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Interventional Orthopaedics

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https://www.readbyqxmd.com/read/27908676/effect-of-selective-dorsal-rhizotomy-on-daily-care-and-comfort-in-non-walking-children-and-adolescents-with-severe-spasticity
#1
A I Buizer, P E M van Schie, E A M Bolster, W J van Ouwerkerk, R L Strijers, L A van de Pol, A Stadhouder, J G Becher, R J Vermeulen
BACKGROUND: In non-walking children with severe spasticity, daily care can be difficult and many patients suffer from pain. Selective dorsal rhizotomy (SDR) reduces spasticity in the legs, and therefore has the potential to improve daily care and comfort. AIM: To examine effects of SDR on daily care and comfort in non-walking children with severe spasticity due to different underlying neurological conditions. METHODS: Medical history, changes in daily care and comfort and satisfaction with outcome were assessed retrospectively in non-walking children who underwent SDR in our center, with a mean follow-up of 1y 7m (range 11m-4y 3m)...
October 22, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27900269/vitamin-d-and-spine-surgery
#2
REVIEW
Thomas Mabey, Weerasak Singhatanadgige, Wicharn Yingsakmongkol, Worawat Limthongkul, Sittisak Honsawek
Vitamin D is crucial for musculoskeletal health, maintenance, and function. Vitamin D insufficiency is common among patients undergoing spine surgery and the ideal vitamin D level for spine surgery has yet to be investigated. There is a high prevalence of hypovitaminosis D in patients with musculoskeletal pain regardless of surgical intervention. With the frequency and costs of spine surgery increasing, it is imperative that efforts are continued to reduce the impact on patients and healthcare services. Studies into vitamin D and its associations with orthopaedic surgery have yielded alarming findings with regards to the prevalence of vitamin D deficiency...
November 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/27895373/percutaneous-ilio-sacral-screw-fixation-for-unstable-pelvic-ring-injuries
#3
Muhammad Suhail Amin, Muhammad Khurram Habib, Ammar Khalid
This prospective interventional study was planned to determine the clinical and radiological outcome of percutaneous iliosacral screw fixation for unstable pelvic ring injuries. It was conducted from March 2008 to June 2014 at the Department of Orthopaedic Surgery Combined Military Hospital (CMH) at Lahore, Multan, Rawalpindi and Muzaffarabad. It comprised 50 patients with unstable pelvic ring injuries. Visual analogue scale (VAS), Majeed pelvic score and Lindahl criteria were used for functional and radiological outcomes assessment...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27878660/residual-bone-growth-after-lengthening-procedures
#4
Pierre Journeau, Pierre Lascombes, Dominique Barbier, Dmitry Popkov
The prognosis of limb length discrepancy is a major subject in paediatric orthopaedic surgery. The strategy depends on the prognosis and must be adapted to each patient. The residual growth of the lengthened segment often remains unknown, but is dependent on age, the percentage of lengthening and other factors. Using a large cohort of 150 children who had undergone bone lengthening procedures, we describe five patterns of post-intervention growth and identify factors that are favourable for normal residual growth...
November 23, 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27875491/assessing-the-efficacy-of-prothrombin-complex-concentrate-in-multiply-injured-patients-with-high-energy-pelvic-and-extremity-fractures
#5
Bellal Joseph, Mazhar Khalil, Caitlyn Harrison, Tianyi Swartz, Narong Kulvatunyou, Ansab A Haider, Tahereh O Jokar, David Burk, Ali Mahmoud, Rifat Latifi, Peter Rhee
OBJECTIVES: Prothrombin complex concentrate (PCC) is being increasingly used for reversing induced coagulopathy of trauma. However, the use of PCC for reversing coagulopathy in multiply injured patients with pelvic and/or lower extremity fractures remains unclear. The aim of our study was to assess the efficacy of PCC for reversing coagulopathy in this group of patients. DESIGN: Two-year retrospective analysis. SETTING: Our level I trauma center...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27872768/hip-replacement-surgery-in-14-year-old-girl-with-factor-v-deficiency-haemostatic-treatment-and-thromboprophylaxis
#6
María Eva Mingot-Castellano, Josefina Pérez-Núñez, Lourdes Baeza-Montañez
Factor V (FV) is a pivotal coagulation factor present in plasma and platelets. It plays an essential role in secondary haemostasis acting as a cofactor in the prothrombinase complex, catalysing the conversion of prothrombin to thrombin. There is little evidence on the management of mayor orthopaedic surgery in paediatric or adolescents subjects with this coagulopathy and almost no information about thromboprophylaxis in these situations. We report a case of a hip replacement in a 14-year-old girl with moderate FV deficiency (0...
