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Orthopedic Clinics of North America

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https://www.readbyqxmd.com/read/29929721/obesity
#1
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929720/foot-and-ankle-surgery-in-the-diabetic-population
#2
REVIEW
Aaron J Guyer
The surgical treatment of diabetic patients can be challenging. The physiologic and metabolic abnormalities seen in diabetic patients can adversely affect healing and outcomes in even the simplest of procedures. This article examines some of the special considerations in the treatment of diabetic patients undergoing foot and ankle surgeries.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929719/obesity-in-elective-foot-and-ankle-surgery
#3
REVIEW
Matthew Stewart
Obesity is a global health problem with significant economic and health consequences. There is very little literature in regards to obesity and its effect on foot and ankle surgery, and to the author's knowledge, there has been no consolidated review on this subject to date. The purpose of this article is to provide a comprehensive review as it pertains to foot and ankle surgery, with hopes of improving surgeon decision making, mitigating risk, and providing better outcomes for patients. A better understanding of the effects of obesity also allows for improved prognostic performance...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929718/the-influence-of-obesity-on-total-elbow-arthroplasty
#4
REVIEW
Mark E Morrey, Mario Hevesi
Total elbow arthroplasty (TEA) has undergone a significant evolution in indications and outcomes in the past decade. Although rheumatoid patients once had the overwhelming number of TEAs, now TEAs for the sequelae of trauma predominate. Furthermore, as obesity has mirrored the increase in the posttraumatic population, TEA complications have increased whereas the durability of implants under these loads has decreased. Solutions are urgently needed to address the complications and revision burden related to posttraumatic deformity and obesity...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929717/the-effect-of-obesity-in-shoulder-arthroplasty-outcomes-and-complications
#5
REVIEW
Ivan De Martino, Lawrence V Gulotta
The effect of obesity in shoulder arthroplasty has been recently reported in the literature with different and conflicting results. This review analyzes the role of obesity on outcomes and complications in shoulder arthroplasty. Morbid obesity (body mass index >40 kg/m2 ), more than standard obesity, is associated with a longer operative time, higher complication rate, reoperation rate and superficial infection. Obesity does not have a detrimental effect on functional outcomes. The magnitude of functional improvement in obese patients, however, can be inferior to that in nonobese patients...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929716/the-impact-of-obesity-on-orthopedic-upper-extremity-surgery
#6
REVIEW
Jon Cooper Wall, Hillary Powers Wall, Bradley O Osemwengie, Brendan J MacKay
Obese patients have increased rates of upper extremity injury, carpal tunnel syndrome, and upper extremity osteoarthritis. Preoperative considerations include cardiovascular disease, pulmonary disease, and diabetes mellitus. Intraoperative and anesthetic considerations include specialized equipment, patient positioning, and the physiology of obese patients. Postoperative considerations should include increased risk of cardiovascular complications as well as surgical site infections and malunion. Surgery of the hand and upper extremity may be less prone to the postoperative complications seen in other regions of the body...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929715/obesity-in-pediatric-trauma
#7
REVIEW
Philip Ashley, Shawn R Gilbert
Obese children with high-energy injuries present with more severe injuries, more extremity injuries, and higher Injury Severity Scores. They are at increased risk for complications, prolonged ventilation, and ICU stay and have increased mortality. Obesity is associated with altered bone mass accrual and higher fracture rates. Obese patients have a higher risk of loss of reduction of forearm fractures, more severe supracondylar fractures, and a higher likelihood of lateral condyle fractures. Obese patients are more likely to have complications with femur fractures and have higher rates of foot and ankle fracture...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929714/the-musculoskeletal-aspects-of-obesity-in-neuromuscular-conditions
#8
REVIEW
Michael J Conklin, Jeffrey M Pearson
Obesity is a common problem in children and adolescents with neuromuscular disease. The available literature on obesity in cerebral palsy, spina bifida, and Duchenne muscular dystrophy as it relates to orthopedic treatment is reviewed, including the demographics and measurement of obesity as well as the mechanisms of obesity in these individuals. In addition, the effect of obesity on function, patient evaluation, and orthopedic treatment are reviewed.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929713/management-of-pelvic-and-acetabular-fractures-in-the-obese-patient
#9
REVIEW
Kevin F Purcell, Patrick F Bergin, Clay A Spitler, Matthew L Graves, George V Russell
Acetabular and pelvic ring injuries in obese patients are difficult to treat. Obese patients require great attention to detail during the trauma evaluation to prevent medical and anesthetic complications in the perioperative period. Radiographic evaluation is often compromised by modalities available and loss of resolution with plain film imaging. Patient positioning must be meticulous to ensure stability on the bed while allowing access to the operative site, preventing pressure necrosis, and minimizing ventilation pressure...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929712/obesity-in-the-polytrauma-patient
#10
REVIEW
Clay A Spitler, R Miles Hulick, Matthew L Graves, George V Russell, Patrick F Bergin
The rates of obesity continue to increase in the United States and the overall impact of obesity on health care spending and patient outcomes after trauma is considerable. The unique physiology of the obese places them at higher risk for complications, including infection, failure of fixation, nonunion, multiorgan failure, and death. These physiologic differences and overall patient size can make orthopedic care in obese patients with trauma more difficult, but appropriate initial resuscitation, careful preoperative planning, meticulous surgical technique, diligent postoperative medical management, and specialized rehabilitation give these patients their best opportunity for a good outcome...
