What’s New in Orthopaedic Rehabilitation.

What’s New in Orthopaedic Rehabilitation.

Filed under: Rehab Centers

J Bone Joint Surg Am. 2012 Nov 21; 94(22): 2106-11
Baldwin K, Namdari S, Hosalkar H, Spiegel DA, Keenan MA

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[Evaluation of 10 Years Experience with Endo-Exo Femur Prostheses – Background, Data and Results.]

Filed under: Rehab Centers

Z Orthop Unfall. 2012 Nov 21;
Aschoff HH, Juhnke DL

Between 1999 and 2011 the Endo-Exo femur prosthesis has been applied to 54 patients. This comparatively new method for patient rehabilitation after upper leg amputation includes a two-step surgical procedure. The first step is an operation where the endomodule of the stem prosthesis is implanted in the bone via a press-fit technique. Then the soft tissue coat is closed to give the bone enough time for a secure osseointegration of the prosthesis. About six weeks later a stoma is cut out and the adapter for the exo-part is connected. The prosthesis is therefore intramedullary anchored and percutaneously penetrating the skin. A critical examination of this procedure has to put its main attention to the latent danger of an ascending, intramedullary infection. This may arise from the skin-penetrating stoma region at the distal stump. All data derived from patients operated in Lübeck, Germany have been evaluated focusing on reasons for objectionable operative procedures and their resulting terms of treatment. The evaluation shows that the initially high rate of stoma-associated infections of the soft tissue coat could be dramatically reduced through a change of design of the skin-penetrating parts. In between January 2009 and December 2011 (altogether 24 implants/23 patients) no operative revisions had to be undertaken because of infections of the stoma. Next to this there are more characteristics conditionally caused by the implant – like fractures of the affected extremity and other complications – presented in terms of cause-related case histories.
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The dorsal stream contribution to phonological retrieval in object naming.

Filed under: Rehab Centers

Brain. 2012 Nov 20;
Schwartz MF, Faseyitan O, Kim J, Coslett HB

Meaningful speech, as exemplified in object naming, calls on knowledge of the mappings between word meanings and phonological forms. Phonological errors in naming (e.g. GHOST named as ‘goath’) are commonly seen in persisting post-stroke aphasia and are thought to signal impairment in retrieval of phonological form information. We performed a voxel-based lesion-symptom mapping analysis of 1718 phonological naming errors collected from 106 individuals with diverse profiles of aphasia. Voxels in which lesion status correlated with phonological error rates localized to dorsal stream areas, in keeping with classical and contemporary brain-language models. Within the dorsal stream, the critical voxels were concentrated in premotor cortex, pre- and postcentral gyri and supramarginal gyrus with minimal extension into auditory-related posterior temporal and temporo-parietal cortices. This challenges the popular notion that error-free phonological retrieval requires guidance from sensory traces stored in posterior auditory regions and points instead to sensory-motor processes located further anterior in the dorsal stream. In a separate analysis, we compared the lesion maps for phonological and semantic errors and determined that there was no spatial overlap, demonstrating that the brain segregates phonological and semantic retrieval operations in word production.
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