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Orthopedics

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https://www.readbyqxmd.com/read/28295127/the-crush-index-orthopedic-trauma-as-an-economic-indicator
#1
Armin Arshi, Justin H Barad, Riki K Patel, J Ben Allis, Nelson F Soohoo, Eric E Johnson
The purpose of this study was to evaluate the relationship between economic activity and the incidence of high-energy orthopedic trauma. California's Office of Statewide Health Planning and Development patient discharge database was queried to identify monthly orthopedic trauma incidence from 1995 to 2010. Patient inclusion required 1 diagnosis code and 1 associated procedural code for fractures of the femur, tibia, ankle, pelvis, or acetabulum. Data on composite market indices, energy and transportation use, and unemployment were obtained from government sources...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295126/gluteus-maximus-advancement-flap-procedure-for-reconstruction-of-posterior-soft-tissue-deficiency-in-revision-total-hip-arthroplasty
#2
Benjamin F Ricciardi, Peter W Henderson, Alexander S McLawhorn, Geoffrey H Westrich, Mathias P Bostrom, Lloyd B Gayle
The current study describes the surgical technique and early outcomes of a gluteus maximus advancement flap procedure for the treatment of posterior soft tissue insufficiency among patients with complex revision total hip arthroplasty. This retrospective case series was conducted with a prospective, single-institution arthroplasty registry. Patients who underwent a gluteus maximus advancement flap procedure in the setting of revision total hip arthroplasty between January 2012 and January 2016 were eligible for inclusion (N=7)...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295125/treatment-of-locked-posterior-shoulder-dislocation-with-bone-defect
#3
Yousuf M Khira, Adel M Salama
Locked posterior shoulder dislocation is an uncommon condition and is associated with a reverse Hill-Sachs lesion in 50% of cases. The condition is likely to occur in cases of violent trauma, seizures, or electric shock. Unrecognized dislocation with humeral head fracture affects joint function and humeral head vascularity and may lead to chronic instability, osteonecrosis, and osteoarthritis. A group of 12 patients, including 10 men and 2 women, with neglected locked posterior shoulder dislocation with a reverse Hill-Sachs lesion were treated with the modified McLaughlin technique...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295124/evaluation-of-the-effect-of-platelet-rich-fibrin-on-long-bone-healing-an-experimental-rat-model
#4
Turan Cihan D├╝lgeroglu, Hasan Metineren
Pseudoarthrosis, or nonunion, of the long bones is a challenging medical condition for orthopedic surgeons to treat. Therefore, healing enhancer materials are commonly used. The authors investigated whether platelet-rich fibrin accelerates long bone healing by comparing radiological and histological findings in a rat model of open femoral fracture. Platelet-rich fibrin is a current biomaterial that contains many growth factors and platelets. There are no studies in the literature investigating the effects of platelet-rich fibrin on fracture healing...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295123/new-proximal-femoral-compaction-blade-provides-strong-antirotation-stability-of-the-femoral-head
#5
Shinya Hayashi, Yukiaki Hirata, Daiki Okamoto, Satoshi Kakunai, Shingo Hashimoto, Koji Takayama, Tomoyuki Matsumoto, Takahiro Niikura, Takaaki Fujishiro, Takafumi Hiranaka, Kotaro Nishida, Ryosuke Kuroda
This study investigated the mechanical properties of a new rectangular compaction blade and compared this blade with other types of nail. Three types of nail were tested: the Magnum lag screw (Robert Reid Inc, Tokyo, Japan), proximal femoral nail, and Magnum Fid blade (Robert Reid Inc). The nails were inserted into solid rigid polyurethane foam, and the torsional moments were loaded with an Instron testing machine (Instron, Kanagawa, Japan). The force curve was recorded, and the average maximum torque was calculated from this curve...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295122/epiphysiodesis-screw-bending
#6
Brett M Normandin, David J Tennent, Todd H Baldini, Alesia M Blanchard, Jason T Rhodes
Percutaneous epiphysiodesis using transphyseal screws is a common method for treatment of limb length discrepancy and angular deformity. The authors report 3 cases of a previously unreported complication following treatment with percutaneous epiphysiodesis using transphyseal screws: bending of the transphyseal screw. In each case, this rare complication was associated with difficult removal of the screw. This retrospective case report accessed the medical records of 3 children, 2 boys and 1 girl, 9 to 14 years old...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295121/outcomes-at-a-minimum-of-2-years-after-medial-collateral-ligament-reconstruction-using-partial-thickness-quadriceps-tendon-bone-autograft
#7
Iftach Hetsroni, Gideon Mann
This study reports outcomes at a minimum of 2 years after a technique using quadriceps tendon-bone autograft for medial collateral ligament reconstruction. This technique effectively restored medial stability in medial collateral ligament-deficient knees. It is particularly valuable when nonirradiated allograft is unavailable or harvesting medial knee restraints (semitendinosus) for medial collateral ligament reconstruction is to be avoided. [Orthopedics. 201x; xx(x):xx-xx.].
