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orthopedics, trauma, arthroplasty, fracture

Aniruddh Agrawal, Vinod Agrawal, Sandeepkumar Yadav, Shushil K Soni, Sawan Kumar Pawar
Introduction: Total femur arthroplasty (TFA) is a rare salvage limb procedure which serves as an effective alternative to limb amputation. Most commonly, it is indicated for oncologic orthopedic cases, and very few cases of a purely traumatic history for TFA have been documented. The decision to perform this complex procedure involves paying careful attention to reconstructive needs and functional expectations of the patient. Alternatives to this procedure are quite detrimental and include hip disarticulation and above-the-knee amputation...
July 2017: Journal of Orthopaedic Case Reports
David P Taormina, Sanjit R Konda, Frank A Liporace, Kenneth A Egol
INTRODUCTION: Much has been studied with reference to methicillin resistant Staphylococcus aureus (MRSA) and methicillin sensitive S. aureus (MSSA) colonization and associated outcomes and comorbidities. In the area of Orthopedic surgery, literature predominantly comes from the field of arthroplasty. Little is known about outcomes of fracture and Orthopedic trauma patients in the setting of S. aureus colonization. We believe that MRSA/MSSA colonization in and of itself may be a weak marker for generally poor protoplasm, potentially with complex medical history including previous hospitalization or rehab placement...
October 31, 2017: Journal of Infection and Public Health
G Falzarano, A Piscopo, G Rollo, A Medici, P Grubor, M Bisaccia, V Pipola, R Cioffi, F Nobile, L Meccariello
PURPOSE: Periprosthetic acetabular fractures represent a growing and serious complication of total hip arthroplasty (THA). The purpose of the study is to report our experience in the use of tantalum for the treatment of Paprosky type IV and V periprosthetic acetabular fractures. METHOD: We analyzed 24 patients with type IV and V periprosthetic acetabular fractures. Patients were treated with a revision surgery using tantalum components, in some cases in association with posterior plating...
April 2018: Musculoskeletal Surgery
Vaibhav Bagaria, Kshitij Chaudhary
INTRODUCTION: Preoperative planning is an important aspect of any orthopedic surgery. Traditionally, surgeons mentally rehearse the operation and anticipate problems based on data available from "radiography" like MRI and CT. 3D printed bio-models and tools, or "3Dgraphy" can simplify this mental exercise and provide a realistic and user-friendly portrayal of this radiographic data. METHODS: Five surgeons participated in this multicenter study. 3D printed biomodels were obtained for 50 surgical cases that included periarticular trauma (24), pelvic trauma (11), complex primary (7), and revision arthroplasty (8)...
September 1, 2017: Injury
Mélissa Laflamme, Pierre-Philippe Grenier-Gauthier, Alexandre Leclerc, Stéphanie Antoniades, Anne-Marie Bédard
BACKGROUND: When necessary, radial head integrity after a fracture can be re-created by the use of a radial head arthroplasty if the radial head is judged irreparable. The purpose of this study was to compare the clinical and radiographic outcomes of metal modular radial head replacements with a smooth vs. a porous stem. METHODS: A retrospective cohort study of radial head replacements performed in the first 4 weeks after a trauma in an adult patient at our institution between 2000 and 2014 was completed...
August 2017: Journal of Shoulder and Elbow Surgery
Lukas L Negrin, David Seligson
BACKGROUND: Acetabular fractures are quite challenging injuries for the orthopedic surgeon because of their low incidence and their deep and complex anatomy. The objective of this study was to evaluate surgeon-independent parameters that might influence radiographic outcome and early complication rates of high-energy acetabular fractures treated by open reduction and internal fixation via the Kocher-Langenbeck approach, the golden standard for posterior access. METHODS: One hundred sixty-seven consecutive patients (111 males and 56 females) with a mean age of 41...
