Hospitals, Cambridge, England. Abstract not available. Introduction provided instead. Orthopedic procedures like joint arthroplasty and joint arthroscopy can lead to unrecognized arterial injuries that later cause the formation of pseudoaneurysms. Here we present 5 cases of patients who underwent successful endovascular management of pseudoaneurysms that developed after lower limb joint arthroplasty or arthroscopy. Am J Orthop. 2008;37(5):E99-E102.
103	Sciatic Neuropathy From a Giant Hibernoma of the Thigh: A Case Report Salim Ersozlu, MD, Orcun Sahin, MD, Ahmet Fevzi Ozgur, MD, and Tolga Akkaya, MD Dr. Ersozlu is Medical Doctor, Department of Orthopedics and Traumatology, Konya Research Center, Baskent University, Konya, Turkey. Abstract not available. Introduction provided instead. Hibernomas—rare, uniformly benign soft-tissue tumors of brown fat—were originally described in 1906 by Merkel.1 These tumors are usually found in the scapular2 and posterior cervical regions or (more rarely) in the folds of the buttocks or on the thigh.3-5 Sciatic neuropathy is an infrequently diagnosed focal mononeuropathy. Few case reports of lipomas compressing the sciatic nerve or its peripheral branches have appeared in the literature.6-8 The present case report is to our knowledge the first on sciatic nerve palsy caused by a hibernoma. Am J Orthop. 2008;37(5):E103-E106.

241	The Forgotten Joints Glenn B. Pfeffer, MD Dr. Pfeffer, the journal’s Associate Editor for Foot and Ankle, is Director, Foot and Ankle Center, Cedars-Sinai Medical Center, Los Angeles, California. Abstract not available. Am J Orthop. 2008;37(5):241.
242	Bias in Research Steven S. Agabegi, MD, and Peter J. Stern, MD Dr. Agabegi is Resident, Department of Orthopaedic Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio. Bias is a systematic inconsistency in research that contaminates the primary comparison. There are several forms of bias, and there are specific methods of minimizing them in different study designs. The randomized controlled trial (RCT) is the gold standard to which all other study designs are compared. However, errors can be made at various stages of a RCT that introduce bias. Furthermore, not all questions can be addressed by a RCT, and in some cases another study design may be more appropriate. Observational studies are more prone to bias, but, when properly conducted with rigorous methods to minimize bias, these studies can be valuable in clinical research. Am J Orthop. 2008;37(5):242-248.
251	Midfoot Arthritis Siraj A. Sayeed, MD, Fazel A. Khan, MD, Norman S. Turner III, MD, and Harold B. Kitaoka, MD Dr. Sayeed is Staff Orthopedic Surgeon, Andrews Air Force Base, Maryland. Foot and ankle complaints are commonly encountered in orthopedic practice. Midfoot arthritis has the potential to cause a significant amount of pain and disability. A variety of conditions can cause or lead to midfoot arthritis. Treatment consists of either conservative management or surgical arthrodesis of the painful joints. In this article, we review the midfoot (its basic anatomy and biomechanics) and midfoot arthritis (its clinical presentation and etiology, radiographic evaluation, and treatment options). Am J Orthop. 2008;37(5):251-256.
257	Incidence and Pattern Types of Fractures of the Lateral Process of the Talus Phillip Langer, MD, and Christopher DiGiovanni, MD Dr. Langer is Trauma Fellow, Department of Orthopedic Surgery, Brown Medical School/Rhode Island Hospital, Providence, Rhode Island, and Clinical Instructor, University Orthopedics, Inc., Providence, Rhode Island. Fractures of the lateral process of the talus have historically been considered unusual. This study sought to more precisely define the typical lateral talar process fracture pattern and its incidence in general trauma patients. Such information may have implications for the clinical treatment of these seemingly increasingly recognized injuries. A retrospective review was performed at our level I trauma center of the x-rays and available computed tomography scans of all talus fractures treated between 2000 and 2005 to identify the respective incidence and variation in fracture configuration of all isolated lateral process injuries. The incidence was 10.4%. The fractures were most commonly single large fragments closely followed in frequency by nonarticular chip patterns. Am J Orthop. 2008;37(5):257-258.
259	Overcompression of the Syndesmosis During Ankle Fracture Fixation: A Case Report Robert E. Rupp, MD Dr. Rupp is a faculty member of the Lake Tahoe Sports Medicine Fellowship program and is with the Lake Tahoe Orthopaedic Institute, Zephyr Cove, Nevada. Abstract not available. Am J Orthop. 2008;37(5):259-261.
262	Intramalleolar Triplane Fracture With Osteochondral Talar Defect Wendy L. Heusch, DO, and Henry W. Albers, MD Dr. Heusch is Orthopedic Surgeon, Rainer Orthopedic Institute, Puyallup, Washington. Abstract not available. Am J Orthop. 2008;37(5):262-266.
268	Peroneal Nerve Compression Secondary to an Anomalous Biceps Femoris Muscle in an Adolescent Athlete Kevin M. Kaplan, MD, Abhay Patel, MD, and Drew A. Stein, MD Dr. Kaplan is Orthopaedic Resident, Hospital for Joint Diseases, New York, New York. Common peroneal nerve compression is a well-recognized entity that can cause severe debilitating clinical manifestations. The current literature describes numerous locations and mechanisms of compression, including both structural and systemic causes. Anatomical variants should be considered part of the differential diagnosis in peroneal nerve impingement. We present the case of a 14-year-old basketball player with footdrop secondary to compression of the common peroneal nerve from an accessory biceps femoris muscle, which was treated by neurolysis. In addition, we review the systematic workup of patients with nerve compression. Am J Orthop. 2008;37(5):268-271.
272	Fibula Osteotomy Using a Rib Cutter Daniel Omonbude, MBBS, MRCS, and Frank Howell, MA, FRCS Ed Dr. Omonbude is Specialist Registrar in Trauma and Orthopaedics, Dianna Princess of Wales Hospital, Grimsby, United Kingdom. We find the use of a rib cutter to be a useful alternative instrument in carrying out a fibular osteotomy. Am J Orthop. 2008;37(5):272.

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