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https://www.readbyqxmd.com/read/28530768/perioperative-management-of-rheumatoid-medications-in-orthopedic-surgery
#1
Kunal Sindhu, Brian Cohen, Joseph A Gil
Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disorder known to cause progressive joint destruction. Over time, untreated RA can lead to pain and increasing disability, making orthopedic intervention necessary. The treatment of RA revolves around a variety of medications that blunt the overall immune response. However, this may increase the risk of infection and impair wound healing. Given the nature of this disease, orthopedists frequently encounter patients with RA in the operative setting. To optimize surgical outcomes, orthopedists must carefully manage and pay special attention to the adverse side effects of the complicated medication regimens of these patients perioperatively...
May 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/28529861/local-intra-wound-administration-of-powdered-antibiotics-in-orthopaedic-surgery
#2
REVIEW
Andrew N Fleischman, Matthew S Austin
Surgical site infection (SSI) is one of the most common complications after orthopaedic surgery, leading to significant morbidity and its associated costs. Surgical guidelines strongly recommend the use of systemic antibiotic prophylaxis to reduce the risk for developing SSI. Locally administered powdered antibiotics have the potential to provide remarkably high intra-wound concentrations without risk for systemic toxicity. However, a paucity of high quality evidence in the orthopaedic literature has prevented widespread adoption of this technique...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28525491/surgery-for-chronic-traumatic-atlantoaxial-dislocation-associated-with-myelopathy
#3
Lingjun Wang, Yong Gu, Liang Chen, Huilin Yang
STUDY DESIGN: A retrospective study. OBJECTIVE: To evaluate the outcomes of myelopathy caused by atlantoaxial dislocation (AAD). SUMMARY OF BACKGROUND DATA: No reports to date have accurately evaluated the results of surgery for delayed myelopathy for patients with chronic AAD. Thus, the appropriate surgical time and methods of decompression and fusion remain a hot debate. MATERIALS AND METHODS: In our study, 18 patients underwent decompression, fixation, and fusion...
June 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28521832/recurrent-symphysitis-culminating-in-pelvic-ring-fracture-after-hyperextended-transurethral-prostate-resection-and-vaporization-with-symphysis-erosion-a-case-report
#4
Holger Gerullis, Arne Eitzen, Jens Uphoff, Fadi Daaboul, Ajay Chavan, Leander Ermert, Friedhelm Wawroschek, Alexander Winter
BACKGROUND: Short-term and long-term complications of transurethral prostate resection can be different in nature. Capsule perforation and subsequent fistulation after resection and electrovaporization is seldom reported in the literature. CASE PRESENTATION: Here we report the case of a 79-year-old caucasian man with capsule perforation after transurethral prostate resection and electrovaporization resulting in a severe and recurrent symphysitis and subsequent pelvic ring fracture...
May 19, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28515749/thromboembolic-complications-after-an-ankle-joint-open-fracture-in-a-patient-with-a-history-of-deep-vein-thrombosis-in-the-lower-limbs
#5
Tomasz Stankowski, Sleiman Sebastian Aboul-Hassan, Piotr Stępiński, Anna Szymańska, Jakub Marczak, Romuald Cichoń
A 55-year-old patient was admitted to the Department of Orthopedics due to an open fracture in the right ankle joint. On the seventh day of hospitalization the patient experienced a transient ischemic attack. During the next day, dyspnea, chest pain and a 'rider' type pulmonary embolism in the pulmonary trunk occluding both pulmonary arteries and its branches were diagnosed. The patient was transferred to the Department of Cardiac Surgery. He underwent pulmonary embolectomy for massive pulmonary, right and left atrial embolism, and left ventricular embolism...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514130/-measuring-adherence-to-self-care-guidelines-for-patients-with-type-2-diabetes-with-diabetic-ulcers-admitted-to-the-orthopedic-rehabilitation-department-at-tel-hashomer-hospital-during-2012-2013
#6
Sigal Ezra, Itzhak Siev-Ner, Itzhak Zaidise
INTRODUCTION: Diabetic foot is a devastating complication of diabetes and represents the major cause of lower limb amputations in the western world in the 21st century. The World Health Organization predicts a dramatic increase in the number of diabetes patients over the next decade and by the year 2025, their number is expected to increase to 300 million. AIMS: Examine whether training leads to improving performance in the built-in self-care guidelines in patients with type 2 diabetes who were hospitalized with diabetic ulcers in the Orthopedic Rehabilitation Ward in Tel Hashomer between the years 2012-2013...
