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https://www.readbyqxmd.com/read/28323806/improving-pain-management-and-long-term-outcomes-following-high-energy-orthopaedic-trauma-pain-study
#1
Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323795/assessment-of-severe-extremity-wound-bioburden-at-the-time-of-definitive-wound-closure-or-coverage-correlation-with-subsequent-postclosure-deep-wound-infection-bioburden-study
#2
Michael J Bosse, Clinton K Murray, Anthony R Carlini, Reza Firoozabadi, Theodore Manson, Daniel O Scharfstein, Joseph C Wenke, Mary Zadnik, Renan C Castillo
Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323699/use-of-nanocrystalline-hydroxyapatite-with-autologous-bma-and-local-bone-in-the-lumbar-spine-a-retrospective-ct-analysis-of-posterolateral-fusion-results
#3
Stephen Robbins, Carl Lauryssen, Matthew N Songer
STUDY DESIGN: A retrospective, multicenter, medical record review and independent analysis of computed tomographic scans was performed in 46 patients to determine radiographic arthrodesis rates after 1-segment, 2-segment, or 3-segment instrumented posterolateral fusions (PLF) using autograft, bone marrow aspirate (BMA), and a nanocrystalline hydroxyapatite bone void filler (nHA). OBJECTIVE: To determine the radiographic arthrodesis rates after instrumented lumbar PLF using local autograft, BMA, and nHA...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28319248/cyclic-tensile-strain-enhances-human-mesenchymal-stem-cell-smad-2-3-activation-and-tenogenic-differentiation-in-anisotropic-collagen-glycosaminoglycan-scaffolds
#4
W G Grier, A S Moy, B A Harley
Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. However, few reliable clinical studies have been published, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system...
March 20, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28316963/the-results-of-proximal-femoral-nail-for-intertrochanteric-fracture-in-hemodialysis-patient
#5
Kyung Sub Song, Sang Phil Yoon, Su Keon Lee, Seung Hwan Lee, Bong Seok Yang, Byeong Mun Park, Ick Hwan Yang, Beom Seok Lee, Ji Ung Yeom
PURPOSE: Hip fractures in hemodialysis patients are accompanied by high rates of complications and morbidities. Previous studies have mainly reported on nonunion and avascular necrosis of femoral neck fractures in this patient group. In this study the complication and clinical results of hemodialysis patients with intertrochanteric fractures treated with proximal femoral intramedullary nailing have been investigated through comparison with patients with normal kidney function. MATERIALS AND METHODS: Forty-seven patients were included; the hemodialysis group (n=17) and the control group with normal kidney function (n=30)...
March 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28297828/-treatment-of-geriatric-ankle-osteoarthritis-by-arthrodesis-with-screw-fixation-through-lateral-malleolus-osteotomy
#6
W Q Qu, Z H Wang, J Y Zhang, S J Dong, D Wang
Objective: To evaluate the Treatment effect of geriatric ankle osteoarthritis by arthrodesis with screw fixation through lateral malleolus osteotomy. Methods: Thirty-three patients with severe osteoarthritis according to the classification of Takakura-Tanakawere treated by ankle arthrodesis through lateral malleolus osteotomy with screw fixation from January 2010 to June 2015. Twenty-five patients were combined with more than 1 internal diseases. Twenty-six patients owned ankle injury history. Clinical and radiologic evaluations were performed before surgery and at the most recent follow-up...
