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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/28521149/long-term-outcomes-of-external-femoral-derotation-osteotomies-in-children-with-cerebral-palsy
#1
Sylvia Õunpuu, Matthew Solomito, Katharine Bell, Kristan Pierz
External femoral derotation osteotomy (FDO) is an orthopaedic intervention to correct increased femoral anteversion and associated excessive internal hip rotation and internal foot progression during gait in children with cerebral palsy. The resulting functional issues may include clearance problems and hip abductor lever-arm dysfunction. The purpose of this study was to evaluate long-term gait outcomes of FDO. Twenty ambulatory patients (27 sides) with cerebral palsy who underwent pre-operative (P0) and a one year post-operative (P1) gait analysis as part of the standard of care had a second post-operative analysis (P2) approximately 11 years post-surgical intervention...
April 29, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28509822/fracture-prevention-in-the-orthopaedic-environment-outcomes-of-a-coordinator-based-fracture-liaison-service
#2
Earl R Bogoch, Victoria Elliot-Gibson, Dorcas Beaton, Joanna Sale, Robert G Josse
BACKGROUND: Fracture liaison services focus on secondary fracture prevention by identifying patients at risk for future fracture and initiating appropriate evaluation, risk assessment, education, and therapeutic intervention. This study describes key clinical outcomes including bone mineral densitometry, physician assessment, and pharmacotherapy initiation in pharmacotherapy-naïve patients undergoing treatment for fragility fracture in a Canadian fracture liaison service. METHODS: We determined rates of post-fracture investigation and treatment for inpatients and outpatients with a fragility fracture seen in a coordinator-based fracture liaison service at an urban university trauma hospital...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28507421/orthopaedic-tumors-what-problems-are-we-solving-and-are-universities-and-major-medical-centers-doing-enough
#3
Mohamed Mediouni, Daniel R Schlatterer
Little has been published about the complexity of orthopaedic tumors compared to others tumors. The current study in the literature treated this problem in terms of classification, surgical intervention and impact on the patient. In this article, factors risks of tumors will be we identified. A strategy based on three dimensional simulations will be explained in order to improve the clinical trials.
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28497097/a-randomized-controlled-pilot-study-of-educational-techniques-in-teaching-basic-arthroscopic-skills-in-a-low-income-country
#4
Abhiram R Bhashyam, Catherine Logan, Heather J Roberts, Rameez A Qudsi, Jacky Fils, George S M Dyer
BACKGROUND: Little is known about how to introduce complex technologies like arthroscopy into low-income countries. Thus, we compared low- versus high-resource intensive methods of teaching basic arthroscopic skills in a randomized controlled trial in Haiti. METHODS: Forty-eight Haitian orthopaedic surgeons and residents attending an orthopaedic conference in Haiti were block randomized to receive instruction through a composite video (Control) or a composite video plus hands-on teaching with an expert visiting surgeon (Intervention)...
March 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28488163/historical-review-of-arthroscopic-surgery-of-the-hip
#5
REVIEW
Abigail C L Magrill, Naoki Nakano, Vikas Khanduja
BACKGROUND & PURPOSE: Increasing our appreciation of the historical foundations of hip arthroscopy offers greater insight and understanding of the field's current and future applications. This article offers a broad history of the progress of hip arthroscopy. METHODS: Hip arthroscopy's development from the early technologies of endoscopy to the present day is described through a review of the available literature. RESULTS: Endoscopic science begins with the Lichtleiter, developed by Phillip Bozzini (1779-1809) in 1806, but endoscopes were not applied to joints until 1912, as presented by Severin Nordentoft (1866-1922)...
May 9, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28475261/impact-of-the-orthopaedic-nurse-practitioner-role-on-acute-hospital-length-of-stay-and-cost-savings-for-patients-with-hip-fracture-a-retrospective-cohort-study
#6
Linda L Coventry, Sharon Pickles, Michelle Sin, Amanda Towell, Margaret Giles, Kevin Murray, Di Twigg
AIMS: To compare acute hospital length of stay and cost-savings for patients with hip fracture before-and-after commencement of the Orthopaedic Nurse Practitioner and identify variables that increase length of stay in hospital. BACKGROUND: Globally, hip fractures are associated with significant morbidity and mortality. Whilst the practical benefits of the Orthopaedic Nurse Practitioner have been anecdotally shown, an analysis showing the cost-saving benefits has yet to be published...
May 5, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28471915/incidence-of-delayed-diagnosis-of-orthopaedic-injury-in-pediatric-trauma-patients
#7
Jeremy D Podolnick, Daniel S Donovan, Alfred W Atanda
TITLE: Incidence of delayed diagnosis of orthopaedic injury in pediatric trauma patients OBJECTIVE:: Determine the incidence of the delayed diagnosis of orthopaedic injuries in pediatric trauma patients. DESIGN: Cross-sectional retrospective analysis. SETTING: Level I pediatric trauma center. PATIENTS/PARTICIPANTS: All patients with an orthopaedic consultation following a trauma activation with a diagnosis of fracture, dislocation, traumatic arthrotomy, neurovascular injury, amputation, and tendon or ligament injury requiring intervention...
