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https://www.readbyqxmd.com/read/28207621/mri-based-decision-making-of-implant-removal-in-deep-wound-infection-after-instrumented-lumbar-fusion
#1
Masahiro Kanayama, Tomoyuki Hashimoto, Keiichi Shigenobu, Fumihiro Oha, Akira Iwata, Masaru Tanaka
STUDY DESIGN: A retrospective study. OBJECTIVE: The aim of the study was to review the treatment of deep wound infection after posterior instrumented lumbar fusion, and thereby to optimize the decision-making process of implant removal or retention on the basis of magnetic resonance imaging (MRI) assessment. SUMMARY OF BACKGROUND DATA: Biofilm formed on the surface of the spinal implant prevents infiltration of antibiotics and makes the infection treatment more complicated...
March 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28202380/impact-of-surgical-site-infection-and-surgical-debridement-on-lumbar-arthrodesis-a-single-institution-analysis-of-incidence-and-risk-factors
#2
Timothy Y Wang, Adam G Back, Eliza Hompe, Kevin Wall, Oren N Gottfried
This study identifies the rate of pseudarthrosis following surgical debridement for deep lumbar spine surgical site infection and identify associated risk factors. Patients who underwent index lumbar fusion surgery from 2013 to 2014 were included if they met the following criteria: 1) age >18years, 2) had debridement of deep lumbar SSI, and had 3) lumbar spine AP, lateral and flexion/extension X-rays and computed tomography (CT) at 12months or greater postoperatively. Criteria for fusion included 1) solid posterolateral, facet, or disk space bridging bone, 2) no translational or angular motion on flexion/extension X-rays, and 3) intact posterior hardware without evidence of screw lucency or breakage...
February 12, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28192827/the-use-of-mesh-plates-for-difficult-fractures-of-the-patella
#3
David Volgas, Tina K Dreger
Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28182170/complications-of-minimally-invasive-percutaneous-plating-for-distal-tibial-fractures
#4
Nasir Muzaffar, Rafiq Bhat, Mohammad Yasin
BACKGROUND: The management of distal tibia fractures continues to remain a source of controversy and debate. OBJECTIVES: The aim of this study was to evaluate the various complications of minimally invasive percutaneous plate osteosynthesis (MIPPO) using a locking plate for closed fractures of distal tibia in a retrospective study. PATIENTS AND METHODS: Twenty-five patients with distal tibial fractures, treated by minimally invasive percutaneous plate osteosynthesis, were evaluated in a retrospective study...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28173717/double-plating-of-distal-fibula-fractures
#5
Danica D Vance, J Turner Vosseller
INTRODUCTION: Distal fibula fractures are common orthopaedic injuries that often require open reduction internal fixation (ORIF) to anatomically reduce the fracture and minimize the risk of posttraumatic arthritis. In certain clinical situations, stouter fixation may be advantageous to decrease the risk of fixation failure. In this study, the authors report on 12 patients who underwent distal fibula ORIF with 2 one-third tubular plates. MATERIALS AND METHODS: Twelve consecutive patients who underwent distal fibula ORIF with 2 one-third tubular plates were retrospectively reviewed...
February 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28159050/subtalar-arthroscopic-arthrodesis-technique-and-outcomes
#6
Jesús Vilá-Rico, María Angeles Mellado-Romero, Beatriz Bravo-Giménez, Verónica Jiménez-Díaz, Cristina Ojeda-Thies
PURPOSE: The goal of this study was to describe the surgical technique and our results with arthroscopic posterior subtalar arthrodesis. MATERIAL AND METHODS: Retrospective case series of 65 patients (38 men and 27 women) averaging 50 years of age (range 21-72 years) undergoing posterior arthroscopic subtalar arthrodesis using one or two percutaneous 6.5-7.3mm screws between May 2004 and February 2011, with a mean follow-up of 57.5 months (range 24-105 months). RESULTS: We achieved a 95...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28149734/medial-closing-wedge-distal-femoral-osteotomy-for-genu-valgum-with-lateral-compartment-disease
#7
James D Wylie, Travis G Maak
Lateral compartment disease combined with valgus alignment can lead to progressive knee joint degeneration. In the symptomatic patient with isolated lateral compartment disease, a varus-producing distal femoral osteotomy can unload the diseased lateral compartment. This osteotomy may be combined with other cartilage or meniscal restorative techniques to optimize knee joint preservation and pain relief. The osteotomy can be performed with a medial closing-wedge or lateral opening-wedge technique. Both techniques have been reported to improve knee-related quality of life in patients with lateral compartment disease...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28146404/minimally-invasive-double-button-fixation-of-displaced-lateral-clavicular-fractures-in-athletes
#8
Maximiliano Ranalletta, Luciano A Rossi, Hugo Barros, Francisco Nally, Ignacio Tanoira, Santiago L Bongiovanni, Gastón D Maignon
BACKGROUND: Early union and a rapid return to prior function are the priorities for young athletes with lateral clavicular fractures. Furthermore, it is essential to avoid nonunion in this subgroup of patients, as this is frequently associated with persistent pain, restriction of movement, and loss of strength and endurance of the shoulder. PURPOSE: To analyze the time to return to sport, functional outcomes, and complications in a group of athletes with displaced lateral clavicular fractures treated using closed reduction and minimally invasive double-button fixation...
