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Journal of Surgical Orthopaedic Advances

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https://www.readbyqxmd.com/read/29130881/distal-radius-skyline-view-how-to-prevent-dorsal-cortical-penetration
#1
Benjamin C Taylor, Andy R Malarkey, Ryan L Eschbaugh, John Gentile
Volar locked plating has become a standard treatment for operative stabilization of distal radius fractures. It is assumed that volar plating portends a low risk of extensor tendon irritation and rupture, especially when compared with dorsal plating constructs; however, extensor tendon tenosynovitis and rupture is a well-described complication after volar plating of the distal radius. Dorsal cortical penetration of screws may go unnoticed with traditional intraoperative fluoroscopic techniques and may contribute to extensor tendon irritation...
November 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130880/two-patients-and-two-knee-cysts
#2
Hale Ersoy, Stephen J Pomeranz
Differential diagnosis of a cystic lesion adjacent to menisci can be a challenge even when the case presents as seemingly straightforward. To "tell the story" as accurately as possible, the radiologist must be familiar with the natural history of these lesions as well as distinctive imaging features and must take all relevant factors into consideration, such as patient's age, activity level, and surgical history. This article presents two cases to illustrate how imaging features affect the report and management plan...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130879/vascularized-medial-femoral-condyle-graft-for-manubrium-nonunion-case-report-and-review-of-the-literature
#3
William R Aibinder, Michael E Torchia, Allen T Bishop, Alexander Y Shin
Fractures of the sternum are rare. Persistent nonunions, however, can lead to chronic pain and significant functional limitations. The vascularized medial femoral condyle is a versatile tool in the surgeon's armamentarium. Traditionally, it has been used as a thin corticoperiosteal graft in the treatment of nonunion of tubular bones. Its use as a structural corticocancellous graft has also been expanding. This report presents a case of a patient with a recalcitrant symptomatic nonunion of the manubrium treated with the unique combined corticoperiosteal and corticocancellous vascularized bone graft from the medial femoral condyle and reviews the literature concerning these uncommon nonunions...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130878/a-novel-technique-utilizing-a-vastus-lateralis-anchor-in-treatment-of-chronic-patellar-dislocation-after-total-knee-arthroplasty
#4
Allison Mayfield, Vamsi Singaraju, Afshin A Anoushiravani, Zain Sayeed, Jamal K Saleh, Khaled J Saleh
Extensor mechanism complications involving the patella frequently result in total knee arthroplasty (TKA) failure. Postoperative patellar dislocation may be caused by soft tissue imbalance, improper sizing, and position of the prosthesis. This report describes a case of revision TKA requiring several rounds of soft tissue releases in an effort to treat the patient's chronic patellar dislocation. In the process, a novel surgical approach was developed for the surgical management of refractory chronic patellar dislocations...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130877/reduction-loss-after-distal-radius-fracture-fixation-with-locked-volar-plates
#5
Michael M Vosbikian, Constantinos Ketonis, Ronald Huang, James A Costanzo, Asif M Ilyas
Distal radius fractures are among the most common injuries in the upper extremity. While many studies have looked at the maintenance of reduction with volar locking plates, there is a paucity of literature comparing the ability of different plates to maintain reduction over time. This study reviews the ability of various plates to maintain radiographic reduction at union after distal radius fracture treatment. Loss of some aspect of fracture reduction was routinely observed following locked volar plating regardless of implant...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130876/efficacy-of-arthroscopic-teaching-methods-a-prospective-randomized-controlled-study
#6
Luke Robinson, Jonathon Spanyer, Zachary Yenna, Patrick Burchell, Andrew Garber, John Riehl