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28295120/geometric-analysis-of-the-proximal-humerus-in-elderly-japanese-patients-implications-for-implant-selection-in-reverse-shoulder-arthroplasty
#8
Keisuke Matsuki, Hiroyuki Sugaya, Shota Hoshika, Yusuke Ueda, Norimasa Takahashi, Morihito Tokai, Kazutomo Onishi, Scott A Banks
The implants used in reverse shoulder arthroplasty were originally designed for white patients; thus, they might not be optimal for smaller Asian patients. The selection of reverse shoulder arthroplasty systems is limited in Japan. The purpose of this study was to measure the geometry of the proximal humerus in elderly Japanese patients to inform implant selection according to humerus size. This study included 155 shoulders from 148 patients 50 years or older who underwent computed tomography for shoulder disorders other than arthritis and trauma...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28241088/clinical-outcome-of-total-knee-arthroplasty-after-prior-microfracture-a-matched-cohort-study
#9
Mohammad Humza Ansari, Ayoosh Pareek, Nick R Johnson, Matthew P Abdel, Michael J Stuart, Aaron J Krych
Microfracture (MFX) is a common operation for articular cartilage lesions. Data for patients who underwent total knee arthroplasty (TKA) after previous MFX are limited. The purpose of this study was to determine the outcomes, complications, and factors that influence outcomes in patients with previous MFX compared with those without previous MFX. Between 2005 and 2014, twenty-one TKAs were performed at a single tertiary care academic institution in patients with prior history of MFX surgery. These patients were retrospectively reviewed and matched 2:1 to patients who did not undergo previous MFX (n=42)...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28241087/characteristics-of-orthopedic-publications-in-high-impact-general-medical-journals
#10
Benedict U Nwachukwu, Cynthia A Kahlenberg, Jason D Lehman, Stephen Lyman, Robert G Marx
Orthopedic studies are occasionally published in high-impact general medical journals; these studies are often given high visibility and have significant potential to impact health care policy and inform clinical decision-making. The purpose of this review was to investigate the characteristics of operative orthopedic studies published in high-impact medical journals. The number of orthopedic studies published in high-impact medical journals is relatively low; however, these studies demonstrate methodological characteristics that may bias toward nonoperative treatment...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28241086/the-anatomy-of-the-medial-patellofemoral-ligament
#11
Thai Q Trinh, Jason R Ferrel, Jared C Bentley, Robert N Steensen
Recurrent patellar dislocation is observed in many patients treated nonoperatively following primary dislocation. Injury to the medial patellofemoral ligament (MPFL) is reported in the majority of patients following dislocation. There is an increased interest in repair or reconstruction of the MPFL for patients experiencing recurrent instability. The femoral attachment of the MPFL is critical in determining graft behavior following reconstruction. The femoral attachment can be determined by referencing local anatomy, fluoroscopic imaging or on the basis of desired graft-length changes...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28241085/using-accelerometer-based-portable-navigation-to-perform-accurate-total-knee-arthroplasty-bone-resection-in-asian-patients
#12
Hideki Ueyama, Yoshio Matsui, Yukihide Minoda, Masanori Matsuura, Hiroaki Nakamura
Implant alignment is an important factor affecting clinical results associated with total knee arthroplasty (TKA). No report exists showing the utility of an accelerometer-based portable navigation system among patients with marked femoral bowing. The aim of this study was to evaluate the accuracy of a portable navigation system for implant alignment in Asian patients with marked femoral bowing. The authors evaluated 142 consecutive TKAs performed for primary osteoarthritis since July 2013. A portable navigation system was used in 67 knees, and a conventional jig was used in 75 knees...
