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Orthopedic injury

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https://www.readbyqxmd.com/read/28918266/nanomedicine-for-safe-healing-of-bone-trauma-opportunities-and-challenges
#1
REVIEW
Shahed Behzadi, Gaurav A Luther, Mitchel B Harris, Omid C Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing...
September 4, 2017: Biomaterials
https://www.readbyqxmd.com/read/28910466/surgical-instrument-sets-for-special-operations-expeditionary-surgical-teams
#2
Diane F Hale, Justin C Sexton, Linda C Benavides, Jerry M Benavides, Jonathan B Lundy
BACKGROUND: The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. METHODS: The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28902861/epigenetic-regulation-of-metalloproteinases-and-their-inhibitors-in-rotator-cuff-tears
#3
Mariana Ferreira Leal, Leonardo Caires Dos Santos, Adrielle Martins de Oliveira, Paulo Santoro Belangero, Eduardo Antônio Figueiredo, Carina Cohen, Felipe de Seixas Alves, Wânia Hiromi Yanaguizawa, Carlos Vicente Andreoli, Alberto de Castro Pochini, Benno Ejnisman, Marília Cardoso Smith, Maria Teresa de Seixas Alves, Moises Cohen
Rotator cuff tear is a common orthopedic condition. Metalloproteinases (MMP) and their inhibitors (TIMP) seem to play a role in the development of joint injuries and in the failure of tissue healing. However, the mechanisms of regulation of gene expression in tendons are still unknown. Epigenetic mechanisms, such as DNA methylation and microRNAs regulation, are involved in the dynamic control of gene expression. Here, the mRNA expression and DNA methylation status of MMPs (MMP1, MMP2, MMP3, MMP9, MMP13, and MMP14) and TIMPs (TIMP1-3) and the expression of miR-29 family members in ruptured supraspinatus tendons were compared with non-injured tendons of individuals without this lesion...
2017: PloS One
https://www.readbyqxmd.com/read/28890059/covered-stent-grafts-for-acquired-arterial-venous-fistulas-a-case-series
#4
Timur P Sarac, Lina Vargas, Vikram Kashyap, Jonathan Cardella, Cassius Ochoa Chaar
INTRODUCTION: Stent grafts have become the preferred method for treating abdominal aortic aneurysms (AAAs), but also have utility in treating other vasculopathies. In 2005, peripheral stent grafts were approved for treating superficial femoral artery (SFA) occlusive disease. This report describes our experience using covered stent grafts to treat acquired arterial venous fistulae (aAVF). METHODS: We reviewed the records of patients treated for aAVF with covered stent grafts...
September 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28884100/relationship-between-the-critical-shoulder-angle-and-the-development-of-rotator-cuff-lesions-a-retrospective-epidemiological-study
#5
Leandro Cardoso Gomide, Thiago Correa do Carmo, Guilherme Henrique Moreira Bergo, Glauber Araújo Oliveira, Igor Severino Macedo
OBJECTIVE: To perform a retrospective epidemiological study of radiographs in order to evaluate the relationship between the anatomy of the scapula and the development of rotator cuff injuries (RCIs). METHODS: This study retrospectively evaluated the relation of the critical shoulder angle (CSA) and RCIs from January 2011 to November 2013; patients were examined in the Orthopedics and Traumatology Department of a university hospital. The CSA was measured by radiographic standardization of two groups: a control group of 34 asymptomatic shoulders and a study group of 44 shoulders with complete RCIs...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28882375/surgical-treatment-of-osteoporotic-fractures-an-update-on-the-principles-of-management
#6
Eyal Yaacobi, Daniela Sanchez, Hemil Maniar, Daniel S Horwitz
The treatment of osteoporotic fractures continues to challenge orthopedic surgeon. The fragility of the underlying bone in conjunction with the need for specific implants led to the development of explicit surgical techniques in order to minimize implant failure related complications, morbidity and mortality. From the patient's perspective, the existence of frailty, dementia and other medical related co-morbidities induce a complex situation necessitating high vigilance during the perioperative and post-operative period...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28881529/-results-for-the-treatment-of-fresh-type-thoracolumbar-vertebral-fracture-according-to-the-intraoperative-ct-scan
#7
Y W Li, H J Wang, Y S Wang, W Cui
Objective: To evaluate the value of intraoperative CT scanning in the treatment of fresh thoracolumbar burst fractures. Methods: From January 2008 to January 2015 , 161 patients with thoracolumbar fractures in Department of Orthopedics, Luohe City Central Hospital, were divided into two groups: 79 cases were treatment group which were treated with intraoperative CT scan and decompression mode was determined according to CT scan results during the period from October 2012 to January 2015. 82 patients as the observation group were treated without intraoperative CT scan and direct laminectomy were performed during the period...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28880464/dual-growth-factor-immobilized-asymmetrically-porous-membrane-for-bone-to-tendon-interface-regeneration-on-rat-patellar-tendon-avulsion-model
#8
Joong-Hyun Kim, Se Heang Oh, Hyun Ki Min, Jin Ho Lee
Insufficient repair of the bone-to-tendon interface (BTI) with structural/compositional gradients has been a significant challenge in orthopedics. In this study, dual growth factor [platelet-derived growth factor-BB (PDGF-BB) and bone morphogenetic protein-2 (BMP-2)]-immobilized polycaprolactone (PCL)/Pluronic F127 asymmetrically porous membrane was fabricated to estimate its feasibility as a potential strategy for effective regeneration of BTI injury. The growth factors immobilized (via heparin-intermediated interactions) on the membrane were continuously released for up to ∼80% of the initial loading amount after 5 weeks without a significant initial burst...
