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Trauma orthopedics

Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Mark Gage, Frank Liporace, Kenneth Egol, Toni McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
Douglas B Cooper, Glenn Curtiss, Patrick Armistead-Jehle, Heather G Belanger, David F Tate, Matthew Reid, Amy O Bowles, Carmen S Velez, Jan E Kennedy, Rodney D Vanderploeg
OBJECTIVE: To examine differences in objective neurocognitive performance and subjective cognitive symptoms in individuals with a history of a single concussion, multiple concussions, orthopedic injuries, and posttraumatic stress disorder (PTSD). METHOD: Participants included 116 military service members who sustained a mild traumatic brain injury (mTBI) during combat deployment. Subjects were subdivided into groups based on concussion frequency: a single concussion (n = 42), 2 concussions (n = 21), and 3 or more concussions (n = 53)...
March 2018: Journal of Head Trauma Rehabilitation
Yi-Ling Cai, Jin-Tao Ju, Wen-Bao Liu, Jian Zhang
Introduction: Forward surgical teams (FSTs) have been used as highly mobile surgical facilities that provide "damage control" medical support in modern wars. FST regiments differ greatly in different armed services and nations. We systemically reviewed the utilization of FSTs around the world with an emphasis on the medical conditions and workloads encountered by FSTs in modern wars. Materials and Methods: We searched for terms related to FSTs, such as "Forward Surgical Team" and "Field Surgical Team," in the PubMed, EMBASE, Web of Science, and MEDLINE databases and collected any articles that provided numerical data on the organization of medical personnel combat casualty characteristics, including the casualty composition, injury types and locations, and mechanisms of injury, and surgical procedures performed...
March 1, 2018: Military Medicine
L Bause, A Niemeier, V Krenn
The German Society of Orthopaedic Rheumatology (DGORh) honored Prof. Dr. med. Veit Krenn (MVZ-ZHZMD-Trier) with the Arthur Vick Prize 2017. With this award, scientific results with high impact on the diagnosis, therapy and pathogenetic understanding of rheumatic diseases are honored. In cooperation with pathologists and colleagues from various clinical disciplines Prof. Dr. med. Veit Krenn developed several histopathologic scoring systems which contribute to the diagnosis and pathogenetic understanding of degenerative and rheumatic diseases...
March 5, 2018: Zeitschrift Für Rheumatologie
Ali Abidali, Alicia Mangram, Gina R Shirah, Whitney Wilson, Ahmed Abidali, Phillip Moeser, James K Dzandu
BACKGROUND Dobhoff tube insertion is a common procedure used in the clinical setting to deliver enteral nutrition. Although it is often viewed as an innocuous bedside procedure, there are risks for numerous complications such as tracheobronchial insertion, which could lead to deleterious consequences. We present to our knowledge the first reported case of bilateral pneumothoraces caused by the insertion of a Dobhoff tube. In addition, we also discuss common pitfalls for confirming the positioning of Dobhoff tubes, as well as risk factors that can predispose a patient to improper tube placement...
March 5, 2018: American Journal of Case Reports
Elizabeth W Hubbard, Anthony I Riccio
The management of pediatric fractures has evolved over the past several decades, and many injuries that were previously being managed nonoperatively are now being treated surgically. The American Academy of Orthopaedic Surgeons has developed clinical guidelines to help guide decision making and streamline patient care for certain injuries, but many topics remain controversial. This article analyzes the evidence regarding management of 5 of the most common and controversial injuries in pediatric orthopedics today...
April 2018: Orthopedic Clinics of North America
Adam E M Eltorai, Wesley M Durand, Jack M Haglin, Lee E Rubin, Arnold-Peter C Weiss, Alan H Daniels
Understanding trends in reimbursement is critical to the financial sustainability of orthopedic practices. Little research has examined physician fee trends over time for orthopedic procedures. This study evaluated trends in Medicare reimbursements for orthopedic surgical procedures. The Medicare Physician Fee Schedule was examined for Current Procedural Terminology code values for the most common orthopedic and nonorthopedic procedures between 2000 and 2016. Prices were adjusted for inflation to 2016-dollar values...
