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Fifth fracture

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https://www.readbyqxmd.com/read/28426562/asymptomatic-cervical-spine-fractures-current-guidelines-can-fail-older-patients
#1
Christopher D Healey, Sarah K Spilman, Bradley D King, Joseph E Sherrill, Carlos A Pelaez
BACKGROUND: Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28413381/delayed-cytoreductive-nephrectomy-following-three-years-of-targeted-therapy-for-metastatic-renal-cell-carcinoma
#2
Ariel Schulman, Mathew Fakhoury, Jean P Wuilleumier, Kevin Becker, Bernadine Donahue, Ruoqing Huang, James Butler, Howard Goodman, Ervin Teper, David Silver
We present a 55-year-old male, with good performance status who was diagnosed with a case of metastatic renal cell carcinoma following a pathologic femur fracture. Despite good performance status, multifocal metastases and poor-prognostic features portended a grim prognosis with predicted overall survival of less than nine months. On initial presentation, he was excluded from cytoreductive nephrectomy based on brain metastasis and interleukin-2 was not pursued as the primary tumor was to be left in situ. The patient was reconsidered for cytoreductive nephrectomy after sustained response to fifth line targeted therapies with shrinkage of tumor burden...
January 2017: Current Urology
https://www.readbyqxmd.com/read/28398547/patients-preferences-for-anti-osteoporosis-drug-treatment-a-cross-european-discrete-choice-experiment
#3
Mickaël Hiligsmann, Benedict G Dellaert, Carmen D Dirksen, Verity Watson, Sandrine Bours, Stefan Goemaere, Jean-Yves Reginster, Christian Roux, Bernie McGowan, Carmel Silke, Bryan Whelan, Adolfo Diez-Perez, Elisa Torres, Georgios Papadakis, Rene Rizzoli, Cyrus Cooper, Gill Pearson, Annelies Boonen
Objectives.: To estimate the preferences of osteoporotic patients for medication attributes, and analyse data from seven European countries. Methods.: A discrete choice experiment was conducted in Belgium, France, Ireland, the Netherlands, Spain, Switzerland and the UK. Patients were asked to choose repeatedly between two hypothetical unlabelled drug treatments (and an opt-out option) that varied with respect to four attributes: efficacy in reducing the risk of fracture, type of potential common side effects, and mode and frequency of administration...
April 6, 2017: Rheumatology
https://www.readbyqxmd.com/read/28391778/delayed-right-chylothorax-after-left-blunt-chest-trauma-a-case-report
#4
Jonggeun Lee, Jeong Su Cho, Hoseok I, Yeong Dae Kim
BACKGROUND: Chylothorax is a disease that has various causes such as neoplasm, infection, post-surgery trauma, congenital, and venous thrombosis. In approximately 15% of cases of chylothorax, the exact cause is unknown. We report a case of delayed occurrence of right chylothorax in a patient who had multiple segmental ribs fracture on his left side. CASE PRESENTATION: A 70-year-old Asian man had a "rollover" accident in which the cultivator he was driving overturned...
April 10, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28378776/locking-plate-alone-versus-in-combination-with-two-crossed-kirschner-wires-for-fifth-metacarpal-neck-fracture
#5
Hongyi Zhu, Zhengyu Xu, Haifeng Wei, Xianyou Zheng
Fracture of fifth metacarpal neck commonly requires open reduction and internal fixation. However, the current methods of internal fixation in fifth metacarpal neck fractures remain unsatisfactory. Patients with fractures of fifth metacarpal neck received open reduction and internal fixation with either locking plate in combination with two crossed Kirschner wires (K-wires) or locking plate alone were evaluated for the clinical outcomes. Clinical outcomes included grip strength, Michigan hand outcomes questionnaire (MHQ), final angulation and range of motion (ROM) one year after treatment...
April 5, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28368901/fortuitous-diagnosis-of-preexisting-neuropathy-during-ultrasound-guided-regional-anesthesia-performance-a-case-report
#6
Philippe Marty, Bertrand Basset, Constance Marquis, Medhi Merouani, Olivier Rontes, Alain Delbos
Ultrasound-guided regional anesthesia requires the anesthesia provider to interpret new information. This article reports on the case of a 38-year-old man scheduled for a fifth metacarpal fracture repair. Ultrasound nerve examination revealed abnormal pathology of the axillary brachial plexus consisting of an increased volume of the terminal nerves of the brachial plexus. Ultrasound scanning initiated the subsequent diagnosis of multifocal motor neuropathy. Regional anesthesia was abandoned in favor of general anesthesia...
