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https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#1
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
August 17, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28819612/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#2
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in the pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed, and the fracture was seen on the post-operative radiographs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819603/bilateral-ankle-fusion-in-leak-syndrome-induced-deformity-a-case-report
#3
Luis Sobral, Ana C Ângelo, Afonso Caetano, Joaquim Rodeia, Isabel Rosa
INTRODUCTION: Systemic capillary leak syndrome (SCLS) is a rare condition of unknown etiology defined by sudden episode of hypotension, high hematocrit, and low serum protein concentration due to capillary hyperpermeability. Several treatments have been published for this pathology and eventual compartment syndrome but not for the disabling consequences. This clinical case highlights the negative orthopedic consequences of a severe systemic attack and reports a subsequent deformity treatment option that resulted in the patient quality of life improvement...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28817534/radius-regeneration-after-open-fracture-and-extrusion-a-case-report
#4
Kristopher B McCall, David Y Chong
A pediatric patient presenting with an open forearm fracture with segmental defect is rare, and the pediatric orthopedic literature to guide treatment is sparse. There are several described methods to treat the defect, including bone grafting and bone transport techniques. In addition, there are reports of fibular regeneration after resection if the periosteum is left intact. We present a case report of complete regeneration of over half of a pediatric radial shaft with an intact periosteum, after traumatic extrusion from an open fracture...
August 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28817161/biomechanical-evaluation-of-unicortical-stress-risers-of-the-proximal-humerus-associated-with-pectoralis-major-repair
#5
David J Wilson, Brian P Milam, William F Scully, Todd P Balog, Kyong S Min, Christopher S Chen, Bryant G Marchant, Edward D Arrington
Proximal humerus fracture after pectoralis major tendon repair has been recently reported. Although this complication is rare, it may be possible to decrease such risk using newer techniques for myotenodesis. This study was designed to evaluate various unicortical stress risers created at the proximal humeral metadiaphysis during myotenodesis for repair of pectoralis major ruptures. A simulated pectoralis major myotenodesis was performed using fourth-generation Sawbones (N=30). Using previously described anatomic landmarks for the tendinous insertion, 3 repair techniques were compared: bone trough, tenodesis screws, and suture anchors (N=10 each)...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28817157/extent-and-morbidity-of-lateralization-of-a-trochanteric-fixation-nail-blade
#6
Phillip A Sandifer, Robert M Hulick, Matthew L Graves, Clay A Spitler, George V Russell, Josie M Hydrick, LaRita C Jones, Patrick F Bergin
This study examined the incidence and risk factors associated with lateral helical blade migration and trochanteric pain with the trochanteric fixation nail. A retrospective review was performed of 141 cases of pertrochanteric femur fracture treated with a trochanteric fixation nail at a level I trauma center over a period of 42 months. Exclusion criteria included follow-up of less than 60 days, preexisting osteonecrosis of the femoral head, and prophylactic trochanteric fixation nail treatment. Patient demographics, operative findings, and radiographic findings were recorded...
August 17, 2017: Orthopedics
https://www.readbyqxmd.com/read/28814096/ankle-block-vs-single-shot-popliteal-fossa-block-as-primary-anesthesia-for-forefoot-operative-procedures-prospective-randomized-comparison
#7
Oliver N Schipper, Kenneth J Hunt, Robert B Anderson, W Hodges Davis, Carroll P Jones, Bruce E Cohen
BACKGROUND: Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures...
August 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28811110/characterizing-the-diagnosis-and-treatment-of-allergic-contact-dermatitis-to-2-octyl-cyanoacrylate-used-for-skin-closure-in-elective-orthopedic-surgery
#8
Brian P Chalmers, Heath P Melugin, Peter K Sculco, Jennifer J Schoch, Rafael J Sierra, Mark W Pagnano, Michael J Stuart, Michael J Taunton
BACKGROUND: While studies have shown that postoperative wound complications can predispose to deep infection following orthopedic surgery, the best form of skin closure has not been elucidated. Furthermore, the unique risks and benefits of each type of wound closure have not been studied. The goal of this study is to present the diagnosis and treatment of patients with allergic contact dermatitis (ACD) from 2-octyl cyanoacrylate, a skin adhesive commonly used in wound closure. METHODS: Twenty-nine patients with ACD to 2-octyl cyanoacrylate (Prineo, Ethicon, NJ) following elective orthopedic surgeries from 2013 to 2016 were retrospectively reviewed; this occurred in 29 of 6088 units of Prineo used at our institution, for an estimated incidence of 0...
