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G Prunières, S Gouzou, S Facca, A-S Matheron, N Maire, J-J Hidalgo Díaz, P Liverneaux
: Unstable distal phalanx fractures are typically treated by pinning of the distal phalanx or the distal interphalangeal joint (DIP). Complications include unstable fixation, K-wire migration, septic arthritis and osteoarthritis. To limit these complications, we wanted to explore the benefits of using locked extra-articular DIP pinning. The cohort consisted of 12 patients (mean age 36.3 years) who had an extra-articular (6 cases) or intra-articular distal phalanx fracture (6 cases). All patients were treated surgically with a construct consisting of two connected K-wires: one was placed inside the shaft of the distal phalanx and the other was placed perpendicular to the middle phalanx...
October 2016: Hand Surgery and Rehabilitation
X L Griffin
No abstract text is available yet for this article.
October 25, 2016: BMJ: British Medical Journal
Raju Vaishya, Amit-Kumar Agarwal, Nishint Gupta, Vipul Vijay
The management of multiple complicated injured patients remains a great challenge despite advance- ments in modern medical care. We present a rare case of bilateral unstable pelvic fractures associated with bilateral segmental femoral shaft fractures.We have proposed a mechanism of such complex injury pattern and discussed the plan of management. We believe that a timely and aggressive surgical intervention to fix all the major fractures soon after medically stabilizing the patient helped our patient to overcome these serious and lethal injuries...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Y Ozaki, Y Homma, K Sano, T Baba, H Ochi, A Desroches, M Matsumoto, T Yuasa, K Kaneko
INTRODUCTION: Lateral femoral cutaneous nerve (LFCN) injury is a risk specific to the direct anterior approach (DAA) for total hip arthroplasty (THA). However, prevention strategies have not been established. This study aimed to identify the predisposing factors determining LFCN injury during THA via a DAA. HYPOTHESIS: Patients with LFCN injury after THA via DAA would demonstrate predisposing factors. MATERIAL AND METHODS: LFCN injury was identified using a patient questionnaire...
October 21, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Emmanuel João Nogueira Leal Silva, Laise Silva Villarino, Victor Talarico Leal Vieira, Thais Accorsi-Mendonça, Henrique Dos Santos Antunes, Gustavo De-Deus, Hélio Pereira Lopes
INTRODUCTION: This study evaluated the bending resistance and cyclic fatigue life of a new single-file reciprocating instrument (Unicone; Medin, Nové Město na Moravě, Czech Republic). Reciproc (VDW, Munich, Germany) and WaveOne (Dentsply Maillefer) instruments were used as references for comparison. METHODS: Flexibility was determined by 45° bending tests using a universal testing machine. The cyclic fatigue test was performed using a custom-made device. For this test, an artificial canal with a 60° angle and a 5-mm radius of curvature was used...
October 21, 2016: Journal of Endodontics
Alessandro Innocenti, Sara Tanini, F Mori, D Melita, M Innocenti
INTRODUCTION: Genitalia are linked to self-esteem and male sexual identity, especially among young men, who sometimes require a surgical procedure to acquire more confidence. Among the surgical procedures requested for aesthetical purposes, circumcision is one of the most popular. Although it can be considered to be a simple surgical practice, it may cause severe complications such as penile skin necrosis. PRESENTATION OF CASE: We report a case of a catastrophic situation after a circumcision performed on a 27-year-old HIV positive man resulted in a drastic reduction in the length of the penile shaft due to extensive skin loss; this was subsequently restored using dartos-fascio-myo-cutaneous flaps...
October 15, 2016: International Journal of Surgery Case Reports
William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Norachart Sirisreetreerux, Babar Shafiq, Greg M Osgood, Erik A Hasenboehler
OBJECTIVES: To determine the location of distal medial neurovascular structures, identifying a medial "safe zone" for minimally invasive plate osteosynthesis to treat displaced femoral condylar fractures. METHODS: Eleven uninjured lower-half torsos were dissected on the bilateral medial lower thigh. A longitudinal incision was made at the midsagittal plane of the medial thigh starting 1 cm proximal to the knee joint and extending to the proximal one-third of the femur...
November 2016: Journal of Orthopaedic Trauma
Gareth Davies, Gerald Yeo, Mahendrakumar Meta, David Miller, Erik Hohmann, Kevin Tetsworth
OBJECTIVES: To compare the risk of major complications after either minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing (IMN) of humeral shaft fractures. DESIGN: Retrospective, case-match controlled study. SETTING: A major metropolitan tertiary referral trauma center in Australia. PATIENTS: Thirty patients with fractures of the humeral shaft. INTERVENTION: Either MIPO or IMN were performed on 15 patients each with traumatic humeral shaft fractures...
November 2016: Journal of Orthopaedic Trauma
Heather A Vallier
Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment...
November 2016: Journal of Orthopaedic Trauma
Yong Sung Won, Seung-Ju Lee, Hee Youn Kim, Dong Sup Lee
INTRODUCTION: Narrow working space is a major problem to overcome during retroperitoneoscopic ureterolithotomy. We evaluated initial 5 years experience of retroperitoneoscopic ureterolithotomy for large impacted upper ureteral calculi. PATIENTS AND METHODS: Between January 2011 and December 2015, a total of 37 consecutive patients were evaluated. A 12-mm camera port at middle of midaxillary line and two 5-mm working ports in posterior axillary line were created...