July 2016: Harefuah
https://www.readbyqxmd.com/read/28511727/rejection-sensitivity-as-a-moderator-of-psychosocial-outcomes-following-pediatric-traumatic-brain-injury
#7
Emily A Meadows, Keith Owen Yeates, Kenneth H Rubin, H Gerry Taylor, Erin D Bigler, Maureen Dennis, Cynthia A Gerhardt, Kathryn Vannatta, Terry Stancin, Kristen R Hoskinson
OBJECTIVES: The current study examines whether psychosocial outcomes following pediatric traumatic brain injury (TBI) vary as a function of children's rejection sensitivity (RS), defined as their disposition to be hypersensitive to cues of rejection from peers. METHODS: Children ages 8-13 with a history of severe TBI (STBI, n=16), complicated mild/moderate TBI (n=35), or orthopedic injury (OI, n=49) completed measures assessing self-esteem and RS on average 3.28 years post-injury (SD=1...
May 17, 2017: Journal of the International Neuropsychological Society: JINS
https://www.readbyqxmd.com/read/28507965/posterior-hip-dislocation-with-ipsilateral-femoral-head-and-shaft-fracture-using-a-temporary-external-fixator-as-a-method-for-closed-reduction
#8
Abduljabbar Alhammoud, Masson Alnouri, Mahmood Ali Arbash, Abdul Moeen Baco
INTRODUCTION: Complex fractures are increasing because of various traumatic mechanisms. They drift from standard classifications, and their treatment is controversial. Of such cases are hip dislocations with associated fractures of the ipsilateral femur. CASE REPORT: This case report describes the condition of a 30-year-old man involved in a motor vehicle collision. Clinical examination, X-rays, and computed tomography scan revealed a posterior hip dislocation with an ipsilateral femoral head and mid-shaft fractures...
November 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28507884/a-retrospective-analysis-of-complications-associated-with-bone-morphogenetic-protein-2-in-anterior-lumbar-interbody-fusion
#9
Kevork Hindoyan, Justin Tilan, Zorica Buser, Jeremiah R Cohen, Darrel S Brodke, Jim A Youssef, Jong-Beom Park, S Tim Yoon, Hans-Joerg Meisel, Jeffrey C Wang
STUDY DESIGN: Retrospective review. OBJECTIVE: The aim of our study was to quantify the frequency of complications associated with recombinant human bone morphogenetic protein 2 (rhBMP-2) use in anterior lumbar interbody fusion (ALIF). METHODS: The orthopedic subset of the Medicare database (PearlDiver) was queried for this retrospective cohort study using International Statistical Classification of Diseases 9 (ICD-9) and Current Procedure Terminology (CPT) codes for ALIF procedures with and without rhBMP-2 between 2005 and 2010...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28504811/percutaneous-screw-fixation-for-scaphoid-fractures
#10
Mohamed E Al-Ashhab, Hossam El-Dein A Elbegawi
Treatment of nondisplaced scaphoid waist fractures has evolved from conventional cast immobilization to percutaneous screw insertion. This study assessed clinical and radiologic outcomes of volar percutaneous screw fixation for 15 type B2 scaphoid fractures (according to the Herbert and Fisher classification). All patients were followed for an average of 33 months (range, 6-50 months). All fractures achieved radiographic union at an average of 57 days (range, 35-70 days), requiring no additional procedures...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28504809/effect-of-lymphedema-treatment-for-management-of-acute-pilon-fractures
#11
John M Whatley, James A Lalonde, Craig C Greene, Kevin B Riche, Danielle M Tatum
