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https://www.readbyqxmd.com/read/29244676/severe-metal-hypersensitivity-following-internal-fixation-of-an-ankle-fracture-a-case-report
#1
Bradley M Kruckeberg, Taylor J Ridley, Lee M Reichel
CASE: A 67-year-old woman underwent internal fixation of an ankle fracture. Ten days postoperatively, the patient developed systemic hives, difficulty breathing, and oral swelling. At 8 weeks postoperatively, the hardware was removed because of a suspected metal hypersensitivity. Despite experiencing perioral edema and difficulty breathing after the hardware removal, she had complete resolution of the symptoms at the 2-week, 6-week, and 12-month follow-up appointments. CONCLUSION: Hypersensitivities to metal-based implants can develop and cause local and systemic reactions...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29238660/salvage-penile-prosthetic-surgery-utilizing-temporary-malleable-implants
#2
REVIEW
Michael Lao, R James Graydon, Jared M Bieniek
The inflatable penile prosthesis (IPP) is an effective erectile dysfunction (ED) treatment modality when oral and injectable therapies fail to achieve satisfactory results. Unfortunately, infection of the prosthetic remains a dreaded complication occurring in a small fraction of patients despite advances in device design and surgical techniques. With a prosthetic infection or erosion, classic management has included removal of all hardware with thorough irrigation of the infected spaces. To prevent corporal fibrosis and scarring that can make a subsequent implant challenging, an immediate salvage procedure with a three-piece prosthesis has been advocated when possible...
November 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29235440/leveraging-multi-layer-imager-detector-design-to-improve-low-dose-performance-for-megavoltage-cone-beam-computed-tomography
#3
Yue-Houng Hu, Joerg Rottmann, Rony Fueglistaller, Marios E Myronakis, Adam Wang, Pascal Huber, Daniel Shedlock, Daniel Morf, Paul Baturin, Josh M Star-Lack, Ross I Berbeco
While megavoltage (MV) cone-beam computed tomography (CBCT) using an electronic portal imaging device (EPID) provides many advantages over kilovoltage (kV) CBCT, clinical adoption is limited by its high doses. Multi-layer imager (MLI) EPIDs increase DQE(0) while maintaining high resolution. However, even well-designed, high-performance MLIs suffer from increased electronic noise from each readout, degrading low-dose image quality. To improve low-dose performance, shift-and-bin addition (ShiBA) imaging is proposed, leveraging the unique architecture of the MLI...
December 13, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/29232685/surgical-management-of-deep-brain-stimulator-scalp-erosion-without-hardware-removal
#4
Michael D Staudt, Navid Pourtaheri, Gregory E Lakin, Hooman T Soltanian, Jonathan P Miller
BACKGROUND: Scalp erosion in patients with deep brain stimulation (DBS) hardware is an uncommon complication that lacks a clearly defined management strategy. Previous studies have described various therapies including conservative treatment with antibiotics and surgical debridement with or without hardware removal. OBJECTIVES: The aim of this study was to review the efficacy of a hardware-sparing management strategy for the treatment of scalp erosion. METHODS: Five patients with previous DBS implantation presented with scalp erosion and visible hardware exposure at the calvarial burr hole site, and underwent tension-free, vascularized, rotational scalp flap, with preservation of the leads under the pericranium...
December 13, 2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/29227406/unexpected-blooming-artifact-in-brain-magnetic-resonance-imaging
#5
Akilesh Ramasamy, Balasubramanian Madhan, Balasubramanian Krishnan
Unexpected foreign bodies are occasionally discovered during magnetic resonance imaging (MRI). These are often present unknown to the patient, missed during routine pre-MRI screening and result in unnecessary delay during MRI. The authors present a patient with traumatically embedded foreign body in the scalp that escaped pre-MRI screening and caused susceptibility artifacts during brain MRI. The object was surgically removed to allow the imaging to be completed. Patients with suspicion or history of facial trauma or with dental restorations are referred to concerned specialists for compatibility of hardware, restorations and for assessing risks during MRI due to these...
December 7, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29223594/femoral-neck-fractures-after-removal-of-hardware-in-healed-trochanteric-fractures
#6
REVIEW
Antonio Barquet, Peter V Giannoudis, Andrés Gelink
INTRODUCTION: Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention...
December 2017: Injury
https://www.readbyqxmd.com/read/29219118/adaptive-quantization-of-local-field-potentials-for-wireless-implants-in-freely-moving-animals-an-open-source-neural-recording-device
#7
Dominique Martinez, Maxime Clement, Belkacem Messaoudi, Damien Gervasoni, Philippe Litaudon, Nathalie Buonviso
OBJECTIVE: Modern neuroscience research asks for electrophysiological recording of local field potentials (LFPs) in moving animals. Wireless transmission has the advantage of removing the wires between the animal and the recording equipment but is hampered by the large amount of data to be sent at a relatively high rate. APPROACH: To reduce transmission bandwidth, we propose an encoder/decoder scheme based on adaptive non-uniform quantization. Our algorithm uses the current transmitted codeword to adapt the quantization intervals to changing statistics in LFP signals...