2016: Case Reports in Hematology
https://www.readbyqxmd.com/read/27870669/operating-room-efficiency-benefits-of-an-orthopaedic-traumatologist-at-a-level-ii-trauma-center
#7
Peter L Althausen, Justin R Kauk, Steven Shannon, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. DESIGN: Retrospective review...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27855056/-mixed-knee-arthrodesis-a-rescue-alternative-in-knee-periprosthetic-joint-infection
#8
Roberto Enrique López-Cervantes, Adrián Huematzin Rivera-Villa, Adrián Miguel-Pérez, René Morales-de Los Santos, Rubén Torres-González, José Manuel Pérez-Atanasio
BACKGROUND: Knee arthrodesis is a rescue procedure for patients with knee periprosthetic joint infection who are not candidates for a revision surgery. The actual methods present a high complication rate with only moderate efectivity. METHODS: We retrospectively analyzed 17 cases, of patients with knee periprosthetic joint infection and bone loss treated by intramedular expandable nail and monoplanar external fixator with a mínimum evolution of 1 year, evaluating the medical records and digitalized X-rays by 2 sub specialized doctors in osteoarticular rescue surgery...
2016: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/27851679/telephone-follow-up-by-nurse-after-total-knee-arthroplasty-results-of-a-randomized-clinical-trial
#9
Kirsten Szöts, Hanne Konradsen, Søren Solgaard, Birte Østergaard
BACKGROUND/PURPOSE: Because of shorter hospitalizations, patients now have to take responsibility for their recovery period at a very early stage. We evaluated the effects of structured, nurse-managed telephone follow-up (TFU) after discharge from the hospital following total knee arthroplasty (TKA). METHOD/DESIGN: The design was a single-center, unblinded, parallel-group randomized clinical trial. The primary outcome was self-reported physical function according to the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index...
November 2016: Orthopaedic Nursing
https://www.readbyqxmd.com/read/27848261/risk-factors-for-failure-to-enter-vocational-rehabilitation-services-among-individuals-with-disabilities
#10
F L Fredrik G Langi, Fabricio E Balcazar
PURPOSE: To investigate the risk factors for failure of individuals with disabilities to enter the vocational rehabilitation (VR) programme, including the cases where they had been formally accepted but were yet to receive any service. METHODS: We used prospective cohort data from a Midwestern US state, and analysed 126,251 and 94,517 individuals, respectively, for acceptance and admission into VR services. Statistical analysis was conducted using Poisson regression models with robust variance estimator...
November 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27848247/hospital-rehabilitation-for-patients-with-obesity-a-scoping-review
#11
Jennifer C Seida, Arya M Sharma, Jeffrey A Johnson, Mary Forhan
PURPOSE: To explore the evidence on rehabilitation for hospitalized patients with obesity. METHODS: Medline, Embase, CENTRAL, CINAHL, and PubMed were searched from 1994 to May 2016. Grey literature was hand-searched. Two reviewers independently selected studies examining patients with obesity receiving hospital-based therapy for a physical impairment. One reviewer extracted the data and a second reviewer verified a random sample. RESULTS: Thirty-nine studies (two trials, 37 observational) were included...
November 16, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27846875/the-design-of-a-randomised-controlled-trial-to-evaluate-the-cost-effectiveness-of-the-posterolateral-versus-the-direct-anterior-approach-for-tha-polada-trial
#12
K Rykov, I H F Reininga, B A S Knobben, M S Sietsma, B L E F Ten Have
BACKGROUND: Total hip arthroplasty (THA) is one of the most successful orthopaedic procedures. Because of the increasing number of THAs, a growing demand for faster recovery and a greater emphasis on cost-effectiveness, minimally invasive THAs have been introduced in the last decades. The direct anterior approach is a minimally invasive, tissue-sparing approach in which intermuscular planes are used. Theoretically, this approach should result in a faster recovery of physical functioning and higher health-related quality of life...
November 15, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27835963/flip-flop-footwear-with-a-moulded-foot-bed-for-the-treatment-of-foot-pain-a-randomised-controlled-trial
#13
Vivienne Helaine Chuter, Angela Searle, Martin J Spink
BACKGROUND: Foot pain is a common problem affecting up to 1 in 5 adults and is known to adversely affect activities of daily living and health related quality of life. Orthopaedic footwear interventions are used as a conservative treatment for foot pain, although adherence is known to be low, in part due to the perception of poor comfort and unattractiveness of the footwear. The objective of this trial was to assess the efficacy of flip-flop style footwear (Foot Bio-Tec©) with a moulded foot-bed in reducing foot pain compared to participant's usual footwear...