April 26, 2017: Journal of Orthopaedic Surgery and Research
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
Christoph Ihle, Thomas Freude, Christian Bahrs, Eva Zehendner, Janick Braunsberger, Hans Konrad Biesalski, Christine Lambert, Ulrich Stöckle, Elke Wintermeyer, Julia Grünwald, Leonard Grünwald, Gunnar Ochs, Ingo Flesch, Andreas Nüssler
INTRODUCTION: Suboptimal nutritional status is often observed among hospitalized patients across all medical specialties. The objective of the present study was to (1) analyze the prevalence of malnutrition in hospitalized orthopedic and trauma patients and (2) to evaluate the relationship between malnutrition and selected clinical outcomes. MATERIALS AND METHODS: The prospective field study was conducted between 06/2014 and 06/2015 in a German level I trauma center (Department of Traumatology, Septic Trauma Surgery and Arthroplasty) with a total number of 1055 patients...
March 2017: Injury
P Garcia, C Domnick, G Lodde, M J Raschke
BACKGROUND: Since 2005, when the Diagnosis-Related Group (DRG) system was introduced, an increasing number of surgical procedures have been reported in Germany. In particular, the numbers of elective arthroplasty and spinal surgery procedures have been controversial. OBJECTIVES: The focus of this study was analyzing the development of spinal surgery, arthroplasty, and fracture management. MATERIALS AND METHODS: We analyzed the database for all musculoskeletal operating procedure codes (OPS codes 5‑78 to 5‑86) from 2005 to 2013 collected by the German Federal Statistical Office...
November 11, 2016: Der Unfallchirurg
Charles A Cefalu, Thomas P Royals, Peter C Krause
Pseudoaneurysms are uncommon in patients with trauma, but can cause diagnostic difficulty and result in significant morbidity. Etiologies range from penetrating and nonpenetrating trauma to operative injury during fracture fixation, arthroscopy, total joint arthroplasty, and hardware loosening and removal. Pseudoaneurysms can conspicuously present as a pulsatile mass with an audible bruit, or as a subtly expanding hematoma. In either case, the complications can be serious if diagnosed late. The authors report a case of a pseudoaneurysm arising from the descending geniculate artery following a tibial plateau fracture...
January 1, 2017: Orthopedics
Swapnil B Shah, Theodore T Manson, Jason W Nascone, Marcus F Sciadini, Robert V O'Toole
A retrospective review was conducted at an academic trauma center to determine whether fracture characteristics or aspects of native anatomy are predictive of early failure after fixation of posterior wall acetabular fractures. A chart review of posterior wall acetabular fractures treated from 2004 to 2009 yielded the study group that met the inclusion criteria. The study group included 18 consecutive patients who had clinical failure. The control group included 27 patients who did not have clinical failure...
November 1, 2016: Orthopedics
Jason A Solomon, Sheeba M Joseph, Yousef Shishani, Brian N Victoroff, John H Wilber, Reuben Gobezie, Robert J Gillespie
Complex proximal humerus fractures in older patients can be treated with hemiarthroplasty (HA) or reverse shoulder arthroplasty (RSA), with both providing good pain relief and function. This study compared the costs, complications, and outcomes of HA vs RSA after proximal humerus fracture in older patients. Patients 65 years or older who were admitted between January 2007 and August 2011 with a 3- or 4-part proximal humerus fracture and treated with HA or RSA were identified. Surgeries were performed at the same institution by 1 of 3 surgeons trained in trauma or shoulder surgery...
July 1, 2016: Orthopedics
Julian Dexel, Franziska Beyer, Cornelia Lützner, Christian Kleber, Jörg Lützner
The purpose of this study was to evaluate the surgical effort of total knee arthroplasty (TKA) for posttraumatic osteoarthritis (PTOA) compared with primary osteoarthritis (OA). A total of 1841 TKAs were analyzed, including 170 patients with PTOA, that resulted from soft tissue trauma in 83 patients and fractures in 87 patients. Results showed that patients were significantly younger at the time of surgery in the posttraumatic group (62 vs 71 years; P<.001). Furthermore, fracture was associated with 3.7 years earlier need of TKA compared with soft tissue trauma...
May 2016: Orthopedics
Nabil A Ebraheim, Leanne H Kelley, Xiaochen Liu, Ian S Thomas, Robert B Steiner, Jiayong Liu
This study was designed to itemize and analyze the classification of fracture types and their corresponding outcomes in an attempt to provide a better understanding of the current treatment methods. Two PubMed searches were performed using the words "periprosthetic distal femur fracture" and "periprosthetic supracondylar femur fracture" in studies that were published in the previous 10 years (2004-2014). Data from 41 articlesthat met the general inclusion criteria, were collected and categorized into fracture type and treatment method groupings...
