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https://www.readbyqxmd.com/read/28087435/postmyelotomy-closure-of-spinal-cord-zip-lock-technique-an-initial-experience
#1
Daljit Singh, Shaam Bodeliwala, Hukum Singh, Anita Jagetia, Amit Mittal
Proper closure of the pia matter is necessary to restore the normal anatomy and prevent postoperative painful dysesthesia after excision of intramedullary spinal cord tumor. Two methods of closure of the pia have been described: welding technique and conventional suturing. Here, we report our initial experience with a new "pial press" or "zip-lock" technique for pial closure where pial layers are simply held together and plunged into each other with small micro tooth forceps. Advantages of the technique over other techniques are its less chances of suture related complications or trauma to the posterior column and simplicity of the technique...
January 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28087211/the-effect-of-bone-growth-onto-massive-prostheses-collars-in-protecting-the-implant-from-fracture
#2
Paul Fromme, Gordon W Blunn, William J Aston, Tasneem Abdoola, Jacob Koris, Melanie J Coathup
Limb-sparing distal femoral endoprotheses used in cancer patients have a high risk of aseptic loosening. It had been reported that young adolescent patients have a higher rate of loosening and fatigue fracture of intramedullary stems because the implant becomes undersized as patients grow. Extracortical bone growth into the grooved hydroxyapatite-coated collar had been shown to reduce failure rates. The stresses in the implant and femur have been calculated from Finite Element models for different stages of bone growth onto the collar...
January 10, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28079807/a-case-report-distal-humeral-diaphyseal-fracture-in-a-child
#3
Yuji Tomori, Takuya Sawaizumi, Mitsuhiko Nanno, Shinro Takai
RATIONALE: Distal humeral diaphyseal fractures are much less common than supracondylar humeral fractures. The triangular shape and thinner periosteum in the diaphyseal region than in the supracondylar region of the distal diaphysis makes the treatment of diaphyseal fractures difficult. Nonoperative treatment for this fracture is challenging and troublesome; thus, open reduction and internal fixation (OR/IF) is generally recommended. PATIENT CONCERNS: We herein report a distal humeral diaphyseal fracture in a child...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28077901/feasibility-and-value-of-radiographic-union-score-hip-fracture-after-treatment-with-intramedullary-nail-of-stable-hip-fractures
#4
Daniele Maiettini, Michele Bisaccia, Auro Caraffa, Giuseppe Rinonapoli, Luigi Piscitelli, Olga Bisaccia, Giuseppe Rollo, Luigi Meccariello, Paolo Ceccarini, Alberto Rebonato
INTRODUCTION: Given the importance of fracture healing on patient outcome in clinical practice, it is critical to assess fracture healing. AIM: The aim of this study was to evaluate the feasibility of the Radiographic Union Score Hip fracture after treatment with intramedullary nail of stable hip fractures. PATIENTS AND METHODS: We retrospectively collected the data from the clinical records of our institution of the 47 patientswho had undergone intertrochanteric hip fracture treatment using an intramedullary nail...
December 2016: Acta Informatica Medica: AIM
https://www.readbyqxmd.com/read/28072705/posterior-only-vertebral-column-resection-for-revision-surgery-in-post-laminectomy-rotokyphoscoliosis-associated-with-late-onset-paraplegia-a-case-report-and-literature-review
#5
Youping Tao, Jigong Wu, Huasong Ma
RATIONALE: Severe post-laminectomy spinal deformity associated with late-onset paraplegia is a complex and rare disorder. Little is known about revision surgery in post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia treated by the single stage posterior-only vertebral column resection (VCR) procedure. PATIENT CONCERNS AND DIAGNOSES: The patient was a 14-year-old male diagnosed as post-laminectomy rotokyphoscoliosis associated with late-onset paraplegia...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072652/in-vivo-correlation-of-radiographic-scoring-rust-and-biomechanical-data-in-a-sheep-osteotomy-model-can-we-define-union-radiographically
#6
Paul Tornetta, Jody Litrenta, William Ricci, Roy Sanders, Robert V O'Toole, Jason W Nascone, Henry Faber, Darren Wilson
OBJECTIVE: To determine 1) the reliability of the standard and modified RUST score in a sheep osteotomy model, and 2) the standard and modified RUST score that represents biomechanical union. DESIGN: The tibia cortices in a sheep osteotomy model treated by intramedullary nails were radiographically evaluated using standard and modified RUST scores. Scores that correlated with biomechanical union, based on the torsional stiffness of the contralateral tibia, were determined...
