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Orthopedic Surgery

Rupen Shah, Kristopher Attwood, Shipra Arya, Daniel E Hall, Jason M Johanning, Emmanuel Gabriel, Anthony Visioni, Steven Nurkin, Moshim Kukar, Steven Hochwald, Nader N Massarweh
Importance: Failure to rescue (FTR), or death after a potentially preventable complication, is a nationally endorsed, publicly reported quality measure. However, little is known about the impact of frailty on FTR, in particular after low-risk surgical procedures. Objective: To assess the association of frailty with FTR in patients undergoing inpatient surgery. Design, Setting, and Participants: This study assessed a cohort of 984 550 patients undergoing inpatient general, vascular, thoracic, cardiac, and orthopedic surgery in the National Surgical Quality Improvement Program between January 1, 2005, and December 31, 2012...
March 21, 2018: JAMA Surgery
Supriya Singh, Kamary Coriolano, Jacob Davidson, Megan Cashin, Timothy Carey, Debra Bartley
Trampolines are widely used by children, but trampoline injuries can be severe and may require hospital care or even surgery. This pilot study examined the effectiveness of an educational intervention on caregivers' perceptions of trampoline use and safety for their children. Primary caregivers were recruited from the orthopedic clinic at the Children's Hospital at our institution in 2015. Caregivers were asked to complete a survey at two time points, initially in clinic and one week post educational intervention...
June 2018: Preventive Medicine Reports
Érica Lofrano Reghine, Caio César Inaco Cirino, André Amate Neto, Fabiana Rossi Varallo, Paulo Roberto Barbosa Évora, Tales Rubens de Nadai
BACKGROUND Kirschner wires are often used to perform osteosynthesis. Migration through tissue of these wires is a rare but well-known occurrence. CASE REPORT A 65-year-old female presented with light intensity pain complaints in the upper left chest area; personal history included left clavicle fracture 20 years ago that was treated surgically with fixation using a K-wire. Chest radiography showed the presence of metallic foreign body in the left pulmonary apex. An exploratory axillary thoracotomy was performed, and the foreign body was extracted by a pneumotomy...
March 21, 2018: American Journal of Case Reports
Tsuyoshi Yamada, Toshitaka Yoshii, Naoki Yamamoto, Takashi Hirai, Hiroyuki Inose, Atsushi Okawa
BACKGROUND: Concurrent cervical and lumbar spinal canal stenosis is known as tandem spinal stenosis (TSS). As research on TSS is limited, there is no consensus on the optimal surgical approach to this problem. We evaluated the prevalence and clinical characteristics of TSS in patients with symptomatic lumbar spinal canal stenosis (LCS). METHODS: The authors performed a retrospective analysis of the outcomes of 565 patients who underwent lumbar surgeries performed for symptomatic LCS...
March 20, 2018: Journal of Orthopaedic Surgery and Research
Elizabeth M White, Jessica G Smith, Rebecca L Trotta, Matthew D McHugh
OBJECTIVES: To investigate whether care in a hospital with more nurses holding at least a Bachelor of Science in Nursing (BSN) degree is associated with lower mortality for individuals with Alzheimer's disease and related dementias (ADRD) undergoing surgery ADRD. DESIGN: Cross-sectional data from 2006-07 Medicare claims were linked with the Multi-State Nursing Care and Patient Safety Survey of nurses in 4 states. SETTING: Adult, nonfederal, acute care hospitals in California, Florida, New Jersey, and Pennsylvania (N=531)...
March 20, 2018: Journal of the American Geriatrics Society
Andrew S Moon, Walter Smith, Sawyer Mullen, Brent A Ponce, Gerald McGwin, Ashish Shah, Sameer M Naranje
BACKGROUND: The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries. METHODS: The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing five common orthopedic procedures: hip (THA), knee (TKA), and shoulder arthroplasty (TSA), spinal fusion, and traumatic femur fracture fixation...
March 20, 2018: Substance Abuse
Ezekiel Maloney, Andrew M Zbojniewicz, Jie Nguyen, Yu Luo, Mahesh M Thapa
Ligamentous injuries of the pediatric wrist, once thought to be relatively uncommon, are increasingly recognized in the context of acute high-energy mechanism trauma and chronic axial loading, including those encountered in both recreational and high-performance competitive sports. Recent advances in MR-based techniques for imaging the pediatric wrist allow for sensitive identification of these often radiographically occult injuries. Detailed knowledge of the intrinsic and supportive extrinsic ligamentous complexes, as well as normal developmental anatomy and congenital variation, are essential to accurately diagnose injuries to these structures...
March 20, 2018: Pediatric Radiology
Pinar Yilgor Huri, Seren Hamsici, Emre Ergene, Gazi Huri, Mahmut Nedim Doral
Infrapatellar fat pad is a densely vascularized and innervated extrasynovial tissue that fills the anterior knee compartment. It plays a role in knee biomechanics as well as constitutes a source of stem cells for regeneration after knee injury. Infrapatellar fat pad-derived stem cells (IPFP-ASCs) possess enhanced and age-independent differentiation capacity as compared to other stem cells, which makes them a very promising candidate in stem cell-based regenerative therapy. The aims of this review are to outline the latest advances and potential trends in using IPFP-ASCs and to emphasize the advantages over other sources of stem cells for applications in orthopedic surgery...