March 7, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28295124/evaluation-of-the-effect-of-platelet-rich-fibrin-on-long-bone-healing-an-experimental-rat-model
#7
Turan Cihan Dülgeroglu, Hasan Metineren
Pseudoarthrosis, or nonunion, of the long bones is a challenging medical condition for orthopedic surgeons to treat. Therefore, healing enhancer materials are commonly used. The authors investigated whether platelet-rich fibrin accelerates long bone healing by comparing radiological and histological findings in a rat model of open femoral fracture. Platelet-rich fibrin is a current biomaterial that contains many growth factors and platelets. There are no studies in the literature investigating the effects of platelet-rich fibrin on fracture healing...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293506/treatment-of-radial-nonunion-with-corticocancellous-bone-graft-and-fascia-of-anterolateral-thigh-free-flap-the-wrap-technique
#8
Mario Cherubino, Mario Ronga, Davide Sallam, Alessandro Fagetti, Luigi Valdatta, Paolo Cherubino
The management of nonunion of the forearm bones is a challenging task. Multiple factors have been associated with the establishment of forearm nonunion, such as the fracture position and complexity, general condition of the patient, and the previously utilized surgical technique. The optimal surgical treatment of a bone gap remains a subject of discussion. Autogenous corticocancellous bone grafts and vascularized bone flaps have been used with differing results. The authors describe a technique for the treatment of posttraumatic nonunion of the radius with a 5-cm bone gap using the free anterolateral thigh fascial flap wrapped around a tricortical iliac bone graft...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28292542/prevention-of-infection-in-open-fractures
#9
REVIEW
Charalampos G Zalavras
Open fractures are complex injuries that are associated with increased risk for complications, such as infection and nonunion. The goals of open fracture management are prevention of infection, fracture union, and restoration of function. These goals are best achieved by careful patient and injury assessment, early administration of systemic antibiotics supplemented by local delivery of antibiotics in severe injuries, thorough surgical debridement, wound management with soft tissue coverage if needed, and stable fracture fixation...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28291441/surgical-treatment-of-bilateral-femoral-stress-fractures-related-with-long-term-alendronate-therapy
#10
Ulunay Kanatlı, M Baybars Ataoğlu, Mustafa Özer, H Nevzat Topçu, Mehmet Çetinkaya
A 67-year-old female patient admitted to our outpatient clinic suffering from pain in both thighs for one year without any history of trauma. Patient was receiving alendronate therapy for five years. Physical examination revealed pain increasing with weight-bearing in both thighs with full range of hip and knee movements. Radiographs showed an area of thickened cortex of middle femoral diaphysis in both femurs, but no fracture. Bone scan showed a single area of increased uptake of radioisotope. These images were compatible with stress fractures of both femurs...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28291436/the-effects-of-radial-bowing-and-complications-in-intramedullary-nail-fixation-of-adult-forearm-fractures
#11
Ali Çağdaş Yörükoğlu, Ahmet Fahir Demirkan, Alp Akman, Ali Kitiş, Hande Usta
OBJECTIVES: This study aims to evaluate the effects of radial bowing changes on fracture healing and functional results in adult forearm intramedullary nail applications and complications of forearm nails that have been discussed rarely in the literature. PATIENTS AND METHODS: Twenty-three patients -11 with isolated radius and 12 with both radius and ulna fractures- (17 males, 6 females; mean age 38.6 years; range 18 to 69 years) who were operated between September 2009 and August 2014 were included in the study...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28291142/lower-extremity-avulsion-fractures-in-the-pediatric-and-adolescent-athlete
#12
Jonathan Schiller, Steven DeFroda, Travis Blood
Lower extremity avulsion fractures are uncommon in the pediatric population and can be misdiagnosed without proper imaging and/or clinical suspicion for these injuries. The most common locations of avulsion injuries are the ischial tuberosity, anterior superior iliac spine, and anterior inferior iliac spine. Less often, avulsion fractures occur in the tibial tubercle, calcaneus, and greater and lesser trochanters. When treated properly with rest and altered weight bearing, most of these injuries heal without complication...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28286465/evaluation-of-new-biphasic-calcium-phosphate-bone-substitute-rabbit-femur-defect-model-and-preliminary-clinical-results
#13
Yeong-Jang Chen, Jwo-Luen Pao, Chiang Sang Chen, Yu-Chun Chen, Chun-Chien Chang, Fang-Ming Hung, Chih-Hung Chang
Autogenous bone grafting, used to repair bone defects, is limited and the donor site can experience complications. Compared to autogenous bone graft, artificial bones have different porosity, which might make them suitable alternatives to bone grafts. Here, two porous biphasic calcium phosphate bone substitutes, namely Bicera™ and Triosite™, are used in an animal study and clinical practice to find a suitable porosity for implantation. Bicera™ and Triosite™ consist of 60 wt% hydroxyapatite and 40 wt% β-tricalcium phosphate, with the porosity of Bicera™ (82%) being higher than that of Triosite™ (70%)...
