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Orthopedic injury

Mark Gage, Frank Liporace, Kenneth Egol, Toni McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
Feng Yang, Ming-Sheng Tan, Ping Yi, Xiang-Sheng Tang, Qing-Ying Hao, Ying-Na Qi
OBJECTIVE: To compare the clinical effect between spinal card decompression combined with traditional Chinese medicine and simple spinal card decompression for cervical spondylotic myelopathy. METHODS: From June 2012 to June 2015, 73 patients with cervical spondylotic myelopathy were treated, including 42 males and 31 females, aged from 29 to 73 years old with a mean of 50.9 years old. The patients were divided into the simple operation group (34 cases) and the operation combined with traditional Chinese medicine group(39 cases) according to the idea of themselves...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Nishant Ganesh Kumar, Nicholas Hricz, Brian C Drolet
BACKGROUND: Carpal tunnel release (CTR) is the most common hand surgery operation performed in the United States. While serious complications are rare, they can be life-altering to patients. In some cases, patients will pursue malpractice claims against the surgeon. This study aimed to understand the patient, procedure, and surgeon factors involved in CTR malpractice litigation. METHODS: The Westlaw legal database was queried for all recorded CTR malpractice cases resulting in jury verdicts and settlements...
March 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Avinash Rao, Hesham Soliman, Mayank Kaushal, Oleysa Motovylak, Aditya Vedantam, Matthew D Budde, Brian Schmit, Marjorie Wang, Shekar N Kurpad
BACKGROUND: Fractional anisotropy (FA) of the high cervical cord correlates with upper limb function in acute cervical cord injury. We investigated the correlation between preoperative FA at the level of maximal compression and functional recovery in a group of patients after decompressive surgery for cervical spondylotic myelopathy (CSM). OBJECTIVE: To determine the usefulness of FA as a biomarker for severity of CSM and as a prognostic biomarker for improvement after surgery...
February 23, 2018: Neurosurgery
Andrew E Yang, Jamie M Hall, Gilford S Vincent, Lowell Chambers
Vascular injuries resulting from arthroscopic surgeries are rare with a reported incidence of 0.005% of elective orthopedic procedures. We report a case of a 49-year-old male who developed a deep brachial artery pseudoaneurysm following an arthroscopic shoulder debridement and lysis of adhesions. He was successfully embolized with resolution of the pseudoaneurysm within 6 weeks of treatment. A review of the literature demonstrates that pseudoaneurysm formation after arthroscopic procedures is rare and pseudoaneurysms of the deep brachial artery have yet to be reported...
January 1, 2018: Vascular and Endovascular Surgery
Hope C Davis, Jeffery T Spang, Richard F Loeser, Staffan Larsson, Veronica Ulici, J Troy Blackburn, R Alexander Creighton, Ganesh M Kamath, Joanne M Jordan, Stephen W Marshall, Brian Pietrosimone
BACKGROUND: To determine the association between time from injury to ACL reconstruction (TimeInjury-ACLR ) and biochemical markers of cartilage metabolism and inflammation six months following ACL reconstruction (ACLR). METHODS: Individuals with a unilateral ACL injury were enrolled at initial presentation in the orthopedic clinic; blood was collected six months following ACLR. Enzyme-linked immunosorbent assays were used to analyze the ratio of serum concentrations of type-II collagen breakdown (C2C) to synthesis (CPII), plasma matrix metalloproteinase-3 (MMP-3), interleukin-6 (IL-6), and serum aggrecan neoepitope (ARGS)...
March 7, 2018: Knee
Lorena Bejarano-Pineda, Annunziato Amendola
Participation in sports activity has increased significantly during the last several decades. This phenomenon has exposed orthopedic sports medicine surgeons to new challenges regarding the diagnosis and management of common sport-related injuries. Arthroscopy is becoming more commonly used in many of the surgical procedures for these injuries and carries the risk of complications. Wound and nerve complications make up the bulk of complications in most procedures. This article describes these complications associated with the common surgical procedures related to foot and ankle sport-related injuries and how to address and prevent them...
