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https://www.readbyqxmd.com/read/28214465/acute-and-chronic-lateral-ankle-instability-diagnosis-management-and-new-concepts
#1
Rachel Shakked, Steven Sheskier
Lateral ankle instability is a common entity that can result in degenerative arthritis if left untreated. Acute ligament injuries should primarily be treated nonoperatively with a course of physical therapy and functional bracing. Chronic ankle instability is defined as mechanical or functional and can be diagnosed using a combination of history, physical examination, stress radiographs, and magnetic resonance imaging. After failure of nonoperative treatment, surgical treatment with anatomic ligament repair and inferior extensor retinaculum augmentation has the best clinical outcomes...
January 2017: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/28213607/efficacy-and-safety-of-nonoperative-treatment-for-acute-appendicitis-a-meta-analysis
#2
REVIEW
Roxani Georgiou, Simon Eaton, Michael P Stanton, Agostino Pierro, Nigel J Hall
CONTEXT: Nonoperative treatment (NOT) with antibiotics alone of acute uncomplicated appendicitis (AUA) in children has been proposed as an alternative to appendectomy. OBJECTIVE: To determine safety and efficacy of NOT based on current literature. DATA SOURCES: Three electronic databases. STUDY SELECTION: All articles reporting NOT for AUA in children. DATA EXTRACTION: Two reviewers independently verified study inclusion and extracted data...
February 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/28193544/current-approach-to-liver-traumas
#3
Levent Kaptanoglu, Necmi Kurt, Hasan Ediz Sikar
INTRODUCTION: Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. PRESENTATION OF CASE: Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003-2013...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28193139/the-relationship-between-radiological-alignment-of-united-distal-radius-fractures-and-functional-and-patient-perceived-outcomes-in-elderly-patients
#4
Erik Hohmann, Mahendrakumar Meta, Vasudev Navalgund, Kevin Tetsworth
PURPOSE: The purpose of this study was to investigate the relationship between radiological alignment and functional outcomes including strength, range of motion (ROM), and disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores in elderly patients with united distal radius fractures. METHODS: We reviewed 118 patients (mean age of 76.2 ± 9.5 years, mean follow-up 36.3 ± 17.6 months). Outcome measures included the DASH and PRWE scores, ROM, and grip and pinch strength were measured using a validated mobile hand-held dynamometer...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#5
Mallory S Bray, Andrew J Borgert, Milan E Folkers, Shanu N Kothari
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) carries a small but significant risk of perforation. Recent data suggest that select patients can be managed non-operatively. We sought to evaluate the management of ERCP perforations at our community medical center. METHODS: ERCPs performed from 2004 to 2015 were reviewed. RESULTS: Twenty-one of 2423 patients who underwent ERCP had a perforation (0.9%). ERCP procedures included balloon sweep with/without sphincterotomy and pancreatic duct stent (71%), common bile duct brushing (10%), and pancreatic duct stenting (5%)...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28167056/managing-complications-of-calcaneus-fractures
#6
REVIEW
Michael P Clare, William S Crawford
Calcaneus fractures remain among the most complicated fractures for orthopedic surgeons to manage because of the complexity of various fracture patterns, the limited surrounding soft tissue envelope, and the prolonged rehabilitation issues impacting function after successful treatment. Despite this, appropriate management of complications associated with calcaneus fractures is critical for the complete care of this injury, whether treated operatively or nonoperatively. The authors present the common complications encountered with fractures of the calcaneus and management thereof...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28166172/cost-and-cost-effectiveness-analysis-of-treatment-options-for-sanders-ii-and-iii-calcaneus-fractures-in-laborers
#7
R Carter Clement, Pamela J Lang, Brett J Pettett, Robert A Overman, Robert F Ostrum, Josh N Tennant
OBJECTIVE: This study compares the cost and cost-effectiveness of treatments options for Sanders II/III displaced intra-articular calcaneus fractures (DIACF's) in laborers. METHODS: Literature on Sanders type II and III fractures was reviewed to determine complication rates and utility values for each treatment option. Costs were calculated using Medicare reimbursement and implant prices from our institution. Monte Carlo simulations were used to analyze a decision-tree to determine the cost and cost-effectiveness of each treatment from a societal perspective...
