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Trauma orthopedics

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https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#1
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27903758/oprm1-and-comt-gene-gene-interaction-is-associated-with-postoperative-pain-and-opioid-consumption-after-orthopedic-trauma
#2
Heba Khalil, Susan M Sereika, Feng Dai, Sheila Alexander, Yvette Conley, Gary Gruen, Li Meng, Peter Siska, Ivan Tarkin, Richard Henker
BACKGROUND: mu-opioid receptor (OPRM1) and catechol-O-methyltransferase (COMT) contribute to the neurotransmission pathway of pain. COMT affects mu receptor expression and density in the brain. The aim of this study was to explore the OPRM1 and COMT interaction effects on postoperative pain and opioid consumption. METHODS: This cross-sectional exploratory study used genotype and clinical data from 153 postoperative patients. Using multiple regression analyses, four single-nucleotide polymorphisms of COMT (rs6269, rs4633, rs4818, and rs4680), their haplotypes, and diplotypes were considered for their interactions with A118G of OPRM1 regarding postoperative pain and opioid consumption...
November 30, 2016: Biological Research for Nursing
https://www.readbyqxmd.com/read/27900711/lacertus-fibrosus-augmentation-for-distal-biceps-brachii-rupture-repair-surgical-technique
#3
M Fontana, A Trimarchi, A Colozza
BACKGROUND: Repair of distal biceps tendon ruptures has become widely accepted. Unfortunately, care of retracted-degenerated injuries remains a challenge for orthopedic surgeons. Complication rates appear to increase when surgery is performed in chronic cases compared to those operated acutely. Multiple techniques for chronic reconstruction with the use of grafts have been described. Recently Morrey, from the Mayo Clinic, proposed a direct anatomic repair of retracted distal biceps tendon ruptures in extreme flexion (60°-90°) to avoid grafting...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27891319/hyaluronic-acid-hope-of-light-to-black-triangles
#4
Jyotsana Tanwar, Shital A Hungund
Interdental papilla construction, especially in the esthetic area, is one of the most challenging tasks. Interdental papilla loss might occur due to several reasons as a consequence of periodontal surgery or trauma. The purpose of this study is to report the reconstruction of lost interdental papilla using hyaluronic acid gel. Hyaluronic acid is a glycosaminoglycan molecule with anti-inflammatory, anti-edematous properties on periodontal tissues invaded by submicrobial flora. It enhances wound healing and accelerates periodontal repair and regeneration...
September 2016: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/27890816/pathophysiology-of-hemophilic-arthropathy-and-potential-targets-for-therapy
#5
REVIEW
Astrid E Pulles, Simon C Mastbergen, Roger E G Schutgens, Floris P J G Lafeber, Lize F D van Vulpen
Hemophilia is a congenital clotting factor deficiency characterized by spontaneous and trauma-related bleeding. Spontaneous bleeding shows a predilection for joints, and repeated hemarthroses lead to a disabling condition called hemophilic arthropathy. Treatment of this condition consists of preventing joint bleeding on the one hand and orthopedic surgery as a last resort on the other. Up till now, there is no disease modifying therapy available to fill the gap between these extremes. This review provides an overview of the pathogenesis of hemophilic arthropathy in order to identify potential targets for therapy...
November 24, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27889558/the-periosteal-microcirculation-in-health-and-disease-an-update-on-clinical-significance
#6
REVIEW
Andrea Szabó, Ágnes Janovszky, Levente Pócs, Mihály Boros
Apart from its nutritive functions, the periosteum critically affects bone regeneration via its stem/osteoprogenitor cell content. Normal healing after bone fractures, trauma-orthopedic interventions and invasive dental procedures is critically linked to the reestablishment of the periosteal microcirculation, but the reconstruction, replacement or repair of lost tissues may also be performed with autologous periosteum. Besides the initiation of cell differentiation during bone repair and remodeling processes, the periosteum together with the endosteum plays significant roles in the pathogenesis of both hormone-related and trauma-induced osteoporotic alterations in the bone metabolism...
