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Fracture joint orthopaedics

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https://www.readbyqxmd.com/read/28074463/importance-of-fixation-of-posterior-malleolus-fracture-in-trimalleolar-fractures-a-retrospective-study
#1
Sinan Karaca, Meriç Enercan, Güzelali Özdemir, Sinan Kahraman, Mutlu Çobanoğlu, Metin Küçükkaya
BACKGROUND: The aim of this retrospective study was to evaluate treatment effect and importance of posterior malleolus (PM) fixation in surgically treated trimalleolar fractures. METHODS: A total of 57 cases of ankle joint fracture involving PM and treated with open reduction and internal fixation technique between 2004 and 2011 were evaluated. PM fixation was performed with cannulated screws in 46 cases, and in 11 cases, PM plate was used. All patients were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, American Academy of Orthopedic Surgeons (AAOS) foot and ankle questionnaire, and Visual Analog Score (VAS) pain scale...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28074258/the-treatment-options-for-posterior-malleolar-fractures-in-tibial-spiral-fractures
#2
Jialiang Guo, Lei Liu, Zongyou Yang, Zhiyong Hou, Wei Chen, Yingze Zhang
PURPOSE: The posterior malleolar fracture (PMF) in tibial spiral fractures are a common type of complication that occurs in tibial fractures. However, the indication of fixation for posterior fractures is still under debate and varies between different surgeons'. It is not unusual to find the smaller PMF (<25%), which could be treated conservatively within guidelines, treated with internal fixation in clinic. The aim of this study is to evaluate the clinical outcomes of tibial spiral fractures with PMF and provide proper guidance for the treatment of this special fracture...
January 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28060238/single-institution-early-experience-with-the-bundled-payments-for-care-improvement-initiative
#3
Richard Iorio, Joseph Bosco, James Slover, Yousuf Sayeed, Joseph D Zuckerman
The Centers for Medicare & Medicaid Services (CMS) implemented the Bundled Payments for Care Improvement (BPCI) initiative in 2011. Through BPCI, organizations enlisted into payment agreements that include both performance and financial accountability for episodes of care. To succeed, BPCI requires quality maintenance and care delivery at lower costs. This necessitates physicians and hospitals to merge interests. Orthopaedic surgeons must assume leadership roles in cost containment, surgical safety, and quality assurance to deliver cost-effective care...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28057631/ultimate-fracture-load-of-cadaver-proximal-humeri-correlates-more-strongly-with-mean-combined-cortical-thickness-than-with-areal-cortical-index-dexa-density-or-canal-to-calcar-ratio
#4
J G Skedros, C S Mears, W Z Burkhead
OBJECTIVES: This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND METHODS: A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28053389/is-pre-operative-assessment-of-coagulation-profile-with-thrombelastography-teg-useful-in-predicting-venous-thromboembolism-vte-following-orthopaedic-surgery
#5
Apurve Parameswaran, Vignesh P Krishnamoorthy, Anil T Oommen, Anita Jasper, Ravi J Korula, Sukesh C Nair, Pradeep M Poonnoose
INTRODUCTION: Epidemiologic data on the incidence of venous thromboembolism (VTE) in Indian population vary widely. Most studies show that the incidence of VTE is lower in Asian patients than in Western population. Screening tools to identify high-risk patients should enable us to reduce this complication. METHODS: The incidence of VTE in 101 patients who underwent knee or hip arthroplasty, or surgery for hip fractures, without chemoprophylaxis for deep vein thrombosis (DVT) was documented...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28053267/assessment-of-resuscitation-as-measured-by-markers-of-metabolic-acidosis-and-features-of-injury
#6
D S Weinberg, A S Narayanan, T A Moore, H A Vallier
AIMS: The best time for definitive orthopaedic care is often unclear in patients with multiple injuries. The objective of this study was make a prospective assessment of the safety of our early appropriate care (EAC) strategy and to evaluate the potential benefit of additional laboratory data to determine readiness for surgery. PATIENTS AND METHODS: A cohort of 335 patients with fractures of the pelvis, acetabulum, femur, or spine were included. Patients underwent definitive fixation within 36 hours if one of the following three parameters were met: lactate < 4...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28042119/periprosthetic-femoral-fractures-and-trying-to-avoid-them-what-is-the-contribution-of-femoral-component-design-to-the-increased-risk-of-periprosthetic-femoral-fracture
#7
A V Carli, J J Negus, F S Haddad
AIMS: Periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) are devastating complications that are associated with functional limitations and increased overall mortality. Although cementless implants have been associated with an increased risk of PFF, the precise contribution of implant geometry and design on the risk of both intra-operative and post-operative PFF remains poorly investigated. A systematic review was performed to aggregate all of the PFF literature with specific attention to the femoral implant used...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#8
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/27984445/economic-impact-of-non-modifiable-risk-factors-in-orthopaedic-fracture-care-is-bundled-payment-feasible
#9
Lorraine Hutzler, Richard S Yoon, Siddharth A Mahure, Joseph A Bosco
OBJECTIVES: To determine if 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 - 2014, A total of 23,643 operatively treated fracture patients and 544,067 total joint arthroplasty patients were identified using the New York State SPARCS Database. INTERVENTIONS: Severity of Illness (SOI), hospital charges ($USD), length of stay (days), discharge disposition (homebound vs not) were collected...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27977849/conservative-interventions-for-treating-middle-third-clavicle-fractures-in-adolescents-and-adults
#10
REVIEW
Mário Lenza, Flávio Faloppa
BACKGROUND: Clavicle (collarbone) fractures account for around 4% of all fractures. Most (76%) clavicle fractures involve the middle-third section of the clavicle. Treatment of these fractures is usually non-surgical (conservative). Commonly used treatments are arm slings, strapping and figure-of-eight bandages.This is an update of a Cochrane review first published in 2009 and updated in 2014. OBJECTIVES: To evaluate the effects (benefits and harms) of different methods for conservative (non-operative) treatment for acute (treated soon after injury) middle third clavicle fractures in adolescents and adults...
15, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27909130/the-use-of-ultra-low-dose-ct-scans-for-the-evaluation-of-limb-fractures-is-the-reduced-effective-dose-using-ct-in-orthopaedic-injury-reduction-protocol-effective
#11
S R Konda, A M Goch, P Leucht, A Christiano, S Gyftopoulos, G Yoeli, K A Egol
AIMS: To evaluate whether an ultra-low-dose CT protocol can diagnose selected limb fractures as well as conventional CT (C-CT). PATIENTS AND METHODS: We prospectively studied 40 consecutive patients with a limb fracture in whom a CT scan was indicated. These were scanned using an ultra-low-dose CT Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury (REDUCTION) protocol. Studies from 16 selected cases were compared with 16 C-CT scans matched for age, gender and type of fracture...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#12
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27890891/mid-term-clinical-results-of-versys-hip-system-zimmer-uncemented-total-hip-replacement-arthroplasty
#13
Hidemi Kawaji, Takuya Uematsu, Naoya Hoshikawa, Hiroshi Watanabe, Shinro Takai
: Recent reports suggest that uncemented total hip replacement arthroplasty (THR) results in favorable short- to mid-term clinical results. In the present study, we assessed the mid-term clinical results of VerSys Hip System uncemented THR at our hospital. MATERIALS AND METHODS: We studied patients who received THR using VerSys Hip System and who could be followed-up more than 3 years. Clinical records were used to retrospectively identify patient characteristics, which included age, gender, disease requiring THR, preoperative and postoperative pain score of the Japan Orthopaedic Association scoring system, range of motion in flexion and abduction, operating time, intraoperative complication, and additional operation or revision surgery...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27852383/-surgery-of-ipsilateral-hawkins-%C3%A2-talus-neck-and-ankle-joint-fractures-via-internal-and-lateral-approaches-with-herbert-screws
#14
P Zhang, Q R Dong, Z Y Wang, B Chen, J H Wan, L Wang
Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27814724/severe-open-lisfranc-injuries-one-stage-operation-through-internal-fixation-associated-with-vacuum-sealing-drainage
#15
Wenqing Qu, Shuqin Ni, Zhenhai Wang, Yong Zhao, Shimin Zhang, Yiheng Cheng, Tong Liu, Min Yu, Dan Wang
BACKGROUND: This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD). METHODS: The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed. RESULTS: At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69...
November 4, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27803231/the-use-of-high-dose-dual-impregnated-antibiotic-laden-cement-with-hemiarthroplasty-for-the-treatment-of-a-fracture-of-the-hip-the-fractured-hip-infection-trial
#16
A P Sprowson, C Jensen, S Chambers, N R Parsons, N M Aradhyula, I Carluke, D Inman, M R Reed
AIMS: A fracture of the hip is the most common serious orthopaedic injury, and surgical site infection (SSI) is one of the most significant complications, resulting in increased mortality, prolonged hospital stay and often the need for further surgery. Our aim was to determine whether high dose dual antibiotic impregnated bone cement decreases the rate of infection. PATIENTS AND METHODS: A quasi-randomised study of 848 patients with an intracapsular fracture of the hip was conducted in one large teaching hospital on two sites...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27796800/is-pes-cavus-alignment-associated-with-lisfranc-injuries-of-the-foot
#17
Jeremy D Podolnick, Daniel S Donovan, Nicholas DeBellis, Alejandro Pino
BACKGROUND: Lisfranc (tarsometatarsal joint) injuries are relatively rare, accounting for less than 1% of all fractures, and as many as 20% of subtle Lisfranc injuries are missed at the initial patient presentation. An undiagnosed Lisfranc injury can have devastating consequences to the patient. Therefore, any factor that can raise a clinician's index of suspicion to make this diagnosis is potentially important. The cavus foot has been associated with various maladies of the lower extremity, but to our knowledge, it has not been reported to be associated with Lisfranc injury...
October 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27790530/a-randomized-controlled-study-to-compare-conventional-and-evidence-based-treatment-protocols-in-fresh-compound-fractures
#18
Kanika Mahajan, Vikas Verma, Girish Kumar Singh, Santosh Kumar, Sachin Avasthi
INTRODUCTION: A recent concept review in Journal of Bone and Joint Surgery (JBJS) outlines evidence to control peri-operative infections in compound fractures. However, evidence for impact of adopting a protocol combining measures that have some evidence is lacking in literature. The present method of treatment at King George's Medical University (KGMU) is representative of the conventional practice of managing compound fractures in India and is an appropriate control for trial against the Experimental Evidence Based Protocol (EBP)...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27769856/the-impact-of-helipad-designation-on-meeting-the-best-practice-tariff-for-fractured-neck-of-femur-cases-in-a-major-trauma-centre
#19
John Dabis, Aliyah Hussein, Mark Rickman
Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. This study aimed to assess the impact of the helipad designation on the Trust's ability to meet the Best Practice Tariff (BPT) criteria for FNOF patients...
October 18, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27756739/defining-the-fracture-population-in-a-pragmatic-multicentre-randomised-controlled-trial-profher-and-the-neer-classification-of-proximal-humeral-fractures
#20
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
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