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Orthopedic pain

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https://www.readbyqxmd.com/read/29160755/comparison-of-visual-analog-pain-score-reported-to-physician-vs-nurse
#1
Kevin D Martin, J Preston Van Buren, Jeffrey Wake, Laura Dawson
BACKGROUND: The visual analog scale (VAS) is considered a reliable and validated measure of patient-reported acute pain. Patient-reported outcome measures are becoming the standard of care throughout the orthopedic community, but interpretation and clinical applications are still under investigation. The aim of the current study was to compare preoperative patient-reported VAS scores reported at the same visit to nursing staff and the treating surgeon. Our hypothesis was that there would be no difference in the scores reported...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29160725/management-of-neurologic-deformity-of-the-ankle-and-foot-with-concurrent-osteomyelitis-with-the-ilizarov-method
#2
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
https://www.readbyqxmd.com/read/29157058/tramadol-prescription-patterns-in-patients-followed-by-general-practitioners-and-orthopedists-in-germany-in-the-year-2015
#3
Karel Kostev, Christian von Vultée, Dienthard M Usinger, Jens-Peter Reese
OBJECTIVES: The aim of this study was to analyze tramadol prescription patterns in acute pain patients followed by general practitioners and orthopedists in Germany. METHODS: This study included patients ≥18 years diagnosed with acute pain who received at least one tramadol prescription each in one of 1,129 general or 179 orthopedic practices in Germany between January and December 2015 (index date). Patients were excluded if they had received a prescription for another analgesic in the year prior to the index date, had a follow-up of less than 15 months after the index date, or were prescribed tramadol for a period of more than three months...
November 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29156072/clinical-and-radiologic-outcomes-of-metatarsophalangeal-hemiarthroplasty-a-review-of-12-consecutive-cases
#4
Florian Wanivenhaus, Jacqueline Fust, Matthias Erschbamer, Andreas Schirm
This study examined function, pain, satisfaction, and radiologic outcomes among patients treated with first metatarsophalangeal hemiarthroplasty. Patients were invited to participate in an outcome study conducted with questionnaires on subjective and objective outcomes and clinical and radiographic follow-up. A total of 12 patients (12 feet; mean patient age, 58.8±12.3 years) agreed to participate. Mean follow-up was 22.3±19.8 months. Of these patients, 7 were satisfied with the postoperative result. The mean visual analog scale pain score decreased significantly from 7...
November 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29156068/lmwf-5a-for-the-treatment-of-severe-osteoarthritis-of-the-knee-integrated-analysis-of-safety-and-efficacy
#5
Brian Cole, Brian McGrath, Kristin Salottolo, David Bar-Or
The low-molecular-weight fraction of 5% human serum albumin (LMWF-5A) is being developed to treat the signs and symptoms of severe osteoarthritis of the knee. This study was a post hoc pooled analysis of 3 randomized placebo-controlled trials of a single intra-articular injection of LMWF-5A, focusing on the subset of patients with severe osteoarthritis of the knee (Kellgren-Lawrence grade 4). Patients were randomized 1:1 to receive a single 4-mL intra-articular knee injection of either LMWF-5A or saline. Safety was assessed as the incidence and severity of adverse events...
November 20, 2017: Orthopedics
https://www.readbyqxmd.com/read/29145984/outpatient-pediatric-orthopedic-surgery
#6
REVIEW
Daniel J Miller, Susan E Nelson, Apurva S Shah, Theodore J Ganley, John Jack M Flynn
Outpatient surgery refers to a surgical procedure that is performed without an overnight stay in a hospital. Outpatient surgery is associated with decreased individual and societal costs while achieving equivalent health outcomes and excellent patient satisfaction. Successful outpatient pediatric surgery is predicated on appropriate patient selection, adequate pain control, thorough preoperative education, and close clinical follow-up. Continuous research in quality, value, and patient safety are needed to ensure that this practice continues in as safe and efficient a manner as possible...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145327/current-practice-and-usual-care-of-major-cervical-disorders-in-korea-a-cross-sectional-study-of-korean-health-insurance-review-and-assessment-service-national-patient-sample-data
#7
A Ryeon Choi, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Min-Seok Oh, Eun-Jung Lee, Sungchul Kim, Mia Kim, In-Hyuk Ha
Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29145297/therapeutic-effect-of-neoadjuvant-chemotherapy-combined-with-curettage-to-treat-distal-femoral-osteosarcoma-a-case-report
#8
Qi Lai, Conglin Ye, Tian Gao, Jun Xiao, An Xie, Xuqiang Liu, Xiaolong Yu, Jun Liu, Min Dai, Hucheng Liu, Bin Zhang