November 23, 2016: Microvascular Research
https://www.readbyqxmd.com/read/27889267/attribution-2-0-whose-complication-is-it
#7
Greg Hambright, Theresa Jackson, Vaidehi Agrawal, Antonio Arazosa, Benjamin Newman, Michael S Truitt
BACKGROUND: Payment models aimed at improving quality and curbing costs are being deployed, and hospitals are evaluating complications more closely. To decrease complications, hospitals must first "attribute" them to a responsible party. Our study uses a rigorous approach to attribution in the trauma population. METHODS: Twelve months of complications were reviewed by a multidisciplinary panel. Physicians, patients, nursing, and the hospital were all incorporated into the model...
September 28, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27889092/current-quality-measurement-tools-are-insufficient-to-assess-complications-in-orthopedic-surgery
#8
Arjun S Sebastian, Stephanie F Polites, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima, Sanjeev Kakar
PURPOSE: The American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) is a clinically-derived, validated tool to track outcomes in surgery. The Agency for Healthcare Research and Quality Patient Safety Indicators (AHRQ-PSI) are a set of computer algorithms run on administrative data to identify adverse events. The purpose of this study is to compare complications following orthopedic surgery identified by ACS-NSQIP and AHRQ-PSI. METHODS: Patients between 2010 and 2012 who underwent orthopedic procedures (arthroplasty, spine, trauma, foot and ankle, hand, and upper extremity) at our tertiary-care, academic institution were identified (n = 3,374)...
November 23, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/27885472/a-prospective-randomized-trial-comparing-anterior-cervical-discectomy-and-fusion-versus-plate-only-open-door-laminoplasty-for-the-treatment-of-spinal-stenosis-in-degenerative-diseases
#9
Yun-Qi Jiang, Xi-Lei Li, Xiao-Gang Zhou, Chong Bian, Han-Ming Wang, Jian-Ming Huang, Jian Dong
OBJECTIVE: For three or more involved cervical levels, there is a debate over which approach yields the best outcomes for the treatment of multilevel cervical degenerative disease. Our objective is to compare the radiological and clinical outcomes of two treatments for multilevel cervical degenerative disease: anterior cervical discectomy and fusion (ACDF) versus plate-only open-door laminoplasty (laminoplasty). METHODS: Patients were randomized on a 1:1 randomization schedule with 17 patients in the ACDF group and 17 patients in the laminoplasty group...
November 24, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27881043/experimental-research-methods-in-orthopedics-and-trauma
#10
Willem-Jan Metsemakers
No abstract text is available yet for this article.
November 24, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27876383/helmet-use-and-injury-severity-among-pediatric-skiers-and-snowboarders-in-colorado
#11
Melissa Milan, Sandeep Jhajj, Camille Stewart, Laura Pyle, Steven Moulton
INTRODUCTION: Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay...
November 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27874908/rivaroxaban-for-thromboprophylaxis-after-nonelective-orthopedic-trauma-surgery-in-switzerland
#12
Pierre Hoffmeyer, Hanspeter Simmen, Marcel Jakob, Christoph Sommer, Andreas Platz, Thomas Ilchmann, Erik Grossen, Christian Ryf, Panayiotis Christofilopoulos, Michael Schueler, Michael Rud Lassen, Markus Rimle, Urs E Gasser
This study investigated the effectiveness and the outcomes of rivaroxaban vs the standard of care for venous thromboembolic prophylaxis in patients undergoing fracture-related surgery. A total of 413 patients undergoing fracture-related surgery from 9 Swiss orthopedic and trauma centers were enrolled. The authors selected the type of venous thromboembolic prophylaxis according to standardized medical practice at the participating centers before the inclusion of patients: 208 patients received rivaroxaban and 205 received the standard of care...
