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Journal of Surgical Orthopaedic Advances

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https://www.readbyqxmd.com/read/28644124/scapulothoracic-joint-dysfunction
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28459426/osteochondral-autograft-transfer-system-procedure-for-posterior-osteochondral-lesions-of-the-talus-through-prone-position-midline-achilles-tendon-splitting-approach
#10
Justin D Orr, Kenneth A Heida
Posteriorly based osteochondral lesions of the talus (OCLTs) are relatively rare, and when they are symptomatic and not amenable to traditional arthroscopic treatment techniques, they may require osteochondral graft transfer procedures, such as the osteochondral autograft transfer system (OATS) procedure. Historically described osteotomies to gain perpendicular access to these OCLTs, while excellent techniques, present many possible postoperative morbidities. This technical tip describes the use of a prone position midline Achilles tendon-splitting approach, a well-described approach to the posterior ankle and hindfoot, to perform osteochondral autograft transfer without need for any malleolar osteotomies...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459424/does-physician-reimbursement-correlate-to-risk-in-orthopaedic-trauma
#11
Vasanth Sathiyakumar, Rachel V Thakore, Cesar S Molina, William T Obremskey, Manish K Sethi
This study investigated whether current Medicare reimbursements for orthopaedic trauma procedures correlate with complications. A total of 18,510 patients representing 33 orthopaedic trauma procedures from 2005 to 2011 were studied. Adverse events and Medicare payments for each orthopaedic trauma procedure were collected. Linear regressions determined correlations between complications and Medicare payments for orthopaedic trauma procedures. A weak correlation between Medicare payments and complications was found for all procedures (r = ...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459423/multivariate-analysis-of-blood-transfusion-rates-after-shoulder-arthroplasty
#12
Joseph J King, Matthew R Patrick, Ryan E Schnetzer, Kevin W Farmer, Aimee M Struk, Cyndi Garvan, Thomas W Wright
A retrospective review was performed of all shoulder arthroplasties with patients grouped on the basis of transfusion protocol time period. Group 1 had transfusions if postoperative hematocrit was <30. Group 2 had transfusions based on symptomatic anemia. Bivariate analysis of transfusion factors and multivariate analysis of significant bivariate factors were performed. Protocol change decreased transfusion rates from 16% (group 1, 153 arthroplasties) to 8% (group 2, 149 arthroplasties). Reverse shoulder arthroplasty (RTSA) transfusion rate decreased dramatically (from 24% to 5%)...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459421/comparison-of-fatigue-performance-between-fully-and-partially-threaded-cannulated-screws-used-for-stabilization-of-slipped-capital-femoral-epiphyses
#13
Stephen Stacey, William Barfield, Luke Pietrykowski, John DesJardins, James Mooney
Cannulated screws are widely used for the treatment of slipped capital femoral epiphysis; however, the optimal choice and number of implants have not been clearly defined. Studies have shown that two screws are biomechanically superior to a single screw in load-to-failure testing, but the fatigue performance of different screw designs has not been investigated. This study compared the fatigue characteristics of fully and partially threaded cannulated screws. Partially and fully threaded 7.3-mm screws were subjected to cyclic loading on a custom testing fixture...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459420/is-total-elbow-arthroplasty-safe-as-an-outpatient-procedure
#14
Ben M Albert, Anna Lee, Taylor W McLendon, Randolph S Devereaux, Craig C Odum, Guy D Foulkes
Ambulatory surgery centers are the preferred setting for many procedures formerly performed in a hospital setting. This study sought to determine whether outpatient total elbow arthroplasty (TEA) is as safe as inpatient TEA. A retrospective analysis was performed of inpatient (IP) versus outpatient (OP) TEA by a single surgeon over a period of 18 years. Demographic, social, and comorbidity measures as well as complication rates were analyzed and stratified by IP or OP status. Bivariate comparison showed increased prevalence of coronary artery disease in the OP group (32% vs...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459419/complications-of-surgical-release-break-of-carpal-tunnel-syndrome-a-systematic-review