RATIONALE: Osteosarcoma is the most common malignant bone tumor in children and adolescents. Metastasis occurs early, the mortality rate is high, and the tumor results in a tremendous physical, mental, and economic burden on patients. Therefore, the treatment of osteosarcoma has been important for orthopedic surgeons. However, treatment has always been a difficult problem globally. PATIENT CONCERN: We present the case of a 22-year-old girl with increasing local pain in the distal left thigh...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29142758/ethnic-differences-in-patients-perceptions-towards-isolated-orthopedic-injuries-a-pilot-study
#9
Boris A Zelle, Gurpreet Singh, Deanna L Kitchen, Roberto J Fajardo, Mohit Bhandari, Melissa A Valerio
Background: Patients' perceptions of their healthcare have been reported to influence clinical outcomes following orthopedic trauma. Findings across clinical outcomes have demonstrated significant differences in perceptions towards healthcare between Hispanics and non-Hispanic whites. However, ethnic disparities in perceptions towards orthopedic injuries have not been examined in the literature. Aim of study: The aim of this pilot study is to explore whether Hispanic patients with isolated orthopedic injuries will demonstrate different perceptions towards their injury as compared to non-Hispanic white patients...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29142563/posterior-occipito-cervical-decompression-with-fixation-and-fusion-in-cranio-vertebral-junction-compression
#10
Lal Rehman, Iram Bokhari, Ali Afzal, Shakeel Ahmad
Objective: To find out the clinical outcome of posterior decompression with occipitocervical fixation and fusion in patients with Craniovertebral junction instability. Methods: Eighty consecutive patients of cranio vertebral junction (CVJ) compression were treated in the department of neurosurgery, Jinnah Postgraduate Medical Centre (JPMC), Karachi over a period of 05 years from 1(st) January 2012 till 31(st) August 2016. All patients underwent posterior decompression with occipitocervical fusion (OCF) and fixation...
September 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29137084/vertebral-column-decortication-for-the-management-of-sharp-angular-spinal-deformity-in-pott-disease-case-report
#11
Hong-Tao Hu, Feng-Yu Liu, Jin-He Yu, Liang Ren, Zhen-Fang Gu, Xian-Ze Sun
RATIONALE: Extremely sharp angular spinal deformity of healed tuberculosis can be corrected by vertebral column resection (VCR). However, the VCR techniques have many limitations including spinal column instability, greater blood loss, and greater risk of neurologic deficit. PATIENT CONCERNS: We described a new spinal osteotomy technique to collect sharp angular spinal deformity in Pott disease. A 52-year-old woman presented with back pain and gait imbalance. DIAGNOSIS: The kyphosis of healed tuberculosis was diagnosed based on history and imaging examinations...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29137023/a-case-report-of-schatzker-type-vi-tibial-plateau-fracture-treated-with-double-reverse-traction-closed-reduction-combined-with-minimally-invasive-percutaneous-plate-osteosynthesis-technique-a-case-report
#12
Dian-Qing Li, De-Ye Song, Jiang-Dong Ni, Mu-Liang Ding, Jun Huang
RATIONALE: The knee joint is an important weight-bearing joint, tibial plateau fractures affect knee function and stability. High-energy intra-articular fractures involving the tibial plateau can cause management-related problems such as wound dehiscence; severe comminution leading to malalignment; and delayed complications such as varus collapse, implant failure, and arthritis of the knee joint. The treatment of severe or complex tibial plateau fractures can be quite difficult. Traditional methods of open reduction and plating require extensive exposures, which may further compromise soft tissue and devascularize bone fragments, leading to infection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29136258/ultra-short-versus-conventional-uncemented-stems-for-hip-replacement-in-octogenarians
#13
Young-Hoo Kim, Jang-Won Park, Jun-Shik Kim
The aim of this study was to determine how an ultra-short anatomic uncemented stem vs a diaphyseal filling five-eighths porous coated uncemented femoral stem (conventional stem) affects the survival of primary total hip arthroplasties in octogenarians. The current study consisted of 52 patients (55 hips) in the ultra-short stem group (mean age, 85.5±5.3 years) and 61 patients (72 hips) in the diaphyseal (conventional) stem group (mean age, 84.1±4.8 years). The predominant diagnosis was osteoarthritis, followed by osteonecrosis of the femoral head, in both groups...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136257/risk-factors-for-pathological-fracture-and-metastatic-epidural-spinal-cord-compression-in-patients-with-spinal-metastases
#14
Catherine S Hibberd, Gerald M Y Quan
