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Orthopedic injury

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https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#1
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27900711/lacertus-fibrosus-augmentation-for-distal-biceps-brachii-rupture-repair-surgical-technique
#2
M Fontana, A Trimarchi, A Colozza
BACKGROUND: Repair of distal biceps tendon ruptures has become widely accepted. Unfortunately, care of retracted-degenerated injuries remains a challenge for orthopedic surgeons. Complication rates appear to increase when surgery is performed in chronic cases compared to those operated acutely. Multiple techniques for chronic reconstruction with the use of grafts have been described. Recently Morrey, from the Mayo Clinic, proposed a direct anatomic repair of retracted distal biceps tendon ruptures in extreme flexion (60°-90°) to avoid grafting...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899200/-mucoadhesive-buccal-films-of-tramadol-for-effective-pain-management
#3
Xiao-Qin Li, Zhao-Ming Ye, Jian-Bing Wang, Cai-Rong Fan, Ai-Wu Pan, Cong Li, Ren-Bing Zhang
BACKGROUND AND OBJECTIVES: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. METHODS: Buccal films of tramadol hydrochloride were prepared by solvent casting method...
November 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27895107/long-noncoding-rna-h19-accelerates-tenogenic-differentiation-and-promotes-tendon-healing-through-targeting-mir-29b-3p-and-activating-tgf-%C3%AE-1-signaling
#4
Ying-Fei Lu, Yang Liu, Wei-Ming Fu, Jia Xu, Bin Wang, Yu-Xin Sun, Tian-Yi Wu, Liang-Liang Xu, Kai-Ming Chan, Jin-Fang Zhang, Gang Li
Tendon injures are common orthopedic conditions, but tendon development and the pathogenesis of tendon injures, such as tendinopathy, remain largely unknown and have limited the development of clinical therapy. Studies on tenogenic differentiation at the molecular level may help in developing novel therapeutic strategies. As novel regulators, long noncoding RNAs (lncRNAs) have been found to have widespread biological functions, and emerging evidence demonstrates that lncRNAs may play important regulatory roles in cell differentiation and tissue regeneration...
November 28, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27894329/efficacy-of-early-controlled-motion-of-the-ankle-compared-with-no-motion-after-non-operative-treatment-of-an-acute-achilles-tendon-rupture-study-protocol-for-a-randomized-controlled-trial
#5
Kristoffer Weisskirchner Barfod, Maria Swennergren Hansen, Per Holmich, Anders Troelsen, Morten Tange Kristensen
BACKGROUND: Early controlled ankle motion is widely used in the non-operative treatment of acute Achilles tendon rupture, though its safety and efficacy have never been investigated in a randomized setup. The objectives of this study are to investigate if early controlled motion of the ankle affects functional and patient-reported outcomes. METHODS/DESIGN: The study is performed as a blinded, randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups...
November 29, 2016: Trials
https://www.readbyqxmd.com/read/27892447/a-study-on-variations-of-nutrient-foramen-of-humerus-with-its-clinical-implications
#6
D I Mansur, P Manandhar, M K Haque, D K Mehta, S Duwal, B Timalsina
Background Nutrient foramen is an opening into shaft of humerus which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Method The present study consisted of 253 (108 right and 145 left) dried humeri excluding any fracture or pathological abnormalities during the period of 15th December 2014 - 14th February 2015...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27890214/-pathology-of-the-triangular-fibrocartilaginous-complex-in-distal-radius-fractures
#7
D Fontès
Distal radius fracture is actually quite rarely isolated and triangular fibrocartilaginous complex (TFCC) is often involved with the same mechanism of injury. A contemporary management of the treatment of the initial fracture is ideal and so benefits from a routine arthroscopic management. Nevertheless, in the absence of diagnosis and therefore early treatment, the symptoms may be located at the ulnar crossroads and justify specific treatment of TFCC. It is generally conducted after an accurate arthroscopic lesion classification guiding a procedure, depending on the lesion vascularization as well as its possible destabilization potential (debridement, capsular suture or foveal reattachment)...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27886835/shoulder-injuries-in-the-overhead-throwing-athlete
#8
REVIEW
Ryan A Mlynarek, Simon Lee, Asheesh Bedi
The overhead pitching motion is a coordinated sequence of movements that subjects the shoulder to extreme forces. The ultimate goal of this complex, dynamic activity is to generate high ball velocity and accuracy. In doing so, repetitive throwing can cause adaptive and pathologic changes in the thrower's shoulder. This article reviews the relevant shoulder anatomy, the kinetic chain, and throwing mechanics, as well as common shoulder injuries and surgical options for the treating orthopedic surgeon.