April 2018: Clinics in Sports Medicine
Christos D Karkos, Georgios Koudounas, Ioakeim T Giagtzidis, Maria-Aphroditi Mitka, Ioannis Pliatsios, Konstantinos O Papazoglou
Popliteal artery injury is a potentially-limb threatening complication of traumatic knee dislocation. We describe two such cases that had been treated in our unit over the last decade. The first one was a 23-year-old woman who injured her right knee during a long jump competition and the second was a 27-year-old man who had a motorbike accident. Both suffered traumatic knee dislocation along with significant ligament and neurovascular injuries. In the first patient, the popliteal artery was found thrombosed due to intimal rupture and required thrombectomy and vein patch repair, whereas, in the second patient, the artery was completely transected and required end-to-end anastomosis...
March 5, 2018: Annals of Vascular Surgery
Jacob D Bolzenius, Benjamin S C Wade, Carmen S Velez, Ann Marie Drennon, Douglas B Cooper, Jan E Kennedy, Matthew W Reid, Amy O Bowles, Paul M Thompson, Boris Gutman, Jeffrey D Lewis, John L Ritter, Gerald E York, Erin D Bigler, David F Tate
OBJECTIVE: To assess interactions of subcortical structure with subjective symptom reporting associated with mild traumatic brain injury (mTBI), using advanced shape analysis derived from volumetric MRI. PARTICIPANTS: Seventy-six cognitively symptomatic individuals with mTBI and 59 service members sustaining only orthopedic injury. DESIGN: Descriptive cross-sectional study. MAIN MEASURES: Self-report symptom measures included the PTSD Checklist-Military, Neurobehavioral Symptom Inventory, and Symptom Checklist-90-Revised...
March 2018: Journal of Head Trauma Rehabilitation
Douglas B Cooper, Glenn Curtiss, Patrick Armistead-Jehle, Heather G Belanger, David F Tate, Matthew Reid, Amy O Bowles, Carmen S Velez, Jan E Kennedy, Rodney D Vanderploeg
OBJECTIVE: To examine differences in objective neurocognitive performance and subjective cognitive symptoms in individuals with a history of a single concussion, multiple concussions, orthopedic injuries, and posttraumatic stress disorder (PTSD). METHOD: Participants included 116 military service members who sustained a mild traumatic brain injury (mTBI) during combat deployment. Subjects were subdivided into groups based on concussion frequency: a single concussion (n = 42), 2 concussions (n = 21), and 3 or more concussions (n = 53)...
March 2018: Journal of Head Trauma Rehabilitation
Yi-Ling Cai, Jin-Tao Ju, Wen-Bao Liu, Jian Zhang
Introduction: Forward surgical teams (FSTs) have been used as highly mobile surgical facilities that provide "damage control" medical support in modern wars. FST regiments differ greatly in different armed services and nations. We systemically reviewed the utilization of FSTs around the world with an emphasis on the medical conditions and workloads encountered by FSTs in modern wars. Materials and Methods: We searched for terms related to FSTs, such as "Forward Surgical Team" and "Field Surgical Team," in the PubMed, EMBASE, Web of Science, and MEDLINE databases and collected any articles that provided numerical data on the organization of medical personnel combat casualty characteristics, including the casualty composition, injury types and locations, and mechanisms of injury, and surgical procedures performed...
March 1, 2018: Military Medicine
Katarzyna Szpilewska, Jan Juzwiszyn, Zofia Bolanowska, Zofia Bolanowska, Magdalena Milan, Mariusz Chabowski, Dariusz Janczak
INTRODUCTION: The main reason of the emergence of enteric stoma is colorectal cancer. Enteric stoma is a serious health, as well as life problem. In Poland, there are about 6,000 stoma surgeries yearly. It changes the functioning of patients, restricts their daily activity and influences their quality of life significantly. Therefore, in the modern treatment process, all spheres of human life and its surroundings are considered. The evaluation of the quality of life and the level of acceptance of the disease enables us to identify the regions in which patients require attention and help, as well as places to which health promotion among patients with a stoma should be directed...
February 28, 2018: Polski Przeglad Chirurgiczny
Ali Abidali, Alicia Mangram, Gina R Shirah, Whitney Wilson, Ahmed Abidali, Phillip Moeser, James K Dzandu
BACKGROUND Dobhoff tube insertion is a common procedure used in the clinical setting to deliver enteral nutrition. Although it is often viewed as an innocuous bedside procedure, there are risks for numerous complications such as tracheobronchial insertion, which could lead to deleterious consequences. We present to our knowledge the first reported case of bilateral pneumothoraces caused by the insertion of a Dobhoff tube. In addition, we also discuss common pitfalls for confirming the positioning of Dobhoff tubes, as well as risk factors that can predispose a patient to improper tube placement...