2017: Journal of Medical and Biological Engineering
https://www.readbyqxmd.com/read/28284492/posterior-arthroscopic-subtalar-arthrodesis-clinical-and-radiologic-review-of-19-cases
#14
Xavier Martín Oliva, Pedro Falcão, Raul Fernandes Cerqueira, Ricardo Rodrigues-Pinto
Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or post-traumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated...
March 8, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28280708/evaluation-of-postoperative-complications-according-to-treatment-of-third-molars-in-mandibular-angle-fracture
#15
Hye-Youn Lim, Tae-Young Jung, Sang-Jun Park
OBJECTIVES: The aim of this study was to evaluate the implication of third molars in postoperative complications of mandibular angle fracture with open reduction and internal fixation (ORIF). MATERIALS AND METHODS: Data were collected on patients who presented with mandibular angle fracture at our Department of Oral and Maxillofacial Surgery between January 2011 and December 2015. Of the 63 total patients who underwent ORIF and perioperative intermaxillary fixation (IMF) with an arch bar, 49 patients were identified as having third molars in the fracture line and were followed up with until plate removal...
February 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
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
#16
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/28266690/lengthening-primary-cilia-enhances-cellular-mechanosensitivity
#17
G-I Im
Stem cell research arose from the need to explore new therapeutic possibilities for intractable and lethal diseases. Although musculoskeletal disorders are basically nonlethal, their high prevalence and relative ease of performing clinical trials have facilitated the clinical application of stem cells in this field. However, few reliable clinical studies have been published, despite the plethora of in vitro and preclinical studies in stem cell research for regenerative medicine in the musculoskeletal system...
February 21, 2017: European Cells & Materials
https://www.readbyqxmd.com/read/28261423/cementless-total-hip-arthroplasty-involving-trochanteric-osteotomy-without-subtrochanteric-shortening-for-high-hip-dislocation
#18
Soong Joon Lee, Jeong Joon Yoo, Hee Joong Kim
BACKGROUND: Total hip arthroplasty with subtrochanteric shortening osteotomy is widely performed for high hip dislocation. However, suboptimal leg length discrepancy correction and nonunion of the osteotomy site remain concerns. Although total hip arthroplasty using trochanteric osteotomy without subtrochanteric osteotomy was introduced, cemented implants have been more commonly used than contemporary cementless implants in this procedure. We evaluated the long-term results of cementless total hip arthroplasty with trochanteric osteotomy without subtrochanteric osteotomy for high hip dislocation...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28259113/surgeon-based-3d-printing-for-microvascular-bone-flaps
#19
Erin M Taylor, Matthew L Iorio
Background Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models...
March 4, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28258831/greater-trochanteric-reattachment-using-the-third-generation-cable-plate-system-in-revision-total-hip-arthroplasty
#20
In-Sung Kim, Nachiket Pansey, Rajeev K Kansay, Je-Hyun Yoo, Hwang-Yong Lee, Jun-Dong Chang
BACKGROUND: The purpose of the study is to evaluate the radiologic and functional results of greater trochanteric reattachment using the third-generation cable plate system in revision total hip arthroplasty (THA). METHODS: A total of 47 trochanteric fixations (27 men and 18 women; mean age of 60.2 years) using the third-generation cable plate system in revision THA were retrospectively evaluated. The mean follow-up was 80.4 months (range 27-148 months). The osteotomized greater trochanter was reattached using the Cable-Ready system (Zimmer, Warsaw, IN) and the Dall-Miles cable system (Stryker, Mahwah, NJ)...
January 20, 2017: Journal of Arthroplasty
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