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Fracture joint orthopaedics

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https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#1
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28474269/intra-operative-fiducial-based-ct-fluoroscope-image-registration-framework-for-image-guided-robot-assisted-joint-fracture-surgery
#2
Giulio Dagnino, Ioannis Georgilas, Samir Morad, Peter Gibbons, Payam Tarassoli, Roger Atkins, Sanja Dogramadzi
PURPOSE: Joint fractures must be accurately reduced minimising soft tissue damages to avoid negative surgical outcomes. To this regard, we have developed the RAFS surgical system, which allows the percutaneous reduction of intra-articular fractures and provides intra-operative real-time 3D image guidance to the surgeon. Earlier experiments showed the effectiveness of the RAFS system on phantoms, but also key issues which precluded its use in a clinical application. This work proposes a redesign of the RAFS's navigation system overcoming the earlier version's issues, aiming to move the RAFS system into a surgical environment...
May 4, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28473334/the-efficacy-of-rotational-control-designs-in-promoting-torsional-stability-of-hip-fracture-fixation
#3
J D Gosiewski, T P Holsgrove, H S Gill
OBJECTIVES: Fractures of the proximal femur are a common clinical problem, and a number of orthopaedic devices are available for the treatment of such fractures. The objective of this study was to assess the rotational stability, a common failure predictor, of three different rotational control design philosophies: a screw, a helical blade and a deployable crucifix. METHODS: Devices were compared in terms of the mechanical work (W) required to rotate the implant by 6° in a bone substitute material...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28473333/the-clinical-and-cost-effectiveness-of-a-virtual-fracture-clinic-service-an-interrupted-time-series-analysis-and-before-and-after-comparison
#4
A McKirdy, A M Imbuldeniya
OBJECTIVES: To assess the clinical and cost-effectiveness of a virtual fracture clinic (VFC) model, and supplement the literature regarding this service as recommended by The National Institute for Health and Care Excellence (NICE) and the British Orthopaedic Association (BOA). METHODS: This was a retrospective study including all patients (17 116) referred to fracture clinics in a London District General Hospital from May 2013 to April 2016, using hospital-level data...
May 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#5
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28404548/the-tip-apex-distance-in-the-x-bolt-dynamic-plating-system
#6
M A Fernandez, A Aquilina, J Achten, N Parsons, M L Costa, X L Griffin
OBJECTIVES: The Sliding Hip Screw (SHS) is commonly used to treat trochanteric hip fractures. Fixation failure is a devastating complication requiring complex revision surgery. One mode of fixation failure is lag screw cut-out which is greatest in unstable fracture patterns and when the tip-apex distance of the lag screw is > 25 mm. The X-Bolt Dynamic Hip Plating System (X-Bolt Orthopaedics, Dublin, Ireland) is a new device which aims to reduce this risk of cut-out. However, some surgeons have reported difficulty minimising the tip-apex distance with subsequent concerns that this may lead to an increased risk of cut-out...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28395420/-application-of-the-method-of-anatomic-coracoclavicular-ligament-reconstruction-for-distal-clavicle-fractures
#7
J H Fang, G L Tang, H Chen, L J Song, X Li
Objective: To assess the clinical results of the method of anatomic coracoclavicular ligament reconstruction for distal clavicle fractures. Methods: From August 2013 to January 2015, the super image system was used to measure the CT data of 16 patients suffering distal clavicle fractures before operation in Department of Orthopaedics , the First Affiliated Hospital of Nanjing Medical Univerisity. The fractures' morphological features and acromioclavicular dislocation degree were assessed. By referring to the data collected by the my research group on Chinese people's coracoclavicular ligament, the injuries of the coracoclavicular ligament were estimated, which was then to verify the actual injuries detected during operation...
