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https://www.readbyqxmd.com/read/28430722/the-use-of-liposomal-bupivacaine-administered-with-standard-bupivacaine-in-ankle-fractures-requiring-open-reduction-internal-fixation-a-single-blinded-randomized-controlled-trial
#1
Roy Davidovitch, Abraham Goch, Adam Driesman, Sanjit Konda, Christian Pean, Kenneth Egol
OBJECTIVES: To determine the efficacy of liposomal bupivacaine compared to placebo for post-operative pain control in patients undergoing operative fixation of ankle fractures. DESIGN: Prospective single blinded randomized control trial SETTING:: Academic Medical CenterPatients/Participants: After IRB approval, seventy-six patients who sustained an acute ankle fracture (OTA 44A-C) requiring operative fixation met inclusion criteria. INTERVENTION: Patients were randomly assigned to one of two groups, control (local intra-operative sterile saline injection under general anesthesia) or interventional (local intra-operative liposomal bupivacaine and bupivacaine injection under general anesthesia)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28428917/ulnolunate-ligament-avulsion-fracture-of-the-lunate-a-case-report
#2
Ryosuke Sato, Naohito Hibino, Yoshitaka Hamada, Koichi Sairyo
Traumatic lunate fractures are very rare and those treatments require an understanding of anatomical features. We present a case of an ulnolunate ligament avulsion fracture of the lunate that was successfully repaired by surgical fixation with open reduction and internal fixation. We believe that restoration of ulnolunate ligament function is important to prevent further deterioration of wrist function after this injury.
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428911/early-rehabilitation-of-distal-radius-fractures-stabilized-by-volar-locking-plate-a-prospective-randomized-pilot-study
#3
Stefan Quadlbauer, Christoph Pezzei, Josef Jurkowitsch, Brigitta Kolmayr, Tina Keuchel, Daniel Simon, Thomas Hausner, Martin Leixnering
Background Distal radius fractures are very common and an increased incidence of 50% is estimated by 2030. Therefore, both operative and postsurgical treatment remains pertinent. Main aim in treating intra-articular fractures is to restore the articular surface by internal fixation and early mobilization (EM). Questions/Purposes The purpose of this study was to compare functional results between EM immediately after surgery and 5 weeks of immobilization (IM). Patients and Methods In a randomized prospective study, 30 patients with an isolated distal radius fracture were treated by open reduction and internal fixation using a single volar locking plate excluding bone graft...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428032/does-semi-automatic-bone-fragment-segmentation-improve-the-reproducibility-of-the-letournel-acetabular-fracture-classification
#4
M Boudissa, B Orfeuvre, M Chabanas, J Tonetti
BACKGROUND: The Letournel classification of acetabular fracture shows poor reproducibility in inexperienced observers, despite the introduction of 3D imaging. We therefore developed a method of semi-automatic segmentation based on CT data. The present prospective study aimed to assess: 1) whether semi-automatic bone-fragment segmentation increased the rate of correct classification; 2) if so, in which fracture types; and 3) feasibility using the open-source itksnap 3.0 software package without incurring extra cost for users...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28426464/comparative-effectiveness-in-urology-a-state-of-the-art-review-utilizing-a-systematic-approach
#5
Jathin Bandari, Charles B Wessel, Bruce L Jacobs
PURPOSE OF REVIEW: Comparative effectiveness research plays a vital role in healthcare delivery by guiding evidence-based practices. We performed a state-of-the-art review of comparative effectiveness research in the urology literature for 2016, utilizing a systematic approach. Seven high-impact papers are reviewed in detail. RECENT FINDINGS: Across the breadth of urology, there were several important studies in comparative effectiveness research, of which we will highlight two randomized controlled trials and five observational trials: radiotherapy, prostatectomy, and active monitoring have equivalent mortality outcomes in patients with localized prostate cancer; the ideal modality of patient education is yet to be determined, and written education has minimal effect on patient perception of prostate specific antigen screening; robotic prostatectomy is associated with higher perioperative complication rates on a population basis; racial disparities exist in incontinence rates after treatment for localized prostate cancer, but not in irritative, bowel, or sexual function; androgen deprivation therapy is associated with higher fracture, peripheral artery disease, and cardiac-related complications than bilateral orchiectomy; robotic and open cystectomy offer comparable cancer-specific mortality and perioperative outcomes; and bonuses for low-cost hospitals can inadvertently reward low-quality hospitals...