December 8, 2017: Journal of Neural Engineering
https://www.readbyqxmd.com/read/29205141/deep-spinal-infection-in-instrumented-spinal-surgery-diagnostic-factors-and-therapy
#8
M Dobran, A Marini, M Gladi, D Nasi, R Colasanti, R Benigni, Francesca Mancini, M Iacoangeli, M Scerrati
AIM: Postoperative surgical site infections (SSI) are complication of spinal surgery. These complications may lead to a poor outcome with neurological deficits, spinal deformity and chronic pain. The purpose of this study is to explore the statistical value of diagnostic parameters and the proper therapy. METHOD: We retrospectively reviewed 550 patients who underwent spinal instrumentation at our department from January 2011 to December 2015. The SSI was present in 16 patients out of 550 operated...
May 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29202993/wide-awake-foot-and-ankle-surgery-a-retrospective-analysis
#9
A Luke MacNeill, D Joshua Mayich
BACKGROUND: The "wide-awake" approach to foot and ankle surgery is characterized by a surgeon-administered mixture of local anesthetic and epinephrine. No tourniquet, sedation, or general anesthesia are required for surgery. This paper describes a retrospective survey of the initial patients to undergo wide-awake foot and ankle surgery at our center. METHODS: Thirty former wide-awake patients were surveyed about their perioperative anxiety, pain, and satisfaction...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29200480/stitchless-percutaneous-endoscopic-cervical-discectomy-are-we-moving-towards-day-care-discectomy-procedure
#10
Sunil M Nadkarni, Pavankumar Kohli, Bhupesh Patel, Satishchandra Gore, Bhagyashree S Kulkarni
Background: STITCHLESS percutaneous endoscopic cervical discectomy s[PECD] is safe, precise, targeted, and a complete endoscopic procedure to treat soft cervical disc herniation with unilateral radiculopathy. It allows direct visualization of herniated fragment and its removal, inspection of decompressed nerve root in an awake and aware patient. It reduces the risk related to general anesthesia and to the neurological structures. However, all the patients treated with PECD can be candidates for anterior cervical discectomy and fusion (ACDF)...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29196871/three-cases-of-metallosis-associated-with-spine-instrumentation
#11
Reed Ayers, Mackenzie Miller, Jeffery Schowinsky, Evalina Burger, Vikas Patel, Christopher Kleck
The characteristic trait of metallosis is the presence of tissue staining. Analyzing explanted revision hardware from spine surgeries and performing ICPMS/AES analysis on removed tissue samples, a clinically relevant definition for metallosis may be developed. Results of the analysis identified hardware fretting wear and corrosion, and ICP-MS/AES analysis identified elevated metal ion concentrations in all cases. This supports the hypothesis that corrosion may be linked to poor health outcomes and potential need for revision surgery...
December 1, 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/29195898/outcomes-of-displaced-olecranon-fractures-treated-with-the-olecranon-sled
#12
Andrew J Lovy, Isaiah Levy, Aakash Keswani, Todd Rubin, Michael R Hausman
BACKGROUND: Tension-band wiring is largely considered the gold standard for fixation of displaced olecranon fractures despite high rates of hardware complications. The purpose of this study was to report the outcomes of displaced olecranon fractures treated with the Olecranon Sled. METHODS: We retrospectively reviewed all displaced olecranon fractures from 2011-2015 treated with the Olecranon Sled. Inclusion was limited to functionally independent patients with Mayo type II fractures and minimum 12-month follow-up...
November 28, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29192935/predictors-of-persistent-pain-after-fixation-of-distal-clavicle-fractures-in-an-active-military-population
#13
Paul J Lanier, Joshua Speirs, Logan Koehler, Julia Bader, Amr Abdelgawad, Brian R Waterman
Patients who undergo open reduction and internal fixation of distal clavicle fractures have a high rate of hardware removal and persistence of symptoms, particularly when attempting to return to high-demand activities. This study evaluated the outcomes of military servicemembers after surgical treatment of distal clavicle fractures. The authors performed a retrospective analysis of active duty servicemembers who underwent open reduction and internal fixation of Neer type II distal clavicle fractures between October 17, 2007, and July 20, 2012, with a minimum of 2-year clinical follow-up...
November 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/29192509/a-comparison-of-removal-rates-of-headless-screws-versus-headed-screws-in-calcaneal-osteotomy
#14
Daniel Kunzler, Pejma Shazadeh Safavi, Daniel Jupiter, Vinod K Panchbhavi
BACKGROUND: Calcaneal osteotomy has been used to successfully treat both valgus and varus hindfoot deformities. Pain associated with implanted hardware may lead to further surgical intervention for hardware removal. Headless screws have been used to reduce postoperative hardware-associated pain and accompanying hardware removal, but data proving their effectiveness in this regard is lacking. The purpose of this study is to compare the rates of removal of headed and headless screws utilized in calcaneal osteotomy...
