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https://www.readbyqxmd.com/read/29456053/conjoint-analysis-of-treatment-preferences-for-nondisplaced-scaphoid-fractures
#1
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
#2
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)...
February 16, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29383279/ulnar-neck-fractures-associated-with-distal-radius-fractures
#3
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
#4
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...
January 30, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29346237/pediatric-pelvic-fractures-and-differences-compared-with-the-adult-population
#5
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
#6
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
#7
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...
November 14, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29078712/management-modalities-and-outcomes-following-acute-scaphoid-fractures-in-children-a-quantitative-review-and-meta-analysis
#8
Ashkaun Shaterian, Pauline Joy F Santos, Christine J Lee, Gregory R D Evans, Amber Leis
BACKGROUND: Early evaluation and appropriate management of pediatric scaphoid fractures are necessary to avoid complications. To date, current management of pediatric fractures varies among providers. The objective of this study was to compare clinical outcomes following different treatment modalities. METHODS: A PubMed literature search identified studies involving acute scaphoid fractures in children. Studies were evaluated for treatment provided and their respective effects on union rate, wrist range of motion, and wrist pain...
October 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29054355/the-effect-of-bisphosphonates-on-the-clinical-and-radiographic-outcomes-of-distal-radius-fractures-in-women
#9
Kristin E Shoji, Brandon E Earp, Tamara D Rozental
PURPOSE: To compare clinical and radiographic outcomes of distal radius fractures (DRF) treated with nonsurgical management in female postmenopausal patients receiving bisphosphonate (BP) therapy at the time of injury with those not receiving BP therapy. METHODS: We prospectively enrolled 33 female postmenopausal patients with 35 DRF between December 2010 and January 2014 at 2 Level I tertiary care centers. Eleven patients with 12 DRF were currently receiving BP at the time of injury (BP group) and were compared with 22 controls with 23 DRF (CONT group) who were not receiving BP at the time of injury...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#10
REVIEW
Marc A Childress
There are a variety of causes of neck pain, including trauma and degenerative changes. The history of onset helps to direct evaluation, including the need for imaging or ancillary testing. Patterns of pain, weakness, and other specific physical examination findings also aid in diagnosis. Management of most soft tissue injuries involves early mobilization, whereas fractures are managed based on patterns of instability. Acute spinal cord injury requires emergent care, to include possible decompressive surgery...
October 2017: FP Essentials
https://www.readbyqxmd.com/read/28953082/distal-humerus-fractures-in-the-elderly-population
#11
Thomas F Varecka, Chad Myeroff
Distal humerus fractures present complex challenges in the elderly patient. These fractures often occur in patients who are living independently but have poor bone quality and low physiologic reserve, thus complicating management decisions and treatment. The goal is a painless, functional, stable elbow that allows completion of the activities of daily living. Nonsurgical management is reserved for those who cannot tolerate surgery. Open reduction and internal fixation is the preferred choice in fractures amenable to rigid fixation and early motion...
October 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28867251/dorsal-plate-fixation-of-scapular-fracture
#12
REVIEW
Takashi Noguchi, James F Mautner, Scott F M Duncan
Scapular fractures are uncommon injuries. When they occur, they are usually treated nonsurgically. However, certain indications remain for operative intervention for the treatment of these injuries. In this article, we review some operative indications as well as the surgical technique. We present a case to demonstrate the indications and surgical technique of treatment. As with most surgical approaches, technique is critical to minimize morbidity and maximize functional outcome. Using these techniques, operative management of scapular fractures can be successful...
August 31, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28816880/management-of-hangman-s-fractures-a-systematic-review
#13
Hamadi Murphy, Gregory D Schroeder, Weilong J Shi, Christopher K Kepler, Mark F Kurd, Andrew N Fleischman, Frank Kandziora, Jens R Chapman, Lorin M Benneker, Alexander R Vaccaro
BACKGROUND: Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. The purpose of this review is to provide an evidence-based analysis of the literature and clinical outcomes associated with the surgical and nonsurgical management of hangman's fractures. METHODS: A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, COMPENDEX) for all articles describing the treatment of hangman's fractures in 2 or more patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28816875/controversies-in-the-management-of-geriatric-odontoid-fractures
#14
Scott C Wagner, Gregory D Schroeder, Christopher K Kepler, Alexander J Schupper, Frank Kandziora, Emiliano N Vialle, Cumhur Oner, Michael G Fehlings, Alexander R Vaccaro
Fractures of the odontoid process of C2 have become increasingly prevalent in the aging population and are typically associated with a high incidence of morbidity. Dens fractures comprise the majority of all cervical fractures in patients older than 80 years and remain the most common cervical fracture pattern in all geriatric patients. Type II odontoid fractures have been associated with limited healing potential, and both nonoperative and operative management are associated with high mortality rates. Historically, there has been some debate in the literature with regards to optimal management strategies to maximize outcomes in geriatric patients...