September 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28874986/neuropathic-pain-related-with-spinal-disorders-a-systematic-review
#9
REVIEW
Kwang-Sup Song, Jae Hwan Cho, Jae-Young Hong, Jae Hyup Lee, Hyun Kang, Dae-Woong Ham, Hyun-Jun Ryu
Systematic literature review. To review the evidence from high-quality studies regarding the treatment of neuropathic pain originating specifically from spinal disorders. In general, treatment guidelines for neuropathic pain cover all its various causes, including medical disease, peripheral neuropathy, and cancer. However, the natural history of neuropathic pain originating from spinal disorders may differ from that of the pain originating from other causes or lesions. An expert research librarian used terms related to neuropathic pain and spinal disorders, disc herniation, stenosis, and spinal cord injury to search in MEDLINE, Embase, and Cochrane CENTRAL for primary research from January 2000 to October 2015...
August 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28874926/craniosacral-therapy-and-visceral-manipulation-a-new-treatment-intervention-for-concussion-recovery
#10
Gail Wetzler, Melinda Roland, Sally Fryer-Dietz, Dee Dettmann-Ahern
Background: Military service members and veterans face health issues related to traumatic brain injury (TBI), especially during combat, use of heavy equipment, and exposures to environmental hazards and explosives. There were 400,000 TBIs reported in deployed U.S. troops in 2012. Athletes are also subject to TBI. Studies have indicated that some manual therapies could be helpful for treating patients who have post-concussive syndrome. Objective: This case series report describes the effects of CranioSacral Therapy (CST), Visceral Manipulation (VM), and Neural Manipulation (NM) modalities for treating patients who have post-concussion syndrome...
August 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/28872149/correlation-between-diffusion-tensor-imaging-parameters-and-clinical-assessments-in-patients-with-cervical-spondylotic-myelopathy-with-and-without-high-signal-intensity
#11
Y Liu, C Kong, L Cui, X Yuan, P Zhao, Y Zhang, Y Guan, X Chen
STUDY DESIGN: A cross-sectional observational study. OBJECTIVES: The aim of this study is to compare the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) between patients with cervical spondylotic myelopathy (CSM) with and without high T2-weighted signal intensity, and to correlate each parameter with clinical assessments. SETTING: CSM is a common cause of spinal cord dysfunction. The significance of T2 high signal intensity in the prognosis of CSM remains controversial...
September 5, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28863195/risk-factors-for-14-day-rehospitalization-following-trauma-with-new-traumatic-spinal-cord-injury-diagnosis-a-10-year-nationwide-study-in-taiwan
#12
Carlos Lam, Ping-Ling Chen, Jiunn-Horng Kang, Kuang-Fu Cheng, Ray-Jade Chen, Kuo-Sheng Hung
OBJECTIVES: Fourteen-day rehospitalization with new traumatic spinal cord injury (tSCI) diagnosis is used as an indicator for the diagnostic quality of the first hospitalization. In this nationwide population-based cohort study, we identified risk factors for this indicator. METHODS: We conducted a nested case-control study by using the data of patients who received a first hospitalization for trauma between 2001 and 2011. The data were retrieved from Taiwan's National Health Insurance Research Database...
2017: PloS One
https://www.readbyqxmd.com/read/28856354/severity-weighting-of-postoperative-adverse-events-in-orthopedic-surgery
#13
Daniel D Bohl, Junyoung Ahn, Adam M Lukasiewicz, Andre M Samuel, Matthew L Webb, Bryce A Basques, Nicholas S Golinvaux, Kern Singh, Jonathan N Grauer
Studies of adverse events (AEs) after orthopedic surgery commonly use composite AE outcomes. An example of such an outcome is any AE. These types of outcomes treat AEs with different clinical significance (eg, death, urinary tract infection) similarly. We conducted a study to address this shortcoming in research methodology by creating a single severity-weighted outcome that can be used to characterize the overall severity of a given patient's postoperative course. All orthopedic faculty members at 2 academic institutions were invited to complete a severity-weighting exercise in which AEs were assigned a percentage severity of death...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28854841/psychosocial-and-executive-function-recovery-trajectories-one-year-after-pediatric-traumatic-brain-injury-the-influence-of-age-and-injury-severity
#14
Heather T Keenan, Amy E Clark, RIchard Holubkov, Charles S Cox, Linda Ewing-Cobbs
Time since traumatic brain injury (TBI) and developmental stage at injury may affect the trajectory of outcomes associated with adjustment and school success. We prospectively enrolled a cohort of 519 children with either TBI or orthopedic injury (OI) aged 2.5 - 15 years to examine children's psychosocial and executive function outcomes at 3 and 12-months post-injury. Outcome measures included the Child Behavior Checklist (CBCL), Strengths and Difficulties Questionnaire (SDQ) and Behavior Rating Inventory of Executive Function (BRIEF) ratings...