Pilon fractures are high-energy injuries that often result in considerable edema and compromise of the soft tissue envelope of the ankle. These injuries are typically staged with an external fixator until the soft tissue is amenable for definitive fixation. This study was conducted to determine the effects of lymphedema treatment for the management of pilon fractures. Patients who underwent open reduction and internal fixation of pilon fractures between 2007 and 2014 at the authors' level II trauma center were identified by Current Procedural Terminology codes indicative of placement of an external fixator (20690) and open reduction and internal fixation of a pilon fracture (27826, 27827, or 27828)...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28504808/outcome-of-reverse-shoulder-arthroplasty-for-patients-with-parkinson-s-disease-a-matched-cohort-study
#12
Michael C Cusick, Randall J Otto, Rachel E Clark, Mark A Frankle
Parkinson's disease (PD) is a progressive neurologic disorder that affects the musculoskeletal system. Currently, the use of reverse shoulder arthroplasty (RSA) for patients with PD has not been adequately studied. The authors sought to determine if RSA provided similar functional outcomes for patients with PD compared with a matched cohort of patients without PD. Between 2004 and 2011, 10 patients with PD (4 men, 6 women) underwent RSA. Patients with PD were matched to patients without PD at a 1:4 ratio based on age (average, 76 years; range, 63-85 years), sex (16 men, 24 women), preoperative diagnosis, and length of follow-up (average, 43 months; range, 24-128 months)...
May 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28502902/retinoic-acid-mediated-anti-inflammatory-responses-in-equine-immune-cells-stimulated-by-lps-and-allogeneic-mesenchymal-stem-cells
#13
Leila Abdelhamid, Hayam Hussein, Mostafa Ghanem, Nour Eissa
Retinoic acid (RA), an active metabolite of vitamin A, has shown potential therapeutic immunomodulatory properties. Allogeneic mesenchymal stem cells (MSCs)-based therapy is an effective approach to induce tissue healing and regeneration in many equine orthopedic conditions. However, MSCs-based therapies induced inflammatory responses in vivo. This study aimed to: 1. Determine the effect of RA cell culture treatment on inflammatory responses of lipopolysaccharides (LPS)- and allogeneic MSCs-stimulated peripheral blood mononuclear cells (PBMCs)...
May 5, 2017: Research in Veterinary Science
https://www.readbyqxmd.com/read/28501960/a-modified-minimally-invasive-technique-for-intra-articular-displaced-calcaneal-fractures-fixed-by-transverse-and-axial-screws
#14
K C Kapil Mani, Parimal Acharya, R C Dirgha Raj, Bandhu Ram Pangeni, Arun Sigdel, Suman Babu Marahatta
The management of displaced, intra-articular calcaneal fracture represents a surgical challenge to even an experienced orthopedic surgeon. Plate osteosynthesis using an extended lateral approach is complicated by soft tissue problems, while those treated by closed reduction and percutaneous pinning cannot address all the intra-articular fragments sufficiently. The objective of our study is to evaluate restoration of subtalar joint and long-term functional outcomes in intra-articular displaced calcaneal fractures treated with transverse subcondral screws through a small incision on lateral aspect of calcaneus and percutaneously placed axial screws through the calcaneal tuberosity...
May 13, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28501353/beta-tricalcium-phosphate-for-orthopedic-reconstructions-as-an-alternative-to-autogenous-bone-graft
#15
P Hernigou, A Dubory, J Pariat, D Potage, F Roubineau, S Jammal, C H Flouzat Lachaniette
Autogenous bone graft (autograft) remains the gold standard in the treatment of many orthopedic problems. However, graft harvest can lead to perioperative morbidity and increased cost. We tested the hypothesis that an osteoconductive matrix, beta-tricalcium phosphate (β-TCP), would be a safe and effective alternative to autograft alone. Beta-tricalcium phosphate (β-TCP) is considered as one of the most promising biomaterials for bone reconstruction. This study analyzes the outcomes of patients who received β-TCP as bone substitutes in orthopedic surgery...
