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https://www.readbyqxmd.com/read/29438635/twenty-year-follow-up-study-comparing-operative-versus-nonoperative-treatment-of-anterior-cruciate-ligament-ruptures-in-high-level-athletes
#1
Daan T van Yperen, Max Reijman, Eline M van Es, Sita M A Bierma-Zeinstra, Duncan E Meuffels
BACKGROUND: An anterior cruciate ligament (ACL) rupture has major consequences at midterm follow-up, with an increasing chance of developing an old knee in a young patient. The long-term (≥20 years) effects of the operative and nonoperative treatment of ACL ruptures are still unclear. PURPOSE: To compare the long-term treatment outcomes of operative versus nonoperative treatment of ACL ruptures in high-level athletes. STUDY DESIGN: Cohort study; Level of evidence, 2...
February 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29435624/arthroscopic-soft-tissue-reconstruction-in-anterior-shoulder-instability
#2
REVIEW
R M Frank, A A Romeo
Anterior glenohumeral instability remains a difficult problem in the athletic and working patient populations. Treatment strategies are variable and range from nonoperative approaches incorporating immobilization and rehabilitation to surgical management. Surgical decision-making can be challenging, especially with a high-level patient who wishes to return to high-demand activities. Operative options range from open soft tissue stabilization to arthroscopic soft tissue stabilization, with both open and arthroscopic options for bony reconstruction in the setting of clinically significant anterior glenoid bone loss...
February 2018: Der Orthopäde
https://www.readbyqxmd.com/read/29433645/difficulty-in-decision-making-in-the-treatment-of-displaced-proximal-humerus-fractures-the-effect-of-uncertainty-on-surgical-outcomes
#3
Joey LaMartina, Kaitlyn N Christmas, Peter Simon, Jonathan J Streit, Jesse W Allert, Jonathan Clark, Randall J Otto, Adham Abdelfattah, Mark A Mighell, Mark A Frankle
BACKGROUND: Decision making in the management of proximal humerus fractures can be difficult in situations in which the surgeon is uncertain of the ideal treatment. METHODS: Two shoulder surgeons operatively treated 476 proximal humerus fractures from 1998-2014 with open reduction-internal fixation (ORIF), hemiarthroplasty, or reverse shoulder arthroplasty. Operative treatment was stratified by year to determine the evolution of technological influences on treatment over time...
March 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29433644/what-happens-to-patients-when-we-do-not-repair-their-cuff-tears-five-year-rotator-cuff-quality-of-life-index-outcomes-following-nonoperative-treatment-of-patients-with-full-thickness-rotator-cuff-tears
#4
Richard S Boorman, Kristie D More, Robert M Hollinshead, James P Wiley, Nicholas G Mohtadi, Ian K Y Lo, Kelly R Brett
BACKGROUND: The purpose of this study was to examine 5-year outcomes in a prospective cohort of patients previously enrolled in a nonoperative rotator cuff tear treatment program. METHODS: Patients with chronic (>3 months), full-thickness rotator cuff tears (demonstrated on imaging) who were referred to 1 of 2 senior shoulder surgeons were enrolled in the study between October 2008 and September 2010. They participated in a comprehensive, nonoperative, home-based treatment program...
March 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29430388/arthroscopic-labral-repair-in-the-setting-of-recurrent-posterior-shoulder-instability
#5
George Sanchez, Nicholas I Kennedy, Márcio B Ferrari, Sandeep Mannava, Salvatore J Frangiamore, Matthew T Provencher
Posterior shoulder instability, although relatively rare in the general population, is more commonly seen in athletes, especially those in contact sports. Although nonoperative treatment has been associated with satisfactory results in the setting of posterior shoulder instability, conservative management may ultimately fail and lead to recurrence particularly in young, male patients. Both arthroscopic and open repair techniques to address posterior instability have been described, with each showing positive patient-reported outcomes, low risk of recurrence, and considerably high return-to-sport rates...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29430265/nonoperative-treatment-of-midshaft-clavicle-fractures-in-adults
#6
REVIEW
Sören Waldmann, Emanuel Benninger, Christoph Meier
Clavicle fractures are among the most common skeletal injuries accounting for 2-5% of all adult fractures. Historically, nonoperative treatment of midshaft clavicular fractures was considered the gold standard of care. Furthermore, nonoperative treatment has been challenged by an increasing popularity and rate of surgical fixations in recent years despite a lack of clear evidence in the current literature. Most fractures are suitable for conservative treatment. There is solid evidence in favour of nonoperative treatment for fractures with a displacement of less than 2cm and remaining contact of the bone fragments...
2018: Open Orthopaedics Journal
https://www.readbyqxmd.com/read/29429777/effects-of-surgical-and-nonoperative-treatment-on-wrist-function-of-patients-with-distal-radius-fracture
#7
Peng Zhang, Bo Jia, Xiao-Kun Chen, Yu Wang, Wei Huang, Tian-Bing Wang
PURPOSE: To study the effects of surgical and nonoperative treatment on wrist function in patients with distal radius fracture. METHODS: In total, 97 patients treated for distal radius fracture in the Department of Orthopedic Trauma at the People's Hospital of Peking University from Jan. 2010 to Jun. 2016 were selected for outpatient follow-up, including manipulative reduction and dorsal splint fixation in 24 cases, bivalve cast fixation in 19 cases and open reduction and internal fixation in 54 cases...