April 19, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#6
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28423998/preexisting-lesions-associated-with-complete-diaphyseal-fractures-of-the-third-metacarpal-bone-in-12-thoroughbred-racehorses
#7
Sarah N Gray, Mathieu Spriet, Tanya C Garcia, Francisco A Uzal, Susan M Stover
We characterized features of complete diaphyseal fractures of third metacarpal bones in Thoroughbred racehorses. Given that stress fractures are known to occur in the third metacarpal bone, an additional aim was to determine if complete fractures are associated with signs of a preexisting incomplete stress fracture. Bilateral metacarpi from 12 Thoroughbred racehorses euthanized because of complete unilateral metacarpal diaphyseal fracture were examined visually and radiographically. Open, comminuted, transverse or short oblique fractures occurred in the middle of the diaphysis or supracondylar region...
April 1, 2017: Journal of Veterinary Diagnostic Investigation
https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#8
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420623/externalised-locking-compression-plate-as-an-alternative-to-the-unilateral-external-fixator-a-biomechanical-comparative-study-of-axial-and-torsional-stiffness
#9
B F H Ang, J Y Chen, A K S Yew, S K Chua, S M Chou, S L Chia, J S B Koh, T S Howe
OBJECTIVES: External fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF)...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28420360/operative-versus-conservative-treatment-of-apophyseal-avulsion-fractures-of-the-pelvis-in-the-adolescents-a-systematical-review-with-meta-analysis-of-clinical-outcome-and-return-to-sports
#10
H Eberbach, L Hohloch, M J Feucht, L Konstantinidis, N P Südkamp, J Zwingmann
BACKGROUND: Avulsion fractures of the pelvic apophyses typically occur in adolescent athletes due to a sudden strong muscle contraction while growth plates are still open. The main goals of this systematic review with meta-analysis were to summarize the evidence on clinical outcome and determine the rate of return to sports after conservative versus operative treatment of avulsion fractures of the pelvis. METHODS: A systematic search of the Ovid database was performed in December 2016 to identify all published articles reporting outcome and return to preinjury sport-level after conservative or operative treatment of avulsion fractures of the pelvis in adolescent patients...
April 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28419843/a-review-of-in-office-dynamic-image-navigation-for-extraction-of-complex-mandibular-third-molars
#11
Robert W Emery, Oxana Korj, Ravi Agarwal
PURPOSE: We performed a retrospective review of in-office removal of complex mandibular third molars with a dynamic image navigation system (DINS). MATERIALS AND METHODS: A retrospective review was conducted of cases completed from 2010 to 2014 by a single oral and maxillofacial surgeon. The average age of the patients was 47 years (range, 27 to 72 years). Extraction complexity was classified with Juodzbalys and Daugela's classification system. The included study cases had complexity scores of 9 or greater...
March 25, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28419036/emerging-u-s-national-trends-in-the-treatment-of-pediatric-supracondylar-humeral-fractures
#12
Joshua B Holt, Natalie A Glass, Nicholas A Bedard, Stuart L Weinstein, Apurva S Shah
BACKGROUND: Understanding national trends in the treatment of pediatric supracondylar humeral fractures will provide important insight into variations in regional treatment and identify areas for improving value and quality in care delivery in the U.S. METHODS: U.S. national trends in the treatment of supracondylar humeral fractures were evaluated through query of the Humana (2007 to 2014) and ING (2007 to 2011) administrative claims databases. Geographic variation and changes in surgical and transfer rates over time were further explored through the Nationwide Emergency Department Sample (NEDS) database (2006 to 2011)...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28419034/complications-and-functional-outcomes-after-pantalar-dislocation
#13
Kaeleen A Boden, Douglas S Weinberg, Heather A Vallier
BACKGROUND: Pantalar dislocations without associated talar fracture are rare and have high risks of complications, including infection, osteonecrosis, and posttraumatic osteoarthrosis. Limited information on later function exists. This study evaluated complications and outcomes following pantalar dislocation without talar fracture. METHODS: Nineteen patients were identified with open (n = 14) or closed (n = 5) pantalar dislocations without talar fracture. Ten male and 9 female patients with a mean age of 39...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418573/trends-in-surgical-management-and-costs-for-operative-treatment-of-proximal-humerus-fractures-in-the-elderly
#14
Eddie K Hasty, Edward W Jernigan, Adrianne Soo, Dax T Varkey, Ganesh V Kamath
Proximal humerus fractures in the elderly are increasing in frequency as the population ages. The purpose of this study was to investigate surgical and cost trends in the Medicare population. The PearlDiver database was queried using diagnosis codes to identify Medicare recipients with proximal humerus fractures from 2005 to 2012. Surgical trends, demographics, and charge/reimbursement data were analyzed. There were 750,426 proximal humerus fractures in Medicare recipients during the 8-year period. Eighty-five percent of the fractures were treated nonoperatively; however, the percentage of operative vs nonoperative management increased significantly over time for all fractures, isolated fractures, and fracture dislocations...
