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orthopedics, trauma, arthroplasty, fracture

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...
January 22, 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...
October 31, 2016: 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
Neil V Shah, Robert Meislin
Bone and tissue adhesives are common and beneficial supplements to standard methods of musculoskeletal tissue suture repair. Knowledge and development of biologically derived or inspired adhesives useful in orthopedic surgery are rapidly advancing. Recent literature demonstrates the increased adjunct or primary use of biological adhesives in the repair of musculoskeletal soft tissues, chondral fractures, and osteochondral fractures. Adhesives offer more benefits and enhancements to tissue healing than current fixation methods afford, including improved biocompatibility, resorbability, and non-immunogenicity...
December 2013: Orthopedics
Brianne Burton, Anne Gaspar, David Josey, Jindra Tupy, Marc D Grynpas, Thomas L Willett
Bone allografts are often used in orthopedic reconstruction of skeletal defects resulting from trauma, bone cancer or revision of joint arthroplasty. γ-Irradiation sterilization is a widely-used biological safety measure; however it is known to embrittle bone. Irradiation has been shown to affect the post-yield properties, which are attributed to the collagen component of bone. In order to find a solution to the loss of toughness in irradiated bone allografts, it is important to fully understand the effects of irradiation on bone collagen...
April 2014: Bone
Michael A Mont, Robert Pivec, Kimona Issa, Steven F Harwin
The presence of retained femoral hardware, usually as a consequence of prior orthopedic trauma, has been classically presented as something that must be removed prior to total hip arthroplasty. However, hardware removal is not without risks, including pain, creation of stress risers, and refracture. The authors report a patient with a retained retrograde femoral nail who underwent total hip arthroplasty with a short, neck-preserving femoral stem used to avoid the need for hardware removal. Clinical results at short-term follow-up have been excellent...
October 1, 2013: Orthopedics
S Boisgard, S Descamps, B Bouillet
Although total hip arthroplasty is now a classic procedure that is well controlled by orthopedic surgeons, some cases remain complex. Difficulties may be due to co-morbidities: obesity, skin problems, muscular problems, a history of neurological disease or associated morphological bone deformities. Obese patients must be informed of their specific risks and a surgical approach must be used that obtains maximum exposure. Healing of incisions is not a particular problem, but adhesions must be assessed. Neurological diseases may require tenotomy and the use of implants that limit instability...
February 2013: Orthopaedics & Traumatology, Surgery & Research: OTSR
Giacomo Trivellin, Andrea Sandri, Nicola Bizzotto, Marco Andrea Marino, Silvio Mezzari, Elena Sambugaro, Dario Regis
Dislocation is one of the most common complications of total hip arthroplasty (THA). To the authors' knowledge, late recurrent dislocation of a THA with a ceramic-on-ceramic coupling secondary to fatigue fracture of the ceramic liner has never been described. A 76-year-old woman with right hip osteoarthritis underwent cementless modular THA with a ceramic-on-ceramic coupling. Approximately 10 years postoperatively, she experienced right hip pain with no trauma, which resolved in 14 days. Family members reported that the patient had shown a progressive cognitive and muscular decline in the previous months...
January 2013: Orthopedics
Liliana Savin, C Barhăroşie, P Botez
UNLABELLED: Endoprosthetic hip arthroplasty is a surgical intervention that significantly improves the quality of the patient's life, with excellent long term results, but with an increased risk of major complications. One such complication is the periprosthetic femoral fracture, which may occur in both young and old patients due to several risk factors typical to the elderly (osteoporosis, fall risk), cementless press-fit implants, implant loosening, and revision arthroplasty. MATERIAL AND METHODS: This study tries to evaluate the risk factors for periprosthetic femoral fractures treated at the Orthopedics and Trauma Department of the Iaşi Rehabilitation Hospital...
July 2012: Revista Medico-chirurgicală̆ a Societă̆ţ̜ii de Medici ş̧i Naturaliş̧ti Din Iaş̧i
Thierry Rod Fleury, Bernard Favrat, Wilson Belaieff, Pierre Hoffmeyer
Following elective orthopaedic surgery or the treatment of a fracture, patients are temporarily unable to drive. This loss of independence may have serious social and economic consequences for the patient. It is therefore essential to know when it is safe to permit such patients to return to driving. This article, based upon a review of the current literature, proposes recommendations of the time period after which patients may safely return to driving. Practical decisions are made based upon the type of surgical intervention or fracture...
2012: Swiss Medical Weekly
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