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Hardware removal

Matthieu Malatray, Michel Henri Fessy, Jean-Luc Besse
INTRODUCTION: The Scarf osteotomy is a commonly used surgical procedure for treating hallux valgus in Europe. Screw fixation is standard practice, although some surgeons now go without internal fixation. Plate fixation is still being studied. The aim of this study was to compare the radiological outcomes of these fixation methods, which has not been performed up to now. HYPOTHESIS: Relative to screw fixation, plate fixation of a Scarf osteotomy of the first metatarsal (M1) prevents secondary impaction, without increasing the complication rate or recurrence rate...
June 19, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yves P Acklin, Andreas Bircher, Mario Morgenstern, R Geoff Richards, Christoph Sommer
Routine implant removal is frequently performed although evidence-based guidelines are lacking. But routinely planned implant removal has significant economic implications and shows considerable complication rates. In general, clinical outcome seems to improve but pain relief after operation is often unpredictable. Even in patients reporting implant-related pain, implant removal does not guarantee relief and may be associated with further complications. The intra- and postoperative complication rate remains very high...
June 2018: Injury
Xiaobang Hu, Isador H Lieberman
PURPOSE: To examine the incidence of occult infection in revision spine surgeries and its correlation with preoperative inflammatory markers. METHODS: We retrospectively reviewed all patients who underwent revision spine surgery and hardware removal between 2010 and 2016. Patients who had preoperative clinical signs of infection were excluded. The hardware and surrounding tissue culture results were obtained. The patients' diagnosis and preoperative inflammatory marker (ESR, CRP, and procalcitonin) levels were recorded...
June 20, 2018: European Spine Journal
Pooya Hosseinzadeh, Clarabelle A DeVries, Ena Nielsen, Lindsay A Andras, Megan Mignemi, Jeffrey R Sawyer, John M Flynn, Stephen A Albanese
BACKGROUND: There has been an increase in the number of the graduates of pediatric orthopaedic fellowship programs over the past decade creating the potential for increased competition in the field. The purpose of this study was to analyze the effect of increased number of pediatric orthopaedic fellowship graduates on case volume as well as the type of procedures performed by recent graduates of pediatric orthopaedic fellowship programs from 2004 to 2014. METHODS: Case logs submitted for the American Board of Orthopaedic Surgery Part II examination by applicants with the self-declared subspecialty of pediatric orthopaedics from 2004 to 2014 were analyzed...
June 18, 2018: Journal of Pediatric Orthopedics
Michael Nienhaus, Ivan Zderic, Dieter Wahl, Boyko Gueorguiev, Pol Maria Rommens
BACKGROUND: Displaced transverse patellar fractures require open reduction and internal fixation. State-of-the-art stabilization techniques are tension band wiring (TBW) using Kirschner wires or cannulated screws. These techniques are associated with high rates of secondary fracture displacement, implant migration, implant prominence, wound-healing disturbances, and the need for implant removal. Recently, a locked intraosseous patellar nail prototype was developed. The aim of the present study was to investigate the biomechanical performance of this nail compared with TBW using cannulated screws...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Philipp Lacour, Claas Buschmann, Christian Storm, Jens Nee, Abdul Shokor Parwani, Martin Huemer, Philipp Attanasio, Leif-Hendrik Boldt, Geraldine Rauch, Andreas Kucher, Burkert Pieske, Wilhelm Haverkamp, Florian Blaschke
BACKGROUND: Postmortem interrogations of cardiac implantable electronic devices (CIEDs), recommended at autopsy in suspected cases of sudden cardiac death, are rarely performed, and data on systematic postmortem CIED analysis in the forensic pathology are missing. The aim of the study was to determine whether nonselective postmortem CIED interrogations and data analysis are useful to the forensic pathologist to determine the cause, mechanism, and time of death and to detect potential CIED-related safety issues...
June 19, 2018: Circulation
Antoine Morice, Florian Ducellier, Pascal Bizot
INTRODUCTION: The indications for total hip arthroplasty (THA) after failed internal fixation of a proximal femur fracture vary. Published studies on this topic are broad-ranging and do not distinguish between intracapsular and extracapsular fractures. This led us to conduct a retrospective analysis comparing the clinical outcomes, radiological outcomes, technical problems and complications between these two types of fractures. HYPOTHESIS: The functional outcomes of THA after an extracapsular fracture will be worse than the ones after an intracapsular fracture...
