Ernest Amory Codman, MD, 1869–1940

This biographical sketch on Ernest Amory Codman corresponds to the historic text, The Classic: The Registry of Bone Sarcomas as an Example of the End-Result Idea in Hospital Organization, available at DOI 10.1007/s11999-009-1048-7 and The Classic: Registry of Bone Sarcoma: Part I.—Twenty-Five Criteria for Establishing the Diagnosis of Osteogenic Sarcoma. Part II.—Thirteen Registered Cases of “Five Year Cures” Analyzed According to These Criteria, available at DOI 10.1007/s11999-009-1049-6

The Classic: The Registry of Bone Sarcomas as an Example of the End-Result Idea in Hospital Organization

This Classic Article is a reprint of the original work by Ernest Amory Codman, The Registry of Bone Sarcomas as an Example of the End-Result Idea in Hospital Organization. An accompanying biographical sketch of Ernest Amory Codman, MD, and The Classic: Registry of Bone Sarcoma: Part I.—Twenty-Five Criteria for Establishing the Diagnosis of Osteogenic Sarcoma. Part II.—Thirteen Registered Cases of “Five Year Cures” Analyzed According to These Criteria are available at DOIs 10.1007/s11999-009-1047-8 and 10.1007/s11999-009-1049-6, respectively. The Classic Article is ©1924 by the Bulletin of the American College of Surgeons and is reprinted with permission from Codman EA. The registry of bone sarcoma as an example of the end-result idea in hospital organization. Bull Am Coll Surg. 1924;8:34–38

The Classic: Registry of Bone Sarcoma: Part I.—Twenty-Five Criteria for Establishing the Diagnosis of Osteogenic Sarcoma. Part II.—Thirteen Registered Cases of “Five Year Cures” Analyzed According to These Criteria

This Classic Article is a reprint of the original work by Ernest Amory Codman, Registry of Bone Sarcoma: Part I.—Twenty-Five Criteria for Establishing the Diagnosis of Osteogenic Sarcoma. Part II.—Thirteen Registered Cases of “Five Year Cures” Analyzed According to These Criteria. An accompanying biographical sketch of Ernest Amory Codman, MD, and The Classic: The Registry of Bone Sarcomas as an Example of the End-Result Idea in Hospital Organization are available at DOIs 10.1007/s11999-009-1047-8 and 10.1007/s11999-009-1048-7, respectively. The Classic Article is ©1926 by the Journal of the American College of Surgeons and is reprinted with permission from Codman EA. Registry of bone sarcoma; part I, twenty-five criteria for establishing diagnosis of osteogenic sarcoma; part II, 13 registered cases of 5 year cures analyzed according to these criteria. Surg Gynecol Obstet. 1926;42:381–393

Doctors under the microscope: the birth of medical audit

In 1989 a UK government White Paper introduced medical audit as a comprehensive and statutory system of assessment and improvement in quality of care in hospitals. A considerable body of research has described the evolution of medical audit in terms of a struggle between doctors and National Health Service managers over control of quality assurance. In this paper we examine the emergence of medical audit from 1910 to the early 1950s, with a particular focus on the pioneering work of the American surgeons Codman, MacEachern and Ponton. It is contended that medical professionals initially created medical audit in order to articulate a suitable methodology for assessing individual and organisational performance. Rather than a means of protecting the medical profession from public scrutiny, medical auditing was conceived and operationalised as a managerial tool for fostering the active engagement of senior hospital managers and discharging public accountability. These early debates reveal how accounting was implicated in the development of a system for monitoring and improving the work of medical professionals, advancing the quality of hospital care, and was advocated in ways, which included rather than excluded managers

Chondroblastoma of the cuboid with an associated aneurysmal bone cyst: a case report

We report the case of a young adult who presented with a painful foot due to chondroblastoma associated with an aneurismal bone cyst

MRI Findings for Frozen Shoulder Evaluation: Is the Thickness of the Coracohumeral Ligament a Valuable Diagnostic Tool?

Recent studies have demonstrated that the coracohumeral ligament (CHL) is shortened and thickened in a frozen shoulder. We analyzed the rate in CHL visualization between patients with frozen shoulder and normal volunteers using Magnetic Resonance Imaging (MRI) to determine the CHL thickness in the patients with a frozen shoulder.>0.05).MR Imaging is a satisfactory method for CHL depiction, and a thickened CHL is highly suggestive of frozen shoulder

Inter- and intraobserver reliability of the MTM-classification for proximal humeral fractures: A prospective study

<p>Abstract</p> <p>Background</p> <p>A precise modular topographic-morphological (MTM) classification for proximal humeral fractures may address current classification problems. The classification was developed to evaluate whether a very detailed classification exceeding the analysis of fractured parts may be a valuable tool.</p> <p>Methods</p> <p>Three observers classified plain radiographs of 22 fractures using both a simple version (fracture displacement, number of parts) and an extensive version (individual topographic fracture type and morphology) of the MTM classification. Kappa-statistics were used to determine reliability.</p> <p>Results</p> <p>An acceptable reliability was found for the simple version classifying fracture displacement and fractured main parts. Fair interobserver agreement was found for the extensive version with individual topographic fracture type and morphology.</p> <p>Conclusion</p> <p>Although the MTM-classification covers a wide spectrum of fracture types, our results indicate that the precise topographic and morphological description is not delivering reproducible results. Therefore, simplicity in fracture classification may be more useful than extensive approaches, which are not adequately reliable to address current classification problems.</p

External rotation during elevation of the arm

Background Knowledge about the pattern of rotation during arm elevation is necessary for a full understanding of shoulder function, and it is also useful for planning of rehabilitation protocols to restore range of motion in shoulders in disorder. However, there are insufficient in vivo data available

Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography?

The purpose of this study was to retrospectively evaluate sensitivity and specificity of a single magnetic resonance (MR) arthrography series in abduction external rotation (ABER) position compared with conventional MR arthrography for detection of supraspinatus tendon tears, with arthroscopy as gold standard, and to assess interobserver variability. Institutional review board approval was obtained; informed consent was waived. MR arthrograms of 250 patients (170 men and 80 women; mean age, 36 years) were retrospectively and independently evaluated by three observers. Oblique coronal T1-weighted fat-suppressed images, proton density, and T2-weighted images and axial T1-weighted images and oblique sagittal T1-weighted fat-suppressed images were analyzed to detect supraspinatus tendon tears. Separately, a single T1-weighted fat-suppressed oblique axial series in ABER position was evaluated. Both protocols were scored randomly without knowledge of patients' clinical history and arthroscopy results. Tears were subclassified, based on articular surface integrity and extension (Lee classification). Interobserver agreement was assessed by kappa statistics for all patients. Ninety-two of 250 patients underwent arthroscopy; sensitivity and specificity of ABER and conventional MR arthrography were calculated and compared using paired McNemar test. Weighted kappa values of ABER and conventional MR arthrography were 0.48-0.65 and 0.60-0.67, respectively. According to arthroscopy, 69 of 92 patients had an intact cuff, and 23 patients had a cuff tear (16 partial thickness and seven full thickness). There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (48-61% and 52-70%, respectively) and specificity (80-94% and 91-95%). Sensitivity and specificity of a single T1-weighted series in ABER position and conventional MR arthrography are comparable for assessment of rotator cuff tear