February 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28142266/inflammatory-microenvironment-persists-after-bone-healing-in-intra-articular-ankle-fractures
#9
Samuel B Adams, Elizabeth M Leimer, Lori A Setton, Richard D Bell, Mark E Easley, Janet L Huebner, Thomas V Stabler, Virginia B Kraus, Steven A Olson, Dana L Nettles
BACKGROUND: Post-traumatic osteoarthritis (PTOA) is responsible for the majority of cases of ankle arthritis. While acute and end-stage intra-articular inflammation has previously been described, the state of the joint between fracture healing and end-stage PTOA remains undefined. This study characterized synovial fluid (SF) composition of ankles after bone healing of an intra-articular fracture to identify factors that may contribute to the development of PTOA. METHODS: Of an original 21 patients whose SF was characterized acutely following intra-articular ankle fractures, 7 returned for planned hardware (syndesmotic screw) removal after bone healing (approximately 6 months) and consented to a second bilateral SF collection...
January 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28122599/is-there-a-clinical-benefit-of-additional-tension-band-wiring-in-plate-fixation-of-the-symphysis
#10
Myung-Sik Park, Sun-Jung Yoon, Seung-Min Choi, Kwanghun Lee
BACKGROUND: The purpose of this study was to determine whether additional tension band wiring in the plate for traumatic disruption of symphysis pubis has clinical benefits. Therefore, outcomes and complications were compared between a plate fixation group and a plate with tension band wiring group. METHODS: We retrospectively evaluated 64 consecutive patients who underwent open reduction and internal fixation of the symphysis pubis by using a plate alone (n = 39) or a plate with tension band wiring (n = 25)...
January 25, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28120073/complications-in-craniovertebral-junction-instrumentation-hardware-removal-can-be-associated-with-long-lasting-stability-personal-experience
#11
Massimiliano Visocchi, Pier Paolo Mattogno, Francesco Signorelli, Jun Zhong, Gerardo Iacopino, Giuseppe Barbagallo
BACKGROUND: The causes of craniovertebral junction (CVJ) instabilities include trauma, rheumatological diseases, tumors, infections, congenital malformations, and degenerative disease processes; these complex pathologies often require CVJ instrumentation. Hardware complications were analyzed in a personal series of 48 treated patients. In light of the analysis of very unusual radiological and clinical findings, the authors tried to better investigate the related mechanisms and to reach possible useful conclusions...
2017: Acta Neurochirurgica. Supplement
https://www.readbyqxmd.com/read/28118229/hospital-transfer-of-open-tibial-fractures-requiring-microsurgical-reconstruction-negatively-impacts-clinical-outcomes
#12
Christopher S Crowe, Anna Luan, Gordon K Lee
INTRODUCTION: Open tibial fractures are orthopedic emergencies that may present with severe soft tissue damage. Free tissue transfer is often required when local tissues are insufficient and patients may require hospital transfer to tertiary care centers for this purpose. Although the negative impact of inter-facility transfer has been well demonstrated in trauma patients, less is known regarding transfers for lower extremity injury patients. This study investigates differences in outcomes based on transfer status after open tibial fracture...