Vertebral pathological fracture and metastatic epidural spinal cord compression (MESCC) due to metastatic cancer inevitably cause pain, neurological deficit, impaired function, and decreased quality of life and are indications for surgery. In such cases, earlier surgical intervention has the potential to prevent permanent neurological deficit and disability and to maintain function and quality of life. Therefore, the aim of this study was to identify and evaluate risk factors for pathological fracture and MESCC in patients with spinal metastases...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29136255/loss-of-internal-tibial-rotation-after-anterior-cruciate-ligament-reconstruction
#15
Shawn R Brandenburg, Thomas M Matelic
The flexion angle of the knee and the position of the tibia need to be considered during tensioning of the anterior cruciate ligament (ACL) graft to avoid overconstraining the knee. The purpose of this report was to describe 2 cases of loss of tibial internal rotation after single-bundle anatomic ACL reconstruction with graft tensioning in flexion. Retrospective review of each patient's operative chart revealed that the graft was tensioned in flexion and placed in an anatomic position in the femoral tunnel at the time of the index operation...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29130653/-advances-in-diagnosis-and-treatment-of-posterior-distal-injury-of-pelvic-fracture
#16
REVIEW
Zhen Tan, Guang-Lin Wang
Pelvic fracture is one of the common diseases of traumatic orthopedics. With the increase of accidents such as traffic accidents,high craters and crush injuries in China,the incidence of pelvic fractures is also increasing year by year. Since pelvic bones and the ligament structure are close to neurovascular,cavity organs and the urogenital structure,early diagnosis and treatment of pelvic fractures is essential for preventing early complications and late sequelae. The treatment of pelvic ring injury has been the focus of pelvic fracture treatment,which determines the outcome of treatment...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29129946/application-of-materials-as-medical-devices-with-localized-drug-delivery-capabilities-for-enhanced-wound-repair
#17
Esther J Lee, Beom Kang Huh, Se Na Kim, Jae Yeon Lee, Chun Gwon Park, Antonios G Mikos, Young Bin Choy
The plentiful assortment of natural and synthetic materials can be leveraged to accommodate diverse wound types, as well as different stages of the healing process. An ideal material is envisioned to promote tissue repair with minimal inconvenience for patients. Traditional materials employed in the clinical setting often invoke secondary complications, such as infection, pain, foreign body reaction, and chronic inflammation. This review surveys the repertoire of surgical sutures, wound dressings, surgical glues, orthopedic fixation devices and bone fillers with drug eluting capabilities...
August 2017: Progress in Materials Science
https://www.readbyqxmd.com/read/29126259/an-open-label-study-of-sufentanil-sublingual-tablet-30%C3%A2-mcg-in-patients-with-postoperative-pain
#18
Jacob L Hutchins, David A Leiman, Harold S Minkowitz, Maurice Jove, Karen P DiDonato, Pamela P Palmer
Objective: To evaluate sufentanil sublingual tablet 30 mcg (SST 30 mcg) for postoperative pain in an older patient population with comorbidities. Design: Multicenter, open-label, single-arm study. Setting: Nine hospitals across the United States. Subjects: Adults aged ≥40 years who had undergone a surgical procedure. Methods: Patients with a postoperative pain intensity score ≥4 on an 11-point numeric rating scale (NRS) were allowed to enter the study and receive SST 30 mcg as requested for pain (minimum 60-minute redosing interval) over the 12-hour study period...
November 3, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29121211/external-validation-and-update-of-the-ricp-a-multivariate-model-to-predict-chronic-postoperative-pain
#19
Tim Mathes, Carolina Pape-Köhler, Lena Moerders, Eberhard Lux, Edmund A M Neugebauer
Objective: The development of chronic postsurgical pain (CPSP) is influenced by several factors. The risk index for chronic pain (RICP) was developed to identify patients at high risk for CPSP. The aim of this study was the external validation and update of the RICP. Design: Prospective cohort study. Setting: Two German hospitals. Subjects: Participants who underwent orthopedic surgery, general surgery, visceral surgery, and neurosurgery...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29120007/incidence-of-heterotopic-ossification-following-a-multimodal-pain-protocol-in-total-hip-arthroplasty-with-the-posterior-approach
#20
Peter B White, Prem N Ramkumar, Morteza Meftah, Narges Ghazi, Amar S Ranawat, Chitranjan S Ranawat
Heterotopic ossification (HO) is prevalent after total hip arthroplasty (THA). Oral nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 (COX-2) inhibitors have reduced the incidence of HO; however, to the authors' knowledge, no studies have reported the incidence and severity of HO with a pain protocol highlighted by celecoxib in the pre- and postoperative period with a posterolateral approach. Between October 2014 and October 2015, a retrospective study was conducted of 687 consecutive primary THAs with minimum 1-year follow-up performed between January 2009 and December 2013...
November 8, 2017: Orthopedics
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