January 30, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28162264/nonfunctioning-small-incidental-pancreatic-neuroendocrine-tumors-results-of-a-nonoperative-approach-cohort
#8
Catalina Uribe Galeano, Joan Fabregat Prous, Juli Busquets Barenys, Nuria Pelaez Serra, Lluís Secanella Medayo, Emilio Ramos Rubio, Sandra Ruiz Osuna, Carlos Villabona Artero
OBJECTIVE: The availability of new imaging techniques has conditioned an increase in the incidental diagnosis of small nonfunctioning pancreatic neuroendocrine tumors (PNET-NF). The best treatment is controversial, some authors advise a conservative approach in selected cases. Our aim is to analyze the evolution of incidental, small size PNET-NF, treated with clinical follow-up without surgery. METHODS: We performed a retrospective analysis of a prospective database of patients diagnosed incidentally with PNET-NF since November 2007 to September 2015...
February 2, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28155059/outcomes-and-financial-implications-of-intra-articular-distal-radius-fractures-a-comparative-study-of-open-reduction-internal-fixation-orif-with-volar-locking-plates-versus-nonoperative-management
#9
Dong Hao Toon, Rex Antony Xavier Premchand, Jane Sim, Rajaratnam Vaikunthan
BACKGROUND: To evaluate the functional and radiographic outcomes, as well as the treatment costs, of closed displaced intra-articular distal radius fractures treated with either open reduction internal fixation (ORIF) with volar locking plates or nonoperative treatment with plaster cast immobilisation. MATERIALS AND METHODS: A total of 60 patients (32 receiving ORIF, 28 receiving nonoperative treatment) with closed intra-articular distal radius fractures were included...
February 2, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28152148/evaluation-of-a-minimally-disruptive-treatment-protocol-for-frontal-sinus-fractures
#10
Sapna A Patel, Angelique M Berens, Karthik Devarajan, Mark E Whipple, Kris S Moe
Importance: Despite common goals of frontal sinus fracture treatment (restoring forehead contour and creating a safe sinus), there remains significant variability in evaluation and treatment. Objective: To describe our experience with a minimally disruptive treatment protocol for the treatment of frontal sinus fractures. Design, Setting, and Participants: Analysis of prospectively collected data from 2010 through 2015 at a level 1 trauma center...
February 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28144574/current-management-of-talar-osteochondral-lesions
#11
REVIEW
Arianna L Gianakos, Youichi Yasui, Charles P Hannon, John G Kennedy
Osteochondral lesions of the talus (OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation (BMS), or replacement procedures, such as autologous osteochondral transplantation (AOT)...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28144210/intestinal-intussusception-etiology-diagnosis-and-treatment
#12
REVIEW
Priscilla Marsicovetere, S Joga Ivatury, Brent White, Stefan D Holubar
Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. Idiopathic ileocolic intussusception is the most common form in children and is typically managed with nonoperative reduction via pneumatic and/or hydrostatic enemas. In the adult population, intussusception is uncommon and occurs more often in the small intestine than in the colon. It is associated with lead point pathology in most symptomatic cases presenting as bowel obstruction. When lead point pathology is present in adult small bowel intussusception, it is usually benign, though when malignant it is most frequently due to diffuse metastatic disease, for example, melanoma...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144206/functional-disorders-rectoanal-intussusception
#13
REVIEW
Kristen Blaker, Joselin L Anandam
Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. Patients may present with constipation, incomplete evacuation, incontinence, or may be asymptomatic. Defecography has been the gold standard for detection. Magnetic resonance imaging defecography and dynamic anal endosonography are alternatives to conventional defecography. However, both methods are not as sensitive as conventional defecography. Treatment options range from conservative/medical treatment such as biofeedback to surgical procedures such as Delorme, rectopexy, and stapled transanal rectal resection...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28141687/what-are-the-indications-for-spinal-fusion-surgery-in-scheuermann-kyphosis
#14
David W Polly, Charles G T Ledonio, Beverly Diamond, Hubert Labelle, Daniel J Sucato, M Timothy Hresko, John B Emans, Michael G Vitale, Mark A Erickson, A Noelle Larson
BACKGROUND: Surgical indications for Scheuermann kyphosis are variable. We sought to evaluate the characteristics of patients undergoing operative versus nonoperative treatment of Scheuermann kyphosis to better understand current practices and the factors which contribute to the decision for surgical management. METHODS: Multicenter prospective cohort study. We evaluated consecutive patients presenting with Scheuermann kyphosis. Patients underwent either surgical or nonoperative management according to surgeon and patient discretion...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28139385/nonoperative-management-versus-reverse-shoulder-arthroplasty-for-treatment-of-3-and-4-part-proximal-humeral-fractures-in-older-adults