February 27, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195609/anatomical-relationship-of-the-axillary-nerve-to-the-pectoralis-major-tendon-insertion
#13
Brian Shiu, Ehsan Jazini, Astor Robertson, R Frank Henn, S Ashfaq Hasan
Axillary nerve injury is a risk of the deltopectoral approach to the proximal humerus. The anterior motor branch is potentially vulnerable during subdeltoid dissection. Insertion of the pectoralis major tendon is an easily identifiable landmark on the humerus. This anatomical study explored whether the superior aspect of the pectoralis major tendon is a useful landmark for localizing the anterior motor branch of the axillary nerve as it travels under the lateral and anterior deltoid muscle. A total of 30 fresh-frozen human bilateral cadaveric upper extremities were examined...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195608/proximal-hamstring-tendinosis-and-partial-ruptures
#14
Ashley N Startzman, Oliver Fowler, Dominic Carreira
Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195607/effects-of-cementing-on-ligament-balance-during-total-knee-arthroplasty
#15
Jimmy Chow, Kevin Wang, Leah Elson, Christopher Anderson, Martin Roche
Complications related to joint imbalance may contribute to some of the most predominant modes of failure in total knee arthroplasty (TKA). These complications include instability, aseptic loosening, asymmetric component wear, and idiopathic pain. Fixation may represent a step that introduces unchecked variability into the procedure and may contribute to the incidence of joint imbalance-related complications. The ability to quantify in vivo loading in the medial and lateral compartments would allow for the ability to confirm balance after fixation and prior to wound closure...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#16
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195605/the-implications-of-inaccuracy-comparison-of-coding-in-heterotopic-ossification-and-associated-trauma
#17
Matt Fury, Mitchell John, Stuart Schexnayder, Harry Molligan, Olivia Lee, Peter Krause, Vinod Dasa
Retrospective studies using large databases serve a major purpose in providing evidence in the current literature. However, the quality of medical coding is highly variable. This retrospective cohort study aimed to evaluate the documentation regarding the diagnosis of heterotopic ossification (HO) and the implications it may have for conducting retrospective research using electronic medical records (EMRs). A retrospective chart review using the EMR was performed to identify all patients with a diagnosis of HO within 7 university-affiliated hospital facilities...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195604/early-postoperative-displacement-of-combined-pelvic-ring-injury-with-acetabular-fracture
#18
Arthur E Hess, Herman S Johal, Robert V O'Toole, Jason W Nascone
Combined pelvic ring and acetabular injuries present a management challenge. The literature on this topic is scarce, with few outcomes studies available. This retrospective study assessed whether the incidence of postoperative displacement and loss of reduction is higher with combined injuries compared with isolated pelvic ring injuries and isolated acetabular fractures. The charts and radiographs of 33 patients with combined pelvic ring and acetabular fractures treated operatively during a 7-year period at a single institution were reviewed...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28135373/elution-profiles-of-two-methods-of-antibiotic-tibial-nail-preparations
#19
Matthew R Karek, Nancy M Jackson, Jeffrey C Flynn, Rahul Vaidya, David C Markel
Interlocking nails coated with antibiotic-supplemented cement provide effective treatment of infected long bone nonunion, but the thicker coating on guidewires may provide greater antibacterial activity. This study compared the properties of cement cured on each construct by evaluating 2-cm segments of 8-mm interlocking nails and 3.5-mm guidewires coated with antibiotic-supplemented cement. Each construct (n=7 for each group) was coated with polymethylmethacrylate cement (Simplex; Stryker Orthopaedics, Mahwah, New Jersey) containing either 1 g tobramycin or 1 g vancomycin powder plus 2...
January 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28135372/functional-outcomes-following-surgical-management-of-femoral-neck-stress-fractures
#20
Nicholas A Kusnezov, Emmanuel D Eisenstein, John C Dunn, Brian R Waterman
The Military Health System Management Analysis and Reporting Tool was queried to identify all active duty US military service members who underwent operative fixation of femoral neck stress fractures from 2011 to 2012. A total of 13 patients with 17 femoral neck stress fractures met the inclusion criteria. Average patient age was 23.8┬▒5.1 years, and 62% were women. At a mean 26-month follow-up, approximately one-half (46%) of the young military recruits were able to return to their preoperative activity level...
January 30, 2017: Orthopedics
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