August 30, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28852784/-orthopedic-surgery-with-limited-resources-after-mass-disasters-and-during-armed-conflicts-first-international-guidelines-for-the-management-of-limb-injuries-and-the-experience-of-doctors-without-borders
#15
REVIEW
Inga Osmers
Disasters and armed conflicts are often the unfortunate basis for aid projects run by Doctors Without Borders/Médecins Sans Frontières (MSF). The nature of war and disasters means that surgery is an integral part of this medical emergency aid. In these situations, resources are usually limited. As a result, surgical work in these contexts differs significantly from the daily routine of a surgeon working in a highly resourced hospital. The principles of surgery do not change but surgeons must adapt their tactical approach to the changed context otherwise there is a high risk of failing to improve the health of patients and potentially jeopardizing their prospects for recovery...
August 29, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28852331/conversion-total-hip-arthroplasty-after-failed-basicervical-hip-fracture-fixation-a-case-report-and-review-of-literature
#16
Vineet Tyagi, Oluwaseun Akinbo
Proximal femur fractures are a common orthopedic injury, and it is estimated that their prevalence will continue to increase over the next twenty years. There has been much debate over the optimal management of basicervical fractures, which can be difficult to identify radiographically. There is also a role for conversion total hip arthroplasty in patients where fracture fixation fails. We present a case report of a proximal femur fracture managed as a basicervical fracture, and subsequently needing a conversion arthroplasty and revision surgery...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28845500/screw-migration-in-a-14-year-old-boy-with-hip-osteotomy-a-rare-cause-of-upper-thigh-hematoma
#17
Emre Ünal
Soft tissue injury due to orthopedic hardware migration is an uncommon complication. However particularly patients who have routine physical therapy sessions for extremity contractures are at risk for vascular injury in the setting of migrated screws. Ultrasound is an efficient modality to evaluate migrated screws and adjacent soft tissue structures. As a consequence of repetitive trauma a migrated screw would eventually result in injury. Herein a case of upper thigh hematoma due to screw migration in a patient with hip osteotomy is reported...
December 29, 2016: Medical Ultrasonography
https://www.readbyqxmd.com/read/28844770/preoperative-chronic-opioid-users-in-total-knee-arthroplasty-which-patients-persistently-abuse-opiates-following-surgery
#18
Kelvin Y Kim, Afshin A Anoushiravani, Kevin K Chen, Mackenzie Roof, William J Long, Ran Schwarzkopf
BACKGROUND: Chronic opioid users pose a unique challenge for orthopedic surgeons, as they often report suboptimal outcomes following total knee arthroplasty (TKA). We aim at identifying risk factors associated with patients who were preoperative chronic opioid users and continued to use 6 months following TKA. METHODS: All preoperative chronic opioid users among 338 consecutive TKA cases performed at our institution between February and June 2016 were identified and divided into 2 cohorts: patients who (1) persistently used opioids and (2) discontinued use by the 6-month time point following surgery...
August 3, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28844199/cryopreservation-versus-fresh-frozen-meniscal-allograft-a-biomechanical-comparative-analysis
#19
Shukur Ahmad, Vivek Ajit Singh, Shamsul Iskandar Hussein
Meniscal allograft transplantation may be a better alternative for the treatment of irreparable meniscal injury compared to other forms of treatment. However, it remains to be seen whether the use fresh frozen allograft is better than cryopreserved allograft in treating this type of injury. We hypothesized that cryopreserved meniscal allograft would work better in maintaining the original biomechanical properties compared to fresh frozen ones, due to the lower amount of damage it incurs during the storage process...
September 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28832207/predictors-of-nerve-injury-after-gunshot-wounds-to-the-upper-extremity
#20
William C Pannell, Nathanael Heckmann, Ram K Alluri, Lakshmanan Sivasundaram, Milan Stevanovic, Alidad Ghiassi
BACKGROUND: The purpose of this study is to examine the incidence of nerve injury, clinical variables associated with nerve palsy, and predictive factors of nerve laceration after gunshot wounds to the upper extremity. METHODS: Forty-one patients from a level I trauma center with gunshot wounds to the upper extremity who underwent surgical exploration between 2007 and 2014 were identified retrospectively. Patients with proximal ipsilateral injuries, inadequate documentation, imaging, or with a pre-existing neurologic deficit were excluded...
September 2017: Hand: Official Journal of the American Association for Hand Surgery
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