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https://www.readbyqxmd.com/read/29847416/outcomes-in-thoracolumbar-burst-fractures-with-a-thoracolumbar-injury-classification-score-tlics-of-4-treated-with-surgery-versus-initial-conservative-management
#1
Andrew Nataraj, Andrew S Jack, Ihsan Ihsanullah, Shawn Nomani, Frank Kortbeek, Richard Fox
STUDY DESIGN: This is a single-center, retrospective, observational cohort study. OBJECTIVE: To determine whether surgery or nonoperative treatment has better clinical outcomes in neurologically intact patients with an intermediate severity thoracolumbar burst fracture. SUMMARY OF BACKGROUND DATA: Optimal management, whether initial operative or nonoperative treatment, for thoracolumbar injury classification score (TLICS) 4 burst fractures remains controversial...
July 2018: Clinical Spine Surgery
https://www.readbyqxmd.com/read/29804696/delayed-atraumatic-index-metacarpal-fracture-after-trapeziectomy-and-suture-button-suspensionplasty-for-thumb-carpometacarpal-osteoarthritis-a-report-of-three-cases
#2
Jack G Graham, Michael Rivlin, Jack Abboudi, Kevin Lutsky, Pedro K Beredjiklian
Trapeziectomy with suture-button suspensionplasty is a surgical treatment option for thumb carpometacarpal osteoarthritis refractory to nonsurgical management. We describe the cases of 3 patients who presented with index metacarpal fracture, in the absence of traumatic injury, over 4 months after trapeziectomy with suture-button suspensionplasty. All 3 fractures demonstrated the same pattern: short oblique/spiral, oriented proximal radial to distal ulnar with the distal end in the vicinity of the index metacarpal button, presumably after the orientation of the metacarpal drill hole...
May 24, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29801122/association-of-clinical-outcomes-with-surgical-repair-of-hip-fracture-vs-nonsurgical-management-in-nursing-home-residents-with-advanced-dementia
#3
Sarah D Berry, Randi R Rothbaum, Douglas P Kiel, Yoojin Lee, Susan L Mitchell
Importance: The decision whether to surgically repair a hip fracture in nursing home (NH) residents with advanced dementia can be challenging. Objective: To compare outcomes, including survival, among NH residents with advanced dementia and hip fracture according to whether they underwent surgical hip fracture repair. Design, Setting, and Participants: We conducted a retrospective cohort study of 3083 NH residents with advanced dementia and hip fracture, but not enrolled in hospice care, using nationwide Medicare claims data linked with Minimum Data Set (MDS) assessments from January 1, 2008, through December 31, 2013...
June 1, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#4
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29712534/a-scoping-review-on-health-economics-in-neurosurgery-for-acute-spine-trauma
#5
Brian C F Chan, B Catharine Craven, Julio C Furlan
OBJECTIVE Acute spine trauma (AST) has a relatively low incidence, but it often results in substantial individual impairments and societal economic burden resulting from the associated disability. Given the key role of neurosurgeons in the decision-making regarding operative management of individuals with AST, the authors performed a systematic search with scoping synthesis of relevant literature to review current knowledge regarding the economic burden of AST. METHODS This systematic review with scoping synthesis included original articles reporting cost-effectiveness, cost-utility, cost-benefit, cost-minimization, cost-comparison, and economic analyses related to surgical management of AST, whereby AST is defined as trauma to the spine that may result in spinal cord injury with motor, sensory, and/or autonomic impairment...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709352/radial-head-fracture-fixation-using-tripod-technique-with-headless-compression-screws
#6
REVIEW
Marc D Lipman, Trenton M Gause, Victor A Teran, A Bobby Chhabra, D Nicole Deal
Radial head and neck fractures are one of the most common elbow fractures, comprising 2% to 5% of all fractures, and 30% of elbow fractures. Although uncomplicated Mason type I fractures can be managed nonsurgically, Mason type II-IV fractures require additional intervention. Mason type II-III fractures with 3 or fewer fragments are typically treated with open reduction and internal fixation using 2 to 3 lag screws. Transverse radial neck involvement or axial instability with screw-only fixation has historically required the additional use of a mini fragment T-plate or locking proximal radius plate...
June 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29688959/arthroscopic-management-of-tibial-spine-avulsion-fractures-principles-and-techniques
#7
Eric J Strauss, Daniel James Kaplan, Maxwell E Weinberg, Jonathan Egol, Laith M Jazrawi
Tibial spine fractures are uncommon injuries affecting the insertion of the anterior cruciate ligament on the tibia. They typically occur in skeletally immature patients aged 8 to 14 years and result from hyperextension of the knee with a valgus or rotational force. Diagnosis is based on history, physical examination, and standard radiographs. The use of MRI can identify entrapped soft tissue that may prevent reduction. Open or arthroscopic repair is indicated in patients with partially displaced fractures (>5 mm) with one third to one half of the avulsed fragment elevated, in patients who have undergone unsuccessful nonsurgical reduction and long leg casting or bracing, and in patients with completely displaced fractures...