May 10, 2017: Morphologie: Bulletin de L'Association des Anatomistes
https://www.readbyqxmd.com/read/28497984/recovery-of-working-memory-following-pediatric-traumatic-brain-injury-a-longitudinal-analysis
#16
Stephanie Gorman, Marcia A Barnes, Paul R Swank, Linda Ewing-Cobbs
In a prospective longitudinal study, the trajectory of verbal and visual-spatial working memory (WM) development was examined 2-, 6-, 12-, and 24-months following complicated-mild to severe pediatric traumatic brain injury (TBI; n = 55) relative to an orthopedic injury comparison group (n = 47). Individual growth curve modeling revealed an interaction of age, severity, and time for verbal, but not visual-spatial WM. The youngest children with severe TBI had the lowest scores and slowest verbal WM growth...
May 12, 2017: Developmental Neuropsychology
https://www.readbyqxmd.com/read/28497931/is-outpatient-continuous-regional-analgesia-more-effective-and-equally-safe-than-single-shot-peripheral-nerve-blocks-after-ambulatory-orthopedic-surgery-a-systematic-review-of-randomized-double-blinded-placebo-controlled-trials
#17
Andrea Saporito, Luciano Anselmi, Evelina Sturini, Alain Borgeat, José A Aguirre
BACKGROUND: Continuous regional analgesia is an established technique for effective postoperative pain treatment, particularly after orthopedic surgical procedures. Even if it has been increasingly applied to the outpatient setting as well, many anesthesiologists are still reluctant to discharge patients with a perineural catheter in place. Aim of this review was to clarify the evidences about safety and effectiveness of outpatient continuous peripheral nerve blocks. METHODS: A systematic review of all prospective, randomized, double-blinded, placebo-controlled trials of the last 20 years on outpatient continuous peripheral nerve blocks after ambulatory orthopedic surgery was performed, using both PubMed and OVID databases were...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28496546/the-epidemiology-and-risk-factors-for-postoperative-pneumonia
#18
REVIEW
Morad Chughtai, Chukwuweike U Gwam, Nequesha Mohamed, Anton Khlopas, Jared M Newman, Rafay Khan, Ali Nadhim, Shervin Shaffiy, Michael A Mont
Postoperative pneumonia is a common complication of surgery, and is associated with marked morbidity and mortality. Despite advances in surgical and anesthetic technique, it persists as a frequent postoperative complication. Many studies have aimed to assess its burden, as well as associated risk factors. However, this complication varies among the different surgical specialties, and there is a paucity of reports that comprehensively evaluate this complication. Therefore, the purpose of this study was to review the epidemiology and risk factors of postoperative pneumonia in the setting of: 1) general surgery; 2) cardiothoracic surgery; 3) orthopedic and spine surgery; and 4) head and neck surgery...
June 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28493041/the-sinus-tarsi-approach-in-displaced-intra-articular-calcaneal-fractures
#19
Jin Park, Jin Ho Che
INTRODUCTION: Although the extended lateral approach is typically considered the gold standard of treatment for intra-articular calcaneal fractures, a limited lateral approach may be a good alternative in select cases. METHODS: Forty-seven consecutive patients with intra-articular calcaneal fractures treated using the sinus tarsi approach between March 2010 and April 2015 were retrospectively reviewed. The functional outcomes [including arc range of motion, Visual Analog Scale (VAS) score, and the American Orthopedic Foot and Ankle Society ankle/hindfoot (AOFAS) score], bony outcomes (bony restoration and bony union), and complications were evaluated...
May 10, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#20
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
May 10, 2017: JAMA Surgery
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