December 22, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28066531/radiographic-assessment-of-extremity-osseointegration-for-the-amputee
#7
Munjed Al Muderis, Belinda A Bosley, Anthony V Florschutz, Paul A Lunseth, Tyler D Klenow, M Jason Highsmith, Jason T Kahle
Osseointegration (OI) is a bone-anchoring procedure that allows the direct skeletal attachment of a prosthesis through the use of an implant. Transcutaneous OI implants are similar to subcutaneous intramedullary joint implants with some exceptions. Particularly, OI implants are inserted at the distal aspect of the femur, while intramedullary implants are inserted at the proximal aspect of the femur. In this report, an additional adaptation of the radiographic zonal analysis used for intramedullary implants, known as Gruen zones, is introduced to include OI implants of extremity prosthetics...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28064351/orthopedic-trauma-surgery-and-hospital-cost-analysis-in-refugees-the-effect-of-the-syrian-civil-war
#8
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Alkan Bayrak, Mustafa Cevdet Avkan
PURPOSE: The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees. METHODS: Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost...
January 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28057632/are-two-retrograde-3-5-mm-screws-superior-to-one-7-3-mm-screw-for-anterior-pelvic-ring-fixation-in-bones-with-low-bone-mineral-density
#9
Y P Acklin, I Zderic, S Grechenig, R G Richards, P Schmitz, B Gueorguiev
OBJECTIVES: Osteosynthesis of anterior pubic ramus fractures using one large-diameter screw can be challenging in terms of both surgical procedure and fixation stability. Small-fragment screws have the advantage of following the pelvic cortex and being more flexible.The aim of the present study was to biomechanically compare retrograde intramedullary fixation of the superior pubic ramus using either one large- or two small-diameter screws. MATERIALS AND METHODS: A total of 12 human cadaveric hemipelvises were analysed in a matched pair study design...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28056254/-interpretation-of-american-academy-of-orthopaedic-surgeons-clinical-practice-guideline-on-the-treatment-of-pediatric-diaphyseal-femur-fractures
#10
W Chen, J Li, Y Z Zhang
The original guideline on the Treatment of Pediatric Diaphyseal Femur Fractures (PDFF) was developed by the American Academy of Orthopaedic Surgeons (AAOS) in 2009, and the guideline was updated by AAOS in 2015. In this reissue, all recommendations in the original guideline identified as"inconclusive" were removed with seven recommendations reserved and without new recommendations added. The recommendations in the current guideline were listed as follows: (1) Children younger than 36 months with PDFF should be evaluated for child abuse...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28053850/disseminated-coccidioidomycosis-presenting-with-intramedullary-spinal-cord-abscesses-management-challenges
#11
Kristina L Bajema, Mark F Dalesandro, David N Fredricks, Meena Ramchandani
Coccidioides species are endemic to the southwestern United States and typically cause a mild or asymptomatic primary infection. In some instances, infection can disseminate and involve the central nervous system with meningitis being the most common manifestation. Non-osseous spinal cord involvement is exceedingly rare. We report a case of disseminated coccidioidomycosis in an otherwise healthy 20 year old man with diffuse leptomeningeal enhancement, cerebrospinal fluid findings suggestive of meningitis, and intramedullary spinal cord abscesses...
March 2017: Medical Mycology Case Reports
https://www.readbyqxmd.com/read/28053381/a-simple-method-for-fashioning-an-antibiotic-impregnated-cemented-rod-for-intramedullary-placement-in-infected-non-union-of-long-bones
#12
Ajay Bharti, Umesh Kumar Saroj, Vineet Kumar, Sanjay Kumar, Balram Ji Omar
The intramedullary insertion of antibiotic impregnated PMMA rods, beads or nails are widely used and accepted modality of treatment for chronic osteomyelitis of long bones. But at times it becomes difficult to insert and remove these antibiotic delivery systems owing to narrowed medullary canals. Here we present a technique for preparing PMMA rods with diameter ranging from 6 mm to 3 mm. These rods could easily be placed in narrow intramedullary canal of long bones with chronic osteomyelitis or infected non-union...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053379/closed-vs-open-nailing-for-displaced-middle-third-fracture-of-clavicle-does-it-matter
#13
Hrushikesh Saraf, Sarang Kasture
BACKGROUND: Intramedullary nailing for fractures of middle third clavicle has become increasingly popular. Though open nailing has been widely described, closed nailing finds less mention. OBJECTIVES: In this study we compared closed nailing with open nailing in fractures of middle third of clavicle to assess if the former holds any advantage. MATERIAL AND METHODS: 34 patients with closed nailing were compared to 31 patients with open nailing in terms of operative time, length of incision, pain, time to union and functional outcome...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053268/implant-options-for-the-treatment-of-intertrochanteric-fractures-of-the-hip-rationale-evidence-and-recommendations
#14
A R Socci, N E Casemyr, M P Leslie, M R Baumgaertner
