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Orthopedic Surgery

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https://www.readbyqxmd.com/read/28942855/a-systematic-review-and-meta-analysis-of-factors-for-delirium-in-vascular-surgical-patients
#1
REVIEW
Christopher Oldroyd, Anna F M Scholz, Robert J Hinchliffe, Kathryn McCarthy, Jonathan Hewitt, Terrence J Quinn
BACKGROUND: Delirium is a common syndrome responsible for a large burden of morbidity and mortality. In surgical settings, research into risk factors for postoperative delirium has largely focused on elective orthopedic patients. We performed a systematic review and meta-analysis to evaluate the evidence surrounding risk factors for delirium in vascular surgical populations. METHODS: Two independent reviewers searched five databases (MEDLINE, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO) from January 1987 to December 2015...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28938364/the-role-of-tranexamic-acid-in-plastic-surgery-review-and-technical-considerations
#2
Rod J Rohrich, Min-Jeong Cho
Minimizing blood loss during surgery is critical, and many modalities have been used to decrease unwanted surgical bleeding. Among many methods, use of pharmacological agents such as anti-fibrinolytic drugs have been shown to significantly reduce blood loss and the rates of postoperative blood transfusion in many literatures. Tranexamic acid is an anti-fibrinolytic agent that has been widely used in other surgical specialties, especially in cardiac, orthopedic, and trauma surgery . Despite its known benefits, the use of tranexamic acid in plastic surgery is extremely limited, primarily because most plastic surgery procedures do not involve the extent of blood loss that can lead to anemia and the need for blood transfusion, as is common in major orthopedic and cardiac surgery procedures...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28937469/outcome-of-a-resident-spine-surgical-skills-training-program
#3
Brian P Calio, Christopher K Kepler, John D Koerner, Jeffrey A Rihn, Paul Millhouse, Kris E Radcliff
STUDY DESIGN: Cadaver training lab. OBJECTIVE: To determine if a technical cadaver skills training lab for spinal surgery increases resident confidence, satisfaction in training, and perception of operating room safety. SUMMARY OF BACKGROUND DATA: Resident training is an important topic in the setting of work hour reform. The use of supplemental materials such as videos, sawbones, and simulators may become important to adequately train orthopedic residents...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937463/combined-anterior-posterior-fixation-and-fusion-for-completely-dislocated-hangman-s-fracture-a-retrospective-analysis-of-11-cases
#4
Jianxi Wang, Huajiang Chen, Peng Cao, Wen Yuan, Xiaodong Wu, Gang Liu, Renhu Li, Fazhi Zang, Liangyu Shi, An Wang
STUDY DESIGN: Retrospective clinical study. PURPOSE: To evaluate the effectiveness and feasibility of combined anterior-posterior fixation and fusion for the treatment of completely dislocated hangman's fracture. SUMMARY OF BACKGROUND DATA: A completely dislocated hangman's fracture describes the complete anterior displacement of the C2 vertebral body onto the C3 body. This type of fracture is exceptionally unstable, and for which the management is challenging...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28935338/soft-tissue-surgery-for-adults-with-nonfunctional-spastic-hands-following-central-nervous-system-lesions-a-retrospective-study
#5
Laure Gatin, Alexis Schnitzler, Fabien Calé, Guillaume Genêt, Philippe Denormandie, François Genêt
PURPOSE: Soft tissue surgery for upper extremity contractures can improve hygiene, pain, and appearance in adults with central nervous system lesions. The goal of such interventions is highly individual; thus, goal attainment scaling (GAS; a method of scoring the extent to which patient's individual goals are achieved [5 levels] in the course of intervention and using T score values) is pertinent to evaluate outcome. The objective of this study was to assess the effect of soft tissue surgery for upper extremity muscle contractures in patients with central nervous system lesions using GAS...