November 2015: Orthopaedic Surgery
Benedict U Nwachukwu, William W Schairer, Evan O'Dea, Frank McCormick, Joseph M Lane
As health care in the United States transitions toward a value-based model, there is increasing interest in applying cost-effectiveness analysis within orthopedic surgery. Orthopedic trauma care has traditionally underemphasized economic analysis. The goals of this review were to identify US-based cost-utility analysis in orthopedic trauma, to assess the quality of the available evidence, and to identify cost-effective strategies within orthopedic trauma. Based on a review of 971 abstracts, 8 US-based cost-utility analyses evaluating operative strategies in orthopedic trauma were identified...
August 2015: Orthopedics
Vania Regina Goveia, Isabel Yovana Quispe Mendoza, Bráulio Roberto Gonçalves Marinho Couto, Jose Antonio Guimarães Ferreira, Edson Barreto Paiva, Gilberto Lima Guimarães, Maria Aparecida Resende Stoianoff
OBJECTIVE: to characterize the epidemiological profile of patients undergoing hip replacement, primary or revisional. METHODS: we conducted a retrospective, descriptive study, including hip arthroplasties performed from January 2009 to June 2012 in a Belo Horizonte teaching hospital, Minas Gerais State - MG, Brazil. Data were analyzed using descriptive statistics. RESULTS: orthopedic procedures represented 45% of the operations at the hospital in the period, 1...
March 2015: Revista do Colégio Brasileiro de Cirurgiões
Gert-Jan A ter Boo, Dirk W Grijpma, Thomas F Moriarty, Robert G Richards, David Eglin
Infectious complications occur in a minor but significant portion of the patients undergoing joint replacement surgery or fracture fixation, particularly those with severe open fractures, those undergoing revision arthroplasty or those at elevated risk because of poor health status. Once established, infections are difficult to eradicate, especially in the case of bacterial biofilm formation on implanted hardware. Local antibiotic carriers offer the prospect of controlled delivery of antibiotics directly in target tissues and implant, without inducing toxicity in non-target organs...
June 2015: Biomaterials
Leonard T Buller, Charles M Lawrie, Fernando E Vilella
Acetabular fractures in the elderly are most frequently the result of low-energy trauma and present unique management challenges to orthopedic surgeons. Evaluation and treatment should be performed in a multidisciplinary fashion with early involvement of internal medicine subspecialists and geriatricians. Distinct fracture patterns and pre-existing osteoarthritis and osteoporosis necessitate careful preoperative planning. The role of total hip arthroplasty should also be considered when surgical treatment is indicated...
April 2015: Orthopedic Clinics of North America
Y Z Lawal, M O Ogirima, I L Dahiru, K Abubakar, A Ajibade
INTRODUCTION: The use of drains in trauma and Orthopaedic practice has been affected by the concept of evidence based medicine that has become accepted as standard of care for all surgical or medical practice, which questions all care processes that cannot be backed by evidence to be beneficial to the patient. There have been a large number of multi centre meta-analytical studies that found drains to be of little or no benefit in trauma and Orthopaedic operations. Because of these studies, there are few situations where drains are routinely used e...
May 2014: Nigerian Journal of Clinical Practice
D Wähnert, B Schliemann, M J Raschke, C Kösters
BACKGROUND: Periprosthetic fractures represent a common and complex challenge in the clinical practice in orthopedics and trauma surgery. Due to demographic changes characterized by increased life expectancy and higher numbers of primary arthroplasties, the number of periprosthetic fractures is increasing as well. Factors such as osteoporosis, multimorbidity and a highly active aging population additionally increase the complexity of periprosthetic fractures. INJURY PATTERNS: Most periprosthetic fractures affect the proximal and distal femur; however, periprosthetic fractures of the tibial head, the ankle, shoulders and the upper extremities as well as complex interprosthetic fractures pose an increasing challenge for orthopedic and trauma surgeons...
April 2014: Der Orthopäde
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