February 8, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29429563/return-to-work-or-sport-after-multiligament-knee-injury-a-systematic-review-of-21-studies-and-524-patients
#8
REVIEW
Joshua S Everhart, Amy Du, Radhika Chalasani, James C Kirven, Robert A Magnussen, David C Flanigan
PURPOSE: To systematically review multiligament knee injury (MLKI) outcome studies to determine overall rates of return to work or sport after MLKI and risk factors for lack of return to work or sport after MLKI. METHODS: A search was performed of MLKI outcome studies from 1950 to March 1, 2017. Ninety-two studies were identified. All included reported return to work, return to sport, or Tegner activity scores. Rates of return to work or sport were determined for overall population and by obesity status, injury severity, and presence of peroneal nerve or vascular injury...
February 8, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29429372/anti-inflammatory-effects-of-intra-articular-hyaluronic-acid-a-systematic-review
#9
Roy Altman, Asheesh Bedi, Ajay Manjoo, Faizan Niazi, Peter Shaw, Philip Mease
Objective Osteoarthritis (OA) is one of the leading causes of disability in the adult population. Common nonoperative treatment options include nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular corticosteroids, and intra-articular injections of hyaluronic acid (HA). HA is found intrinsically within the knee joint providing viscoelastic properties to the synovial fluid. HA therapy provides anti-inflammatory relief through a number of different pathways, including the suppression of pro-inflammatory cytokines and chemokines...
February 1, 2018: Cartilage
https://www.readbyqxmd.com/read/29428620/postoperative-chylothorax-after-thoracoabdominal-aortic-aneurysm-repair
#10
Darrell Wu, Arina E Chesnokova, Shahab Akvan, Matt D Price, David J Sugarbaker, Joseph S Coselli, Scott A LeMaire
OBJECTIVE: Chylothorax is a potentially deadly complication that can occur after thoracoabdominal aortic aneurysm (TAAA) repair. We describe our contemporary experience (2005-2014) with this complication, our efforts to identify perioperative variables associated with it, and our attempts to assess treatment outcomes. METHODS: We reviewed the records of 1092 consecutive patients who underwent TAAA repair between 2005 and 2014. Standard bivariate analysis was used to test for between-group differences...
February 8, 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29419692/comparison-of-surgical-or-nonsurgical-treatment-outcomes-in-patients-with-thoracolumbar-fracture-with-score-4-of-tlics-a-randomized-single-blind-and-single-central-clinical-trial
#11
Alireza Mohamadi, Ali Googanian, Ali Ahmadi, Alireza Kamali
BACKGROUND: Thoracolumbar fractures are among the most common types of damages caused to the spinal cord .Therefore, the aim of this study was the comparison of surgical or nonsurgical treatment outcomes in patients with thoracolumbar fracture with score 4 of the thoracolumbar injury classification and severity (TLICS) METHODS:: This study was clinical trial and double blind. Patients with thoracolumbar fracture with score 4 of TLICS entered at this research. We divided patients in 2 groups randomly (each group 25 patients) and then we followed patients for 1 year after start of treatment...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29417785/-therapeutic-progress-in-lumbar-spinal-stenosis
#12
REVIEW
Shao-Yan Shi, Yan-Sheng Huang, Ding-Jun Hao
Along with the population aging in China, patients with lumbar spinal stenosis(LSS) caused by recessive change incessantly increase. At present, there is no adequate evidence to recommend any specific nonoperative treatment for LSS, and surgery is still an effective method. The cilincal symptoms of the patients without conservative treatment got improvement after surgery, which is the strongest evidence base. Spinal instability after simple decompression promotes the development of fusion technique, and the accelerated adjacent segment degeneration and no relief in symptoms after fusion lead to dynamic fixation technology emerge as the times require...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29406451/is-use-of-a-psychological-workbook-associated-with-improved-disabilities-of-the-arm-shoulder-and-hand-scores-in-patients-with-distal-radius-fracture
#13
Stuart Goudie, Diane Dixon, Gail McMillan, David Ring, Margaret McQueen
BACKGROUND: Symptom intensity and magnitude of limitations correlate with stress, distress, and less effective coping strategies. It is unclear if interventions to target these factors can be used to improve outcomes after distal radius fracture in either the short- or longer term. QUESTIONS/PURPOSES: (1) Are there any factors (including the use of a workbook aimed at optimizing psychological response to injury, demographic, radiographic, medical, or psychosocial) associated with improved Disabilities of the Arm, Shoulder and Hand (DASH) and Numerical Rating Scale pain (NRS pain) scores at 6 weeks after management of distal radius fracture? (2) Are any of these factors associated with improved DASH and NRS pain scores at 6 months after management of distal radius fracture? METHODS: We conducted a double-blind randomized controlled trial comparing a workbook designed to optimize rehabilitation by improving psychological response to injury using recognized psychological techniques (the LEARN technique and goal setting) versus a workbook containing details of stretching exercises in the otherwise routine management of distal radius fracture...