September 19, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28934543/long-term-results-of-intercalary-endoprosthetic-short-segment-fixation-following-extended-diaphysectomy
#6
Nicholas S Tedesco, Alexandra L Van Horn, Robert M Henshaw
Intercalary endoprosthetic reconstruction following diaphyseal resection of osseous tumors offers functional advantages through preservation of native joints adjacent to the resected defect. Use of such implants is restricted by the amount of bone available for stem fixation adjacent to the defect. This study aimed to determine whether short osseous segment fixation with acceptable outcomes and complication rate can be reliably achieved with a customized intercalary endoprosthesis following extended diaphysectomy...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28934541/contact-dermatitis-reaction-to-2-octyl-cyanoacrylate-following-3-orthopedic-procedures
#7
Nicholas H Lake, Brian T Barlow, James E Toledano, Johannah Valentine, Lucas S McDonald
Two-octyl cyanoacrylate is a popular skin adhesive used for closing surgical incisions. Since Food and Drug Administration approval in 1998, the few reports of adverse reactions following its use have primarily been limited to the nonorthopedic literature. The authors present a case series of contact dermatitis associated with 2-octyl cyanoacrylate following orthopedic surgery and a review of the literature on the diagnosis and treatment of this complication. All 3 patients presented with blistering around their incisions within 2 weeks of surgery and responded to treatment involving removal of the offending agent and use of oral diphenhydramine and hydroxyzine and topical triamcinolone...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28934540/safe-positioning-for-sexual-intercourse-after-proximal-femoral-replacement
#8
Cory G Couch, Richard W Nicholas, Corey O Montgomery
Hip arthroplasty is a common procedure used for the treatment of fractures and degenerative processes affecting the hip. Proximal femoral replacement is an uncommon type of hip arthroplasty used for reconstruction after extensive bone loss. Proximal femoral replacement is used most commonly after the resection of the proximal femur for malignancies and for extensive bone loss encountered in revision hip arthroplasty and occasionally for extensive bone loss after fractures. The authors present a case of a female patient who sustained a prosthetic dislocation of her proximal femoral replacement during sexual intercourse...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28934538/predictability-of-early-postoperative-ultrasonography-after-arthroscopic-rotator-cuff-repair
#9
Joo Han Oh, Joon Yub Kim, Sae Hoon Kim, Nam Yun Chung
The predictability of early postoperative ultrasonography (USG) for evaluating the structural integrity of repaired rotator cuffs is still unclear. The aim of this study was to compare the predictability of early USG performed 3 and 6 months postoperatively with magnetic resonance imaging (MRI) performed 1 year after arthroscopic cuff repair for structural failure. Among 213 patients who had arthroscopic rotator cuff surgery in 2013, one hundred thirty-eight patients who underwent USG between 3 and 6 months postoperatively and MRI at 1 year postoperatively were enrolled; the postoperative MRI findings were the reference standard used for the comparison...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28933332/the-impact-of-caregivers-anxiety-on-patients-anxiety-before-fast-track-knee-arthroplasty
#10
P Zietek, B Zarzycka, J Zietek, M Stepien-Slodkowska, E Sienko-Awierianow, D Kotrych, K Dobiecki
PURPOSE OF THE STUDY Anxiety may have negative repercussions on the surgery including poorer outcomes. On the other hand, the majority of patients reporting preoperative anxiety fear not receiving enough attention from a caregiver. In patients undergoing fast-track knee arthroplasty, we determined the relationship between patients' preoperative anxiety and the anxiety the patient's caregiver. We also analyzed the influence of selected psychosocial and demographic variables on the relationship between caregivers' and patients' anxiety...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28932982/cerebral-fat-embolism-recognition-complications-and-prognosis
#11
Daniel Agustín Godoy, Mario Di Napoli, Alejandro A Rabinstein
Fat embolism syndrome (FES) is a rare syndrome caused by embolization of fat particles into multiple organs including the brain. It typically manifests with petechial rash, deteriorating mental status, and progressive respiratory insufficiency, usually occurring within 24-48 h of trauma with long-bone fractures or an orthopedic surgery. The diagnosis of FES is based on clinical and imaging findings, but requires exclusion of alternative diagnoses. Although there is no specific treatment for FES, prompt recognition is important because it can avoid unnecessary interventions and clarify prognosis...
September 20, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28932499/evaluation-of-noise-pollution-level-in-the-operating-rooms-of-hospitals-a-study-in-iran
#12
Masoumeh Dorri Giv, Karim Ghazikhanlou Sani, Majid Alizadeh, Ali Valinejadi, Hesamedin Askari Majdabadi
INTRODUCTION: Noise pollution in the operating rooms is one of the remaining challenges. Both patients and physicians are exposed to different sound levels during the operative cases, many of which can last for hours. This study aims to evaluate the noise pollution in the operating rooms during different surgical procedures. MATERIALS AND METHODS: In this cross-sectional study, sound level in the operating rooms of Hamadan University-affiliated hospitals (totally 10) in Iran during different surgical procedures was measured using B&K sound meter...
June 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28932493/magnesium-based-biodegradable-alloys-degradation-application-and-alloying-elements
#13
REVIEW
Maksym Pogorielov, Eugenia Husak, Alexandr Solodivnik, Sergii Zhdanov
In recent years, the paradigm about the metal with improved corrosion resistance for application in surgery and orthopedy was broken. The new class of biodegradable metal emerges as an alternative for biomedical implants. These metals corrode gradually with an appropriate host response and release of corrosion products. And it is absolutely necessary to use essential metals metabolized by hosting organism with local and general nontoxic effect. Magnesium serves this aim best; it plays the essential role in body metabolism and should be completely excreted within a few days after degradation...
