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https://www.readbyqxmd.com/read/29221461/seeking-a-second-medical-opinion-composition-reasons-and-perceived-outcomes-in-israel
#1
Liora Shmueli, Nadav Davidovitch, Joseph S Pliskin, Ran D Balicer, Igal Hekselman, Geva Greenfield
BACKGROUND: Seeking a second-opinion (SO) is a common clinical practice that can optimize treatment and reduce unnecessary procedures and risks. We aim to characterize the composition of the population of SO seekers, their reasons for seeking a SO and choosing a specific physician, and their perceived outcomes following the SO. METHODS: A cross-sectional national telephone survey, using a representative sample of the general Israeli population (n = 848, response rate = 62%)...
December 8, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/29218649/treatment-of-flexor-tendon-reconstruction-failures-multicentric-experience-with-brunelli-active-tendon-implant
#2
A Poggetti, M Novi, M Rosati, D Ciclamini, M Scaglione, B Battiston
INTRODUCTION: Secondary repair of flexor tendon injuries remain a challenging procedure for hand surgeons. Usually, secondary reconstruction should be performed by staged approach. When the tendon and pulley integrity are intact, tenolysis may be the first surgical option. One-/two-stage tendon grafts are suggested when the integrity of flexor tendon is compromised. Active tendon implants (Brunelli prostheses) may represent an efficient option in patients with a poor prognosis, as well as whenever classical techniques fail...
December 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29218129/pubic-symphysis-diastasis-a-case-series-and-literature-review
#3
Jaya Jethra Chawla, Devendra Arora, Namrita Sandhu, Megha Jain, Anju Kumari
Separation of pubic symphysis during delivery is a rare complication resulting in considerable and prolonged morbidity for parturient women. The usual presentation is that of something giving way in the region of the symphysis pubis sometimes with an audible crack at the time of delivery. Unbearable pain on moving from side-to-side and on performing any weight-bearing activity (such as walking or climbing stairs) precludes ambulation in the immediate postpartum period. This could be accompanied by disruption of the sacroiliac joint, hemorrhage, or urine incontinence in severe cases...
November 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/29217672/digital-ischemia-after-application-of-self-adherent-elastic-wrap-dressing-a-case-series
#4
Christopher A Makarewich, Penelope Lang, Douglas T Hutchinson
Self-adherent elastic wrap dressings are a convenient option to manage pediatric hand and finger injuries. However, when improperly applied, they have the potential to cause devastating complications. We detail in this report 5 cases of dressing-induced ischemic injury to the hand in pediatric patients with a review of the literature. All patients were treated by the senior author between 2007 and 2015 and were retrospectively reviewed for initial injury, frequency of dressing changes, presence of pain, time to evaluation by the orthopedic hand team, treatment, and outcome...
December 7, 2017: Pediatrics
https://www.readbyqxmd.com/read/29216700/-assessment-of-pain-function-and-complications-after-minimelly-invasive-decompression-of-morton%C3%A2-s-neuroma-using-a-dorsal-approach-in-16-patients
#5
F Sancho-Barroso, J Strassburger-Weidmann, V Castillo-Anaya
BACKGROUND: The purpose of this paper is to assess pain, function and complications after decompression of Mortons neuroma using a minimally invasive dorsal approach. METHOD AND RESULTS: 16 patients who underwent 19 decompressions were followed-up for 18 months. Pain was assessed with the visual analog scale (VAS), and function was assessed with the American Orthopedic Foot and Ankle Society (AOFAS) scale. Data was analyzed with the Student t test for related samples, which yielded a p value 0...
May 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29216697/-case-report-total-hip-replacement-in-osteogenesis-imperfecta
#6
T Ferrer-Catasús, A León-García, M Tey-Pons, A L Arenas-Díaz, F Marqués-López
We study, apropos of a case, a total hip arthroplasty in a patient with osteogenesis imperfecta. The characteristics of this disease, such as high risk of fracture and the presence of deformities, make this surgery a challenge for the orthopedic surgeon. In this manuscript, we review for the first time in this indication the preoperative planning and the selection of implants, with special emphasis on measures for the prevention of complications.
July 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29214459/the-role-of-intraoperative-cell-salvage-system-on-blood-management-in-major-orthopedic-surgeries-a-cost-benefit-analysis
#7
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Erdem Edipoğlu, Halil Nadir Öneş, Cemal Kural, Mustafa Cevdet Avkan
INTRODUCTION: The aim of this study was to compare the efficiency and cost of cell salvage systems with allogeneic blood transfusions in patients who had major elective orthopedic surgeries. MATERIALS AND METHODS: Consecutive 108 patients who had intraoperative cell saver (CS) performed routinely constitute the study group. In control group, consecutive 112 patients who were operated without intraoperative CS were investigated. Hemoglobin (Hb) level less than 8 mg/dL was regarded as the absolute transfusion indication...