February 2, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29403241/management-of-acute-combined-fractures-of-the-atlas-and-axis-a-retrospective-study-of-two-trauma-centers
#14
Joseph DiDomenico, Kingsley Abode-Iyamah, Ryan Khanna, Helena Roberts, Patrick A Hitchon, Zachary A Smith, Nader S Dahdaleh
Background: Management of combination fractures of the atlas and axis varies from nonoperative immobilization to selective early surgical intervention. In this study, we present our experience in managing these injuries. Materials and Methods: Electronic databases from two level 1 trauma centers were queried to identify all patients diagnosed with C1-C2 combination fractures from 2009 to present. Patient demographics, fracture characteristics, treatment modality, complications, Frankel scores, and fusion status were collected...
October 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/29399372/proximal-humerus-fractures-evaluation-and-management-in-the-elderly-patient
#15
REVIEW
Adam Schumaier, Brian Grawe
Introduction: Proximal humerus fractures are common in the elderly. The evaluation and management of these injuries is often controversial. The purpose of this study is to review recent evidence and provide updated recommendations for treating proximal humerus fractures in the elderly. Methods: A literature review of peer-reviewed publications related to the evaluation and management of proximal humerus fractures in the elderly was performed. There was a focus on randomized controlled trials and systematic reviews published within the last 5 years...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29396100/is-nonoperative-management-of-partial-distal-biceps-tears-really-successful
#16
Tyler M Bauer, Justin C Wong, Mark D Lazarus
BACKGROUND: The current treatment of partial distal biceps tears is a period of nonoperative management, followed by surgery, if symptoms persist. Little is known about the success rate and outcomes of nonoperative management of this illness. METHODS: We identified 132 patients with partial distal biceps tears through an International Classification of Diseases, Ninth Revision code query of our institution's database. Patient records were reviewed to abstract demographic information and confirm partial tears of the distal biceps tendon based on clinical examination findings and confirmatory magnetic resonance imaging (MRI)...
January 29, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29395151/outcome-of-initially-nonoperative-treatment-for-acute-simple-appendicitis-in-children
#17
Ramon R Gorter, Johanna H van der Lee, Florence A C J Heijsters, Huibert A Cense, Roel Bakx, C M Frank Kneepkens, Marc H Wijnen, Alida F W van der Steeg, Klaas H In't Hof, Martin Offringa, Hugo A Heij
PURPOSE: To compare the outcome of initially nonoperative treatment with immediate appendectomy for simple appendicitis in children. METHODS: Between September 2012 and June 2014 children aged 7-17 years with a radiologically confirmed simple appendicitis were invited to participate in a multicentre prospective cohort study in which they were treated with an initially nonoperative treatment strategy; nonparticipants underwent immediate appendectomy. In October 2015, their rates of complications and subsequent appendectomies, and health-related quality of life (HRQOL) were assessed...
December 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29390566/clinical-features-and-outcomes-of-blunt-splenic-injury-in-children-a-retrospective-study-in-a-single-institution-in-china
#18
Kaiying Yang, Yanan Li, Chuan Wang, Bo Xiang, Siyuan Chen, Yi Ji
Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29383279/ulnar-neck-fractures-associated-with-distal-radius-fractures
#19
Sezai Özkan, Stefan F Fischerauer, Thomas J M Kootstra, Femke M A P Claessen, David Ring
Background  There is little published data to guide management of ulnar neck fractures associated with fractures of the distal radius. Purpose  As unplanned surgery usually reflects adverse events and this injury combination is relatively uncommon, we used a large database to study the incidence of unplanned surgeries after surgical and nonsurgical treatment of distal metaphyseal ulna fractures associated with a distal radius fracture and identify factors associated with these unplanned surgeries. Patients and Methods  We identified 277 patients with an ulnar neck fracture associated with a distal radius fracture...
February 2018: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/29381946/efficacy-and-safety-of-9-nonoperative-regimens-for-the-treatment-of-spinal-cord-injury-a-network-meta-analysis
#20
Da-Nian Ma, Xia-Qi Zhang, Jie Ying, Zhong-Jun Chen, Li-Xin Li
OBJECTIVE: This network meta-analysis aims to compare the efficacy and safety of 9 nonoperative regimens (placebo, pregabalin, GM-1 ganglioside, venlafaxine extended-release [venlafaxine XR], fampridine, conventional over-ground training [OT], body-weight-supported treadmill training [BWSTT], robotic-assisted gait training [RAGT] + OT and body-weight-supported over-ground training [BWSOT]) in treating spinal cord injury (SCI). METHODS: Clinical controlled trials of 9 nonoperative regimens for SCI were retrieved in the electronic database...
November 2017: Medicine (Baltimore)
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