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28763409/functional-and-clinical-outcomes-of-nonsurgically-managed-tibial-plateau-fractures
#15
LETTER
Lokesh Kumar Sn, Deepak Kumar
No abstract text is available yet for this article.
September 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28739307/conservative-treatment-for-minimally-displaced-type-b-periprosthetic-femoral-fractures
#16
Young-Kyun Lee, Jung Taek Kim, Ki-Choul Kim, Yong-Chan Ha, Kyung-Hoi Koo
BACKGROUND: Surgical treatment has been invariably indicated for Vancouver type B periprosthetic femoral fractures (PFFs), which involve femoral diaphysis around stem. We evaluated the outcomes of nonoperative management in patients with minimally displaced type B PFFs around cementless stem. METHODS: From October 2009 to March 2016, 60 type B PFFs were treated at 1 institution. Among them, 19 minimally (<5 mm) displaced PFFs (31.7%, 19/60), which occurred around cementless stems, were treated nonsurgically with use of teriparatide...
November 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28737617/management-of-acetabular-fractures-in-the-elderly
#17
Nicholas B Antell, Julie A Switzer, Andrew H Schmidt
The incidence of acetabular fractures in the elderly population is increasing. Fractures in this population differ from those in younger patients, with more frequent involvement of the anterior column, more comminution, and more severe articular impaction in elderly patients. Although acetabular fractures in geriatric patients are more likely the result of low-energy trauma, outcomes are generally poorer than those in young patients. Multiple management options have been proposed, but no intervention has become the standard of care for these fractures in the elderly...
August 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28734536/evaluation-of-functional-outcome-after-nonsurgical-management-of-terrible-triad-injuries-of-the-elbow
#18
Farid Najd Mazhar, Davod Jafari, Alireza Mirzaei
BACKGROUND: Terrible triad (TT) is one of the severe injuries of the elbow that generally requires surgery. Nonsurgical treatment has recently been applied in selected cases of TT injury. Evaluation of the results of this treatment was the main aim of this study. METHODS: In a prospective cohort study, 10 patients with a mean follow-up of 30.6 months were evaluated. The inclusion criteria included a congruent joint after closed reduction, no indication for surgery of the coronoid and radial head fractures, no block in supination and pronation up to 60°, no intra-articular fragments, and a free and stable joint with ulnohumeral extension up to a minimum of 45°...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28733098/obesity-and-failure-of-nonsurgical-management-of-pediatric-both-bone-forearm-fractures
#19
Ugochi C Okoroafor, Lisa K Cannada, Jasmin L McGinty
PURPOSE: In pediatric extremity fractures treated nonsurgically, maintaining reduction can be difficult in obese children owing to the larger soft tissue envelope. The purpose of this study was to investigate the relationship between obesity and failure of nonsurgical management of pediatric both-bone forearm fractures. METHODS: We conducted a retrospective review of 129 skeletally immature patients older than 2 years who received nonsurgical treatment for closed radius and ulna shaft fractures at a level I pediatric trauma center between 2011 and 2014...
September 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28695180/custom-hemiarthroplasties-for-retention-of-existing-hardware-associated-with-osteogenesis-imperfecta
#20
Kevin Nishida, Daniel Choi, Mathias Bostrom
Osteogenesis imperfecta is a rare genetic disorder that presents with heterogeneous phenotypes ranging from brittle bones to impaired hearing. Because of the decreased bone mineral density frequently observed in this patient population, many patients experience recurring and long-term fractures, which often require orthopaedic management. With the advancement of nonsurgical and surgical management and increased longevity of patients with osteogenesis imperfecta, the incidence of osteoarthritis has risen, presenting new orthopaedic challenges...
June 2017: Arthroplasty Today
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