March 1, 2018: Orthopedics
Marília Gabriela Mendes de Alencar, Manoela Moura De Bortoli, Thiago Coelho Gomes da Silva, Emanuel Dias de Oliveira E Silva, José Rodrigues Laureano Filho
The mandibular fracture is one of the most commonly fractures of the facial bones. In high-energy traumas, a comminuted mandible fracture may occur. The closed reduction with external fixator is an interesting alternative for these types of fractures. The aim of this article is to report the case of a patient with comminuted fracture in the right mandibular body, whose surgical treatment was the noninvasive reduction of fracture and stabilization using a Colles' wrist external fixator. After 1 year of follow-up, the patient is without complaints, with satisfactory dental occlusion, adequate contour, and mandibular alignment...
February 23, 2018: Journal of Craniofacial Surgery
George L Vestermark, Bryce A Van Doren, Patrick M Connor, James E Fleischli, Dana P Piasecki, Nady Hamid
BACKGROUND: The prevalence and severity of concomitant rotator cuff pathology in the setting of proximal biceps tendon ruptures are poorly understood. Concomitant rotator cuff disease may have important implications in the prognosis and natural history of this shoulder condition. Therefore, an observational cohort of patients with an acute rupture of the long head of the biceps tendon (LHBT) was evaluated to determine the prevalence and severity of concomitant rotator cuff disease. METHODS: Thirty consecutive patients diagnosed with acute proximal biceps tendon rupture were prospectively enrolled...
February 22, 2018: Journal of Shoulder and Elbow Surgery
Zhihua Han, Mit Bhavsar, Liudmila Leppik, Karla M C Oliveira, John H Barker
Large bone defects are a major problem in trauma and orthopedic surgery. Tissue engineering based treatments have emerged as promising alternatives of traditional bone grafting techniques. Critical size bone defect animal models had been developed and widely used to evaluate and compare therapeutic effectiveness in bone tissue engineering treatments. To measure healing in a given defect, after treatment histological assessment methods are commonly used. These histological methods are typically either qualitative and/or measure the amount of newly formed bone...
February 21, 2018: Tissue Engineering. Part C, Methods
S A Pervukhin, A M Ageenko, M N Lebedeva, R I Golikov
Lumbar epidural anesthesia is a commonly used anaesthetic technique for trauma and orthopedic surgery of the lower extremities. One of the rare complications of epidural anesthesia is pneumocephalia. The article describes a case of pneumocephalia after epidural anesthesia performed for anesthetic management of the hip replacement surgery. Eight hours after the epidural anesthesia the patient had depression of consciousness progressing to coma. Computed tomog- raphy of the brain detected pneumocephalia. Symptomatic treatment provided a regression of neurological deficit...
September 2017: Anesteziologiia i Reanimatologiia
Jeremy Kubik, Prism Schneider, Richard Buckley, Robert Korley, Paul Duffy, Ryan Martin
OBJECTIVES: The surgical reduction of intra-articular olecranon fractures is judged primarily on the lateral elbow radiograph, as orthogonal imaging of the articular surface is not obtainable. We sought to determine surgeon accuracy in identifying intra-articular olecranon malreductions on the lateral elbow radiograph. METHODS: Six human fresh-frozen cadaveric elbow specimens were sagittally sectioned in 5-mm increments after olecranon dissection, preservation of soft tissue envelope, and rigid fixation of the elbow in an external fixator...
March 2018: Journal of Orthopaedic Trauma
M A Faisal, A Z Chowdhury, I K Kundu, K N Arifeen, A S Ullah, C I Mahmud, O M Dastagir, M A Islam, M S Paul
Graft selection for primary anterior cruciate ligament reconstruction is very important part of knee stability. The purpose of this Qasi experimental study was to compare the clinical outcomes after ACL reconstruction using either a BPTB graft or a four-strand hamstrings graft and conducted from January 2012 to December 2013. Patients presented with a symptomatic unilateral ACL rupture who were underwent ACL reconstruction by using either BPTB or Hamstrings graft, IPD of Department of Orthopedics at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka as well as in a private hospital in Dhaka, Bangladesh were selected as study population...