December 6, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29207307/systemic-sclerosis-clinical-manifestations-anesthetic-and-orthopedic-considerations-in-a-patient
#8
Obada Hasan, Muneeba Jessar, Muhammad Ashar, Shahryar Noordin, Tashfeen Ahmad
INTRODUCTION: Systemic sclerosis is a rare and progressive multisystem autoimmune disorder that is characterized pathologically by vascular abnormalities, connective tissue sclerosis and atrophy of skin and various internal organs (e.g., alimentary tract, lungs, heart, kidney, CNS), and autoantibodies. With an unknown etiology, Scleroderma is a complex polygenetic disease. A recent Genome Wide Association Study (GWAS) confirmed a strong association with the Major Histocompatibility Complex (MHC) and autoimmunity...
December 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29202985/surgical-resident-involvement-in-foot-and-ankle-surgery
#9
Christopher E Gross, David Chang, Samuel B Adams, Selene G Parekh, Jordan D Bohnen
BACKGROUND: Surgical resident participation in the operating room is necessary for education and progression toward safe and independent practice. However, the impact of resident involvement on patient outcomes in foot and ankle surgery is unknown. METHODS: The American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database (2005-2012) was used to identify common foot and ankle procedures (by Current Procedural Taxonomy (CPT) code) performed by orthopedic surgeons...
December 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29200484/treatment-of-femoroacetabular-impingement-with-a-mini-open-direct-anterior-approach
#10
Paweł Skowronek, Marek Synder, Michał Polguj, Dariusz Marczak, Marcin Sibiński
Background: The opinion about best methods of femoroacetabular impingement (FAI) treatment are not consistent. Operative treatment of this condition may be arthroscopic, but open procedures with osteotomy of the greater trochanter and hip dislocation has been used. The present study evaluates the benefits of the mini-open direct anterior approach (DAA) in treating patients with FAI, with is a procedure available for most orthopedic surgeons. Materials and Methods: 39 patients treated for FAI (25 men and 14 women) at an average age of 29...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29198186/screening-in-trauma-for-opioid-misuse-prevention-stomp-study-protocol-for-the-development-of-an-opioid-risk-screening-tool-for-victims-of-injury
#11
Randall Brown, Brienna Deyo, Chelsea Riley, Andrew Quanbeck, Joseph E Glass, Rebecca Turpin, Scott Hetzel, Christopher Nicholas, Maireni Cruz, Suresh Agarwal
BACKGROUND: Opioid addiction and overdose are epidemic in the U.S. Victims of traumatic injury are at greater than average risk for opioid misuse and related complications. Potential risk screens and preventive interventions in this clinical population remain under-investigated. The current project seeks to develop and pilot the implementation of a screening tool for opioid risk at American College of Surgeons (ACS) Level I and Level II trauma centers. METHODS: The project began with an online survey, which was sent to Wisconsin trauma center medical directors and trauma coordinators for the purpose of gathering information on current substance use screening practices...
December 4, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29185295/complications-and-survival-of-megaprostheses-after-resection-of-bone-metastases
#12
M De Gori, A D’Arienzo, L Andreani, G Beltrami, D A Campanacci, P De Biase, F Frenos, S Giannotti, F Sacchetti, F Totti, P Parchi, R Capanna
Treatment of bone metastases is often palliative, aiming at pain control and stabilization or prevention of pathological fractures. However, a complete resection with healing purposes can be performed in selected cases. The aim of our work was to evaluate the survival of megaprostheses used for reconstruction after bone metastases. Between January 2001 and March 2015, we implanted 169 Megasystem-C® (Waldemar LINK® GmbH & Co. KG, Hamburg, Germany) after bone metastasis resection. Patients, 95 females and 74 males, were operated at an average age of 61 (12-87) years for proximal femoral resection in 135 (79...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29181549/treating-open-lower-limb-fractures-successfully-thoughts-and-current-practice-on-therapy-and-centralization-in-the-netherlands
#13
K Oflazoglu, J M Hoogendoorn, P van der Zwaal, E T Walbeehm, W A van Enst, H R Holtslag, D Hofstee, P Plantinga, M Elzinga, H Rakhorst
INTRODUCTION: The British Orthopedic Association (BOA) and British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) updated the evidence-based guidelines for the treatment and care of open lower limb fractures (BOAST 4). Following this, a Dutch version has been developed. The main points are multidisciplinary care, planning, and treatment of these injuries. Early osteosynthesis (within 7-14 days) combined with soft-tissue coverage results in more efficient care and less complications...
