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https://www.readbyqxmd.com/read/28220246/treatment-of-open-fractures-of-the-hand-in-the-emergency-department
#1
Nofar Ben Basat, Raviv Allon, Ahmad Nagmi, Ronit Wollstein
Current guidelines suggest early surgical treatment of open fractures. This rule in open hand fractures is not well supported and may be unpractical. Furthermore, desirable debridement and washout can be obtained in the emergency department (ED). The purpose of this study was to evaluate the relationship between the level of contamination, quality of washout in the emergency room, and the development of infection. Sixty-one patients with open fractures of the hand were retrospectively reviewed for demographic and fracture characteristics, and other complications...
February 20, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28216752/management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#2
P R Ramasamy
BACKGROUND: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28210405/titanium-clamps-for-a-simple-low-profile-autologous-osteosynthesis-in-the-reconstruction-of-posttraumatic-craniofacial-convexital-skeletal-disruption
#3
Amos Olufemi Adeleye, Toluyemi Adefolarin Malomo
Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28205479/finger-trauma-due-to-surfing-a-case-series-and-analysis-of-fracture-patterns
#4
A C J Ruijs, L C Langenberg, J Rezzouk
BACKGROUND: The purpose of this study is to research the type of lesions to the hand and fingers in the sport of surfing. METHODS: All surfing related hand injuries reported to our hospital between January 2008 and September 2015 were analyzed. RESULTS: Thirty-seven patient files held a clear description of a trauma related to the surf sport. We found three finger sprains, five wounds needing suture, including one digital nerve lesion and one ring finger with flexor tendon injury, three fingertip amputations and twenty-six digital fractures...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28194393/resection-osteotomy-for-calcaneus-flattening-after-micro-surgical-flap-technical-note
#5
Mário Yoshihide Kuwae, Edegmar Nunes Costa, Ricardo Pereira da Silva, Alexandre Daher Albieri, Frederico Barra de Moraes
An open fracture of the calcaneus with loss of substance is a challenging injury and requires specialized care, involves high costs, and demands attention despite its lower incidence. The main complications are osteomyelitis, pressure ulcers, and fistulas, as well as pain conditions in the lateral, medial, and plantar regions. This is due to the wide loss of tissue and the change in anatomical conformation of the calcaneus in some cases. However, in cases of flattening of the calcaneus bone, these complications may be prevented or treated successfully...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28137303/delayed-methicillin-resistant-staphylococcus-aureus-induced-osteomyelitis-of-the-tibia-after-pin-tract-infection-two-case-reports
#6
Kosuke Hamahashi, Yoshiyasu Uchiyama, Yuka Kobayashi, Masahiko Watanabe
BACKGROUND: Pin tract infection is a common complication of external fixation. It usually heals after treatment with debridement, antibiotics, and/or pin removal, only rarely developing into delayed osteomyelitis. We treated two patients with delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia following pin tract infection. CASE PRESENTATION: One patient, a diabetic 60-year-old Japanese man, underwent definitive external fixation using an Ilizarov fixator for postoperative osteomyelitis of an open fracture of his left ankle...
January 31, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28134628/when-is-a-fracture-not-fresh-aligning-reimbursement-with-patient-outcome
#7
Robert Zura, Zekun Jack Xu, Gregory J Della Rocca, Samir Mehta, R Grant Steen
OBJECTIVE: The clinical value of low-intensity pulsed ultrasound (LIPUS) for fresh fracture is known. Yet in the absence of a definition of what "fresh" is, payers have adopted study inclusion criteria drawn from randomized clinical trials as de facto definitions of which patients should be treated, with "fresh" defined as <1 week old. Fracture patients may thus be ineligible for LIPUS treatment after week 1, which potentially denies access to patients who could benefit from LIPUS...