April 18, 2017: Orthopedics
https://www.readbyqxmd.com/read/28416851/-one-of-the-pitfalls-in-the-surgical-treatment-of-maisonneuve-fractures-a-case-report
#15
H Q Ji, F Zhou, Y Tian, Z S Zhang, Y Guo, Y Lv, Z W Yang, G J Hou
There exist controversies in the surgical treatment of maisonneuve injury with regard to reduction and fixation of syndesmosis and management of proximal fibular fracture. It is very important for the orthopaedic surgeons to learn more techniques and avoid pitfalls from clinical practice. We summarized the clinical data of 1 failed case, a 20-year-old girl with big body weight who underwent a primary surgery for the treatment of maisonneuve fracture with minimally invasive reduction and fixation of ankle syndesmosis and posterior malleolus and open reduction and internal fixation of medial malleolus, then a revision surgery for the treatment of iatrogenic syndesmotic malreduction with open reduction and re-stabilization of ankle syndesmosis supplemented with open reduction and internal fixation of proximal fibular facture...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416832/-minimally-invasive-plate-osteosynthesis-for-treatment-of-proximal-humeral-fractures-through-anterolateral-acromial-approach
#16
Q Zhang, N Sun, Q Huang, S W Zhu
OBJECTIVE: To investigate the feasibility, surgical technique and effect of osteosynthesis for proximal humerus fractures through the minimal incision anterolateral acromion. METHODS: In this study, 32 patients of proximal humeral fractures were selected and treated through the minimal incision antero-lateral acromion between January 2012 and October 2014. Of these patients, there were 19 males and 13 females, with mean age 46 years old (range: 22-78 years). The mechanism of injury was a trauma of simple fall for 21 patients and motor vehicle accident for 11 patients...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416831/-morphology-character-and-reduction-methods-of-sagittally-unstable-intertrochanteric-fractures
#17
S Zhang, J Y Zhang, D M Yang, M Yang, P X Zhang
OBJECTIVE: To investigate the morphology character of sagittally unstable intertrochanteric fractures and reduction methods. METHODS: A retrospective study was used to analyze the clinical data of sagittally unstable intertrochanteric fractures cases, which were treated with proximal femoral nail anti-rotation (PFNA) fixation from March 2009 to June 2016. In the study, 36 cases were followed up completely, in which 17 cases accepted open reduction, and the other 19 cases accepted minimally invasive reduction...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416429/-life-threatening-sleepwalking-elpenor-s-syndrome-in-a-10-year-old-child
#18
M-A Madigand-Tordjman, P-J Egler, F Bertran, M Jokic, F Guénolé
Though benign in the majority of cases, sleepwalking sometimes causes injuries due, among other causes, to falls. Such accidents can be life-threatening - a situation that has been termed Elpenor syndrome (in reference to an accident experienced by a character in Homer's epic The Odyssey) - in particular when entailing defenestration. This syndrome has been described in adults and adolescents; we report here a case in a child. OBSERVATION: This 10-year-old girl was admitted at night to our hospital after a 3-m fall at home...
April 14, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28416088/a-novel-mis-technique-for-posterior-cruciate-ligament-avulsion-fractures
#19
Ashok S Gavaskar, Bhupesh Karthik, Hitesh Gopalan, Parthasarathy Srinivasan, Naveen C Tummala
OBJECTIVE: Open surgical approaches to treat tibial avulsion fractures of the posterior cruciate ligament (PCL) often use large incisions involving extensive muscle dissection and retraction. The objective of this study was to describe a new mini-invasive approach targeting the fractured zone, to minimize surgical dissection and improve recovery and rehabilitation. METHODS: The new approach was used in 15 males and seven females with isolated PCL avulsions. The length of the surgical incision, surgical time, need for conversion to open technique, visual analog scores (VAS) and duration of hospital stay were studied to assess the efficacy, learning curve and advantages of the new technique...
April 13, 2017: Knee
https://www.readbyqxmd.com/read/28412105/how-bone-quality-may-influence-intraoperative-and-early-postoperative-problems-after-angular-stable-open-reduction-internal-fixation-of-proximal-humeral-fractures
#20
Christian Spross, Rebeca Zeledon, Vilijam Zdravkovic, Bernhard Jost
BACKGROUND: With the introduction of the deltoid tuberosity index (DTI), a simple radiographic tool has become available to measure bone mineral density of the proximal humerus. The aim of this study was to assess the influence of local bone mineral density on the early failure rate after angular stable open reduction-internal fixation of proximal humeral fractures (PHFs). METHODS: We retrospectively followed up all patients treated with angular stable implants for PHFs from 2007 to 2014...
April 12, 2017: Journal of Shoulder and Elbow Surgery
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