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https://www.readbyqxmd.com/read/28337732/medicare-reimbursement-and-orthopedic-surgery-past-present-and-future
#1
REVIEW
R Carter Clement, Suneel B Bhat, Meredith E Clement, James C Krieg
PURPOSE OF REVIEW: This paper reviews the history and structure of Medicare reimbursement with a focus on aspects relevant to the field of orthopedic surgery. Namely, this includes Parts A and B, with particular attention paid to the origins of Diagnosis Related Groups (DRG) and the physician fee schedule, respectively. We then review newer policies affecting orthopedic surgeons. RECENT FINDINGS: Recent Medicare reforms relevant to our field include readmission penalties, the evolution of bundled payments including the mandatory Comprehensive Care for Joint Replacement (CJR) and Surgical Hip and Femur Fracture Treatment (SHFFT) programs, and the new mandatory Merit-based Incentive Payment System (MIPS) pay-for-performance program...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337536/functional-and-patient-reported-outcomes-of-the-swanson-metacarpo-phalangeal-arthroplasty-in-the-rheumatoid-hand
#2
Firas K Elherik, Sean Dolan, John Antrum, Frank Unglaub, Colin R Howie, Steffen J Breusch
INTRODUCTION: Replacement of the metacarpo-phalangeal joints (MCPJ) with silastic Swanson's implants can help decrease pain, stiffness and allow for improved function in rheumatoid arthritis (RA). There is a lack of patient reported outcome measure (PROM) studies assessing the efficacy of this procedure in RA. The aim of this study was to report any change in function, pain, stiffness and satisfaction following the Swanson MCPJ replacement using patient reported outcomes in a rheumatoid population...
March 24, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#3
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28333947/surgical-interventions-to-treat-humerus-shaft-fractures-a-network-meta-analysis-of-randomized-controlled-trials
#4
Jia-Guo Zhao, Jia Wang, Xiao-Hui Meng, Xian-Tie Zeng, Shi-Lian Kan
BACKGROUND: There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. METHODS: MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28332986/risk-factors-for-pelvic-insufficiency-fractures-in-locally-advanced-cervical-cancer-following-intensity-modulated-radiation-therapy
#5
Anne Ramlov, Erik Morre Pedersen, Lisbeth Røhl, Esben Worm, Lars Fokdal, Jacob Chr Lindegaard, Kari Tanderup
PURPOSE: To investigate the incidence of and risk factors for pelvic insufficiency fracture (PIF) after definitive chemoradiation therapy for locally advanced cervical cancer (LACC). METHODS AND MATERIALS: We analyzed 101 patients with LACC treated from 2008-2014. Patients received weekly cisplatin and underwent external beam radiation therapy with 45 Gy in 25 fractions (node-negative patients) or 50 Gy in 25 fractions with a simultaneous integrated boost of 60 Gy in 30 fractions (node-positive patients)...
April 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28332125/osteoarthritis-of-the-hip-joint-in-elderly-patients-is-most-commonly-atrophic-with-low-parameters-of-acetabular-dysplasia-and-possible-involvement-of-osteoporosis
#6
Yasuhiro Ishidou, Kanehiro Matsuyama, Daisuke Sakuma, Takao Setoguchi, Satoshi Nagano, Ichiro Kawamura, Shingo Maeda, Setsuro Komiya
As elderly patients with hip osteoarthritis aged, acetabular dysplasia parameters decreased (Sharp's angle, acetabular roof obliquity angle, and acetabular head index) and the incidence of the atrophic type increased. Vertebral body fracture was more frequent in the atrophic type, suggesting the involvement of osteoporosis at the onset of hip osteoarthritis. INTRODUCTION: Osteoarthritis (OA) is associated with increased bone formation at a local site. However, excessive bone resorption has also been found to occur in the early stages of OA...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28331961/-corrective-osteotomies-for-posttraumatic-elbow-deformities
#7
J Nowotny, F Thielemann, A Biewener, K D Schaser
OBJECTIVES: Correcion of elbow joint deformities that usually develop secondary to direct or indirect trauma of the arm or elbow with subsequent inadequate healing and consecutive axial/rotational malalignment and may be associated with cosmetic or functional deficits of the arm. INDICATIONS: Relevant malalignment of the arm axis with corresponding cosmetic or functional deficits for the patient. CONTRAINDICATIONS: Pre-existing degenerative and chronic inflammatory changes...