November 22, 2016: Orthopedics
https://www.readbyqxmd.com/read/27870814/the-contemporary-microbiology-and-rates-of-concomitant-osteomyelitis-in-acute-septic-arthritis
#13
Jessica Branson, Jesus G Vallejo, Anthony R Flores, Kristina G Hulten, Edward O Mason, Sheldon L Kaplan, J Chase McNeil
BACKGROUND: Septic arthritis (SA) and acute osteomyelitis (AO) are among the most common serious bacterial infections of childhood. Knowledge of the microbiology of SA is critical to treatment. Awareness of the presence of attendant AO is also important to guide clinical management. We sought to describe the current microbiology of SA in children as well as describe clinical features associated with coexisting AO. MATERIALS AND METHODS: Patients with SA were identified from the infectious diseases consult service records from 2010-2014...
November 18, 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#14
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870673/financial-impact-of-dual-vendor-matrix-pricing-and-sole-source-contracting-on-implant-costs
#15
Peter L Althausen, Joan Lapham, Lisa Mead
Implant costs comprise the largest proportion of operating room supply costs for orthopedic trauma care. Over the years, hospitals have devised several methods of controlling these costs with the help of physicians. With increasing economic pressure, these negotiations have a tremendous ability to decrease the cost of trauma care. In the past, physicians have taken no responsibility for implant pricing which has made cost control difficult. The reasons have been multifactorial. However, industry surgeon consulting fees, research support, and surgeon comfort with certain implant systems have played a large role in slowing adoption of cost-control measures...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870669/operating-room-efficiency-benefits-of-an-orthopaedic-traumatologist-at-a-level-ii-trauma-center
#16
Peter L Althausen, Justin R Kauk, Steven Shannon, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. DESIGN: Retrospective review...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27868167/the-role-of-ugandan-district-hospital-orthopedic-units-in-the-care-of-vulnerable-road-users-a-cross-sectional-study
#17
Dan K Kisitu, Lauren E Eyler, Isaac Kajja, Gonzaga Waiswa, Titus Beyeza, David R Ragland, Isabelle Feldhaus, Catherine Juillard, Rochelle A Dicker
BACKGROUND: Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization's strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27858179/outcome-parameters-in-orthogeriatric-co%C3%A2-management%C3%A2-a%C3%A2-mini-review
#18
REVIEW
Radko Komadina, Klaus W Wendt, Gerold Holzer, Tomaž Kocjan
Recognizing hip and other fragility fractures as an adverse event of chronic geriatric conditions led to the concept of orthogeriatric co-management (OGC). OGC today represents various forms of structural cooperation between orthopedic trauma surgeons and multiprofessional geriatric teams taking care of frail elderly patients. The models are country specific. Despite several published models there are still no clear recommendations on how this service should be best organized. The 12 outcome parameters published by the Experts' Roundtable in 2013 were recommended to be used for the further assessment of different OCG models...
November 17, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27857985/emergency-physicians-performed-point-of-care-ultrasonography-for-detecting-distal-forearm-fracture
#19
Semra Sivrikaya, Ersin Aksay, Basak Bayram, Nese Colak Oray, Ahmet Karakasli, Emel Altintas
OBJECTIVES: Several studies focusing diagnosis of forearm fracture using Point-of-Care-Ultrasonography (POCUS) had been carried out in children. There is a lack of evidence for the utility of sonographic (US) examination for detecting of distal forearm fracture in adults. We aim to determine the diagnostic sensitivity and specificity of POCUS examination for the fracture of the distal radius and ulna in adult patients presenting with blunt forearm trauma. MATERIAL AND METHODS: Adult patients presenting with acute distal forearm trauma and suspicion of fracture were enrolled into study...
September 2016: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27857495/the-impact-of-resident-involvement-on-outcomes-in-orthopedic-trauma-an-analysis-of-20-090-cases
#20
Phillip M Mitchell, Svetlana A Gavrilova, Ashley C Dodd, Basem Attum, William T Obremskey, Manish K Sethi
BACKGROUND: Involvement in patient care is critical in training orthopedic surgery residents for independent practice. As the focus on outcomes and quality measures intensifies, the impact of resident intraoperative involvement on patient outcomes will be increasingly scrutinized. We sought to determine the impact of residents' intraoperative participation on 30-day post-operative outcomes in the orthopedic trauma population. METHODS: A total of 20,090 patients from the American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2013 were identified...
October 2016: Journal of Clinical Orthopaedics and Trauma
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