February 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28134091/irrigation-solutions-in-open-fractures-of-the-lower-extremities-evaluation-of-isotonic-saline-and-distilled-water
#8
Olukemi Temiloluwa Olufemi, Adeolu Ikechukwu Adeyeye
INTRODUCTION: Open fractures are widely considered as orthopaedic emergencies requiring immediate intervention. The initial management of these injuries usually affects the ultimate outcome because open fractures may be associated with significant morbidity. Wound irrigation forms one of the pivotal principles in the treatment of open fractures. The choice of irrigation fluid has since been a source of debate. This study aimed to evaluate and compare the effects of isotonic saline and distilled water as irrigation solutions in the management of open fractures of the lower extremities...
2017: SICOT-J
https://www.readbyqxmd.com/read/28134070/earthquake-related-orthopedic-injuries-in-adult-population-a-systematic-review
#9
Michelangelo Bortolin, Ilaria Morelli, Amalia Voskanyan, Nina R Joyce, Gregory R Ciottone
: Introduction Earthquake-related trauma results in crush injuries and bony- and soft-tissue trauma. There are no systematic reviews analyzing the typical injury patterns and treatments in "Mega-Mass-Casualty" earthquakes. The characterization of an injury pattern specific to disaster type, be it natural or manmade, is imperative to build an effective disaster preparedness and response system. METHODS: The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)...
January 30, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28131638/treatment-preferences-in-turkey-for-open-fracture-of-the-tibial-diaphysis
#10
Güzelali Özdemir, Barış Yılmaz, Baran Kömür, Evrim Şirin, Nazım Karahan, Erman Ceyhan
OBJECTIVE: The purpose of this study was to investigate different treatment methods employed by orthopedic surgeons for open tibial fracture in adults. METHODS: Survey of 12 questions regarding treatment of open tibial fracture was conducted with 285 orthopedics and traumatology specialists in Turkey in personal interviews and using web-based technique. RESULTS: Of all survey participants, 99.6% responded that tetanus prophylaxis is necessary emergency procedure in cases of adult open tibial diaphysis fracture...
January 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28116272/management-of-large-bone-defects-in-diaphyseal-fractures-by-induced-membrane-formation-by-masquelet-s-technique
#11
R Sivakumar, M Gulam Mohideen, M Chidambaram, T Vinoth, Prahalad Kumar Singhi, V Somashekar
INTRODUCTION: Management of the large gap in long bone fractures is a challenging problem after compound injuries. A novel technique called as Masquelet's technique of "induced membrane formation", is used to bridge a gap of more than 5 cm using bone cement as a spacer in first stage and autologous cancellous bone graft to fill the gap in second stage. CASE PRESENTATION: We present two different and difficult cases with bone defects after open injuries associated with long bone fractures in this paper...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28112782/analysis-of-musculoskeletal-injuries-sustained-in-falls-from-the-united-states-mexico-border-fence
#12
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/28101590/-minimally-invasive-treatment-of-intra-articular-calcaneal-fractures-with-the-2%C3%A2-point-distractor
#13
G Mattiassich, W Litzlbauer, M Ponschab, R Ortmaier, C Rodemund
OBJECTIVE: Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. INDICATIONS: Calcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome. CONTRAINDICATIONS: Local or general contraindications. SURGICAL TECHNIQUE: Standardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control...
January 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#14
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
February 2017: Injury
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#15
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
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#16
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#17
REVIEW
P Bonnevialle
Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique...
January 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28043849/clavicle-fractures
#18
REVIEW
M Ropars, H Thomazeau, D Huten
Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1...
February 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28040299/reimplantation-of-a-large-extruded-segment-of-bone-in-an-open-fracture
#19
REVIEW
Ahmadreza Afshar
Replacing an extruded segment of bone in an open fracture imposes a challenging decision concerning the best and safest patient management. There are numerous advantages to restoring the patient's own extruded bone segment to its original location, particularly when the bone segment is of structural importance. However, reimplantation of contaminated and avascular extruded bone segments can potentially result in serious infection or nonunion. There is no conclusive evidence regarding the best decontamination protocol for the safest use of the recovered bone segment as an autologous graft...
February 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#20
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
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