March 31, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28361017/lower-limb-stress-fractures-in-sport-optimising-their-management-and-outcome
#7
REVIEW
Greg A J Robertson, Alexander M Wood
Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk. "Low risk" stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation...
March 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28358977/plantar-plating-for-the-treatment-of-proximal-fifth-metatarsal-fractures-in-elite-athletes
#8
Ronald J Mitchell, Neil L Duplantier, Domenica A Delgado, Bradley S Lambert, Patrick C McCulloch, Joshua D Harris, Kevin E Varner
Proximal fifth metatarsal fractures, zones II and III, are commonly treated surgically, especially in elite athletes. Intramedullary screw fixation remains the most used construct despite nonunion and refracture. High tensile forces on the plantar-lateral aspect of the fifth metatarsal are difficult to control, and intramedullary screw fixation depends on ideal screw position, length, and width. The authors present a plantar plating technique with cancellous bone autograft for zones II and III proximal fifth metatarsal fractures...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28343329/stress-fractures-of-the-foot-and-ankle-part-2-site-specific-etiology-imaging-and-treatment-and-differential-diagnosis
#9
Jacob C Mandell, Bharti Khurana, Stacy E Smith
Stress fractures of the foot and ankle are a commonly encountered problem among athletes and individuals participating in a wide range of activities. This illustrated review, the second of two parts, discusses site-specific etiological factors, imaging appearances, treatment options, and differential considerations of stress fractures of the foot and ankle. The imaging and clinical management of stress fractures of the foot and ankle are highly dependent on the specific location of the fracture, mechanical forces acting upon the injured site, vascular supply of the injured bone, and the proportion of trabecular to cortical bone at the site of injury...
March 25, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28284470/virtual-fracture-clinic-management-of-fifth-metatarsal-including-jones-fractures-is-safe-and-cost-effective
#10
Kit Brogan, Simon Bellringer, Harold Akehurst, Christopher Gee, Nada Ibrahim, Lucy Cassidy, Ben Rogers, James Gibbs
Virtual clinics have been shown to be safe and cost-effective in many specialties, yet barriers exist to their implementation in orthopaedics. The aims of this study were to look at whether the management of 5th metatarsal fractures using a virtual fracture clinic model is safe, cost effective and avoids adverse outcomes whilst being acceptable to patients using the service. All patients with a fifth metatarsal fracture between September 2013 and September 2015 had a standardised management plan initiated (blackboot, full weightbearing) in the emergency department (ED)...
February 12, 2017: Injury
https://www.readbyqxmd.com/read/28279202/systemic-administration-of-mesenchymal-stem-cells-combined-with-parathyroid-hormone-therapy-synergistically-regenerates-multiple-rib-fractures
#11
Doron Cohn Yakubovich, Dmitriy Sheyn, Maxim Bez, Yeshai Schary, Eran Yalon, Afeef Sirhan, May Amira, Alin Yaya, Sandra De Mel, Xiaoyu Da, Shiran Ben-David, Wafa Tawackoli, Eric J Ley, Dan Gazit, Zulma Gazit, Gadi Pelled
BACKGROUND: A devastating condition that leads to trauma-related morbidity, multiple rib fractures, remain a serious unmet clinical need. Systemic administration of mesenchymal stem cells (MSCs) has been shown to regenerate various tissues. We hypothesized that parathyroid hormone (PTH) therapy would enhance MSC homing and differentiation, ultimately leading to bone formation that would bridge rib fractures. METHODS: The combination of human MSCs (hMSCs) and a clinically relevant PTH dose was studied using immunosuppressed rats...
March 9, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28251687/fracture-risk-after-bariatric-surgery-roux-en-y-gastric-bypass-versus-adjustable-gastric-banding
#12
Elaine W Yu, Moa P Lee, Joan E Landon, Katherine G Lindeman, Seoyoung C Kim
The long-term consequences of bariatric surgery on fracture risk are unclear but are likely to vary by procedure type. In physiologic studies, Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) have differential effects on rates of bone loss. Therefore, our objective was to compare fracture risk in obese adults after RYGB and AGB procedures. Using claims data from a US commercial health plan, we analyzed rates of nonvertebral fractures within a propensity score-matched cohort (n = 15,032) of morbidly obese adults who received either RYGB or AGB surgery between 2005 and 2013...