January 23, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28116277/broken-pieces-of-circlage-wire-lying-in-soft-tissue-envelope-around-knee-joint-a-case-report-and-review-of-literature
#13
Anoop Kalia, Kavin Khatri, Jagdeep Singh, Kapil Bansal, Mohammed Sagy
INTRODUCTION: The migration of circlage wires used in tension band wiring construct of patella fractures in the posterior soft tissue envelope surrounding the knee joint has been rarely reported. CASE PRESENTATION: A 60-year-old woman presented to us with pain over medial aspect of right knee joint. She underwent open reduction and internal fixation for a patellar fracture which she sustained 4 years back and subsequently underwent kirschner wire(k wire) removal for the same around 2 years back...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28106674/open-surgical-release-of-posttraumatic-elbow-contracture-in-children-and-adolescents
#14
Samantha L Piper, Lisa L Lattanza, Tony S Shen, Lindley B Wall, Charles A Goldfarb
BACKGROUND: Posttraumatic elbow contractures in children and adolescents are challenging to manage, and studies investigating surgical treatment are limited by the rarity of this condition. Small case series have shown variable gains in immediate and long-term elbow arc of motion after open surgical release. We reviewed our experience with open surgical release of posttraumatic elbow contracture in patients <21 years old at 2 institutions. METHODS: A retrospective chart review identified patients who underwent posttraumatic open elbow contracture release by 2 surgeons at 2 institutions between 2006 and 2013...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#15
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28104419/pelvic-hardware-eroding-into-the-bladder-a-rare-case-presentation-of-gross-hematuria-bladder-pain-and-refractory-luts
#16
Kristen E Gurtner, Jonathan A Israel, Michael R Pinsky, James F Mautner, June B Miguez, Daniel J Canter
We present a 60 year-old male who presented with gross hematuria, refractory lower urinary tract symptoms, and increasing bladder pain for 3 months. The patient had a prior history of a motorcycle accident and pelvic fracture requiring an extensive pelvic open reduction and internal fixation. During evaluation, the patient was found to have an orthopedic screw from his hardware eroding through the left lateral wall of his bladder and irritating his trigone. The patient underwent pelvic exploration with open cystotomy and hardware removal with the orthopedic service...
January 16, 2017: Urology
https://www.readbyqxmd.com/read/28089595/percutaneous-plating-of-weber%C3%A2-b-fibular-fractures
#17
Amol Saxena, Andrew Yun
The purpose of the present study was to describe a minimally invasive percutaneous technique for plating Weber B distal fibular fractures and to evaluate its efficacy by measuring patient outcomes and hardware removal rates. The data from 17 patients undergoing percutaneous plating of a distal fibular (Weber B) fracture were prospectively studied. A 4- to 6-hole semitubular plate with 3 screws was used for percutaneously plating. The Roles and Maudsley score was used to assess the patients' activity level...
January 12, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28088939/complications-in-the-management-of-closed-high-energy-proximal-tibial-plateau-fractures
#18
Kavin Khatri, Vijay Sharma, Darsh Goyal, Kamran Farooque
PURPOSE: To report complications in the management of complex closed proximal tibial fractures. METHOD: A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 2011 and March 2014. Sixty two patients were included in the study. The mean patient age was (43.16 ± 11...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28072579/development-of-advanced-signal-processing-and-source-imaging-methods-for-superparamagnetic-relaxometry
#19
Ming-Xiong Huang, Bill Anderson, Charles W Huang, Gerd J Kunde, Erika C Vreeland, Jeffrey W Huang, Andrei N Matlashov, Todor Karaulanov, Christopher P Nettles, Andrew Gomez, Kayla Minser, Caroline Weldon, Giulio Paciotti, Michael Harsh, Roland R Lee, Edward R Flynn
Superparamagnetic relaxometry (SPMR) is a highly sensitive technique for the in vivo detection of tumor cells and may improve early stage detection of cancers. SPMR employs superparamagnetic iron oxide nanoparticles (SPION). After a brief magnetizing pulse is used to align the SPION, SPMR measures the time decay of SPION using super-conducting quantum interference device (SQUID) sensors. Substantial research has been carried out in developing the SQUID hardware and in improving the properties of the SPION. However, little research has been done in the pre-processing of sensor signals and post-processing source modeling in SPMR...
February 7, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#20
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
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