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27886680/timing-of-operative-debridement-in-open-fractures
#9
REVIEW
Joshua C Rozell, Keith P Connolly, Samir Mehta
The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27876583/treatment-ofpediatric-forearm-midshaft-fractures-is-there-a-difference-between-types-of-orthopedic-surgeon
#10
Di Lu, Zhou Lin, Jing-Dong Zhang, Hua Chen, Liao-Jun Sun
PURPOSE OF THE STUDY: The objective of this study was tocompare the clinical and radiological outcomes of pediatric forearmmidshaft fractures treated operatively with titanium elastic nails (TENs) bypediatric orthopedists and non-pediatric orthopedists. MATERIAL AND METHODS: We conducted a prospective cohort study of 88 childrenofforearmmidshaft fractures, who were randomized to operative stabilization eitherby pediatric orthopedists (Group A, 44 cases) or by non-pediatric orthopedists (Group B, 44 cases) from April 2013 to February 2014...
November 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27876383/helmet-use-and-injury-severity-among-pediatric-skiers-and-snowboarders-in-colorado
#11
Melissa Milan, Sandeep Jhajj, Camille Stewart, Laura Pyle, Steven Moulton
INTRODUCTION: Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay...
November 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27871591/continuous-intra-articular-local-anesthetic-drug-instillation-versus-discontinuous-sciatic-nerve-block-after-total-knee-arthroplasty
#12
Johannes Cip, Hedwig Erb-Linzmeier, Peter Stadlbauer, Christian Bach, Arno Martin, Reinhard Germann
STUDY OBJECTIVE: Sciatic nerve block (SNB) is commonly used as adjunct to femoralis nerve block (FNB) to achieve high-quality pain relief after total knee arthroplasty (TKA). However, this combination is associated with considerable muscle weakness, foot drop and surgically related nerve injuries may be masked. The purpose of this study was to assess whether low risk continuous intra-articular anesthetic drug instillation is an adequate alternative to SNB when adding to FNB after TKA...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871515/perioperative-antiplatelet-therapy-and-cardiovascular-outcomes-in-patients-undergoing-joint-and-spine-surgery
#13
Nathaniel R Smilowitz, Brandon S Oberweis, Swetha Nukala, Andrew Rosenberg, Steven Stuchin, Richard Iorio, Thomas Errico, Martha J Radford, Jeffrey S Berger
STUDY OBJECTIVE: Perioperative thrombotic complications after orthopedic surgery are associated with significant morbidity and mortality. The use of aspirin to reduce perioperative cardiovascular complications in certain high-risk cohorts remains controversial. Few studies have addressed aspirin use, bleeding, and cardiovascular outcomes among high-risk patients undergoing joint and spine surgery. DESIGN/SETTING/PATIENTS: We performed a retrospective comparison of adults undergoing knee, hip, or spine surgery at a tertiary care center during 2 periods between November 2008 and December 2009 (reference period) and between April 2013 and December 2013 (contemporary period)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870687/when-is-it-ok-to-use-a-splint-versus-cast-and-what-remodeling-can-one-expect-for-common-pediatric-forearm-fractures
#14
Robert S Runyon, Shevaun M Doyle
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of common pediatric forearm fractures, clarify the descriptions used to identify and thereby appropriately treat them with a splint or cast, and explain osseous remodeling that is unique to the skeletally immature. RECENT FINDINGS: Recent literature addresses the gap in standard treatment protocols. There is variability in the management of pediatric forearm fractures because of the multiple subspecialty physicians that care for children's fractures and a lack of well established guidelines...