November 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29185046/functional-outcomes-after-removal-of-hardware-in-patellar-fracture-are-we-helping-our-patients
#15
Arieh Greenberg, Assaf Kadar, Michael Drexler, Zachary T Sharfman, Ofir Chechik, Ely L Steinberg, Nimrod Snir
PURPOSE: Functional outcomes after Open Reduction Internal Fixation (ORIF) of the patella are variable. Common complications of patella ORIF include persistent anterior knee pain, limited range of motion and symptomatic hardware. The purpose of this study was to evaluate if removal of hardware is beneficial to symptomatic patients after patellar fracture fixation. METHODS: Patients who presented to our institution between December 2006 and November 2014 with patella fractures treated with ORIF were eligible for inclusion...
November 28, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29174422/bioabsorbable-magnesium-versus-standard-titanium-compression-screws-for-fixation-of-distal-metatarsal-osteotomies-3-year-results-of-a-randomized-clinical-trial
#16
Christian Plaass, Christian von Falck, Sarah Ettinger, Lena Sonnow, Franco Calderone, Andreas Weizbauer, Janin Reifenrath, Leif Claassen, Hazibullah Waizy, Kiriakos Daniilidis, Christina Stukenborg-Colsman, Henning Windhagen
BACKGROUND: For the treatment of hallux valgus commonly distal metatarsal osteotomies are performed. Persistent problems due to the hardware and the necessity of hardware removal has led to the development of absorbable implants. To overcome the limitations of formerly used materials for biodegradable implants, recently magnesium has been introduced as a novel implant material. This is the first study showing mid-term clinical and radiological (MRI) data after using magnesium implants for fixation of distal metatarsal osteotomies...
November 23, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29163995/delayed-tibial-osteomyelitis-after-anterior-cruciate-ligament-reconstruction-with-hamstrings-autograft-and-bioabsorbable-interference-screw-a-case-report-and-review-of-the-literature
#17
Kevin S Weiss, Justin M Weatherall, Jen Eick, James R Ross
Osteomyelitis following arthroscopically assisted anterior cruciate ligament (ACL) reconstruction has rarely been reported in the literature. We report a case of a 20-year-old female who had delayed tibial osteomyelitis and a pretibial cyst with culture-positive, oxacillin sensitive Staphylococcus epidermidis 15 months after an ACL reconstruction with hamstring autograft. Soft tissue fixation within the tibial tunnel was with a poly-L-D-lactic acid (PLDLA) bioabsorbable interference screw. The patient underwent surgical treatment with curettage, debridement, hardware removal, and bone grafting of the tibial tunnel followed by a course of intravenous antibiotics...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29156167/advancements-in-bone-fixation-utilizing-novel-biointegrative-fixation-technology
#18
REVIEW
Bob Baravarian, Tal Pnina Lindner, Ronit Merchav-Feuermann
Advancement in orthopedics have been increasing rapidly. The most important advances have been in fixation. With time, metallic hardware will begin to be replaced by materials that become one with the body. This progress will not only aid in the repair process it will allow permanent and improved reinforcement of the fixated region. Biointegrative technology is a promising new generation of materials capable of achieving this goal. Over time, it is expected that plates, screws, pins, interference screws, and even possibly joint replacements will incorporate into patients' bodies, negating the need for hardware removal and adding structure and stability to an iatrogenically weakened area...
January 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29107411/fracture-of-fusion-mass-following-anterior-cervical-plate-removal-case-report
#19
Jonathan N Sellin, S Shelby Burks, Allan D Levi
We present the case of a delayed pseudoarthrosis resulting from a fracture at the site of a radiographically confirmed anterior cervical fusion following plate removal. In this case, an anterior cervical plate was removed to allow for further surgery at a supra-adjacent level. A modicum of literature exists describing delayed fractures following hardware removal in thoracolumbar fusion constructs. The development of a fracture/pseudoarthrosis following hardware removal at the site of a radiographically confirmed anterior cervical fusion has not been previously reported...
October 26, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/29104819/significance-of-scapholunate-gap-width-as-measured-by-probe-from-midcarpal
#20
Steffen Löw, Holger Erne, Ute Strobl, Frank Unglaub, Christian K Spies
Background  Geissler's classification is widely accepted in arthroscopic diagnostics of scapholunate (SL) ligament injury. Thereby, probe insertion into the SL gap from the midcarpal would indicate treatment necessity in patients with SL tear as seen from radiocarpal view. Purpose  In this review, the SL gap width, examined by the probe from midcarpal, was arthroscopically assessed in patients with intact SL ligaments, who were treated for ulnar impaction syndrome. The review examined how often lax SL joints can be found in patients with no complaints with respect to the SL ligaments and in which the SL ligaments were proven to be intact from radiocarpal view...
November 2017: Journal of Wrist Surgery
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