April 4, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#8
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28385940/the-evolution-of-fracture-clinic-design-the-activity-and-safety-of-the-edinburgh-trauma-triage-clinic-with-one-year-follow-up
#9
T O White, S P Mackenzie, T H Carter, J G Jefferies, O R Prescott, A D Duckworth, J F Keating
AIMS: Fracture clinics are often characterised by the referral of large numbers of unselected patients with minor injuries not requiring investigation or intervention, long waiting times and recurrent unnecessary reviews. Our experience had been of an unsustainable system and we implemented a 'Trauma Triage Clinic' (TTC) in order to rationalise and regulate access to our fracture service. The British Orthopaedic Association's guidelines have required a prospective evaluation of this change of practice, and we report our experience and results...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28371500/joint-preserving-surgery-for-talar-malunions-or-nonuions
#10
Gang Chen, Mu Hu, Yang Xu, Yue-Huan Zhen, Yuan Hong, Xiang-Yang Xu
OBJECTIVE: To describe the technique and analyze the outcomes of joint-preserving surgical treatments which included anatomical reconstruction or alignment correction for talar malunions or nonunions, and avoid development of degenerative changes in the adjacent joints. METHODS: Eight patients who had painful talar malunions or nonunions treated between 2009 and 2015 were included in this retrospective study. The mean age of the patients was 35.6 years, with patients aged from 18 to 58 years...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28371497/staged-management-of-missed-lisfranc-injuries-a-report-of-short-term-results
#11
Pin Feng, Ya-Xing Li, Jia Li, Xiang-Yu Ouyang, Wei Deng, Yu Chen, Hui Zhang
OBJECTIVE: Lisfranc joint injury is a rare injury and can be easily missed at the initial treatment. Once ignored, late reduction is very difficult and requires extensive dissection. Surgical outcome is not as good as in the case of an early reduction. The aim of this cohort study was to analyze the midterm clinical and radiographic outcomes of staged reduction and fixation in a consecutive series of patients with old Lisfranc injuries. METHODS: Fifteen patients (16 feet) with missed Lisfranc injuries were treated with staged reduction...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28362519/salvage-of-combat-hindfoot-fractures-in-2003-2014-uk-military
#12
Philippa M Bennett, Thomas Stevenson, Ian D Sargeant, Alistair Mountain, Jowan G Penn-Barwell
BACKGROUND: Hindfoot fractures pose a considerable challenge to military orthopaedic surgeons, as combat injuries are typically the result of energy transfers not seen in civilian practice. This study aimed to characterize the pattern of hindfoot injuries sustained by UK military casualties in recent conflicts, define the early amputation and infection rate, and identify factors associated with poor early outcomes. METHODS: The UK Joint Theatre Trauma Registry was searched for British military casualties sustaining a hindfoot fracture from Iraq and Afghanistan between 2003 and 2014...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28360502/citation-analysis-of-the-100-most-common-articles-regarding-distal-radius-fractures
#13
Richard Jones, Travis Hughes, Kevin Lawson, Gregory DeSilva
PURPOSE: Bibliometric studies are increasingly being utilized as a tool for gauging the impact of different literature within a given field. The purpose of this study was to identify the most cited articles related to the management of distal radius fractures to better understand how the evidence of this topic has been shaped and changed over time. METHODS: We utilized the ISI web of science database to conduct a search for the term "distal radius fracture" under the "orthopaedics" research area heading, and sorted the results by number of times cited...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28316964/the-fixation-method-according-to-the-fracture-type-of-the-greater-trochanter-in-unstable-intertrochanteric-fractures-undergoing-arthroplasty
#14
Doohoon Sun, Byeong-Seop Park, Gun-Il Jang, Bongjoo Lee
PURPOSE: We conducted a study on patients who underwent hip joint arthroplasty because of unstable femur intertrochanteric fractures with greater trochanter bony fragments. After dividing patients into three groups depending on their fracture patterns, we evaluated the clinical and radiological outcomes of different operation methods applied to each of these groups. MATERIALS AND METHODS: Using Evan's classification, we defined an unstable intertrochanteric fracture as those characterized as stage 4 or 5...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28285704/the-impact-of-non-weight-bearing-a-prospective-cohort-study