#15
Gregory K Faucher, Jimmy H Daruwalla, John G Seiler
A systematic review of the literature was performed to compare complications of endoscopic and open carpal tunnel release. Techniques were further subdivided into traditional open, limited open, single-portal endoscopic, and two-portal endoscopic. This study also compared incidence of complications in each group based on chronological periods of data collection. The study found that endoscopic release has a higher incidence of transient nerve injury. There was also an increased incidence of superficial palmar arch injuries in the endoscopic group in the 1960-1990 time period as compared with the 1991-2000 and 2001-2012 periods...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28459418/outcomes-after-distal-radius-fracture-treatment-with-percutaneous-wire-versus-plate-fixation-meta-analysis-of-randomized-controlled-trials
#16
Mark S Anderson, Mark Ghamsary, Phillip T Guillen, Montri D Wongworawat
Multiple methods for surgical fixation of distal radius fractures exist, including percutaneous pinning with Kirschner wires and open reduction volar plating. Despite increased costs, the hypothesis of this study was that open reduction and volar plating does not provide improved outcomes over wire fixation. Following Transparent Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a meta-analysis of randomized controlled trials was conducted comparing these two methods with regard to clinical outcomes, radiographic parameters, and complications...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27518300/ponseti-casting-technique-using-the-flags
#17
Anil Agarwal, Abbas Shaharyar, Anubrat Kumar, Mohd Shafi Bhat
Ponseti casts for congenital clubfoot are generally removed in the clinics by soaking and unwrapping them. It is often difficult to find the plaster bandage edge for unwrapping it. The use of flags at cast ends can ease this problem.
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27518299/obtaining-volar-tilt-in-distal-radius-fixation-use-of-a-screw-as-a-proximal-post
#18
B Collier Watson, Benjamin C Taylor, Adam Madsen, Freddie D Persinger, Andy R Malarkey
Volar plating of distal radius fractures was introduced as a means to circumvent some of the issues with dorsal-based plating but has been shown not to be a complete panacea, as other advantages and challenges have subsequently been discovered. Careful attention and proper technique must be utilized to restore and maintain volar tilt. This study reports a technique of using a locking screw as a proximal peg to reliably obtain the volar tilt in a simple fashion.
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27518298/complex-regional-pain-syndrome
#19
REVIEW
Hale Ersoy, Stephen J Pomeranz
Complex regional pain syndrome (CRPS) is a neurological disorder producing peripheral neurogenic inflammatory process in hands and feet distal to injury, which may lead to severe disability. Symptoms are often out of proportion to the initiating event and not limited to a single peripheral nerve. There is no gold standard in diagnosis of this entity, and a multidisciplinary approach is necessary for proper diagnosis. Magnetic resonance imaging (MRI) is one of the most useful diagnostic modalities in early stages of CRPS (when clinical diagnosis is most difficult), the most desirable time to diagnose this disorder to expedite treatment and improve function...
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27518297/arthroscopic-release-of-adhesive-capsulitis-of-the-shoulder-complicated-with-shoulder-dislocation-and-brachial-plexus-injury
#20
Fiesky A Nunez, Anastasios Papadonikolakis, Zhongyu Li
The incidence of brachial plexus injury after shoulder dislocation or arthroscopic shoulder surgery is low. Complex regional pain syndrome (CRPS) is an uncommon but painful condition that can develop after nerve injury. Historically, CRPS has been difficult to treat and therapeutic efforts are sometimes limited to ameliorating symptoms. However, if a dystrophic focus can be identified, the condition can be addressed with surgical exploration for potential neurolysis or nerve repair. The present article reports on a case of type II CRPS that developed in the postoperative setting of arthroscopic shoulder surgery complicated with simple shoulder dislocation...
2016: Journal of Surgical Orthopaedic Advances
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