April 29, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28469904/introducing-a-new-junior-doctor-electronic-weekend-handover-on-an-orthopaedic-ward
#8
Siddharth Maroo, Dipak Raj
Junior Doctors working on the Orthopaedic wards at a district general hospital identified the lack of a formal weekend handover. The Royal Colleges,GMC and Foundation Programme curriculum all emphasise the importance of a safe and effective handover. Doctors found that the current system of using a written, paper-based handover was unreliable, un-legible, and inefficient. Baseline measurements were sought in the form of a questionnaire which allowed us to obtain the limitations to the current handover. After this and a focus group, a new electronic, 'Microsoft Word' based handover was created and a repeat surgery issued in 2 weeks...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28469890/hypokalaemia-addressing-human-factors-and-improving-education-around-prescription-and-administration-of-intravenous-iv-potassium-infusion-in-trauma-and-orthopaedics
#9
Vanushia Thirumal, Gavin Love
A high incidence of hypokalaemia was noted in Trauma and Orthopaedics of Ninewells Hospital. We sought to establish the reason behind this and implemented three PDSA cycles via questionnaires to 30 ward staff, both doctors and nurses over a 1 week period in December, February and July 2016. Key baseline measures include availability of IV fluids with 40mmol potassium on the wards, confidence prescribing or administering IV fluids with 40mmol potassium, necessity for cardiac monitoring during slow IV potassium replacement and recognition of confusion and learning need in this area...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28467648/building-better-bone-the-weaving-of-biologic-and-engineering-strategies-for-managing-bone-loss
#10
Andrew M Schwartz, Mara L Schenker, Jaimo Ahn, Nick J Willett
Segmental bone loss remains a challenging clinical problem for orthopaedic trauma surgeons. In addition to the missing bone itself, the local tissues (soft tissue, vascular) are often highly traumatized as well, resulting in a less than ideal environment for bone regeneration. As a result, attempts at limb salvage become a highly expensive endeavor, often requiring multiple operations and necessitating the use of every available strategy (autograft, allograft, bone graft substitution, Masquelet, bone transport, etc...
May 3, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28459775/smoking-quitting-and-the-provision-of-smoking-cessation-support-a-survey-of-orthopaedic-trauma-patients
#11
Sam McCrabb, Amanda L Baker, John Attia, Zsolt J Balogh, Natalie Lott, Kerrin Palazzi, Justine Naylor, Ian A Harris, Christopher M Doran, Johnson George, Luke Wolfenden, Eliza Skelton, Billie Bonevski
BACKGROUND AND AIMS: Tobacco smoking while recovering from surgery can have a negative impact. Prevalence of smoking in the orthopaedic trauma population has been found to be higher than the general population. This study investigates orthopaedic trauma patients smoking cessation history, intentions to quit, receipt of smoking cessation care during hospital admission; and patient-related factors associated with receipt of smoking cessation care. METHODS: An online cross-sectional survey of orthopaedic trauma patients was conducted in two public hospitals in New South Wales, Australia...
April 25, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28456704/outpatient-treatment-of-osteomyelitis-with-telavancin
#12
Claudia P Schroeder, Lucinda J Van Anglen, Robin H Dretler, John S Adams, Richard C Prokesch, Quyen Luu, Andrew H Krinsky
Telavancin is a lipoglycopeptide antibiotic with bactericidal activity against Gram-positive pathogens including Staphylococcus aureus, the most frequent cause of osteomyelitis. Treatment is often challenging due to needs for surgical intervention along with prolonged administration of intravenous antimicrobials, frequently in an outpatient setting. This was a retrospective analysis of the efficacy and safety of telavancin for treatment of osteomyelitis provided as outpatient parenteral antimicrobial therapy (OPAT) in physician office infusion centres...
April 26, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28456670/there-is-no-increased-risk-of-adjacent-segment-disease-at-the-cervico-thoracic-junction-following-an-anterior-cervical-discectomy-and-fusion-to-c7
#13
Philip K Louie, Steven M Presciutti, Stephanie E Iantorno, Daniel D Bohl, Kevin Shah, Grant D Shifflett, Howard S An
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a very common operative intervention for the treatment of cervical spine degenerative disease in those who have failed non-operative measures. However, studies examining long-term follow up on patients who underwent ACDF reveal evidence of radiographic and clinical degenerative disc disease at the levels adjacent to the fusion construct. Consistent with other junctional regions of the spine, the cervicothoracic junction (CTJ) has significant morphological variations...
April 26, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28452628/informed-consent-to-research-with-cognitively-impaired-adults-transdisciplinary-challenges-and-opportunities
#14
Beth Prusaczyk, Steven M Cherney, Christopher R Carpenter, James M DuBois
Due to issues related to informed research consent, older adults with cognitive impairments are often excluded from high-quality studies that are not directly related to cognitive impairment, which has led to a dearth of evidence for this population. The challenges to including cognitively impaired older adults in research and the implications of their exclusion are a transdisciplinary issue. The ethical challenges and logistical barriers to conducting research with cognitively impaired older adults are addressed from the perspectives of three different fields-social work, emergency medicine, and orthopaedic surgery...