June 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
A Biazzo, A Manzotti, K Motavalli, N Confalonieri
Introduction: The aim of this paper is to present our experience with femoral press-fit fixation in anterior cruciate ligament reconstruction using bone-patellar tendon-bone autograft. Methods: The patient population was randomly placed in two groups: group A (58 patients), who underwent femoral screw fixation; group B (62 patients), who underwent femoral press-fit fixation. Results: At last follow-up 9.2% of patients were lost; 28% of patients in group A and 64% of patients in group B had excellent International Knee Documentation Committee score (grade A); 66% of patients in group A and 32% of patients in group B had good International Knee Documentation Committee scores (grade B)...
April 2018: Journal of Clinical Orthopaedics and Trauma
Andrew D Hahn, Jeff Kammerman, Sean B Fain
PURPOSE: A novel technique is presented for retrospective estimation and removal of gas-phase hyperpolarized Xenon-129 (HP 129 Xe) from images of HP 129 Xe dissolved in the barrier (comprised of parenchymal lung tissue and blood plasma) and red blood cell (RBC) phases. The primary aim is mitigating RF pulse performance limitations on measures of gas exchange (e.g., barrier-gas and RBC-gas ratios). Correction for gas contamination would simplify technical dissemination of HP 129 Xe applications across sites with varying hardware performance, scanner vendors, and models...
June 12, 2018: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
Nirbhay S Jain, Christopher B Horn, Adrian A Coleoglou Centeno, Obeid N Ilahi, John E Mazuski, Grant V Bocchichio, Laurie J Punch
BACKGROUND: Chronic osteomyelitis associated with a stage IV decubitus ulcer is a challenging condition to manage, characterized by frequent relapses and need for long-term anti-microbial therapy. Although gram-positive cocci are the most common causes, fungal infections have been reported, usually in immunocompromised hosts. We present a case of Cladophialophora osteomyelitis in a patient without known immunocompromised that was managed with a Girdlestone pseudoarthroplasty. CASE REPORT: A 70-year-old male presented to our emergency room with fever, right hip pain, and purulent drainage from a right greater trochanter stage IV decubitus ulcer...
June 12, 2018: Surgical Infections
Evan Luther, Timur Urakov, Steven Vanni
BACKGROUND AND STUDY OBJECTIVE:  Complex traumatic lumbar spine fractures are difficult to manage and typically occur in younger patients. Surgical immobilization for unstable fractures is an accepted treatment but can lead to future adjacent-level disease. Furthermore, large variations in fracture morphology create significant difficulties when attempting fixation. Therefore, a surgical approach that considers both long-term outcomes and fracture type is of utmost importance. We present a novel technique for percutaneous fixation without interbody or posterolateral fusion in a young patient with bilateral pedicle dissociations and an acute-onset incomplete neurologic deficit...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
Philipp Franck, Jaime L Bernstein, Leslie E Cohen, Roger Härtl, Ali A Baaj, Jason A Spector
OBJECTIVES: Patients with neoplastic disease involving the spine either from primary or metastatic disease present a unique challenge given these patients' frequent poor nutritional status at the time of surgery, the delivery of early post-operative chemotherapy or radiation, and placement of large amounts of hardware and avascular bone graft into a wound bed that is atrophic, previously operated or irradiated. As a result, wound morbidity has traditionally been high in this cohort of patients...
May 29, 2018: Clinical Neurology and Neurosurgery
Shunxing Bao, Yuankai Huo, Prasanna Parvathaneni, Andrew J Plassard, Camilo Bermudez, Yuang Yao, Ilwoo Lyu, Aniruddha Gokhale, Bennett A Landman
When processing large medical imaging studies, adopting high performance grid computing resources rapidly becomes important. We recently presented a "medical image processing-as-a-service" grid framework that offers promise in utilizing the Apache Hadoop ecosystem and HBase for data colocation by moving computation close to medical image storage. However, the framework has not yet proven to be easy to use in a heterogeneous hardware environment. Furthermore, the system has not yet validated when considering variety of multi-level analysis in medical imaging...