AIMS: The aim of this paper is to review the evidence relating to the anatomy of the proximal femur, the geometry of the fracture and the characteristics of implants and methods of fixation of intertrochanteric fractures of the hip. MATERIALS AND METHODS: Relevant papers were identified from appropriate clinical databases and a narrative review was undertaken. RESULTS: Stable, unstable, and subtrochanteric intertrochanteric fractures vary widely in their anatomical and biomechanical characteristics, as do the implants used for their fixation...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28050817/phosphatidylcholine-coatings-deliver-local-antimicrobials-and-reduce-infection-in-a-murine-model-a-preliminary-study
#15
Michael A Harris, Karen E Beenken, Mark S Smeltzer, Warren O Haggard, J Amber Jennings
BACKGROUND: Phosphatidylcholine coatings have been shown to elute antibiotics for several days. A recently developed biofilm inhibitor, cis-2-decenoic acid (C2DA), has been shown to exhibit synergistic activity with several common antibiotics. This study aims to evaluate the effectiveness of C2DA and amikacin dual drug delivery from a phosphatidylcholine coating. QUESTIONS/PURPOSES: (1) What are the in vitro elution profiles of amikacin and C2DA from phosphatidylcholine-coated coupons in incubated phosphate-buffered saline? (2) Does the presence of C2DA in eluate samples lower the amount of amikacin needed for bacterial inhibition in overnight bacterial turbidity assays? (3) Does addition of amikacin and C2DA result in decreased colony-forming units (CFUs) on wire implants and bone when compared with phosphatidylcholine coatings alone in a mouse model of periprosthetic joint infection? METHODS: Effects of loading concentrations were assessed during 7-day in vitro elution studies for coatings containing all mixtures of 0%, 5%, 15%, and 25% wt of amikacin and C2DA (n = 4) through quantitative high-performance liquid chromatography concentration determination and plotting concentration eluted over time...
January 3, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28050809/the-treatment-of-olecranon-fractures-in-adults
#16
REVIEW
A J Powell, O M Farhan-Alanie, J K Bryceland, T Nunn
Olecranon fractures are common. They are usually managed surgically with open reduction and either tension band wiring or plate fixation. Currently, there are few studies comparing fracture treatments. We aim to review the available literature to guide the orthopaedic surgeon on the management of these fractures. A literature review of peer-reviewed publications in international orthopaedic journals detailing olecranon fracture treatment was conducted. An additional focus was placed on the evidence base for and surgical outcomes of tension band wiring for common two-part fractures...
January 3, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28050546/medial-migration-of-the-intramedullary-gamma-3-nail-a-case-report
#17
Ana Costa Pinheiro, Bruno Alpoim, António Félix, Carlos Alves, Cristina Sousa, António Rodrigues
Intertrochanteric femur fractures are very common in patients over 65 years old, and are often associated with osteoporosis. Proximal femoral nails are preferred because of their biomechanical advantages in the treatment of these fractures, especially if the fracture is unstable. However, many complications associated with intramedullary fracture fixation have been described. The medial migration of the intramedullary gamma nail is a rare complication. The authors report an uncommon but potentially fatal complication, medial and intrapelvic migration of the intramedullary Gamma 3 nails, recorded after one month of osteosynthesis...
November 2016: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28045852/overview-on-criteria-for-mep-monitoring
#18
David B MacDonald
Intraoperative motor evoked potentials include the D-wave as a surrogate for long-term motor outcome and muscle motor evoked potentials as a surrogate for early outcome. Their efficacy depends on excluding confounding factors and on warning criteria; insufficiently sensitive criteria could result in unpredicted deficits, whereas excessively sensitive ones could cause false alarms deterring surgical treatment and jading surgeons to alerts, eventually leading to deficits through failure to intervene. Although D-waves have few indications, they are nonsynaptic, linear, and stable-properties that support amplitude reduction criteria: >50% for intramedullary spinal cord tumor surgery and >30% to 40% for peri-Rolandic brain surgery...
January 2017: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://www.readbyqxmd.com/read/28043849/clavicle-fractures
#19
REVIEW
M Ropars, H Thomazeau, D Huten
Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28043310/electromagnetic-navigation-in-distal-locking-of-long-diaphyseal-interlocking-intramedullary-nailing
#20
Zhentao Zhou, Xiaozhong Zhou, Bingchen Shan, Haibin Zhou, Zhengfeng Lu, Qirong Dong
OBJECTIVE: To describe the applications and effects of electromagnetic navigation (EN) technology in distal locking for the treatment of long diaphyseal fracture (LDF) with interlocking intramedullary nailing (IIN). STUDY DESIGN: An interventional study. PLACE AND DURATION OF STUDY: The Second Affiliated Hospital of Soochow University, China, from March 2013 to July 2014. METHODOLOGY: Patients who underwent IIN-LDF were selected...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
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