May 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29685082/peripheral-vestibular-disorders-in-children-and-adolescents-with-concussion
#8
Jacob R Brodsky, Talia N Shoshany, Sophie Lipson, Guangwei Zhou
Objective To review peripheral vestibular disorders in pediatric patients with dizziness following concussion. Study Design Case series with chart review. Setting Pediatric vestibular clinic and pediatric multidisciplinary concussion clinic at a tertiary level pediatric hospital. Subjects and Methods We retrospectively reviewed 109 patients seen for dizziness following a concussion between September 2012 and July 2015. Patients were ≤20 years of age at the time of concussion. Incidences of specific peripheral vestibular disorders were assessed along with timing of diagnosis relative to the date of injury, diagnostic test findings, and treatment interventions associated with those diagnoses...
April 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29651626/current-topics-in-the-management-of-acute-traumatic-spinal-cord-injury
#9
Christopher D Shank, Beverly C Walters, Mark N Hadley
Acute traumatic spinal cord injury (SCI) affects more than 250,000 people in the USA, with approximately 17,000 new cases each year. It continues to be one of the most significant causes of trauma-related morbidity and mortality. Despite the introduction of primary injury prevention education and vehicle safety devices, such as airbags and passive restraint systems, traumatic SCI continues to have a substantial impact on the healthcare system. Over the last three decades, there have been considerable advancements in the management of patients with traumatic SCI...
April 12, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29625798/avascular-necrosis-of-the-metacarpal-head-a-review-of-4-cases
#10
Salah Aldekhayel, Erfan Ghanad, Chaitanya S Mudgal
PURPOSE: To report on 4 cases of avascular necrosis of the metacarpal head. METHODS: We retrospectively reviewed 4 patients who received a diagnosis of avascular necrosis of the metacarpal head and were treated from 2000 to 2016. RESULTS: All patients were males with involvement of the dominant hand. Three patients had a history of trauma and/or fractures in another finger and one had a history of fracture in the same finger. The diagnosis was confirmed on regular x-rays and magnetic resonance imaging...
April 3, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29572729/decision-making-for-complex-scapula-and-ipsilateral-clavicle-fractures-a-review
#11
REVIEW
Florian Hess, Ralph Zettl, Daniel Smolen, Christoph Knoth
INTRODUCTION: Complex scapula with ipsilateral clavicle fracures remains a challange and treatment recommendations are still missing.  This review provides an overview of the evolution of the definition, classification and treatment strategies for complex scapula and ipsilateral clavicle fractures. As with other rare conditions, consensus has not been reached on the most suitable management strategies to treat these patients. The aim of this review is twofold: to compile and summarize the currently available literature on this topic, and to recommend treatment approaches...
March 23, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29547069/pediatric-blunt-cerebrovascular-injury-the-mcgovern-screening-score
#12
Joseph P Herbert, Sidish S Venkataraman, Ali H Turkmani, Liang Zhu, Marcia L Kerr, Rajan P Patel, Irma T Ugalde, Stephen A Fletcher, David I Sandberg, Charles S Cox, Ryan S Kitagawa, Arthur L Day, Manish N Shah
OBJECTIVE The objective of this study was to assess the incidence, diagnosis, and treatment of pediatric blunt cerebrovascular injury (BCVI) at a busy Level 1 trauma center and to develop a tool for accurately predicting pediatric BCVI and the need for diagnostic testing. METHODS This is a retrospective cohort study of a prospectively collected database of pediatric patients who had sustained blunt trauma (patient age range 0-15 years) and were treated at a Level 1 trauma center between 2005 and 2015. Digital subtraction angiography, MR angiography, or CT angiography was used to confirm BCVI...
June 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29516235/management-of-a-type-two-avulsion-fracture-of-the-tibial-intercondylar-eminence-in-children-arthroscopic-suture-fixation-versus-conservative-immobilization
#13
Chen Zhao, Qing Bi, Mingguang Bi
BACKGROUND: Treatment of a type II tibial eminence avulsion fracture was controversial. The aim of this study was to compare the clinical outcomes of a modified arthroscopic suture fixation versus conservative immobilization in treatment of this type fracture in immature population. METHODS: A total of 43 type II avulsion fractures of tibial intercondylar eminence in immature patients were retrospectively enrolled in the study. Twenty-two (13 males, 9 females) were treated with arthroscopic suture fixation and 21(12 males, 9 females) with conservative cast immobilization...
