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Orthopedics

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https://www.readbyqxmd.com/read/28195609/anatomical-relationship-of-the-axillary-nerve-to-the-pectoralis-major-tendon-insertion
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28135371/sleep-disturbance-and-anatomic-shoulder-arthroplasty
#9
Brent J Morris, Aaron D Sciascia, Cale A Jacobs, T Bradley Edwards
Sleep disturbance is commonly encountered in patients with glenohumeral joint arthritis and can be a factor that drives patients to consider surgery. The prevalence of sleep disturbance before or after anatomic total shoulder arthroplasty has not been reported. The authors identified 232 eligible patients in a prospective shoulder arthroplasty registry following total shoulder arthroplasty for primary glenohumeral joint arthritis with 2- to 5-year follow-up. Sleep disturbance secondary to the affected shoulder was characterized preoperatively and postoperatively as no sleep disturbance, frequent sleep disturbance, or nightly sleep disturbance...
January 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28135370/patient-satisfaction-reporting-after-total-hip-arthroplasty-a-systematic-review
#10
Cynthia A Kahlenberg, Benedict U Nwachukwu, William W Schairer, Michael E Steinhaus, Michael B Cross
This review evaluated the quality of patient satisfaction reporting after total hip arthroplasty. The initial search of the MEDLINE database yielded 755 studies. Twenty-four met the inclusion criteria. Most studies provided level III or IV evidence (n=15, 62.5%). The most common method used to assess satisfaction was the 10-point visual analog scale (7 studies, 29.2%), followed by an ordinal satisfaction scale (6 studies, 25.0%). The quality of evidence was poor, and the methods used to assess satisfaction were not standardized...
January 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112789/periprosthetic-fractures-in-megaprostheses-algorithmic-approach-to-treatment
#11
Olga D Savvidou, Vasileios I Sakellariou, Panayiotis Megalooikonomou, Andreas F Mavrogenis, Panayiotis J Papagelopoulos
With increases in both life expectancy and the number of patients with endoprosthetic replacements, more periprosthetic fractures are expected to occur. Periprosthetic fractures related to megaprostheses present a treatment challenge, with a high incidence (one-third of affected patients) of secondary revision as a result of prosthetic loosening, infection, nonunion, refracture, or even amputation. Efforts to improve endoprosthetic reconstruction should focus on preventing postoperative complications. Understanding the causes of complications and strategies to avoid them could lead to significant improvements in implant survival, limb function, and patient outcomes...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112788/computed-tomography-guided-catheterization-drainage-to-cure-spinal-tuberculosis-with-individualized-chemotherapy
#12
Jianhua Li, Xuequan Huang, Feifan Chen, Fei Dai, Qiang Zhou, Fei Luo, Jianzhong Xu, Zehua Zhang
The goal of this study was to investigate the effect of individualized chemotherapy delivered via percutaneous catheter drainage on paravertebral abscesses in spinal tuberculosis (TB). Data from 48 patients with spinal TB with paravertebral abscesses who received individualized chemotherapy via computed tomography-guided catheterization between 2009 and 2012 were retrospectively analyzed. The paravertebral abscesses affected the thoracic vertebra (n=12), the lumbar spine (n=20), the thoracolumbar vertebra (n=10), and the lumbosacral (n=6)...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112787/posterior-cortical-axis-a-new-landmark-to-control-femoral-component-rotation-in-total-knee-arthroplasty
#13
Doerte Matziolis, Marius Meiser, Norbert Sieber, Ulf Teichgräber, Georg Matziolis
Rotation errors of the femoral component are held responsible for occurrences such as instability in flexion and midflexion, patellar maltracking, and arthrofibrosis following total knee arthroplasty. However, in many cases, the epicondylar axis cannot be reliably identified due to bone defects or metal artifacts on computed tomography, so alternative landmarks are necessary to evaluate the femoral component rotation. The current study sought to determine the relationship of the posterior cortical bone and the anterior cortical bone in relation to the epicondylar axis...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112786/avascular-necrosis-is-associated-with-increased-transfusions-and-readmission-following-primary-total-hip-arthroplasty
#14
Francis C Lovecchio, John Paul Manalo, Alysen Demzik, Shawn Sahota, Matthew Beal, David Manning