November 11, 2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27815925/microbiological-diagnosis-of-implant-related-infections-scientific-evidence-and-cost-benefit-analysis-of-routine-antibiofilm-processing
#14
Lorenzo Drago, Elena De Vecchi
Prosthetic joint infection is one of the most severe complication following joint arthroplasty, producing a significant worsening of patient's quality of life. Management of PJIs requires extended courses of antimicrobial therapy, multiple surgical interventions and prolonged hospital stay, with a consequent economic burden, which is thought to markedly increase in the next years due to the expected burden in total joint arthroplasties. The present review summarizes the present knowledge on microbiological diagnosis of prosthetic joint infections, focusing on aethiological agents and discussing pros and cons of the available strategies for their diagnosis...
November 5, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27810153/early-prediction-of-tibial-and-femoral-fracture-healing-are-we-reliable
#15
Emily R Squyer, Gregory D Dikos, David M Kaehr, Dean C Maar, Renn J Crichlow
INTRODUCTION: To evaluate the ability of orthopaedic trauma subspecialists to predict early bony union in femoral and tibia shaft fractures. MATERIALS AND METHODS: Eight orthopaedic trauma subspecialists prospectively predicted the probability of bony union at 6 and 12 weeks post-operatively for an aggregate of 48 femoral and tibial shaft fractures treated at a Level 1 trauma centre. An additional orthopaedic trauma subspecialist was blinded to treating surgeon and adjudicated healing at 18 weeks...
December 2016: Injury
https://www.readbyqxmd.com/read/27810152/syndesmosis-reduction-by-computer-assisted-orthopaedic-surgery-with-navigation-feasibility-and-accuracy-in-a-cadaveric-study
#16
Victor Dubois-Ferrière, Axel Gamulin, Ashwin Chowdhary, Jean Fasel, Richard Stern, Mathieu Assal
INTRODUCTION: Syndesmotic disruption may be difficult to reduce and fix, and malreduction is associated with inferior outcomes. Intraoperative computed tomography (CT) can provide accurate assessment of syndesmotic reduction. We hypothesized that three-dimensional (3-D) computer-assisted orthopaedic surgery (CAOS) with navigation of syndesmotic reduction could avoid malreduction. Our goal was to assess feasibility and accuracy of such a technic in a cadaveric study. METHOD: Eleven through-the-knee cadaveric specimens were used...
December 2016: Injury
https://www.readbyqxmd.com/read/27803231/the-use-of-high-dose-dual-impregnated-antibiotic-laden-cement-with-hemiarthroplasty-for-the-treatment-of-a-fracture-of-the-hip-the-fractured-hip-infection-trial
#17
A P Sprowson, C Jensen, S Chambers, N R Parsons, N M Aradhyula, I Carluke, D Inman, M R Reed
AIMS: A fracture of the hip is the most common serious orthopaedic injury, and surgical site infection (SSI) is one of the most significant complications, resulting in increased mortality, prolonged hospital stay and often the need for further surgery. Our aim was to determine whether high dose dual antibiotic impregnated bone cement decreases the rate of infection. PATIENTS AND METHODS: A quasi-randomised study of 848 patients with an intracapsular fracture of the hip was conducted in one large teaching hospital on two sites...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27796189/cervical-traction-for-managing-neck-pain-a-survey-of-physical-therapists-in-the-united-states
#18
Timothy J Madson, John H Hollman
Study Design Cross-sectional survey. Background Systematic reviews provide little support for traction in managing neck pain. While traction usage among physical therapists (PTs) in other countries has been described, usage in the United States has not been examined. Objective To examine how PTs use traction for patients with neck pain, when traction is used, delivery modes and parameters, supplemental interven¬tions, and whether professional demographics influence usage. Methods We surveyed a random sample of 4000 Orthopaedic Section members of the American Physical Therapy Association...
October 30, 2016: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27769090/-treatment-of-osteochondral-lesions-in-the-ankle-a-guideline-from-the-group-clinical-tissue-regeneration-of-the-german-society-of-orthopaedics-and-traumatology-dgou
#19
M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/27763959/mortality-following-surgical-management-of-vancouver-b-periprosthetic-fractures
#20
Ida Leah Gitajn, Marilyn Heng, Michael J Weaver, Natalie Casemyr, Collin May, Mark S Vrahas, Mitchel B Harris
OBJECTIVES: The goals of this study are to evaluate mortality after Vancouver B periprosthetic fractures and determine predictors of mortality; compare mortality among patients with loose femoral stems treated with revision arthroplasty versus fixation alone; compare mortality among patients with radiographically "indeterminate" fractures treated with revision or fixation; evaluate the rate of return to surgery for patients who underwent revision compared to fixation. DESIGN: Retrospective study SETTING:: Three academic level 1 trauma centersPatients/Participants: 203 patients treated for Vancouver B periprosthetic fractures INTERVENTION:: N/A MAIN OUTCOME MEASUREMENTS:: The primary outcome measure was mortality...
October 1, 2016: Journal of Orthopaedic Trauma
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