Arthroscopic education research recently has been focused on the use of skills labs to facilitate resident education and objective measure development to gauge technical skill. This study evaluates the effectiveness of three different teaching methods. Medical students were randomized into three groups. The first group received only classroom-based lecture. The second group received the same lecture and 28 minutes of lab-based hands-off arthroscopy instruction using a cadaver and arthroscopy setup. The final group received the same lecture and 7 minutes of hands-on arthroscopy instruction in the lab on a cadaver knee...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130875/predictors-of-acute-ischemic-stroke-after-total-knee-arthroplasty
#7
Mariano E Menendez, Eric M Greber, Charles S Schumacher, C Lowry Barnes
Although acute ischemic stroke (AIS) is a feared medical complication after total knee arthroplasty (TKA), little is known about its incidence and risk factors. The purpose of this retrospective populationbased study using the Nationwide Inpatient Sample (2008-2011) was to determine the incidence and predictors of AIS following TKA. The rate of perioperative AIS was 0.08%. Patients undergoing bilateral TKA were almost three times more likely to develop AIS compared with unilateral TKA patients. The age group with the highest odds of AIS was ≥85 years...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130874/do-routine-radiographs-obtained-at-initial-outpatient-postoperative-visit-change-management
#8
Eric Grenier, Dave Tennent, Jean Patzkowski, Joseph Hsu, Anthony Johnson
Routine postoperative radiographs are commonly obtained at the initial postoperative visit. The purpose of this study was to demonstrate the clinical utility of routine postoperative radiographs and quantify the radiation exposure and cost to the health care system. All orthopaedic surgeries performed during 2007 at a level I trauma center were retrospectively analyzed. Surgical procedures that were likely to require follow-up radiographs were included. Analysis demonstrated 878 procedures with 471 procedures (54%) receiving initial postoperative radiographs...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130873/influence-of-body-mass-index-on-clinical-outcomes-in-reverse-total-shoulder-arthroplasty
#9
J Michael Wiater, Shannon Carpenter, Denise M Koueiter, David Marcantonio, Brett P Wiater
The purpose of this study was to compare reverse total shoulder arthroplasty (RTSA) outcomes in normal weight, overweight, and obese patients. A RTSA outcomes registry was reviewed for rotator cuff-deficient patients with a minimum 2-year follow-up. Fractures, rheumatoid arthritis, and revisions were excluded. Based on World Health Organization body mass index (BMI) classification, there were 29 normal weight, 50 overweight, and 51 obese patients. All groups demonstrated significant improvements from preoperative to most recent follow-up in function scores, pain, and forward elevation...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130872/a-retrospective-comparative-analysis-of-the-use-of-implantable-bone-stimulators-in-nonunions
#10
J Ryan Martin, George Vestermark, Brian Mullis, Jeffrey Anglen
This study details the use of implantable bone stimulators in the setting of nonunion. A retrospective comparative analysis was used to evaluate the efficacy of implantable bone stimulators in achieving union in the setting of atrophic or oligotrophic nonunion by two fellowship-trained orthopaedic trauma surgeons. Initially, 72 patients underwent surgical intervention for nonunion. Twenty-one patients had an implantable bone stimulator placed at the time of nonunion surgery. Thirty-eight patients had a minimum of 1-year follow-up...
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/29130871/burnout-and-stress-in-medicine-in-the-21st-century-catastrophe-or-opportunity
#11
Cormac A O'Donovan
No abstract text is available yet for this article.
October 2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644124/scapulothoracic-joint-dysfunction
#12
Joseph Ugorji, Stephen J Pomeranz
Scapulothoracic derangements are often overlooked and hidden within the clinical fog created by complex back, shoulder, and rib symptoms. This study reviewed 200 magnetic resonance imaging and computed tomography studies dedicated for scapular imaging between January 2010 and May 2016. This article discusses scapulothoracic pathologies and imaging findings.