November 18, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#15
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27868167/the-role-of-ugandan-district-hospital-orthopedic-units-in-the-care-of-vulnerable-road-users-a-cross-sectional-study
#16
Dan K Kisitu, Lauren E Eyler, Isaac Kajja, Gonzaga Waiswa, Titus Beyeza, David R Ragland, Isabelle Feldhaus, Catherine Juillard, Rochelle A Dicker
BACKGROUND: Musculoskeletal injuries are a common cause of morbidity after road traffic injury (RTI) in motorizing countries. District hospitals provide front-line orthopedic care in Uganda and other sub-Saharan African nations. Improving care at the district hospital level is an important component of the World Health Organization's strategy for surgical and trauma systems strengthening, but the data necessary to inform RTI safety and care initiatives has previously been insufficient at the district hospital level...
December 2016: Injury Epidemiology
https://www.readbyqxmd.com/read/27853666/outcome-instruments-in-spinal-trauma-surgery-a-bibliometric-analysis
#17
REVIEW
Holt S Cutler, Javier Z Guzman, James Connolly, Motasem Al Maaieh, Branko Skovrlj, Samuel K Cho
Study Design Literature review. Objective To identify outcomes instruments used in spinal trauma surgery over the past decade, their frequency of use, and usage trends. Methods Five top orthopedic journals were reviewed from 2004 to 2013 for clinical studies of surgical intervention in spinal trauma that reported patient-reported outcome instruments use or neurologic function scale use. Publication year, level of evidence (LOE), and outcome instruments were collected for each article and analyzed. Results A total of 58 studies were identified...
December 2016: Global Spine Journal
https://www.readbyqxmd.com/read/27851666/factors-associated-with-nonaccidental-trauma-evaluation-among-patients-below-36-months-old-presenting-with-femur-fractures-at-a-level-1-pediatric-trauma-center
#18
Allison M Blatz, Catherine W Gillespie, Arielle Katcher, Allison Matthews, Matthew E Oetgen
BACKGROUND: In 2009, the American Academy of Orthopedic Surgeons published clinical practice guidelines (CPGs) on the treatment of pediatric diaphyseal femur fractures, which recommended a nonaccidental trauma (NAT) evaluation for all patients below 36 months of age. A recent study of these guidelines found <50% clinical compliance with this treatment recommendation. We aimed to identify areas for improvement in compliance with this guideline. METHODS: A retrospective review was performed of all patients presenting to a single pediatric tertiary care hospital with a diaphyseal femur fracture from January 2007 to June 2013 who were below 36 months old...
November 15, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27849458/improving-outcomes-following-extremity-trauma-the-need-for-a-multidisciplinary-approach
#19
Daniel J Stinner
Extremity injuries contribute a significant amount to the overall disability of combat-injured soldiers. Tracking patient outcomes allows military health care providers to gain a better understanding of the disability associated with various injury patterns. Only recently have orthopedic surgeons begun to collect functional outcome measures, and perhaps even more importantly, have begun to collect patient-reported outcomes. There is a growing body of evidence demonstrating the importance of a multidisciplinary approach to optimize outcomes in patients following severe extremity trauma...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27849457/the-center-for-rehabilitation-sciences-research-advancing-the-rehabilitative-care-for-service-members-with-complex-trauma
#20
Brad M Isaacson, Brad D Hendershot, Seth D Messinger, Jason M Wilken, Christopher A Rábago, Elizabeth Russell Esposito, Erik Wolf, Alison L Pruziner, Christopher L Dearth, Marilynn Wyatt, Steven P Cohen, Jack W Tsao, Paul F Pasquina
The Center for Rehabilitation Sciences Research (CRSR) was established to advance the rehabilitative care for service members with combat-related injuries, particularly those with orthopedic, cognitive, and neurological complications. The center supports comprehensive research projects to optimize treatment strategies and promote the successful return to duty and community reintegration of injured service members. The center also provides a unique platform for fostering innovative research and incorporating clinical/technical advances in the rehabilitative care for service members...
November 2016: Military Medicine
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