June 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29456053/conjoint-analysis-of-treatment-preferences-for-nondisplaced-scaphoid-fractures
#14
Ronnie L Shammas, Nathan Mela, Scott Wallace, Betty C Tong, Joel Huber, Suhail K Mithani
PURPOSE: We used conjoint analysis to assess the relative importance of factors that influence a patient's decision between surgical or nonsurgical management of a nondisplaced scaphoid fracture. Our hypothesis was that out-of-pocket costs will have a greater influence on decision making than the time spent in a cast or brace, degree of soreness, or the risk of treatment failure. METHODS: Two-hundred and fifty participants were recruited using Amazon Mechanical Turk and asked to assume that they had experienced a nondisplaced scaphoid waist fracture...
February 15, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29453500/isolated-greater-tuberosity-fractures-of-the-proximal-humerus-anatomy-injury-patterns-multimodality-imaging-and-approach-to-management
#15
Eric A White, Matthew R Skalski, Dakshesh B Patel, Jordan S Gross, Anderanik Tomasian, Nathanael Heckmann, George R Matcuk
The greater tuberosity is an important anatomic structure and its integrity is important for shoulder abduction and external rotation. Isolated fractures of the greater tuberosity are often subtle and may not be detected on initial radiographs. Clinically, these patients display symptoms which mimic a full thickness rotator cuff tear. It is important to differentiate these two entities, as their treatment is different (typically nonsurgical management for minimally displaced fractures versus rotator cuff repair for acute full thickness rotator cuff tears)...
June 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29383279/ulnar-neck-fractures-associated-with-distal-radius-fractures
#16
Sezai Özkan, Stefan F Fischerauer, Thomas J M Kootstra, Femke M A P Claessen, David Ring
Background  There is little published data to guide management of ulnar neck fractures associated with fractures of the distal radius. Purpose  As unplanned surgery usually reflects adverse events and this injury combination is relatively uncommon, we used a large database to study the incidence of unplanned surgeries after surgical and nonsurgical treatment of distal metaphyseal ulna fractures associated with a distal radius fracture and identify factors associated with these unplanned surgeries. Patients and Methods  We identified 277 patients with an ulnar neck fracture associated with a distal radius fracture...
February 2018: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/29381884/osteochondral-injuries-of-the-knee-in-pediatric-patients
#17
Kathryn L Bauer
Osteochondral injuries in pediatric patients may occur as a result of a traumatic injury or secondary to an osteochondritis dissecans (OCD) lesion. Lateral patella dislocation is a common traumatic cause of osteochondral injury that typically occurs at the medial facet of the patella or at the lateral aspect of the distal femur. Multiple theories have been proposed for the cause of an OCD lesion in the knee, including trauma or repetitive microtrauma, local vascular insufficiency, and family history. The most "classic" location for OCD lesions of the knee is the lateral aspect of the medial femoral condyle of the distal femur...
May 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29346237/pediatric-pelvic-fractures-and-differences-compared-with-the-adult-population
#18
Carolina de la Calva, Nadia Jover, Jaime Alonso, Marta Salom
INTRODUCTION: Although pelvic fractures in children are rare, because of anatomical differences between an adult's skeleton and a child's skeleton, these lesions in the pediatric population have specific characteristics that need to be borne in mind when dealing with them. MATERIALS AND METHODS: A retrospective chart review was performed on the pelvic fractures in skeletally immature patients treated in our hospital in the last 20 years. RESULTS: Eighty-one pelvic fractures in children were treated between 1993 and 2013...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29149153/analysis-of-reporting-bias-in-vertebral-augmentation
#19
Douglas P Beall, Sean M Tutton, Kieran Murphy, Wayne Olan, Christopher Warner, Jack B Test
Osteoporotic vertebral compression fractures (OVCFs) are a significant cause of morbidity and mortality in the United States and worldwide, with estimates of 750,000 to 1.5 million occurring annually. As the elderly population continues to increase, the incidence of OVCFs will continue to rise, as will the morbidity and mortality associated with this condition. Vertebral augmentation (VA) was almost universally accepted as the appropriate treatment modality prior to 2 sham trials published in 2009 by the New England Journal of Medicine (NEJM)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29146511/surgical-management-of-proximal-interphalangeal-joint-repetitive-stress-epiphyseal-fracture-nonunion-in-elite-sport-climbers
#20
Yasser El-Sheikh, Chris Lutter, Isabelle Schoeffl, Volker Schoeffl, Sascha Flohe
Repetitive stress fracture of the middle phalanx epiphysis is an injury specific to elite adolescent sport climbers. As sport climbing becomes increasingly popular in younger age groups, an increased number of these injuries have been reported in recent years. To date, treatment of these fractures has been nonsurgical, with strict rest and physiotherapy prescribed until fracture union. However, when these patients present in a delayed fashion with an established nonunion, nonsurgical treatment may fail, leading to disabling chronic pain and/or digital deformity in some cases...
June 2018: Journal of Hand Surgery
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