July 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28809390/clinical-features-and-surgical-outcomes-of-cervical-spondylotic-myelopathy-in-patients-of-different-ages-a-retrospective-study
#9
R J Zhang, C L Shen, J X Zhang, X J Zhang, F L Dong, H Tao, P W Song, P Ge, P Xu, H Q Zhang
STUDY DESIGN: Retrospective chart audit. OBJECTIVES: This study aims to compare the clinical features and surgical outcomes in patients with cervical spondylotic myelopathy (CSM) among different age groups. SETTING: The first Affiliated Hospital of Anhui Medical University, China. METHODS: A total of 460 patients with CSM who were surgically treated over the period of 1995-2009 were investigated. Considering the peak age (40-60 years old) for the onset of symptoms, we divided the patients into three groups by age: young (<40), middle-aged (40-60), and old (>60)...
August 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28807779/syringo-subarachnoid-shunt-for-the-treatment-of-persistent-syringomyelia-following-decompression-for-chiari-type-i-malformation-surgical-results
#10
Jehuda Soleman, Jonathan Roth, Andrea Bartoli, Daniel Rosenthal, Akiva Korn, Shlomi Constantini
BACKGROUND: Approximately 30% of patients treated by foramen magnum decompression (FMD) for Chiari I-associated-syringomyelia will show persistence, recurrence, or progression of the syrinx. OBJECTIVE: This study evaluates the clinical and radiological outcome of syringo-subarachnoid shunt (SSS) as the treatment for persistent syringomyelia after FMD. METHODS: Data was collected retrospectively. The primary outcome measurement was neurological function (assessed with the Modified Japanese Orthopedic Association (mJOA) scale)...
August 11, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28801582/percutaneous-placement-of-iliosacral-screws-under-the-guidance-of-axial-view-projection-of-the-s1-pedicle-a-case-series
#11
Yingchao Yin, Zhiyong Hou, Ruipeng Zhang, Lin Jin, Wei Chen, Yingze Zhang
The aim of this study was to evaluate the safety and efficacy of percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle clinically. This case series includes 58 consecutive unstable pelvic injury patients, which were treated with iliosacral screws between July 2011 and July 2016. Patients were divided into two groups: normal sacrum (n = 31) and dysmorphic sacrum (n = 27). A single orthopedic surgeon operated on all patients, with percutaneous placement of iliosacral screws under the guidance of axial view projection of the S1 pedicle...
August 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28791848/closed-reduction-and-percutaneous-annulated-screw-fixation-in-the-treatment-of-comminuted-proximal-humeral-fractures
#12
Zhe Yu, Lianhe Zheng, Xiaodong Yan, Xiaoxiang Li, Jian Zhao, Bao'an Ma
BACKGROUND: Displaced proximal humeral fractures remain a challenge to orthopedic surgeons. OBJECTIVES: The purpose of this study was to evaluate the functional and radiological outcomes of patients with comminuted proximal humeral fractures treated with closed reduction and percutaneous screw fixation (CRPF). MATERIAL AND METHODS: The authors retrospectively reviewed 38 cases of displaced proximal humeral fractures (2-, 3- or 4-part fractures according to the Neer classification) that were treated using the CRPF technique from May 2009 to April 2013...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28791830/zirconium-the-material-of-the-future-in-modern-implantology
#13
REVIEW
Paweł Kubasiewicz-Ross, Marzena Dominiak, Tomasz Gedrange, Ute U Botzenhart
The authors present the contemporary state of knowledge concerning alternative materials for dental implantology. First of all, factors influencing osseointegration are stated. The most important factors seem to be the type of implant surface. Among the numerous parameters describing them, the most important are: average roughness and porous density. Some studies proved that materials with comparable surface roughness provide similar osseointegration. In modern implantology titanium is the material still considered as a "gold standard"...