#15
Troy A Roberson, Charles M Granade, Quinn Hunt, James T Griscom, Kyle J Adams, Amit M Momaya, Adam Kwapisz, Michael J Kissenberth, Stefan J Tolan, Richard J Hawkins, John M Tokish
BACKGROUND: The treatment of 3- and 4-part proximal humeral fractures in the older adult is controversial. No study has directly compared reverse shoulder arthroplasty (RSA) with nonoperative treatment for these fractures. The purpose of this study was to compare clinical and patient-reported outcomes between RSA and nonoperative treatment groups. METHODS: A retrospective review was performed on all 3- and 4-part proximal humeral fractures treated with either RSA or nonoperative treatment with minimum 1-year follow-up...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28131634/comminuted-intraarticular-fractures-of-the-tibial-plateau-lead-to-posttraumatic-osteoarthritis-of-the-knee-current-treatment-review
#16
REVIEW
Matthias Aurich, Veit Koenig, Gunther Hofmann
Posttraumatic osteoarthritis (PTOA) of the knee is a common complication after intra- and extra-articular fractures. Moreover, PTOA may also be a result of isolated cartilage defects, meniscus resections, and ligament injuries. There are various methods of treatment of knee joint fractures. However, in the final stage of a PTOA, when nonoperative treatment fails, endoprosthetic joint replacement is the method of choice. Primary total knee replacement (TKR) for the treatment for a fracture of the knee joint is a rare indication, even at major treatment centers...
January 25, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28125914/sports-injuries-to-the-latissimus-dorsi-and-teres-major
#17
Benjamin F Donohue, Marc G Lubitz, Timothy E Kremchek
Injuries to the latissimus dorsi and teres major muscles, while rare, are debilitating. They are seen in a variety of sports, although disproportionately in the throwing shoulder of baseball pitchers. There have been 25 case reports and 2 case series published on the nonoperative and operative management of these injuries. Latissimus dorsi and teres major muscle anatomy, function, and common injury patterns are well described in these case reports. Also well detailed are the typical patient presentation, physical examination, and imaging findings...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28125910/biceps-disorder-rehabilitation-for-the-athlete
#18
Dorien Borms, Inge Ackerman, Pieter Smets, Glen Van den Berge, Ann M Cools
BACKGROUND: Progressive biceps loading is recommended in the nonoperative and operative rehabilitation of biceps-related disorders. Previous researchers have proposed a continuum of exercises with low to moderate biceps loads to be used in the early and intermediate phases of rehabilitation. A progression of exercises with moderate to high biceps loads to be used in the more advanced phases of rehabilitation is lacking. PURPOSE: To describe a progression of exercises with progressive moderate to high loads on the biceps brachii (BB) based on electromyographic (EMG) analysis...
December 1, 2016: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28125533/surgical-treatment-of-neuromas-improves-patient-reported-pain-depression-and-quality-of-life
#19
Leahthan F Domeshek, Emily M Krauss, Alison K Snyder-Warwick, Osvaldo Laurido-Soto, Jessica M Hasak, Gary B Skolnick, Christine B Novak, Amy M Moore, Susan E Mackinnon
BACKGROUND: Surgical management of neuromas is difficult, with no consensus on the most effective surgical procedure to improve pain and quality of life. This study evaluated the surgical treatment of neuromas by neurectomy, crush, and proximal transposition on improvement in pain, depression, and quality of life. METHODS: Patients who underwent neuroma excision and proximal transposition were evaluated. Preoperative and postoperative visual analogue scale scores for pain (worst and average), depression, and quality of life were assessed using linear regression, and means were compared using paired t tests...
February 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28124292/injuries-to-the-great-toe
#20
REVIEW
Philip J York, Frank B Wydra, Kenneth J Hunt
PURPOSE OF REVIEW: Injuries to the great toe are common in athletes. While most are managed nonoperatively and allow return to sports activity, some great toe injuries are highly problematic and can impact function. The purpose of this review is to highlight several specific injuries and disease processes involving the hallux and to detail current recommendations and management options in order to help raise suspicion for injuries that can result in long-term dysfunction. RECENT FINDINGS: Toe injuries have been found to represent nearly 10% of injuries presenting to fracture clinics...
January 26, 2017: Current Reviews in Musculoskeletal Medicine
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