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https://www.readbyqxmd.com/read/29222205/novel-use-of-a-trabecular-metal-spacer-in-the-treatment-of-a-long-standing-ulnar-fracture-non-union
#1
Oluwatobi O Onafowokan, Julian S H Gaskin, Rory G Middleton, Mark R Norton
The use of trabecular metal (TM) implants in spine and joint surgery is well documented. However, their use has yet to be reported as an alternative to either allograft or autograft in the management of fracture non-unions. We present our experience in using a TM implant for treating a patient with a long-standing ulnar fracture non-union. Excision of devitalised bone resulted in a 17 mm defect which the TM implant was used to infill. The defect was then bridged with a locking plate. At 2-year clinical and radiographic review, bony union and a pain-free return to full function was noted...
December 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29206797/instability-of-the-hip-joint-after-posterior-acetabular-wall-fracture-independent-risk-factors-remain-elusive
#2
Jay H Patel, Berton R Moed
BACKGROUND: Exact determinants of hip instability have not been established for fractures of the posterior wall of the acetabulum involving ≤50% of the wall. Therefore, examination of the hip under anesthesia (EUA) is routinely performed. Recently, the superior exit point of the fracture has been reported to be an important identifiable risk factor. Pre-existing adult hip dysplasia (developmental dysplasia of the hip [DDH]) is thought to have a similar role. The purpose of this study was to determine if any known radiographic measurements and signs associated with DDH, or any fracture characteristics, are independent risk factors for hip instability after fracture of the posterior wall of the acetabulum...
December 6, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29184051/clinical-efficacy-of-anterior-partial-corpectomy-and-titanium-mesh-fusion-and-internal-fixation-for-treatment-of-old-fracture-dislocation-of-the-lower-cervical-spine
#3
De-Chao Miao, Bao-Yang Zhang, Tao Lei, Yong Shen
BACKGROUND The aim of this study was to analyze the clinical features and to evaluate the efficacy of anterior partial corpectomy and titanium mesh fusion and internal fixation of old fracture dislocation of the lower cervical spine. MATERIAL AND METHODS We retrospectively analyzed the clinical data of 52 patients with old lower cervical fracture and dislocation treated with anterior partial corpectomy and titanium mesh fusion fixation between January 2008 and December 2013, with a mean follow-up period of 4...
November 29, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29181358/a-case-report-upper-thoracic-chance-fracture-with-monoplegia%C3%A2-an-unusual-presentation
#4
Ketan Shripad Khurjeka, Himanshu Gurunath Kulkarni, Shailesh Hadgaonkar, Ajay Kothari, Ashok Shyam, Parag Sancheti
Introduction: Chance fractures, the horizontal splitting vertebral fractures caused by flexion distraction mechanism, are inherently unstable fractures. These fractures can land up with significant visceral injuries. There are most commonly seen at thoracolumbar junction or in lumbar spine due to their high mobility. These fractures are extremely rare in the thoracic spine due to the rigidity of thoracic spine rendered by attachment of ribs. Furthermore, the level of injury makes neurological complications even graver...
July 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29155868/tocilizumab-potentially-prevents-bone-loss-in-patients-with-anticitrullinated-protein-antibody-positive-rheumatoid-arthritis
#5
Yi-Ming Chen, Hsin-Hua Chen, Wen-Nan Huang, Tsai-Ling Liao, Jun-Peng Chen, Wen-Cheng Chao, Ching-Tsai Lin, Wei-Ting Hung, Chia-Wei Hsieh, Tsu-Yi Hsieh, Yi-Hsing Chen, Der-Yuan Chen
Rheumatoid arthritis (RA) is associated with a high risk of osteoporosis and fracture. Interleukin (IL)-6 inhibitors may suppress osteoclast activation. Anticitrullinated protein antibody (ACPA) titers are inversely associated with bone mineral density (BMD). However, the differential effect of ACPA on bone turnover marker (BTM) and BMD changes after IL-6 inhibition remains unclear. This prospective study recruited patients with active RA with inadequate response to methotrexate or biologics. BMD was measured before and after 2-year tocilizumab (TCZ) treatment...
