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https://www.readbyqxmd.com/read/29019639/spine-conditions-cervical-spine-conditions
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28659054/self-reducing-proximal-humerus-fractures
#12
Christopher Fang, Ernest Beng Kee Kwek
BACKGROUND: Proximal humeral fractures are common in the elderly and can present with multiple fracture configurations. Our case series describes a three-part valgus-impacted fracture pattern of the proximal humerus that underwent spontaneous reduction by nonsurgical management with good functional outcomes. METHODS: Seven patients who sustained low-energy three-part valgus-impacted fractures of the proximal humerus were studied. We retrospectively reviewed serial anteroposterior radiographs of each patient taken as part of routine follow-up...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28594521/pediatric-distal-radius-fractures
#13
Karan Dua, Joshua M Abzug, Andrea Sesko Bauer, Roger Cornwall, Theresa O Wyrick
Distal radius fractures are the most common orthopaedic injury that occur in the pediatric population. The annual incidence of distal radius fractures has increased as a result of earlier participation in sporting activities, increased body mass index, and decreased bone mineral density. Most distal radius fractures are sustained after a fall onto an outstretched arm that results in axial compression on the extremity or from direct trauma to the extremity. Physeal fractures of the distal radius are described based on the Salter-Harris classification system...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28594517/adolescent-spondylolysis-management-and-return-to-play
#14
William C Warner, Rodrigo Góes Medéa de Mendonça
The most common causes of low back pain in adolescents are spondylolysis and spondylolisthesis. Mechanical factors combined with rapid growth during adolescence place stress on the spine and can result in a stress fracture. Sports that require athletes to repeatedly place the spine in hyperextension may exacerbate both spondylolysis and spondylolisthesis. Many adolescent athletes with spondylolysis or low-grade spondylolisthesis have minimal symptoms and require no treatment or alteration in activity, including sports activity...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28580255/arthroscopy-assisted-fabella-excision-surgical%C3%A2-technique
#15
Matthew T Provencher, George Sanchez, Márcio B Ferrari, Gilbert Moatshe, Jorge Chahla, Ramesses Akamefula, Robert F LaPrade
The fabella is an anatomic variant not seen in all individuals and can potentially be a source of chronic knee pain due to chondromalacia, osteoarthritis, fractures, or biomechanical pressure against the lateral femoral condyle. It is situated intra-articular, close to the lateral femoral condyle, the lateral gastrocnemius head tendon, and the fabellofibular ligament. Given its rarity, the diagnosis of a symptomatic fabella is often overlooked when evaluating patients with persistent posterolateral knee pain...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28574938/chronic-anterior-pelvic-instability-diagnosis-and-management
#16
Michael D Stover, Adam I Edelstein, Joel M Matta
Chronic anterior pelvic ring instability can cause pain and disability. Pain typically is localized to the suprapubic area or inner thigh; often is associated with lower back or buttock pain; and may be exacerbated by activity, direct impact, or pelvic ring compression. Known etiologies of chronic anterior pelvic ring instability include pregnancy, parturition, trauma, insufficiency fractures, athletics, prior surgery, and osteitis pubis. Diagnosis often is delayed. Physical examination may reveal an antalgic or waddling gait, tenderness over the pubic bones or symphysis pubis, and pain with provocative maneuvers...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28523083/association-of-midfacial-fractures-with-ophthalmic-injury
#17
REVIEW
Constantinus Politis, Alexandra Kluyskens, Titiaan Dormaar
The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28496392/differences-in-the-management-of-pediatric-facial-trauma
#18
REVIEW
Tara L Braun, Amy S Xue, Renata S Maricevich
Craniofacial trauma is common in the pediatric population, with most cases limited to soft tissue and dentoalveolar injury. Although facial fractures are relatively rare in children compared with adults, they are often associated with severe injury and cause significant morbidity and disability. Initial evaluation of a child with facial trauma generally involves stabilizing the patient and identifying any severe concomitant injuries before diagnosing and managing facial injuries. The management of pediatric facial fractures is relatively more conservative than that of adults, and nonsurgical management is preferred when possible to prevent the disruption of future growth and development...
May 2017: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/28379912/functional-and-clinical-outcomes-of-nonsurgically-managed-tibial-plateau-fractures
#19
Christian A Pean, Adam Driesman, Anthony Christiano, Sanjit R Konda, Roy Davidovitch, Kenneth A Egol
INTRODUCTION: This study sought to assess and compare long-term functional and clinical outcomes in patients with tibial plateau fractures that are treated nonsurgically. METHODS: Over a period of 8 years, 305 consecutive tibial plateau fractures were treated by three surgeons at a single institution and followed prospectively in an Institutional Review Board-approved study. Overall, 41 patients (13%) were treated nonsurgically and 37 were available for follow-up...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28323712/trends-in-inpatient-vertebroplasty-and-kyphoplasty-volume-in-the-united-states-2005-2011-assessing-the-impact-of-randomized-controlled-trials
#20
Benjamin P Rosenbaum, Varun R Kshettry, Michael L Kelly, Thomas E Mroz, Robert J Weil
STUDY DESIGN: Retrospective analysis of the Nationwide Inpatient Sample, 2005-2011. OBJECTIVE: To identify trends in procedural volume and rates in the time period surrounding publication of randomized controlled trials (RCTs) that examined the utility of vertebroplasty and kyphoplasty. SUMMARY OF BACKGROUND DATA: Vertebroplasty and kyphoplasty are frequently performed for vertebral compression fractures. Several RCTs have been published with conflicting outcomes regarding pain and quality of life compared with nonsurgical management and sham procedures...
April 2017: Clinical Spine Surgery
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