November 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29181352/a-case-report-of-dual-incision-technique-for-total-femur-arthroplasty-as-a-salvage-procedure-in-infected-non-unions
#14
Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29181345/intrapleural-penetration-of-a-clavicle-fracture-an-indication-for-operative-fixation
#15
Ryan D DeAngelis, Kenneth W Graf, Rakesh P Mashru
Introduction: Clavicle fractures are common injuries treated by orthopedic surgeons, with most injuries managed nonoperatively. Operative fixation of clavicle fractures is indicated in specific clinical scenarios such as open injuries, ipsilateral shoulder trauma, or fractures with associated neurovasculature compromise. Operative fixation is not widely accepted for closed injuries and is typically reserved for instances of failed closed treatment with resultant nonunion or delayed union...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29180198/surgical-tray-optimization-as-a-simple-means-to-decrease-perioperative-costs
#16
James S Farrelly, Crystal Clemons, Sherri Witkins, Walter Hall, Emily R Christison-Lagay, Doruk E Ozgediz, Robert A Cowles, David H Stitelman, Michael G Caty
BACKGROUND: Health care spending in the US remains excessively high. Aside from complicated, large-scale efforts at health care cost reduction, there are still relatively simple ways in which individual hospitals can cut unnecessary costs from everyday operations. Inspired by recent publications, our group sought to decrease the costs associated with surgical instrument processing at a large, multihospital academic center. METHODS: This was a single-site observational study conducted at a large academic medical center...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29180078/surgical-orthopedics-in-a-spondylometaphyseal-dysplastic-patient-a-case-report
#17
Xianzuo Zhang, Xu Li, Pengfei Liu, Haiping Cai, Rui Zhang, Wenzhi Zhang
BACKGROUND: Spondylometaphyseal dysplasia (SMD) is a rare disease characterized by vertebral and metaphyseal abnormalities. The treatment of SMD spinal deformities remains a challenge for spinal surgeons. PURPOSE: To demonstrate the feasibility and effectiveness of vertebral column resection of SMD by thoracolumbar kyphosis and scoliosis. STUDY DESIGN/SETTING: A case report. PATIENT SAMPLE: An SMD patient who has fixed thoracolumbar kyphosis and scoliosis with neurological symptoms...
November 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29167752/a-prospective-study-of-distal-metatarsal-chevron-osteotomies-with-k-wire-fixations-to-treat-hallux-valgus-deformities
#18
M N Baig, Usman Baig, Ali Tariq, Robert Din
Introduction Hallux valgus is one of the most common forefoot deformities worldwide. Females are affected more often than males. The three most common clinical symptoms are the painful bunion, transfer metatarsalgia, and hammer or claw toes. Methods This case series consisted of 20 patients who had chevron osteotomy from January 2015 to January 2016. The clinical assessment was measured by The American Orthopedic Foot and Ankle Score (AOFAS), and radiologic assessment was determined by preoperative and postoperative hallux valgus angle (HVA) and intermetatarsal angle (IMA)...
September 20, 2017: Curēus
https://www.readbyqxmd.com/read/29167605/clinical-outcomes-involving-patients-that-develop-septic-arthritis-with-methicillin-sensitive-staphylococcus-aureus-versus-methicillin-resistant-staphylococcus-aureus
#19
REVIEW
Kristen Combs, Kyle Cox
Septic Arthritis is an orthopedic emergency that requires prompt diagnosis and treatment. Staphylococcus aureus is the most common pathogen causing septic arthritis. This review seeks to describe clinical characteristics and outcomes associated with patients with methicillin-resistant (MRSA) vs. methicillin-sensitive staphylococcus aureus (MSSA) septic arthritis. The review showed that those infected with MRSA were older, had more chronic medical conditions, and higher values of inflammatory markers. MRSA septic arthritis was also associated with more complications, longer duration of antibiotics, and increased mortality...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29160725/management-of-neurologic-deformity-of-the-ankle-and-foot-with-concurrent-osteomyelitis-with-the-ilizarov-method
#20
Nikolay Mikhailovich Kliushin, Anatoliy Sergeyevich Sudnitsyn, Koushik Narayan Subramanyam, Jefferson George
BACKGROUND: The combination of neurologic deformity of the ankle and foot with osteomyelitis is a therapeutic challenge. We investigated the role of Ilizarov with regard to eradication of infection, correction of deformities and improvement of patient function. METHODS: We retrospectively reviewed 77 patients (77 feet) with neurologic deformity of the ankle and foot with osteomyelitis treated sequentially in 3 stages by Ilizarov method. The 3 stages were (1) active debridement and Ilizarov stabilization, (2) further strengthening of Ilizarov fixator and active osteosynthesis consisting of strategies like arthrodesis, osteotomy distraction, bone transport, or combination thereof, (3) consolidation of fusion/regeneration achieved in second stage...
November 1, 2017: Foot & Ankle International
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