#15
Rachele Quested, Danielle Wiltshire, Scott Sommerville, Michael Lutz
BACKGROUND: Patients with lower limb injuries are commonly advised to non weight bear (NWB) on their injured limb as part of treatment. Occasionally, patients complain that offloading one limb, associated with the use of crutches or other mobility aids, may lead to pain on one of the other supporting limbs. This has led to compensation claims (1) but has never been the subject of formal research. METHODS: A prospective cohort trial was undertaken to address this question...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28276651/realignment-surgery-for-malunited-ankle-fracture
#16
Chang-Jun Guo, Xing-Cheng Li, Mu Hu, Yang Xu, Xiang-Yang Xu
OBJECTIVE: To investigate the characteristics and the results of realignment surgery for the treatment of malunited ankle fracture. METHODS: Thirty-three patients with malunited fractures of the ankle who underwent reconstructive surgery at our hospital from January 2010 to January 2014 were reviewed. The tibial anterior surface angle (TAS), the tibiotalar tilt angle (TTA), the malleolar angle (MA), and the tibial lateral surface angle (TLS) were measured. Clinical assessment was performed with use of the American Orthopaedic Foot and Ankle Society (AOFAS) scale and visual analogue scale (VAS) scores, and the osteoarthritis stage was determined radiographically with the modified Takakura classification system...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28276650/comparison-of-arthrodesis-and-non-fusion-to-treat-lisfranc-injuries
#17
Yu-Sen Qiao, Jun-Kun Li, Hao Shen, Hai-Yan Bao, Ming Jiang, Yan Liu, Wasim Kapadia, Hong-Tao Zhang, Hui-Lin Yang
OBJECTIVE: "Lisfranc joint injury" is comprised of a tarsometatarsal joint-complex injury. The Lisfranc complex injury is always a challenge for orthopedists, and the optimum treatment is still up for debate. Anatomic reduction and stable internal fixation prove to have no satisfactory outcomes. This research aims to compare the clinical curative effects, complications and radiographic features of arthrodesis and non-fusion of the Lisfranc joint in the follow-up of the patients who suffered Lisfranc injuries...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28271932/mid-term-results-of-minimally-invasive-plate-osteosynthesis-and-circular-external-fixation-in-the-treatment-of-complex-distal-tibia-fractures
#18
Yunus Imren, Engin Eren Desteli, Mehmet Erdil, Hasan Hüseyin Ceylan, Ibrahim Tuncay, Cengiz Sen
BACKGROUND: The treatment of pilon tibia fractures is challenging. Anatomical reduction of the joint surface is essential. Excessive soft-tissue dissection may interfere with the blood supply and can result in nonunion. We sought to compare the outcomes of distal tibia fractures treated with medial locking plates versus circular external fixators. METHODS: We retrospectively evaluated 41 consecutive patients with closed pilon tibia fractures treated with either minimally invasive locking plate osteosynthesis (n = 21) or external fixation (EF) (n = 20)...
January 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28241726/-bone-cement-dry-prosthetic-with-internal-fixation-treat-senile-osteoporotic-femoral-fractures
#19
Y Jiang, X X Rong, P Chen, Y J Xu, G X Zhu
Objective: To explore the treatment of senile osteoporotic femoral fractures after using internal fixation of bone cement dry prosthetic. Methods: Twelve patients aged from 74 to 94 years with mean age of (84.0±2.5) years with internal fixation of bone cement dry prosthetic surgery who were treated at Department of Orthopaedics in Nanjing Medical University Affiliated Wuxi Second Hospital between May 2013 and May 2015 were retrospectively analyzed. There were 8 male and 4 female, 10 cases of tumble and 2 cases of traffic injury...
March 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28212250/economic-impact-of-nonmodifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#20
Siddharth A Mahure, Lorraine Hutzler, Richard S Yoon, Joseph A Bosco
OBJECTIVES: To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN: Prospective. SETTING: Multicenter. PATIENTS/PARTICIPANTS: Between 2004 and 2014, a total of 23,643 operatively treated patients with fracture and 544,067 patients with total joint arthroplasty (TJA) were identified using the New York State Statewide Planning and Research Cooperative System database...
March 2017: Journal of Orthopaedic Trauma
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