[The Fight Against Polio: A Social-Medical Alliance, Buenos Aires, 1943].

[The fight against polio: a social-medical alliance, Buenos Aires, 1943].

Salud Colect. 2012 Dec; 8(3): 299-314
Testa DE

The present article analyzes the emergence of a volunteer-based social assistance organization that played an active role in the health care provided for poliomyelitis in Argentina: Asociación para la Lucha contra la Parálisis Infantil (Association for the Fight against Child Paralysis). This institution was created in Buenos Aires in 1943 by a group of women from upper and middle class social sectors. In a context of biomedical uncertainty, the organization mobilized material and symbolic resources to respond to the need for rehabilitation of the permanent physical conditions the disease provoked in its victims. Using as a source the institutional memories of the organization, the article demonstrates how doctors and philanthropists formed a social-medical alliance and developed a fundamental interest in practicing a form of treatment sustained in a framework that united Christian ideas with medical and rehabilitative innovations. HubMed – rehab


Pediatric Orthopedic Injuries Requiring Hospitalization: Epidemiology and Economics.

J Orthop Trauma. 2013 May 15;
Nakaniida A, Sakuraba K, Hurwitz EL

OBJECTIVE:: This study aimed to identify the 10 most frequent pediatric orthopaedic injuries requiring hospitalization in the United States, the major causes of these injuries, and their economic burden to healthcare cost. METHODS:: The 2006 Kids’ Inpatient Database (KID) (age range, 0-20 years) was used to determine the 10 most frequent pediatric orthopaedic injuries requiring hospitalization. The injuries were identified by ICD-9-CM codes 800.0-999.9 and external cause of injury codes (E-codes). Discharges were weighted to produce national estimates according to average age at admission, hospital charges, and length of stay. RESULTS:: The two populations accounting for the highest total hospitalization charges ($ , USD) for pediatric orthopaedic injury were young children with femur fractures (aged 11 years, 20%, $ 32 441/visit) and adolescents with vertebral fractures (aged 17 years, 8%, $ 53 992/visit). But the most common injuries requiring hospitalization were femur (aged 11 years; 20%) and humerus (aged 8 years; 18%) fractures. The most costly injuries, vertebral and pelvic injuries, were largely related to motor vehicle accidents (11.7% and 14.4%, respectively). In contrast, humerus and radius fractures had a high rate of playground related injuries (21.9% and 11.3%, respectively). None of the causes accounted for more than 25% of the total incidence for the 10 most common injuries identified in this study. CONCLUSIONS:: Identification of the patients responsible for the majority of the hospitalization charges for pediatric injuries will enable institutions to better plan their budgets on the basis of the local incidence. HubMed – rehab


Accuracy in Radiographic Assessment of Pelvic Ring Fracture Deformity.

J Orthop Trauma. 2013 May 15;
Nystrom LM, McKinley TO, Marsh JL

OBJECTIVES:: To our knowledge, measuring pelvic ring displacement on plain radiographs has not been scientifically evaluated. This study aims to assess the validity and reliability of existing measurement systems utilizing plain radiographs. METHODS:: A sawbones model, validated as part of this study, was fractured in a controlled fashion to simulate known pelvic ring fracture patterns. CT scans with two- and three-dimensional reconstructions of intact and injury models were obtained to measure “true” displacement of anterior and posterior disrupted surfaces. The CT data set was used to create computer reconstructed radiographs (CRR) simulating standard AP, inlet and outlet views. Currently described measurement techniques were utilized by eight senior orthopaedic residents and three fellowship-trained orthopaedic trauma surgeons on the CRR of each model. These measurements were than assessed for interobserver reliability and validity. RESULTS:: Average observer measurements of anterior symphysis diastasis and vertical translation had good validity and reliability with each having an average confidence interval of 4.6 mm. The observer measurements of sacroiliac (SI) joint displacement were significantly less reliable with average confidence interval of 5.8 mm. Kappa correlation calculations for whether the SI joint was displaced more than one centimeter showed an overall agreement of 0.702 and Kappa coefficient of 0.404. CONCLUSIONS:: Computer reconstructed radiographic, and thus plain radiographic, assessments of deformity at the SI joint have poor reliability and accuracy. Clinicians should recognize these limitations when measuring pelvic displacement of the SI joint and cautiously interpret clinical results of treatment of SI joint injuries where displacement is measured on plain radiographs. HubMed – rehab