Avascular necrosis (AVN) may confer an increased risk of complications and readmission following total hip arthroplasty (THA). However, current risk-adjustment models do not account for AVN. A total of 1706 patients who underwent THA for AVN from 2011 to 2013 were selected from the American College of Surgeon's National Surgical Quality Improvement Program database and matched 1:1 to controls using a predetermined propensity score algorithm. Rates of 30-day medical and surgical complications, readmissions, and reoperations were compared between cohorts...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112785/effect-of-humeral-component-version-on-outcomes-in-reverse-shoulder-arthroplasty
#15
Alexander W Aleem, Brian T Feeley, Luke S Austin, C Benjamin Ma, Ryan J Krupp, Matthew L Ramsey, Charles L Getz
Although reverse shoulder arthroplasty provides excellent clinical results in appropriately selected patients, loss of external and internal rotation may occur. Component selection, design, and placement affect postoperative results. Recent studies considered the effect of humeral component version on functional results. The current study investigated whether humeral stem retroversion affects the outcomes of reverse shoulder arthroplasty with a retrospective review of a multisurgeon, industry-sponsored, prospectively gathered database of a single reverse shoulder arthroplasty implant...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112784/update-on-distal-radius-fractures
#16
Adam E M Eltorai, Andrew D Sobel, Nathan P Thomas, Alan H Daniels, Christopher T Born
This article discusses recent reports on distal radius fractures. The keyword "distal radius fracture" was used to query the PubMed database of the US National Library of Medicine. From the resulting list, articles published in the Journal of Hand Surgery (American Volume), the Journal of Hand Surgery (European Volume), and the Journal of Orthopaedic Trauma from April 2014 through December 2015 were reviewed. Related commentaries were also evaluated. Case series of fewer than 5 patients were excluded. The 65 studies and commentaries identified are categorized and summarized...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112783/quadrilateral-space-syndrome-with-involvement-of-the-tendon-of-the-latissimus-dorsi
#17
Ryuji Koga, Kozo Furushima, Hiroshi Kusano, Junichiro Hamada, Yoshiyasu Itoh
Quadrilateral space syndrome (QSS) is the term used to describe axillary nerve palsy due to compression of the axillary nerve and posterior circumflex artery in the quadrilateral space. The precise pathophysiology of QSS is still unclear; hence, a consensus of diagnosis and treatment for QSS has not yet been achieved. The authors present the case of a 17-year-old male baseball player with symptoms of QSS, including right elbow and shoulder joint pain and upper limb numbness while throwing. The symptoms had worsened during baseball...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28112782/analysis-of-musculoskeletal-injuries-sustained-in-falls-from-the-united-states-mexico-border-fence
#18
David R Burk, Adam R Pah, John T Ruth
Injuries sustained by unauthorized individuals who jump or fall from the United States-Mexico border fence are frequently treated by trauma centers in border states. The authors investigated patterns of musculoskeletal injury occurring in these individuals to improve emergency department assessment and to identify strategies to prevent future injuries. A retrospective chart review was performed for patients presenting to an urban, level I trauma center with musculoskeletal injuries sustained in a jump or fall from the United States-Mexico border fence between February 2004 and February 2010...
January 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28075438/quantitative-anatomical-differences-in-the-shoulder
#19
Usman Ali Mohammed Syed, Daniel E Davis, Jia-Wei Ko, Brian K Lee, Daniel Huttman, Adam Seidl, Carl Deirmengian, Joseph A Abboud
This study explored the radiographic and anatomical differences in normal shoulders between men and women, as well as factors such as race, height, weight, and age. A total of 205 patients with documented normal anatomical radiographs comprised the study population. Five fellowship-trained orthopedic surgeon reviewers measured head diameter, humeral head size, head to tuberosity distance, greater tuberosity width, neck-shaft angle, surface-arc angle, glenoid neck length, and distance from the lateral acromion process to the greater tuberosity on anteroposterior radiographs with the shoulder in external rotation...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#20
Stefano Muscatelli, Andrea Howe, Nathan N O'Hara, Robert V O'Toole, Sheila A Sprague, Gerard P Slobogean
The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage...
January 11, 2017: Orthopedics
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