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929711/the-role-of-bariatric-surgery-in-the-obese-total-joint-arthroplasty-patient
#11
REVIEW
Jessica M Hooper, Ajit J Deshmukh, Ran Schwarzkopf
Although bariatric surgery is a proven means of weight loss and treatment of obesity-related comorbidities in morbidly obese patients, it is not yet clear how it affects outcomes after total joint arthroplasty in this high-risk patient population. This article explores the effects of obesity and bariatric surgery on osteoarthritis and total joint arthroplasty, and also discusses the financial and ethical implications of use of bariatric surgery for risk reduction before total joint arthroplasty.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29929710/obesity-the-modifiable-risk-factor-in-total-joint-arthroplasty
#12
REVIEW
Jared S Bookman, Ran Schwarzkopf, Parthiv Rathod, Richard Iorio, Ajit J Deshmukh
Obesity is an epidemic in the health care system. Obesity poses several challenges and raises unique issues for the arthroplasty surgeon. Obese patients are at higher risk for infection and dislocation. Additionally, obese patients have poorer implant survivorship and functional scores postoperatively. Obesity is a modifiable risk factor and weight loss preoperatively should be strongly considered. Obese patients must be counseled so that they have realistic expectations after total joint arthroplasty.
July 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499829/evidence-based-medicine
#13
EDITORIAL
Frederick M Azar
No abstract text is available yet for this article.
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499828/patient-reported-outcomes-in-foot-and-ankle-surgery
#14
REVIEW
Kenneth J Hunt, Eric Lakey
Patient-reported outcomes (PROs) are a measure of health care quality that empower patients to share their health care perceptions with their providers. In orthopedic foot and ankle surgery, these measures can range from global assessments of pain or satisfaction to complex questionnaires designed to assess the function of specific anatomic regions or the recovery from specific procedures. This article seeks to characterize the use of PROs in foot and ankle surgery, describe some of the most commonly used measures, discuss implementation in everyday clinical practice, and explore the future of PROs in foot and ankle orthopedics...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499827/venous-thromboembolism-disease-prophylaxis-in-foot-and-ankle-surgery
#15
REVIEW
Bonnie Y Chien, Tonya Dixon, Daniel Guss, Christopher DiGiovanni
There are limited data to guide the use of venous thromboembolism disease (VTED) prophylaxis after foot and ankle surgery. Although there is general consensus that the overall risk is lower than after hip or knee replacement, subpopulations of patients may be at relatively heightened risk. Furthermore, existing data are often conflicting regarding the efficacy of prophylaxis, with little acknowledgment of the tradeoffs between VTED prophylaxis and potential complications associated with the use of such medications...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499826/venous-thromboembolism-prophylaxis-in-shoulder-surgery
#16
REVIEW
William R Aibinder, Joaquin Sanchez-Sotelo
The incidence of venous thromboembolic events (VTEs) complicating shoulder surgery is difficult to estimate. Case reports, retrospective studies, prospective studies, and systematic reviews vary in terms of separating symptomatic versus asymptomatic VTEs, those occurring in the upper versus lower extremities, and those leading to pulmonary embolism. Reported rates vary between 0.02% and 13%. Arthroplasty is associated with a higher incidence than arthroscopy. Surgery for fracture presents increased risk. Mechanical prophylaxis using compression devices could be considered given its favorable risk-benefit profile...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499825/antibiotic-prophylaxis-and-prevention-of-surgical-site-infection-in-shoulder-and-elbow-surgery
#17
REVIEW
K Keely Boyle, Thomas R Duquin
Infection after orthopedic procedures is a devastating and serious complication associated with significant clinical and financial challenges to the health care system and unfortunate patient. The time and resource-intensive nature of treating infection after orthopedic procedures has turned attention toward enhancing prevention and establishing quality improvement measures. Prevention strategies throughout the perioperative period include host optimization, risk mitigation, reducing bacterial burden and proper wound management...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499824/injection-therapies-for-rotator-cuff-disease
#18
REVIEW
Kenneth M Lin, Dean Wang, Joshua S Dines
Rotator cuff disease affects a large proportion of the overall population and encompasses a wide spectrum of pathologies, including subacromial impingement, rotator cuff tendinopathy or tear, and calcific tendinitis. Various injection therapies have been used for the treatment of rotator cuff disease, including corticosteroid, prolotherapy, platelet-rich plasma, stem cells, and ultrasound-guided barbotage for calcific tendinitis. However, the existing evidence for these therapies remains controversial or sparse...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499823/carpal-tunnel-syndrome-making-evidence-based-treatment-decisions
#19
REVIEW
James H Calandruccio, Norfleet B Thompson
Carpal tunnel syndrome (CTS) is one of the most common musculoskeletal disorders of the upper extremity. Comorbidities associated with the development of CTS include diabetes and obesity. Although a high rate of repetitive hand/wrist motions is a risk factor, there is insufficient evidence to implicate computer use in the development of CTS. Initial treatment generally is nonoperative, with the strongest evidence supporting bracing/splinting. Strong evidence supports operative treatment, regardless of technique, as superior to nonoperative treatment...
April 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29499822/evidence-based-review-of-distal-radius-fractures
#20
REVIEW
Benjamin M Mauck, Colin W Swigler
Distal radius fractures are one of the most commonly treated fractures in the United States. The highest rates are seen among the elderly, second only to hip fractures. With the increasing aging population these numbers are projected to continue to increase. Distal radius fractures include a spectrum of injury patterns encountered by general practitioners and orthopedists alike. This evidence-based review of distal radius fractures incorporates current and available literature on the diagnosis, management, and treatment of fractures of the distal radius...
April 2018: Orthopedic Clinics of North America
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