May 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28790538/comparison-of-plate-nail-and-external-fixation-in-the-management-of-diaphyseal-fractures-of-the-humerus
#14
Michele Bisaccia, Luigi Meccariello, Giuseppe Rinonapoli, Giuseppe Rollo, Marco Pellegrino, Andrea Schiavone, Cristina Ibáñez Vicente, Pellegrino Ferrara, Marco Filipponi, Auro Caraffa
INTRODUCTION: Humeral shaft fractures are quite common in orthopedics and represent 1-3% of adult fractures. The surgical treatment is the a better choice in order to obtain a reduction and stable alignment and to prevent the complications. The goal of this study was to compare the three techniques (IMN, LCP and EF) in the treatment of diaphyseal fractures of the humerus in the adult patient. MATERIALS AND METHODS: We examined 79 patients with diaphyseal fractures of the humerus...
April 2017: Medical Archives
https://www.readbyqxmd.com/read/28790468/management-of-the-infected-total-hip-arthroplasty
#15
D'jon Lopez, Isabel Leach, Elinor Moore, Alan R Norrish
In the United Kingdom approximately 80,000 total hip arthroplasties are undertaken on an average each year. The popularity and demand for this operation are continually increasing. Our understanding of arthroplasty surgery and its complications has evolved greatly, and as a result infection rates are undeniably at an all-time low. The increasing volume of operations being performed does, however, mean that we still continue to see an increased number of cases of infection. There is no doubt that periprosthetic joint infection (PJI) poses a complex clinical and diagnostic predicament to clinicians...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#16
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28781018/high-early-major-complication-rate-after-revision-for-mechanically-assisted-crevice-corrosion-in-metal-on-polyethylene-total-hip-arthroplasty
#17
Brian J McGrory, Anna H Jorgensen
BACKGROUND: Failed total hip arthroplasty caused by mechanically assisted crevice corrosion (MACC) has serious consequences such as adverse local tissue reaction. Revision is currently indicated for significant hip pain, stiffness, and dysfunction; hip instability; progressive bone loss; and soft tissue destruction. Outcomes of this revision surgery are not yet completely understood. METHODS: We examined the surgical outcomes at a minimum of 6 months (average, 25; range, 7-68 months) in a cohort of 27 consecutive patients who underwent revision total hip arthroplasty for MACC associated with a single implant vendor and taper type...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28780224/does-multiple-sclerosis-affect-the-inpatient-perioperative-outcomes-after-total-hip-arthroplasty
#18
Jared M Newman, Qais Naziri, Morad Chughtai, Anton Khlopas, Thomas J Kryzak, Suparna M Navale, Carlos A Higuera, Michael A Mont
BACKGROUND: There is a paucity of studies evaluating the short-term perioperative outcomes of total hip arthroplasty (THA) in multiple sclerosis (MS) patients. Therefore, this study evaluated (1) patient factors; and (2) patient outcomes in MS THA patients compared to non-MS THA patients. METHODS: The Nationwide Inpatient Sample from 2002 to 2013 identified 5899 MS and 2,723,652 non-MS THA patients. Yearly trends, demographics, and comorbidities were compared, and then non-MS THA patients were matched (3:1) to MS THA patients by age, gender, race, comorbidity score, and surgery year...
July 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28776632/interprosthetic-fractures-of-the-femur
#19
Nicholas M Romeo, Reza Firoozabadi
As the rate of hip and knee arthroplasty procedures increases, so will the rate of interprosthetic fractures. Several factors, including bone quality, bone quantity, and stability of the prosthetic components, play a role in determining the appropriate operative treatment. Patients with stable components should undergo reduction and internal fixation, while patients with loose components should undergo either revision arthroplasty, with or without additional fixation, or conversion to total femur replacement...
August 3, 2017: Orthopedics
https://www.readbyqxmd.com/read/28776631/diffuse-pigmented-villonodular-synovitis-as-a-rare-cause-of-graft-failure-following-anterior-cruciate-ligament-reconstruction
#20
Rajiv Rajani, Liliana Ogden, Christopher J Matthews, C Parker Gibbs
This case report describes a 42-year-old woman who was diagnosed with pigmented villonodular synovitis (PVNS) in the knee. The patient had received a bone-patella tendon-bone autograft reconstruction of her anterior cruciate ligament (ACL) 22 years prior to her diagnosis of PVNS. After a traumatic event that tore her ACL graft, she underwent a second surgery to repair the initial reconstruction. However, her pain and joint instability remained unresolved. When radiolucent lesions in her tibia and femur were identified through a radiographic image, the patient was referred to the authors' orthopedic oncology clinic...
August 3, 2017: Orthopedics
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