A new surgical method is introduced offering a less invasive approach to reattach the medial retinaculum following acute patellar dislocation. This retrospective analysis comprised 12 cases of medial retinacular repair in 10 patients. The surgical technique achieved reinforced reattachment of the torn region of the medial retinaculum for improved patellar support and stabilization. During follow-up, no recurrent patellar dislocations occurred, except where one patient reported a subjective feeling of patellar dislocation. The average Kujala score for our sample group after 2 years was 89.2. A plethora of methods are described in the literature to repair a tear to the medial patellofemoral ligament, which attaches at the superomedial patella. However, it is our contention that traumatic patellar dislocation invariably results in osteochondral avulsion at the inferomedial patella, refuting medial patellofemoral ligament involvement, and, rather, implicating the inferior aspect of the deep layer of medial retinaculum. Our surgical technique enables stable fixation of the region, decreasing the rate of recurrent dislocations. No grafts are used, permitting tendinous and ligamentous anatomy to remain intact. We further postulate that performing a CT examination preoperatively may reduce time between diagnosis and surgery, in addition to locating fracture sites more precisely.
Objective This article examined current chiropractic oaths, particularly topics related to aspects of integrity, ethics, and professional behavior. The oaths were then compared for their individual inclusion and emphasis of these components. Methods Data were obtained from 1988 and 2019 papers describing components of the oaths used at each existing chiropractic college as well as those used in the past by colleges that are no longer operational. Additionally, colleges founded after 2019 were contacted to obtain their oaths. Nine oath components related to ethics and professional conduct were selected from 26 topics originally studied. Each oath was evaluated for the presence of and specific wording used to describe those components. The oaths were compared for their inclusion and emphasis of these components. Results Some topics, such as “keeping a patient's confidence” and “refrain from wrongdoing,” demonstrated a high rate of occurrence. Others, including “serving humanity” and “respecting teachers,” were less frequent. The oath of 1 program contained 8 of the topics, 4 program's oaths used 7 topics, 11 schools had 6 topics in their oath, and the oaths of 5 schools included 2 topics. Conclusion There is wide variation in the occurrence and emphasis of themes relating to ethics, integrity, and professionalism in the different chiropractic oaths. This study provides information for institutions to consider with regard to the content of the oath they administer. It is hoped that this article may encourage the creation of a universally accepted chiropractic oath that will help each graduate commit to a fulsome, all-encompassing pledge to become an ethical professional who optimally represents chiropractic.
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