March 2, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28251281/total-wrist-arthrodesis-for-septic-wrist-arthritis-and-loss-of-the-bony-carpus-following-percutaneous-pinning-of-the-fifth-carpometacarpal-joint-a-case-report
#13
C Deml, S A Euler, G Schmidle, S Erhart, M Gabl, R Arora
We report on a patient who developed septic wrist arthritis with destruction of the entire carpus due to osteomyelitis following percutaneous pinning of a fifth metacarpal base fracture. Arthrodesis was performed using a 6 cm vascularized iliac bone graft. This case report may sharpen the surgeon's awareness of risks in orthopedic surgeries, even though the procedure seems to be rather simple and the patient is young and seems to be healthy.
March 1, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28242800/rupture-of-the-extensor-hood-of-the-fifth-toe-a-rare-injury
#14
Sara Venturini, Suchi Gaba, Jitendra Mangwani
Closed injuries of the extensor hood of the lesser toes are rare and seldom reported in the literature. We present the case of a woman aged 25 years who presented to the orthopaedic fracture clinic with a 2-week history of pain in the left fifth toe and inability to extend following a ballet dancing session. Investigations showed no fracture on plain radiographs, but an ultrasound scan demonstrated rupture to the extensor hood of the little toe. Successful surgical repair of the extensor hood was performed, and the patient made a good recovery with return to dancing activities...
February 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28230584/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#15
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28220354/zone-ii-and-iii-fifth-metatarsal-fractures-in-athletes
#16
REVIEW
Michael Le, Robert Anderson
PURPOSE OF REVIEW: This study aimed to review indications, complications, and outcomes of zone II and III fifth metatarsal fractures based on recent literature. RECENT FINDINGS: High rates of nonunion, delayed union, and refracture in athletes treated non-operatively. The standard of care is operative treatment in athletes with intramedullary fixation. Operative treatment of zone II and III fractures in athletes will decrease the risk of nonunion and refracture while leading to an earlier return to play...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28205378/chronic-low-back-pain-and-its-association-with-lumbar-vertebrae-and-intervertebral-disc-changes-in-adults-a-case-control-study
#17
Aranjan L Karunanayake, Arunasalam Pathmeswaran, Lalith S Wijayaratne
AIM: This study was done to determine the association between chronic low back pain and vertebral fractures, intervertebral disc space (IDS) narrowing, vertebral osteophytes and spondylolisthesis among adults. METHOD: This case control study was done in Sri Lanka. Cases were patients with low back pain and controls were without low back pain. Postero-anterior and lateral radiographs of lumbar sacral spine of both groups were studied. To detect vertebral fractures in fourth and fifth lumbar vertebrae, anterior and posterior heights of vertebrae were measured using a Vernier caliper and antero-posterior ratio (A/P) was calculated...
February 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28202370/to-evaluate-the-role-of-platelet-rich-plasma-in-healing-of-acute-diaphyseal-fractures-of-the-femur
#18
Roop Singh, Rajesh Rohilla, Jeetesh Gawande, Paramjit Kumar Sehgal
PURPOSE: New research is focusing on the use of autologous growth factors to increase the effect of bone fracture healing while decreasing the amount of healing time for the patient. Platelets have been demonstrated to be the natural storage vessel for several growth factors and cytokines that promote blood coagulation, tissue repair, and the process of bone mineralization. The present study aims to evaluate the role of platelet-rich plasma (PRP) in healing of acute femoral shaft fractures radiologically...
February 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28144601/proximal-fifth-metatarsal-fractures-anatomy-classification-treatment-and-complications
#19
REVIEW
Chi Nok Cheung, Tun Hing Lui
CONTEXT: Fractures of proximal fifth metatarsal are one of the most common fractures of the foot. EVIDENCE ACQUISITION: A search of PubMed for studies on proximal fifth metatarsal fracture and Jones fracture focusing on the classification and management was performed. The reference list of the retrieved articles was searched for additional related studies. RESULTS: The vascular supply and soft tissue anatomy of the fifth metatarsal explains the increased risk of delayed union and non-union in fractures at the metaphyseal-diaphyseal junction...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28109556/minimally-invasive-lateral-plate-placement-for-metadiaphyseal-fractures-of-the-humerus-and-its-implications-for-the-distal-deltoid-insertion-it-is-not-only-about-the-radial-nerve-a-cadaveric-study
#20
Emanuel Benninger, Christoph Meier
INTRODUCTION: Minimally invasive lateral placement of plates on the humerus may be associated with a risk of injury to the radial nerve. Whereas this potential complication has been investigated in several studies, there is no data regarding potential injuries to the distal insertion of the deltoid muscle when the plates are passed distally in a submuscular tunnel. METHODS: Minimally invasive plate placement was performed on eight arms in fresh cadavers. A lateral deltoid split approach was made and the plates were introduced in an antegrade submuscular manner from proximal to distal...
January 13, 2017: Injury
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