2017: PloS One
https://www.readbyqxmd.com/read/29145978/outpatient-management-of-ankle-fractures
#6
REVIEW
Charles Qin, Robert G Dekker, Mia M Helfrich, Anish R Kadakia
Interest in outpatient orthopedic surgery has been fueled by provider desire to control costs and development of rapid recovery protocols. Open reduction and internal fixation (ORIF) is a commonly elected treatment strategy for ankle fracture that may be performed in an outpatient setting. Lessons on cost-savings of the outpatient model in orthopedics can be learned in total joint replacement and spine surgery. Moreover, in properly selected patients, outpatient ORIF has been shown to be comparably safe. Reasons for admission of the surgically managed patient with ankle fractures, including concern for surgical delay and additional social factors, warrant further investigation...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29137106/trabecular-bone-score-as-a-supplementary-tool-for-the-discrimination-of-osteoporotic-fractures-in-postmenopausal-women-with-rheumatoid-arthritis
#7
Yong Jun Choi, Yoon-Sok Chung, Chang-Hee Suh, Ju-Yang Jung, Hyoun-Ah Kim
Rheumatoid arthritis (RA) is a risk factor for bone fragility, and its effect on fracture risk is independent of bone mineral density (BMD). The trabecular bone score (TBS) is a new indirect parameter of bone quality. In this study, BMD and the TBS were compared between female postmenopausal RA patients with and those without vertebral fractures (VFs).This study had a cross-sectional design. Two hundred seventy-nine postmenopausal women with RA aged 50 years or older were included in this study. TBS measurements were performed on the same vertebrae as those for the BMD measurements...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29130656/-design-of-minimal-invasive-screw-on-posterior-pelvis-ring-and-pelvic-finite-element-analysis
#8
Fan Tang, Li Min, Yan-Ling Wang, Bo Qu, Yong Zhou, Yi Luo, Wen-Li Zhang, Rui Shi, Hong Duan, Chong-Qi Tu
OBJECTIVE: To design minimal invasive screw on posterior pelvic ring and perform threedimensional finite element analysis based on a pelvis finite element model. METHODS: We measured the pelvic anatomical data of 20 healthy volunteers and identified potential designs for minimal invasive screw on posterior pelvic ring. A finite element model of pelvis was then established. Threedimensional finite element analyses were performed under static and dynamic mechanical loading,respectively...
September 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
https://www.readbyqxmd.com/read/29113245/temporomandibular-dislocation-caused-by-pancreatic-cancer-metastasis-a-case-report
#9
Shinpei Matsuda, Hitoshi Yoshimura, Sadahiko Kondo, Kazuo Sano
Metastasis-induced dislocation of the temporomandibular joint (TMJ) is rare. The present study describes a case of TMJ dislocation caused by metastasis from pancreatic cancer, and discusses this in the context of literature on occlusal abnormality and/or dislocation due to metastasis. In the present case, unilateral TMJ dislocation was suspected when the patient first presented; destructive bone changes were not observed on conventional radiographs, and magnetic resonance imaging (MRI) revealed a tumorous lesion...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29110219/reduction-and-fixation-of-displaced-u-shaped-sacral-fractures-using-lumbopelvic-fixation-technical-recommendations
#10
Stefan Piltz, Bianka Rubenbauer, Wolfgang Böcker, Heiko Trentzsch
PURPOSE: U-shaped sacral fractures are extremely rare injuries that usually occur as a result of falls from considerable heights. Almost all treatment methods described to date aim solely at stabilizing the fracture but do not contribute to supporting the reduction of such fractures. Using existing implants the purpose of this study is to present a surgical technique that facilitates both the reduction and the stabilization of these injuries. The presented technique was evaluated in a series of three cases...
November 6, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29099886/risk-of-osteoporotic-fracture-after-steroid-injections-in-patients-with-medicare
#11
Leah Y Carreon, Kevin L Ong, Edmund Lau, Steven M Kurtz, Steven D Glassman
To further evaluate the relationship between steroid injections and osteoporotic fracture risk, we analyzed Medicare administrative claims data on both large-joint steroid injections (LJSIs) into knee and hip and transforaminal steroid injections (TSIs), as well as osteoporotic hip and wrist fractures. Our hypothesis was that a systemic effect of steroid injections would increase fracture risk in all skeletal locations regardless of injection site, whereas a local effect would produce a disproportionate increased risk of spine fracture with spine injection...
September 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/29090349/bone-disease-in-axial-spondyloarthritis
#12
REVIEW
Margot Van Mechelen, Giulia Rossana Gulino, Kurt de Vlam, Rik Lories
Axial spondyloarthritis is a chronic inflammatory skeletal disorder with an important burden of disease, affecting the spine and sacroiliac joints and typically presenting in young adults. Ankylosing spondylitis, diagnosed by the presence of structural changes to the skeleton, is the prototype of this disease group. Bone disease in axial spondyloarthritis is a complex phenomenon with the coexistence of bone loss and new bone formation, both contributing to the morbidity of the disease, in addition to pain caused by inflammation...
October 31, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/29081394/a-case-of-asymptomatic-occipital-condyle-fracture-with-incomplete-occipito-cervical-dislocation-how-did-it-happen
#13
P Anania, P Fiaschi, P F Sbaffi, G L Zona
Atlanto-occipital dislocation (AODs) is a lesion rarely observed in a trauma center, due to high mortality in the preclinical phase. The number of AODs survivors is increasing thanks to the improvement in prehospital resuscitation. Our goal is to describe a case of incomplete atlanto-occipital dislocation presented without any neurological, cardio-respiratory, or metabolic problems, which remained constant even after surgical treatment. Our purpose is also to discuss treatment approaches to minimize subsequent neurological deficits...