March 2018: Proceedings of SPIE
Quintin Liao, Nathan C Skipper, Michael J Brown, Paul J Jenkins
Purpose: To compare reoperation rates between closed reduction with percutaneous pinning (CRPP) and internal fixation with a volar locking plate (VLP) for the treatment of distal radius fractures. Methods: A retrospective review of all patients with dorsally displaced distal radius fractures presenting to a hospital over an eight-year period. Results: 1364 procedures were reviewed after applying the exclusion criteria; 663 underwent CRPP and 701 underwent VLP...
June 2018: Journal of Orthopaedics
Ulrich Woiwode, Roland Johann Reischl, Stephan Buckenmaier, Wolfgang Lindner, Michael Lämmerhofer
The present contribution illustrates the utilization of a chiral × chiral two dimensional liquid chromatography (2DLC) setup with tert-butylcarbamoyl quinine chiral stationary phase (CSP) in the first dimension (1D) and tert-butylcarbamoyl quinidine CSP in the second dimension (2D) to analyze FMOC-derivatized D and L amino acids from peptide hydrolysates. Hereby, in the 1D and 2D chiral separation dimensions factors such as selector and immobilization chemistry of the CSPs, mobile phase, temperature, column hardware dimensions, stationary phase supports, particle type and packing were identical...
June 6, 2018: Analytical Chemistry
S Tamaru, S Tsunegi, H Kubota, S Yuasa
This work presents a vector network analyzer ferromagnetic resonance (VNA-FMR) spectrometer with field differential detection. This technique differentiates the S-parameter by applying a small binary modulation field in addition to the DC bias field to the sample. By setting the modulation frequency sufficiently high, slow sensitivity fluctuations of the VNA, i.e., low-frequency components of the trace noise, which limit the signal-to-noise ratio of the conventional VNA-FMR spectrometer, can be effectively removed, resulting in a very clean FMR signal...
May 2018: Review of Scientific Instruments
Janosch Häberli, Benjamin Voumard, Clemens Kösters, Daniel Delfosse, Philipp Henle, Stefan Eggli, Philippe Zysset
PURPOSE: Dynamic intraligamentary stabilization (DIS) is a primary repair technique for acute anterior cruciate ligament (ACL) tears. For internal bracing of the sutured ACL, a metal spring with 8 mm maximum length change is preloaded with 60-80 N and fixed to a high-strength polyethylene braid. The bulky tibial hardware results in bone loss and may cause local discomfort with the necessity of hardware removal. The technique has been previously investigated biomechanically; however, the amount of spring shortening during movement of the knee joint is unknown...
June 1, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
S Rammelt, E Manke
BACKGROUND: Injuries to the distal tibiofibular syndesmosis are frequent and continue to generate controversy due to an extensive range of diagnostic techniques and therapeutic options. OBJECTIVE: The aim of this review is to summarize the current knowledge on syndesmotic instability and to present some recommendations for the clinical practice for acute an chronic injuries. MATERIAL AND METHODS: Analysis of the current literature concerning the anatomy, etiology, diagnostics and treatment of syndesmosis injuries...
May 29, 2018: Der Unfallchirurg
Matteo Buda, Shaun Kink, Ruben Stavenuiter, Catharina Noortje Hagemeijer, Bonnie Chien, Ali Hosseini, Anne Holly Johnson, Daniel Guss, Walter Christopher DiGiovanni
BACKGROUND: Controversy persists as to whether Lisfranc injuries are best treated with open reduction internal fixation (ORIF) versus primary arthrodesis (PA). Reoperation rates certainly influence this debate, but prior studies are often confounded by inclusion of hardware removal as a complication rather than as a planned, staged procedure inherent to ORIF. The primary aim of this study was to evaluate whether reoperation rates, excluding planned hardware removal, differ between ORIF and PA...
May 1, 2018: Foot & Ankle International
J Isidro, J Llanos, C Sáez, J Lobato, P Cañizares, M A Rodrigo
This work presents the design and evaluation of a new concept of pre-disinfection treatment that is especially suited for highly polluted surface water and is based on the combination of coagulation-flocculation, lamellar sedimentation and filtration into a single-column unit, in which the interconnection between treatments is an important part of the overall process. The new system, the so-called PREDICO (PRE-DIsinfection Column) system, was built with low-cost consumables from hardware stores (in order to promote in-house construction of the system in poor countries) and was tested with a mixture of 20% raw wastewater and 80% surface water (in order to simulate an extremely bad situation)...
May 25, 2018: Journal of Environmental Management
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