January 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28451493/a-multicenter-study-of-the-presentation-treatment-and-outcomes-of-cervical-dural-tears
#15
Kevin R O'Neill, Michael G Fehlings, Thomas E Mroz, Zachary A Smith, Wellington K Hsu, Adam S Kanter, Michael P Steinmetz, Paul M Arnold, Praveen V Mummaneni, Dean Chou, Ahmad Nassr, Sheeraz A Qureshi, Samuel K Cho, Evan O Baird, Justin S Smith, Christopher Shaffrey, Chadi A Tannoury, Tony Tannoury, Ziya L Gokaslan, Jeffrey L Gum, Robert A Hart, Robert E Isaacs, Rick C Sasso, David B Bumpass, Mohamad Bydon, Mark Corriveau, Anthony F De Giacomo, Adeeb Derakhshan, Bruce C Jobse, Daniel Lubelski, Sungho Lee, Eric M Massicotte, Jonathan R Pace, Gabriel A Smith, Khoi D Than, K Daniel Riew
STUDY DESIGN: Retrospective multicenter case series study. OBJECTIVE: Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. METHODS: Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears...
April 2017: Global Spine Journal
https://www.readbyqxmd.com/read/28449618/telerehabilitation-after-arthroscopic-subacromial-decompression-is-effective-and-not-inferior-to-standard-practice-preliminary-results
#16
Jose Manuel Pastora-Bernal, Rocío Martín-Valero, Francisco Javier Barón-López, Noelia Guerrero Moyano, María-José Estebanez-Pérez
Background Telerehabilitation promises to improve quality, increase patient access and reduce costs in health care. Physiotherapy with exercises is generally recommended to restore function after surgery in patients with chronic subacromial syndrome. Relatively few studies have investigated the feasibility of telerehabilitation interventions in musculoskeletal and orthopaedic disorders. The aim of this study was to evaluate the feasibility and effectiveness of a customizable telerehabilitation intervention and compare with traditional care...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28442470/late-outcomes-in-children-with-langerhans-cell-histiocytosis
#17
Tin Wai Chow, Wing Kwan Leung, Frankie Wai Tsoi Cheng, Shekhar Medhukar Kumta, Winnie Chiu Wing Chu, Vincent Lee, Matthew Ming Kong Shing, Chi Kong Li
INTRODUCTION: Langerhans cell histiocytosis (LCH) is a rare disease with diverse clinical courses. Despite improvement in survival outcomes in the recent decades, sequelae of the disease remain a concern. This study aimed to provide information on the long-term outcomes in patients with LCH, particularly on the sequelae and any associated factors. METHOD: Medical records of patients with diagnosis of LCH and being managed in our centre were retrospectively reviewed...
April 25, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28437759/correlation-of-technical-surgical-goals-to-the-gdi-and-investigation-of-post-operative-gdi-change-in-children-with-cerebral-palsy
#18
Christina Bickley, Judi Linton, Nancy Scarborough, Elroy Sullivan, Katy Mitchell, Douglas Barnes
AIM: The purpose of this study was to introduce a standardized set of surgical technical achievement goals (TAGs) as part of a comprehensive outcome assessment model for children with spastic cerebral palsy (CP) undergoing orthopaedic surgical intervention to improve gait. Examination of relationships of these surgical goals to the Gait Deviation Index (GDI) and use of two assessments in tandem provided a thorough picture of technical surgical outcomes. This study also investigated changes in GDI in children with spastic CP after surgery...
April 13, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28430718/trauma-collaborative-care-intervention-effect-on-surgeon-confidence-in-managing-psychosocial-complications-following-orthopaedic-trauma
#19
Stephen Wegener, Eben Carroll, Joshua Gary, Todd McKinley, Robert O'Toole, Debra Sietsema, Renan Castillo, Katherine Frey, Daniel Scharfstein, Yanjie Huang, Susan Collins, Ellen MacKenzie
OBJECTIVES: The impact of the Trauma Collaborative Care (TCC) program on surgeon confidence in managing the psychosocial sequelae of orthopaedic trauma was evaluated as part of a larger prospective, multisite, cluster clinical trial. We compared confidence and perceived resource availability among surgeons practicing in trauma centers that implemented the TCC program with orthopaedic trauma surgeons in similar trauma centers that did not implement the TCC. DESIGN: Prospective cohort design SETTING:: Level 1 Trauma Centers PARTICIPANTS:: Attending surgeons and Fellows...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28407199/comprehensive-geriatric-assessment-for-prevention-of-delirium-after-hip-fracture-a-systematic-review-of-randomized-controlled-trials
#20
Lynn Shields, Victoria Henderson, Robert Caslake
OBJECTIVES: To assess the efficacy of comprehensive geriatric assessment (CGA) in prevention of delirium after hip fracture. DESIGN: Systematic review and metaanalysis. SETTING: Ward based models on geriatrics wards and visiting team based models on orthopaedics wards were included. PARTICIPANTS: Four trials (three European, one U.S.; 973 participants) were identified. Two assessed ward-based, and two assessed team-based interventions...
April 13, 2017: Journal of the American Geriatrics Society
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