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Buckley PD discount 100mg viagra soft with amex, Gearen PF, Petty RW (1991) Structural bone-grafting for early atraumatic avascular necrosis of the femoral head. Boettcher WG, Bonfiglio M, Smith K (1970) Non-traumatic necrosis of the femoral head. Bonfiglio M, Voke EM (1968) Aseptic necrosis of the femoral head and non-union of the femoral neck. Effect of treatment by drilling and bone-grafting (Phemister tech- nique). Smith KR, Bonfiglio M, Montgomery WJ (1980) Non-traumatic necrosis of the femoral head treated with tibial bone-grafting. Nelson LM, Clark CR (1993) Efficacy of Phemister bone grafting in nontraumatic aseptic necrosis of the femoral head. Carter JR, Furey CG, Shaffer JW (1998) Histopathologic analysis of failed vascularized fibular grafts in femoral head osteonecrosis. Malizos KN, Seaber AV, Glisson RR, et al (1997) The potential of vascularized cortical graft in revitalizing necrotic cancellous bone in canines. In: Urbaniak JR, Jones JP Jr (eds) Osteonecrosis: etiology, diagnosis, and treatment, 1st edn. Kane SM, Ward WA, Jordan LC, et al (1996) Vascularized fibular grafting compared with core decompression in the treatment of femoral head osteonecrosis. Berend KR, Gunneson EE, Urbaniak JR (2003) Free vascularized fibular grafting for the treatment of postcollapse osteonecrosis of the femoral head. Plakseychuk AY, Kim SY, Park BC, et al (2003) Vascularized compared with nonvas- cularized fibular grafting for the treatment of osteonecrosis of the femoral head. Judet H, Gilbert A (2001) Long-term results of free vascularized fibular grafting for femoral head necrosis. Malizos KN, Soucacos PN, Beris AE (1995) Osteonecrosis of the femoral head.

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If you wish to pursue any of these in more depth cheap 50 mg viagra soft with amex, useful re- ferences are included at the end of this chapter. Quantitative research generates statistics through the use of large-scale survey research, using methods such as questionnaires or structured interviews. If a market re- searcher has stopped you on the streets, or you have filled in a questionnaire which has arrived through the post, this falls under the umbrella of quantitative research. This type of research reaches many more people, but the con- tact with those people is much quicker than it is in quali- tative research. Qualitative versus quantitative inquiry Over the years there has been a large amount of complex discussion and argument surrounding the topic of re- search methodology and the theory of how inquiry should proceed. Much of this debate has centred on the issue of qualitative versus quantitative inquiry – which might be the best and which is more ‘scientific’. Different meth- odologies become popular at different social, political, historical and cultural times in our development, and, in my opinion, all methodologies have their specific strengths and weaknesses. At the end of this chap- ter references are given if you are interested in following up any of these issues. Certainly, if you were to do so, it 16 / PRACTICAL RESEARCH METHODS would help you to think about your research methodology in considerable depth. Deciding which methodology is right for you Don’t fall into the trap which many beginning (and ex- perienced) researchers do in thinking that quantitative re- search is ‘better’ than qualitative research. Neither is better than the other – they are just different and both have their strengths and weaknesses. What you will find, however, is that your instincts probably lean you towards one rather than the other. Listen to these instincts as you will find it more productive to conduct the type of re- search with which you will feel comfortable, especially if you’re to keep your motivation levels high. Also, be aware of the fact that your tutor or boss might prefer one type of research over the other. If this is the case, you might have a harder time justifying your chosen methodology, if it goes against their preferences. EXAMPLES OF QUALITATIVE RESEARCH METHODOLGIES Action research Some researchers believe that action research is a re- search method, but in my opinion it is better under- stood as a methodology.

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The third part of the book dealt musculature lesion of Volkmann’s contracture with operative indications and furnished much was clearly differentiated from the lesion seen in thoughtful information cheap viagra soft 50 mg without a prescription. The systematization of paralysis following poliomyelitis or peripheral the surgical indications in orthopedic conditions nerve lesions; in Volkmann’s contracture there is is of invaluable service to the orthopedic surgeon. His aim was to attain a satisfactory degree structive surgery of the upper extremity. He of body symmetry and of proper redistribution of published many monographs on different weight by helping in the development of com- reconstructive operations. He was one of the pioneers in this field, by operative means will be necessary are by virtue of and his systematization of exercises and muscle this realignment by compensation without relaxation in re-education for the upper extremity is of great better position to hold after operation than spines oper- interest. In his scholarly book, Reconstructive ated upon in a state of decompensation. Surgery of the Upper Extremity, published in 1923, the functional anatomy of the shoulder, the He never wavered from these ideas, although elbow, the wrist and the fingers was studied care- occasionally, in front of a rapidly progressive case fully. This was an important reference book for of idiopathic scoliosis, he would comment sadly the great development of upper extremity surgery on our great ignorance of the nature of this defor- in the 1930s and the 1940s. The book, Diseases and Deformities of indications for the paralytic arm have stood the the Spine and Thorax, published in 1929, is an test of time. He studied the substitutionary motion excellent compilation of knowledge on the of the shoulder in cases of complete paralysis of subjects from all available sources. In every one the deltoid muscle, observing that deltoid paraly- of the chapters there is a thorough discussion sis was hardly ever strictly isolated. In cases of of the embryology, anatomy, pathomechanics and permanent inability of abduction and failure to biology before the handling of the clinical replace the deltoid action by substitutionary description and the treatment. He studied the permanent results was the arthrodesis of the kinetic problems of the shoulder joint, the flail shoulder joint. For the flail elbow he advocated elbow, the pronation contracture of the forearm, his operation of proximal transposition of flexors and the wrist joint.

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It is generally recommended that the spinal board is removed within 30 minutes of its application whenever possible generic viagra soft 50mg mastercard. If full splintage is required following removal of the spinal board, especially for transit between hospitals, use of a vacuum mattress is recommended. This device is contoured to the patient before air is evacuated from it with a pump. The vacuum causes the plastic beads within the mattress to lock into position. Interface pressures are much lower when a vacuum mattress is used and patients find the device much more comfortable than a spinal board. Paediatric vacuum mattresses are also available and they may be used at the accident scene. A specific clinical problem in spinal cord injury is the early diagnosis of intra-abdominal trauma during the secondary survey. This may be very difficult in patients with high cord lesions (above the seventh thoracic segment) during the initial phase of spinal shock, when paralytic ileus and abdominal distension are usual. For secure immobilisation together with the flaccid paralysis, means that the classical during transportation, forehead and collar tapes should be applied. The signs of peritoneal irritation do not develop but pain may be referred to the shoulder from the diaphragm and this is an important symptom. When blunt abdominal trauma is suspected, peritoneal lavage or computed tomography is recommended unless clinical concern justifies immediate laparotomy. Abdominal bruising from seat belts, especially isolated lap belts in children, is associated with injuries to the Box 2.


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