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644123/pin-malposition-in-external-fixator-stabilization-of-combat-related-pelvic-fractures
#13
Mark P Coseo, Dustin J Schuett, Kevin M Kuhn, Joseph Bellamy
The purpose of this study was to compare the accuracy of pin placement in patients with unstable pelvic fractures undergoing either iliac crest or supra-acetabular external fixation. A retrospective review was performed of computed tomography (CT) scans and injury characteristics for all patients presenting to a North Atlantic Treaty Organization Medical Treatment Facility with data entered into the Department of Defense Trauma Registry from January 2008 to October 2013 who underwent pelvic external fixation for unstable pelvic ring injuries...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644122/fluoroscopic-exposure-with-use-of-mini-c-arm-during-routine-hand-surgery-a-prospective-comparison-of-hand-versus-eye-radiation-dosage
#14
Mark L Wang, C Edward Hoffler, Asif M Ilyas, Pedro K Beredjiklian, Charles F Leinberry
Radiation exposure with use of intraoperative fluoroscopy is a potential orthopedic occupational risk factor. The purpose of this study was to perform a prospective comparison of hand versus eye radiation exposure associated with mini-C-arm utilization and to test the hypothesis that routine mini-C-arm does not yield hand or eye dosages exceeding current recommended levels. Over a 12-month period, hand and eye radiation exposure was prospectively measured in a single board-certified hand surgeon using mini-C-arm fluoroscopy...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644121/intercondylar-fractures-of-the-distal-humerus-in-patients-younger-than-20-years-capsulectomy-results
#15
W Andrew Eglseder, Ebrahim Paryavi
Few reports in the literature have been dedicated to young patients with distal fractures of the humerus, and few have addressed subsequent indications to improve range of motion (ROM). This article is a retrospective review of the elbow flexion-extension ROM in 31 patients (age, 12-19 years) who had been treated with open reduction and internal fixation of intercondylar fractures of the distal humerus at a level I trauma center from 1991 through 2013. The ROM of patients who underwent capsulectomy was compared with that of those who did not...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644120/a-process-improvement-evaluation-of-sequential-compression-device-compliance-and-effects-of-provider-intervention
#16
Jason A Beachler, Chad A Krueger, Anthony E Johnson
This process improvement study sought to evaluate the compliance in orthopaedic patients with sequential compression devices and to monitor any improvement in compliance following an educational intervention. All non-intensive care unit orthopaedic primary patients were evaluated at random times and their compliance with sequential compression devices was monitored and recorded. Following a 2-week period of data collection, an educational flyer was displayed in every patient's room and nursing staff held an in-service training event focusing on the importance of sequential compression device use in the surgical patient...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644119/damage-control-plating-in-open-tibial-shaft-fractures-a-cheaper-and-equally-effective-alternative-to-spanning-external-fixation
#17
Paul S Whiting, Phillip M Mitchell, Aaron M Perdue, Arnold J Silverberg, Sarah E Greenberg, Rachel V Thakore, Vasanth Sathiyakumar, Hassan R Mir, William T Obremskey, Manish K Sethi
The purpose of this study was to evaluate damage control plating (DCP) as an alternative to external fixation (EF) in the provisional stabilization of open tibial shaft fractures. Through retrospective analysis, the study found 445 patients who underwent operative fixation for tibial shaft fractures from 2008 to 2012. Twenty patients received DCP or EF before intramedullary nailing with a minimum follow-up of 3 months. Charts and radiographs were reviewed for postoperative complications. Hospital charges were reviewed for implant costs...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644118/insurance-mandated-stay-prolongs-hospitalization-following-total-shoulder-arthroplasty
#18
Krysten M Bell, Mark E Mildren, Montri D Wongworawat, Torrey Parry, Christopher M Jobe, Wesley P Phipatanakul
Medicare currently requires a 3-night hospitalization for a patient to be considered for skilled nursing facility (SNF) placement. The purpose of this study was to analyze the relationship between length of stay and (a) insurance status and (b) readmission rates in Medicare-age patients undergoing primary total shoulder arthroplasty. A retrospective review of 251 primary consecutive total shoulder arthroplasty cases was performed. In patients discharged to SNF, Medicare insurance was associated with a significantly longer hospital stay (p < ...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644117/reverse-total-shoulder-arthroplasty-for-complex-three-and-four-part-proximal-humerus-fractures-in-elderly-patients-a-review
#19
George F Lebus V, Hassan R Mir, Brandon D Bushnell
Complex proximal humerus fractures in elderly patients represent a difficult problem for orthopaedic surgeons. Classically, treatment methods have included nonoperative management, open reduction and internal fixation, and hemiarthroplasty. Outcomes of nonoperative management for these complex fractures have been poor, and results of traditional operative techniques are variable at best. Over the past several years, reverse total shoulder arthroplasty (RTSA) has been increasingly employed in these injuries with encouraging results...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28644116/axillary-intraneural-ganglion-cysts
#20
Kartik G Krishnan, Nikhil K Prasad, Kimberly K Amrami, Paul J Kurtin, Robert J Spinner
Aside from affecting the stability of the glenohumeral joint, tears in the joint capsule can give rise to extraneural (paralabral) and, very rarely, intraneural ganglion cysts. This report presents the first two cases of axillary intraneural ganglion cysts in the literature with magnetic resonance imaging. Both cases were incidentally noted to have coexisting lesions (lymphadenopathy from an undifferentiated malignancy and suprascapular nerve entrapment, respectively). This report reinforces the applicability of the articular theory for intraneural ganglion cysts at a novel site...
2017: Journal of Surgical Orthopaedic Advances
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