March 2017: Interventional Medicine & Applied Science
https://www.readbyqxmd.com/read/28930037/regional-consolidation-of-orthopedic-surgery-impacts-on-hip-fracture-surgery-access-and-outcomes
#14
Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge
BACKGROUND: Timely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery. METHODS: We retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries...
September 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28928579/to-evaluate-the-efficacy-of-fentanyl-and-dexmedetomidine-as-adjuvant-to-ropivacaine-in-brachial-plexus-block-a-double-blind-prospective-randomized-study
#15
Nyla Farooq, Raj Bahadur Singh, Arindam Sarkar, Mohd Asim Rasheed, Sanjay Choubey
CONTEXT: Anesthesia and analgesia for surgeries to the upper extremity are commonly provided using brachial plexus anesthesia. There are limited or almost no studies comparing the use of ropivacaine with fentanyl to ropivacaine with dexmedetomidine. AIMS: To compare the efficacy of fentanyl and dexmedetomidine as adjuvants to ropivacaine for brachial plexus block among patients undergoing upper limb orthopedic surgeries. SETTINGS AND DESIGN: This was a prospective, randomized, double-blinded study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928571/dexmedetomidine-as-adjuvant-to-lower-doses-of-intrathecal-bupivacaine-for-lower-limb-orthopedic-surgeries
#16
Taznim Mohamed, Indu Susheela, Beena P Balakrishnan, Suvarna Kaniyil
BACKGROUND: Dexmedetomidine, an α2 adrenergic agonist, has been found to be a useful adjuvant to local anesthetics. It has been found to produce satisfactory block with lower doses of spinal bupivacaine. AIM: The aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928553/comparison-of-intrathecal-clonidine-and-fentanyl-as-adjuvant-to-hyperbaric-bupivacaine-in-subarachnoid-block-for-lower-limb-orthopedic-surgery
#17
Sidharth Sraban Routray, Khageswar Raut, Amit Pradhan, Abhilash Dash, Mina Soren
BACKGROUND: Many studies are there using adjuvants such as clonidine and fentanyl with bupivacaine in the subarachnoid block for prolonging postoperative analgesia. However, literature is divided regarding the dosage and efficacy of both intrathecal adjuvants. Furthermore, these adjuvants have their own side effects. Hence, search for ideal intrathecal adjuvant between clonidine and fentanyl to bupivacaine goes on. AIM: The aim of the present study was to compare the effect of intrathecal clonidine and fentanyl as adjuvant to bupivacaine in the subarachnoid block for lower limb orthopedic surgery...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928544/role-of-anesthesiologist-in-the-management-of-a-child-with-cerebral-palsy
#18
REVIEW
Safiya Imtiaz Shaikh, Ganapati Hegade
Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928047/quality-of-meta-analyses-in-major-leading-orthopedics-journals-a-systematic-review
#19
REVIEW
X Zhi, Z Zhang, J Cui, X Zhai, X Chen, J Su
BACKGROUND: Meta-Analyses are the basis of professional and healthcare agencies recommendations and have a growing importance. Quality of meta-analyses has been investigated in some medical fields but to our best knowledge this issue remains fairly investigated in orthopedics. Therefore, we performed a systematic analysis to assess: 1) the quality of meta-analyses before and after the introduction of PRISMA statement as a comprehensive guideline and the use of the AMSTAR tool? 2) have some general characteristics influenced the quality of meta-analyses (country, funding source)? MATERIAL AND METHODS: We systematically searched the meta-analyses in the top four journals with the impact factor (2015) as following: Journal of Bone and Joint Surgery (JBJS), Osteoarthritis Cartilage, Arthroscopy, and Clinical Orthopaedics Related Research (CORR) from 2005 to 2008 and from 2012 to 2015...
September 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28927957/clinical-course-of-the-bony-lesion-of-single-system-single-site-langerhans-cell-histiocytosis-is-appropriate-follow-up-sufficient-treatment
#20
Hiromi Sasaki, Satoshi Nagano, Hirofumi Shimada, Shunsuke Nakamura, Takao Setoguchi, Setsuro Komiya
BACKGROUND: Langerhans cell histiocytosis (LCH) is categorized into three types, which include single-system single-site (SS-s), single-system multiple-site (SS-m) and multisystem (MS). The most commonly affected site in LCH is bone, and the bony lesion of SS-s LCH has a good prognosis. The bony lesion of SS-s LCH has been thought to regress spontaneously. Although treatments such as curettage, direct injection of corticosteroids, and chemotherapy have been performed, regular follow-up is the first line of treatment for the bony lesion of SS-s LCH...
September 16, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
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