March 5, 2018: American Journal of Case Reports
Sungho Lim, Michael J Javorski, Pegge M Halandras, Paul C Kuo, Bernadette Aulivola, Paul Crisostomo
OBJECTIVE: Acute limb ischemia (ALI) in a pediatric patient is a rare condition but may result in lifelong disability. A paucity of evidence exists to derive treatment guidelines; some surgeons advocate conservative management over invasive measures. The purpose of this study was to evaluate the role of surgical revascularization in the pediatric population and outcomes of conservative vs surgical management. METHODS: The Healthcare Cost and Utilization Project State Inpatient Database (California, Iowa, and New York) between 2007 and 2013 was queried using International Classification of Diseases, Ninth Revision codes...
March 1, 2018: Journal of Vascular Surgery
Elizabeth W Hubbard, Anthony I Riccio
The management of pediatric fractures has evolved over the past several decades, and many injuries that were previously being managed nonoperatively are now being treated surgically. The American Academy of Orthopaedic Surgeons has developed clinical guidelines to help guide decision making and streamline patient care for certain injuries, but many topics remain controversial. This article analyzes the evidence regarding management of 5 of the most common and controversial injuries in pediatric orthopedics today...
April 2018: Orthopedic Clinics of North America
Jarosław Pasek, Grzegorz Cieślar, Mikołaj Pietrzak, Leszek Jagodziński, Aleksander Sieroń
For many years the increasing number of patients who indulge different accidents and injuries during executing buildings works was observed. The medical help offered to those patients - the most often surgical or orthopedic - in form of surgical debridement of wound should enable its complete healing. However in many cases the healing process of wounds does not run in correct way and chronic wounds come into being, which need complex treatment. Contemporary physical medicine systematically broadens the healing possibilities by introducing to clinical practice new procedures and the therapeutic devices which in many cases accelerate the healing processes of chronic wounds...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Ally Ha, Carly Richards, Erik Criman, Jillian Piaggione, Christopher Yheulon, Robert Lim
BACKGROUND: Surgical energy injuries are an underappreciated phenomenon. Improper use of surgical energy or poor attention to patient safety can result in operating room fires, tissue injuries, and interferences with other electronic devices, while rare complications can be devastatingly severe. Despite this, there is no current standard requirement for educating surgeons on the safe use of energy-based devices or evaluation of electrosurgery (ES) education in residency training, credentialing, or practice...
March 1, 2018: Surgical Endoscopy
George L Vestermark, Bryce A Van Doren, Patrick M Connor, James E Fleischli, Dana P Piasecki, Nady Hamid
BACKGROUND: The prevalence and severity of concomitant rotator cuff pathology in the setting of proximal biceps tendon ruptures are poorly understood. Concomitant rotator cuff disease may have important implications in the prognosis and natural history of this shoulder condition. Therefore, an observational cohort of patients with an acute rupture of the long head of the biceps tendon (LHBT) was evaluated to determine the prevalence and severity of concomitant rotator cuff disease. METHODS: Thirty consecutive patients diagnosed with acute proximal biceps tendon rupture were prospectively enrolled...
February 22, 2018: Journal of Shoulder and Elbow Surgery
Erik Schiffner, David Latz, Jan P Grassmann, Alberto Schek, Simon Thelen, Joachim Windolf, Johannes Schneppendahl, Pascal Jungbluth
BACKGROUND: Anterior cruciate ligament ruptures (ACLRs) are severe sports-related injuries with significant consequences for affected players and teams. This study aims to identify the epidemiology and injury-related lay-off after ACLR in professional male soccer players from the first-division German Bundesliga. METHODS: Exposure times and incidence of anterior cruciate ligament ruptures were collected during 7.5 consecutive seasons using two media-based registers...
February 22, 2018: Knee
Nathan Lo, Jorge Antonio Gutierrez, Rajesh V Swaminathan
PURPOSE OF REVIEW: The goal of this review is to describe the benefits and limitations of robotic-assisted percutaneous coronary intervention (PCI), the most important and recent clinical data, and the future applications as robotic technology continues to develop. RECENT FINDINGS: Robotic-assisted PCI can reduce occupational hazards of ionizing radiation exposure and orthopedic injury to the interventional cardiologist while offering increased precision and fine control that may confer benefit to the patient...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
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