October 25, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29054991/the-influence-of-bone-mineral-density-and-cortical-index-on-the-complexity-of-fractures-of-the-proximal-humerus
#14
J W A M den Teuling, B S Pauwels, L Janssen, C E Wyers, H M J Janzing, J P W van den Bergh, J W Morrenhof
OBJECTIVES: The goal of this study is to investigate the relation between indicators of osteoporosis (i.e., bone mineral density (BMD), and Cortical Index (CI)) and the complexity of a fracture of the proximal humerus as a result of a low-energy trauma. METHODS: A retrospective chart review of 168 patients (mean age 67.2 years, range 51 to 88.7) with a fracture of the proximal humerus between 2007 and 2011, whose BMD was assessed at the Fracture Liaison Service with Dual Energy X-ray Absorptiometry (DXA) measurements of the hip, femoral neck (FN) and/or lumbar spine (LS), and whose CI and complexity of fracture were assessed on plain anteroposterior radiographs of the proximal humerus...
October 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/29033574/surgical-site-infections-following-instrumented-stabilization-of-the-spine
#15
Ulrike Dapunt, Caroline Bürkle, Frank Günther, Wojciech Pepke, Stefan Hemmer, Michael Akbar
BACKGROUND: Implant-associated infections are still a feared complication in the field of orthopedics. Bacteria attach to the implant surface and form so-called biofilm colonies that are often difficult to diagnose and treat. Since the majority of studies focus on prosthetic joint infections (PJIs) of the hip and knee, current treatment options (eg, antibiotic prophylaxis) of implant-associated infections have mostly been adapted according to these results. OBJECTIVE: The aim of this study was to evaluate patients with surgical site infections following instrumented stabilization of the spine with regard to detected bacteria species and the course of the disease...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29029213/recovery-kinetics-of-radiographic-and-implant-related-revision-patients-following-adult-spinal-deformity-surgery
#16
Peter G Passias, Cyrus M Jalai, Virginie Lafage, Gregory W Poorman, Shaleen Vira, Samantha R Horn, Justin K Scheer, D Kojo Hamilton, Breton G Line, Shay Bess, Frank J Schwab, Christopher P Ames, Douglas C Burton, Robert A Hart, Eric O Klineberg
BACKGROUND: Prior studies have observed similar health-related quality of life (HRQL) in revisions and nonrevision (NR) patients following adult spinal deformity (ASD) correction. However, a novel comparison approach may allow better comparisons in spine outcomes groups. OBJECTIVE: To determine if ASD revisions for radiographic and implant-related complications undergo a different recovery than NR patients. METHODS: Inclusion: ASD patients with complete HRQL (Oswestry Disability Index, Short-Form-36 version 2 (SF-36), Scoliosis Research Society [SRS]-22) at baseline, 6 wk, 1 yr, 2 yr...
October 6, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28960819/circumferential-reconstruction-of-subaxial-cervical-and-cervicothoracic-spine-by-simultaneously-combined-anterior-posterior-approaches-in-the-sitting-position
#17
Yue Han, Xin-Long Ma, Yong-Cheng Hu, Jun Miao, Ji-Dong Zhang, Jian-Qiang Bai, Qun Xia
OBJECTIVE: To introduce and analyze the feasibility of a new surgical strategy for circumferential reconstruction of subaxial cervical and cervicothoracic spine by simultaneously combined anterior-posterior approach in the sitting position. METHODS: A retrospective review was performed for seven patients who underwent the above surgical procedure between July 2011 and January 2015. Among the seven patients, there were six men and one woman, with an average age of 52 years (range, 36-79 years)...
August 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28902760/common-ice-hockey-injuries-and-treatment-a-current-concepts-review
#18
William Mosenthal, Michael Kim, Robert Holzshu, Bryan Hanypsiak, Aravind Athiviraham
Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article...
September 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28870432/the-pseudo-ct-myelogram-sign-an-aid-to-the-diagnosis-of-underlying-brain-stem-and-spinal-cord-trauma-in-the-presence-of-major-craniocervical-region-injury-on-post-mortem-ct
#19
F Bolster, Z Ali, B Daly
AIM: To document the detection of underlying low-attenuation spinal cord or brain stem injuries in the presence of the "pseudo-CT myelogram sign" (PCMS) on post-mortem computed tomography (PMCT). MATERIALS AND METHODS: The PCMS was identified on PMCT in 20 decedents (11 male, nine female; age 3-83 years, mean age 35.3 years) following fatal blunt trauma at a single forensic centre. Osseous and ligamentous craniocervical region injuries and brain stem or spinal cord trauma detectable on PMCT were recorded...
September 1, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28869116/teriparatide-administration-increases-periprosthetic-bone-mineral-density-after-total-knee-arthroplasty-a-prospective-study
#20
Tatsuya Suzuki, Fumio Sukezaki, Takashi Shibuki, Yoichi Toyoshima, Takashi Nagai, Katsunori Inagaki
BACKGROUND: Teriparatide is a currently available therapeutic agent for osteoporosis. Previous studies have reported that teriparatide affects periprosthetic bone mineral density (BMD) after total knee arthroplasty (TKA). However, little agreement has been reached concerning the treatment of periprosthetic BMD after TKA with teriparatide. Moreover, BMD in the femoral and tibial sides of the joints together has never been examined. We investigated the efficacy of teriparatide to inhibit BMD loss in the femoral and tibial side and considered complications such as migration and periprosthetic fractures after TKA...
July 25, 2017: Journal of Arthroplasty
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