March 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28330449/a-cross-sectional-study-of-the-effects-of-load-carriage-on-running-characteristics-and-tibial-mechanical-stress-implications-for-stress-fracture-injuries-in-women
#8
Chun Xu, Amy Silder, Ju Zhang, Jaques Reifman, Ginu Unnikrishnan
BACKGROUND: Load carriage is associated with musculoskeletal injuries, such as stress fractures, during military basic combat training. By investigating the influence of load carriage during exercises on the kinematics and kinetics of the body and on the biomechanical responses of bones, such as the tibia, we can quantify the role of load carriage on bone health. METHODS: We conducted a cross-sectional study using an integrated musculoskeletal-finite-element model to analyze how the amount of load carriage in women affected the kinematics and kinetics of the body, as well as the tibial mechanical stress during running...
March 23, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28328742/treatment-of-proximal-humerus-fractures-in-children-with-a-modified-palm-tree-technique
#9
Ayman M Ali, Sallam I Fawzy, Medhat Moaty, Mohamed Abelaziz
Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28326407/instability-of-the-proximal-tibiofibular-joint-associated-with-total-knee-arthroplasty
#10
Martin Bédard, Simon Corriveau-Durand
To our knowledge, proximal tibiofibular joint instability has never been reported in a patient with a total knee arthroplasty (TKA). We present the case of a patient with anterolateral proximal tibiofibular joint instability associated with a complex primary TKA. In 2010, a male patient of 47 years was referred for TKA after posttraumatic osteoarthritis. The patient's history includes a fracture of the left lateral tibial plateau in 2008 and removal of osteosynthesis material in 2009. TKA with a lateral metal augment and intramedullary stem was performed in 2010...
September 2016: Arthroplasty Today
https://www.readbyqxmd.com/read/28325423/stage%C3%A2-iv-kienb%C3%A3-ck-s-disease-proximal-row-carpectomy-and-application-of-rcpi-implant
#11
A Marcuzzi, F Colantonio, G Petrella, H Ozben, A Russomando
Kienböck disease is an aseptic osteonecrosis of the lunate, which gradually leads to total carpal collapse. Lichtman's classification relates radiographic evidence of wrist damage to four different stages and supports surgical decision-making. This study pertains to six patients (2 males and 4 females) affected by stage IV Kienböck's disease who underwent proximal row carpectomy and received an RCPI implant. The clinical outcomes consisted of wrist range of motion (ROM), pain on a VAS scale (0-10), the DASH score and the patient's level of satisfaction...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28324202/the-influence-of-surgical-approach-on-postoperative-pelvic-tilt-after-total-hip-arthroplasty
#12
Daisuke Inoue, Tamon Kabata, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Takashi Yamamoto, Tomoharu Takagi, Takaaki Ohmori, Hiroyuki Tsuchiya
BACKGROUND: Past reports have shown the tendency of posterior pelvic tilt to increase over time after total hip arthroplasty (THA). We have hypothesized that the volume and extent of released joint capsule may influence the change in postoperative pelvic tilt. This study was conducted to ascertain whether surgical approach during THA (posterior or anterior) has an effect on postoperative changes in pelvic tilt. METHODS: We conducted a retrospective review of 81 hips in 60 patients...
March 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28321570/comparative-analysis-of-locking-plate-versus-hook-plate-osteosynthesis-of-neer-type-iib-lateral-clavicle-fractures
#13
Benjamin Erdle, Kaywan Izadpanah, Martin Jaeger, Patrizia Jensen, Lukas Konstantinidis, Jörn Zwingmann, Norbert P Südkamp, Dirk Maier
INTRODUCTION: Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular joint (ACJ) stabilization. The hypothesis was, that HPO would recreate coracoclavicular stability more effectively and potentially lead to a superior outcome. METHODS: This retrospective, observational cohort study included 32 patients (19 HPO, 13 LPO) with a mean age of 44...