October 21, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Colin G Murphy, Michel P Bonnin, Antoine H Desbiolles, Yannick Carrillon, Tarik Aїt Si Selmi
BACKGROUND: Varus inclination of the uncemented stem is not necessarily a technical error. The proximal femoral anatomy of hips with a coxa vara deformity frequently predisposes varus inclination. METHODS: We reviewed a series of 200 patients undergoing primary uncemented THA with the Corail® hip system. Preoperative data were based on patient demographics, diagnosis, and radiographic information (preoperative templating-CT measurements), and compared postoperative alignment for each stem and type of stem used...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Jessica L Partlow, Meghann Lustgarten, W Rich Redding
To the authors' knowledge, the ultrasonographic appearance of hair shafts within a synovial structure of the horse has not been described previously. The purpose of this descriptive study was to illustrate the clinical, ultrasonographic, and arthroscopic characteristics of confirmed hair shafts within synovial structures of seven horses. A review of medical records of the Farm and Equine Veterinary Medical Center at North Carolina State University College of Veterinary Medicine identified seven horses with clinical signs suspicious for inflammatory or septic synovitis/tenosynovitis that had hair shafts identified within those structures ultrasonographically...
October 20, 2016: Veterinary Radiology & Ultrasound
Xiang He, Ling Jiang, Qi-Qin Dan, Qiang Lv, Yue Hu, Jia Liu, Ting-Hua Wang, Shu-Fen Wang
Collapsin response mediator protein 2 (CRMP2), an important protein involved in axonal growth and the maintenance of neuronal membrane integrity, has proved to be altered in nervous system diseases. This study was aimed to investigate the role of CRMP2 in bone marrow stromal cells (BMSCs) treating rats with cerebral ischemia. BMSCs were isolated from shaft of the femurs, tibiae, and humeri and was intra-carotid administrated immediately after middle cerebral artery occlusion (MCAO). Modified Neurological Severity Scores (mNSS) was conducted at 3, 7, 14 dpo and the electrophysiologic evaluation was evaluated at 14 dpo...
October 17, 2016: Behavioural Brain Research
Gi-Young Park, Jin Hoon Lee, Dae Gil Kwon
Purpose: The purpose of this study was to measure the axillary recess (AR) thickness in an asymptomatic shoulder by using ultrasonography (US) and to analyze the factors affecting it. Methods: We recruited 141 patients (52 males; 89 females; age, 57.7±9.9 years) with unilateral shoulder pain and performed US on the unaffected shoulder. Two physiatrists measured the AR thickness of the unaffected shoulder independently. All patients were examined in an upright sitting position with 90° shoulder abduction...
September 19, 2016: Ultrasonography
Robin C Lenz, Darshan Nagesh, Hannah K Park, John Grady
BACKGROUND: Resection of the medial eminence in hallux valgus surgery is common. True hypertrophy of the medial eminence in hallux valgus is debated. No studies have compared metatarsal head width in patients with hallux valgus and control patients. METHODS: We reviewed 43 radiographs with hallux valgus and 27 without hallux valgus. We measured medial eminence width, first metatarsal head width, and first metatarsal shaft width in patients with and without radiographic hallux valgus...
September 2, 2016: Journal of the American Podiatric Medical Association
G Zhao, H N Liu, N Li, L He, X B Wu
Objective: To evaluate the mid-term clinical efficacy of plate and intramedullary nail for humeral shaft fracture. Methods: In this retrospective study a total of 122 patients with humeral shaft fracture were divided into 2 groups according to surgery type from May 2010 to July 2012. There were 63 patients in plate group and 59 patients in intramedullary nail group. The factors related to the operation for each group were compared respectively. The clinical outcome was evaluated by the Neer scores, Myao scores and EuroQol 5 dimensions scores (EQ-5D)...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Homero Rivas, Ignacio Robles, Francisco Riquelme, Marcelo Vivanco, Julio Jiménez, Boris Marinkovic, Mario Uribe
OBJECTIVE: To evaluate a new magnetic surgical system during reduced-port laparoscopic cholecystectomy in a prospective, multicenter clinical trial. BACKGROUND: Laparoscopic instrumentation coupled by magnetic fields may enhance surgeon performance by allowing for shaft-less retraction and mobilization. The movements can be performed under direct visualization, generating different angles of traction and reducing the number of trocars to perform the procedure. This may reduce well-known associated complications of trocars, including incisional pain, scarring, infection, bowel, and vascular injuries, among others...
October 17, 2016: Annals of Surgery
Jodi A Antonelli, Heather Beardsley, Stephen Faddegon, Monica Sc Morgan, Jeffrey C Gahan, Margaret S Pearle, Jeffrey A Cadeddu
PURPOSE: We developed a polyethylene sack (the PercSac) that fits over the shaft of a rigid nephroscope and is deployed into the collecting system to capture a stone and contain fragments during PCNL. We previously reported results using the PercSac in a percutaneous cystolithopaxy model. Herein we compare the efficiency of stone fragmentation with and without the PercSac in an anatomically correct in vitro PCNL model. MATERIALS AND METHODS: The PCNL model consisted of a human collecting system model created on a 3-D printer...
October 19, 2016: Journal of Endourology
Kiran C Mahabier, Esther M M Van Lieshout, Boyd C Van Der Schaaf, Gert R Roukema, Bas J Punt, Michael H J Verhofstad, Dennis Den Hartog
OBJECTIVES: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. METHODS: 30 observers (25 orthopedic trauma surgeons and five general orthopedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included...
October 13, 2016: Journal of Orthopaedic Trauma
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