January 2018: Mymensingh Medical Journal: MMJ
Simona D Marino, Laura Schiavone, Flavia M C La Mendola, Tiziana Timpanaro, Maria Elena Cucuzza, Filippo Greco, Pierluigi Smilari, Agata Fiumara, Andrea Domenico Praticò
Unilateral palsy of the hypoglossal nerve is a rare complication of orthodontic procedures. The main reported causes of HNP are: orthopedic and otorhinolaryngology surgical interventions, and in particular maneuvers involving compression or overstretching of the hypoglossal nerve, dental procedures and traumas, and also infections, motoneuron disorders, tumors, vascular diseases. Diagnosis is usually performed by electrophysiology studies (EMG-VCN), and brain magnetic resonance imaging (MRI) is useful to exclude other causes...
February 6, 2018: Neurologia i Neurochirurgia Polska
Andre M Samuel, Pablo J Diaz-Collado, Lauren K Szolomayer, Daniel H Wiznia, Wayne W Chan, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Jonathan N Grauer
Proximal tibia fractures are associated with concurrent collateral ligament injuries. Failure to recognize these injuries may lead to chronic knee instability. The purpose of this study was to identify risk factors for concurrent collateral ligament injuries with proximal tibia fractures and their association with inpatient outcomes. A total of 32,441 patients with proximal tibia fractures were identified in the 2011-2012 National Trauma Data Bank. A total of 1445 (4.5%) had collateral ligament injuries, 794 (2...
February 16, 2018: Orthopedics
Aaron I Karlen, Erik J Solberg, Deborah S Quanbeck, Ann E Van Heest
OBJECTIVE: The Orthopaedic In-Training Examination (OITE) is administered annually and is used to assess medical knowledge of orthopedic surgery residents. Beginning in the 2013 to 2014 academic year, the ACGME expanded the postgraduate year (PGY)-1 curriculum from 3 to 6 months of orthopedic surgery rotations. The purpose of this study is to evaluate the effect of increased PGY-1 orthopedic surgery exposure on medical knowledge as measured by the OITE. DESIGN: From 2011 to 2013, 24 PGY-2 residents completed 3 months of PGY-1 orthopedic training (Group 1)...
February 12, 2018: Journal of Surgical Education
Devvrat Katechia, Abdulla Ibrahim
Hand trauma forms an important part of plastic surgery and orthopedic training curricula. Although numerous practical hand trauma courses exist, there is always difficulty in achieving the right balance between educational content and practical workshops. AOTrauma-Hand Fixation for Surgeons is a 2.5-day course for plastic surgery and orthopedic trainees that aims to instill the principles of hand fracture fixation and soft tissue coverage through self-directed learning, lectures, small group discussion, and dry bone practical workshops...
February 13, 2018: Annals of Plastic Surgery
Hongrui Liu, Dongfang Li, Yi Zhang, Minqi Li
Achieving satisfactory reconstruction of bone remains an important goal in orthopedic and dental conditions such as bone trauma, osteoporosis, arthritis, osteonecrosis, and periodontitis. Appropriate temporal and spatial differentiation of mesenchymal stem cells (MSCs) is essential for postnatal bone regeneration. Additionally, an acute inflammatory response is crucial at the onset of bone repair, while an adaptive immune response has important implications during late bone remodeling. Various reports have indicated bidirectional interactions between MSCs and inflammatory cells or molecules...
February 12, 2018: Histochemistry and Cell Biology
Cory Collinge, Basem Attum, Paul Tornetta, William Obremskey, Jaimo Ahn, Gudrun Mirick, Andrew Schmidt, Clay Spitler, Chad Coles, Peter Krause
OBJECTIVES: The goal of this study was to describe current opinions of orthopedic trauma experts regarding acute compartment syndrome (ACS). DESIGN: Web-based survey SETTING:: N/A PARTICIPANTS:: Active Orthopedic Trauma Association (OTA) members METHODS:: A 25 item web-based questionnaire was advertised to active members of the OTA. Using a cross-sectional survey study design, we evaluated the perceived importance of ACS, as well as preferences in diagnosis and treatment...
January 24, 2018: Journal of Orthopaedic Trauma
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