March 19, 2018: Knee Surgery & related Research
Sarel R van Amstel, David E Anderson, Ricardo Videla
CASE DESCRIPTION 3 Angus bulls, aged 2 to 3 years, with severe lameness of 2 to 4 weeks' duration and swelling proximal to the coronary band of the affected limb were evaluated after failing to respond to antimicrobial treatment. CLINICAL FINDINGS Septic arthritis of a distal interphalangeal joint (DIPJ) was diagnosed in all 3 bulls on the basis of results of a physical examination, radiographic and ultrasonographic evaluations of the affected foot, and cytologic evaluation of synovial fluid from the affected DIPJ...
April 1, 2018: Journal of the American Veterinary Medical Association
Chao Xiong, Zhiquan Zhang, Gurpreet S Baht, Niccolo Terrando
Surgery is commonly used to improve and maintain quality of life. Unfortunately, in vulnerable patients such as the elderly, complications may occur and significantly diminish the outcome. Indeed, after routine orthopedic surgery to repair a fracture, as many as 50% of elderly patients suffer from neurologic complications like delirium. Also, the capacity to heal and regenerate tissue after surgery decreases with age, and can impact the quality of fracture repair and even osseous integration of implants. Thus, a better understanding of mechanisms that drive these age-dependent changes could provide strategic targets to minimize risk for such complications and optimize outcomes...
February 27, 2018: Journal of Visualized Experiments: JoVE
Gang Zheng, Qian Tang, Ping Shang, Xiao-Yun Pan, Hai-Xiao Liu
Arthroscopic knee surgery is the most commonly performed orthopedic procedure worldwide and whether thromboprophylaxis should be undertaken after knee arthroscopy is still controversial. To evaluate the efficacy of thromboprophylaxis for deep venous thrombosis (DVT) and venous thromboembolism (VTE) after knee arthroscopic surgery. A meta-analysis was conducted using data from eight randomized trials (4148 patients) to compare thromboprophylaxis with placebo or no prophylactic treatment in patients undergoing knee arthroscopy...
March 16, 2018: Journal of Thrombosis and Thrombolysis
Anne Causeret, Isabelle Ract, Jérémy Jouan, Thierry Dreano, Mickaël Ropars, Raphaël Guillin
Lesion to subcutaneous nerves is a well-known risk of orthopedic surgery and a significant cause of postoperative pain and dissatisfaction in patients. High-resolution ultrasound can be used to visualize the vast majority of small subcutaneous nerves of the upper and lower limbs. Ultrasound detects nerve abnormalities such as focal hypoechoic thickening, stump neuroma, and scar encasement, and provides information not only about the peripheral nerve itself but also about its relationship to adjacent anatomical structures...
March 16, 2018: Skeletal Radiology
Yehia El-Mahallawy, Haytham Al-Mahalawy
PURPOSE: The Herbert bone screw (HBS) is a successful and minimally invasive method of fracture fixation that is used routinely in orthopedic surgery. The aim of this study was to evaluate the clinical and radiographic performances of the HBS in the treatment of anterior mandibular fractures and compare it with the common and established treatment modalities, the lag screw (LS) and the 2.0-mm miniplate (MP). MATERIALS AND METHODS: This study implemented a randomized clinical trial and enrolled a sample of patients with anterior mandibular fractures...
February 19, 2018: Journal of Oral and Maxillofacial Surgery
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Oren Schwartz, Boris Kanevsky, M A J Sergey Kutikov, Cara H Olsen, Israel Dudkiewicz
Introduction: Attrition from training is associated with substantial financial and personnel loss. There is a plethora of medical literature and research of attrition rates related to initial/phase 1 training (basic combat training); however, the analysis of second phase training (commanders training, consisting of schools that qualify junior commanders and officers for infantry and non-infantry combat units) is limited. The purpose of this study is to perform a comprehensive survey regarding to medical attrition from commanders training in the IDF (Israeli Defense Forces) in order to present the commanders of the IDF a detailed situation report that will serve as an evidence-based platform for future policy planning and implementation...
March 14, 2018: Military Medicine
Yang Xiong, Lin Xu, Xing Yu, Yongdong Yang, Dingyan Zhao, Zhengguo Hu, Chuanhong Li, He Zhao, Lijun Duan, Bingbing Zhang, Sixue Chen, Tao Liu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the mid-term outcomes of hybrid surgery and anterior cervical discectomy and fusion for the treatment of contiguous 2-segment cervical degenerative disc diseases. SUMMARY OF BACKGROUND DATA: Hybrid surgery has become one of the most controversial subjects in spine communities, and the comparative studies of hybrid surgery and anterior cervical discectomy and fusion in the mid- and long-term follow-up are rarely reported...
March 15, 2018: Spine
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
Ahmad Nazmi Bin Ahmad Fuad, Kamal Deep, Wei Yao, Philip Rowe
This article presents the construction of a flexible drill which is designed to cut a curved canal in the bone or remove bone materials, to improve the outcome of orthopedic surgery and to facilitate minimally invasive. This article reports the design of the flexible drill and uses it in an experimental rig to evaluate the drilling force generated when cutting bovine bone. The experiments facilitate the measurement of action forces between the mill bits when moving the tip toward or across a bone sample in various configurations caused by bending the flexible drill sheath to enable cutting of a curved path of variable radius in the bone...
March 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Bao-Lin Zhao, Cheng Ji, Jia-Jia Jiang, Ruo-Feng Yin
OBJECTIVE: To explore the clinical effectiveness of various posterior decompression surgeries in the treatment of upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis. METHODS: From January 2010 to December 2015, 22 consecutive patients with combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis were treated with two different approaches of posterior decompression surgeries. In group A with 10 patients, both cervical and thoracic spinal decompression surgeries were performed simultaneously (one-stage surgery); in group B with 8 patients, cervical and thoracic spinal decompression surgeries were performed separately within three months (two-stage surgery)...
March 10, 2018: International Journal of Surgery
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