March 20, 2017: Archives of Orthopaedic and Trauma Surgery
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/28315817/a-figure-eight-suture-loop-with-kirschner-wires-for-fixation-of-anteromedial-coronoid-process-fractures-a-case-series
#15
Longxiang Shen, Xingang Yu, Biao Zhong, Jian Ding
PURPOSE: Sufficient fixation of an anterior or anteromedial facet fracture of the coronoid process in fracture-dislocation of elbow is important to maintain joint stability. The purpose of this study was to report our experience with 11 patients who were managed with an original fixation technique using a "figure-eight" suture loop. METHODS: From February 2010 to March 2011, 11 cases with a fracture of the anterior or anteromedial facet of the coronoid process were treated by coronoid fixation using a figure-eight suture loop...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28314869/-operative-treatment-of-terrible-triad-injury-of-the-elbow-open-reduction-and-internal-fixation
#16
R Babst, C Schraner, F J P Beeres
AIM OF SURGERY: Reconstruction of the most important ligamentous and osseus structures of the elbow after terrible triad injury via the radial head to the lateral collateral ligament complex (LCL) and if necessary beginning at the coronoid process. The aim is a stable concentrically guided elbow with early functional follow-up treatment. The approach depends on the intraoperatively tested stability. INDICATIONS: Osteoligamentous terrible triad injury pattern with or without subluxation position following reduction and temporary immobilization...
March 17, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28298321/ubiquitin-e3-ligase-itch-negatively-regulates-osteoblast-function-by-promoting-proteasome-degradation-of-osteogenic-proteins
#17
J Liu, X Li, H Zhang, R Gu, Z Wang, Z Gao, L Xing
OBJECTIVES: Ubiquitin E3 ligase-mediated protein degradation regulates osteoblast function. Itch, an E3 ligase, affects numerous cell functions by regulating ubiquitination and proteasomal degradation of related proteins. However, the Itch-related cellular and molecular mechanisms by which osteoblast differentiation and function are elevated during bone fracture repair are as yet unknown. METHODS: We examined the expression levels of E3 ligases and NF-κB members in callus samples during bone fracture repair by quantitative polymerase chain reaction (qPCR) and the total amount of ubiquitinated proteins by Western blot analysis in wild-type (WT) mice...
March 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28296040/maxillofacial-trauma-patterns-associated-with-external-auditory-canal-fractures-cone-beam-computed-tomography-analysis
#18
Ibrahim K Ali, Kaustubh Sansare, Freny R Karjodkar, Prashant Salve, Kavita Vanga, Ajinkya M Pawar
BACKGROUND/ AIMS: There is a paucity of literature on EAC fractures secondary to maxillofacial trauma, with most of the literature on EAC fractures consisting of isolated case reports. To the authors' best knowledge, this is the first study to use Cone Beam Computed Tomography to evaluate the EAC region. The aim of this study was to assess the prevalence of external auditory canal (EAC) fracture following maxillofacial trauma and to evaluate the association between EAC fracture and other maxillofacial fractures and the region of trauma...
March 15, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28295125/treatment-of-locked-posterior-shoulder-dislocation-with-bone-defect
#19
Yousuf M Khira, Adel M Salama
Locked posterior shoulder dislocation is an uncommon condition and is associated with a reverse Hill-Sachs lesion in 50% of cases. The condition is likely to occur in cases of violent trauma, seizures, or electric shock. Unrecognized dislocation with humeral head fracture affects joint function and humeral head vascularity and may lead to chronic instability, osteonecrosis, and osteoarthritis. A group of 12 patients, including 10 men and 2 women, with neglected locked posterior shoulder dislocation with a reverse Hill-Sachs lesion were treated with the modified McLaughlin technique...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28294978/discriminative-features-in-three-autosomal-recessive-cutis-laxa-syndromes-cutis-laxa-iia-cutis-laxa-iib-and-geroderma-osteoplastica
#20
REVIEW
Ariana Kariminejad, Fariba Afroozan, Bita Bozorgmehr, Alireza Ghanadan, Susan Akbaroghli, Hamid Reza Khorram Khorshid, Faezeh Mojahedi, Aria Setoodeh, Abigail Loh, Yu Xuan Tan, Nathalie Escande-Beillard, Fransiska Malfait, Bruno Reversade, Thatjana Gardeitchik, Eva Morava
Cutis laxa is a heterogeneous condition characterized by redundant, sagging, inelastic, and wrinkled skin. The inherited forms of this disease are rare and can have autosomal dominant, autosomal recessive, or X-linked inheritance. Three of the autosomal recessive cutis laxa syndromes, namely cutis laxa IIA (ARCL2A), cutis laxa IIB (ARCL2B), and geroderma osteodysplastica (GO), have very similar clinical features, complicating accurate diagnosis. Individuals with these conditions often present with cutis laxa, progeroid features, and hyperextensible joints...
March 15, 2017: International Journal of Molecular Sciences
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