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https://www.readbyqxmd.com/read/28323801/predicting-acute-compartment-syndrome-pacs-the-role-of-continuous-monitoring
#1
Andrew H Schmidt, Michael J Bosse, Katherine P Frey, Robert V OʼToole, Daniel J Stinner, Daniel O Scharfstein, Vadim Zipunnikov, Ellen J MacKenzie
The diagnosis of acute compartment syndrome (ACS) is a common clinical challenge among patients who sustain high-energy orthopaedic trauma, largely because no validated criteria exist to reliably define the presence of the condition. In the absence of validated diagnostic standards, concern for the potential clinical and medicolegal impact of a missed compartment syndrome may result in the potential overuse of fasciotomy in "at-risk" patients. The goal of the Predicting Acute Compartment Syndrome Study was to develop a decision rule for predicting the likelihood of ACS that would reduce unnecessary fasciotomies while guarding against potentially missed ACS...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#2
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323765/misuse-of-opioids-in-orthopaedic-postoperative-patients
#3
Anup Gangavalli, Ajith Malige, George Terres, Saqib Rehman, Chinenye Nwachuku
OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic postoperative patients and principal external sources in obtaining these medications. DESIGN: Ten-month survey-based study. SETTING: Two Level I trauma centers (urban and suburban). PATIENTS/PARTICIPANTS: Two hundred seven patients between the ages of 18 and 89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28317586/strategies-to-improve-local-control-of-resected-pancreas-adenocarcinoma
#4
Paul H Sugarbaker
BACKGROUND: Only approximately one in ten pancreas cancer patients is a candidate for potentially curative resection of this disease. Even this small fraction of patients has a poor prognosis following pancreatico-duodenectomy. The disease has an anatomic location that makes it difficult for the surgeon to maintain adequate margins of resection and prevent tumor spillage at the time of resection. Also, the disease is biologically aggressive and even with a complete visible resection of the disease, micrometastases are likely to remain behind...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#5
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
March 16, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28301397/the-michigan-trauma-quality-improvement-program-results-from-a-collaborative-quality-initiative
#6
Mark R Hemmila, Jill L Jakubus, Anne H Cain-Nielsen, John P Kepros, Wayne E Vander Kolk, Wendy L Wahl, Judy N Mikhail
BACKGROUND: American College of Surgeons verified trauma centers and a third party payer within the state of Michigan built a regional collaborative quality initiative (CQI). The Michigan Trauma Quality Improvement Program began as a pilot in 2008 and expanded to a formal program in 2011. Here, we examine the performance of the collaborative over time with regard to patient outcomes, resource utilization, and process measures. METHODS: Data from the initial 23 hospitals that joined the CQI in 2011 were analyzed...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28301396/can-hyper-realistic-physical-models-of-peripheral-vessel-exposure-and-fasciotomy-replace-cadavers-for-performance-assessment
#7
Jeremy Holzmacher, Babak Sarani, Adam Puche, Guinevere Granite, Valerie Shalin, Kristy Pugh, William Teeter, Samuel Tisherman, Stacy Shackelford, Colin F Mackenzie
BACKGROUND: Work-hour restrictions have reduced operative experience for residents. The Advanced Surgical Skills for Exposure in Trauma course fills this training gap. Cadaver use has limitations including cost and availability. Hyper-realistic synthetic models may provide an alternative to cadavers. We compared same surgeon performance between synthetic and cadaveric models to determine interchangeability for formative evaluation. METHODS: 40 residents (<4wks after ASSET) and 35 faculty (mean 2...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28301362/analysis-of-surfing-injuries-presenting-in-the-acute-trauma-setting
#8
Kevin T Jubbal, Charlie Chen, Todd Costantini, Fernando Herrera, Marek Dobke, Ahmed Suliman
BACKGROUND AND PURPOSE: Surfing is a rapidly growing major worldwide sport; however, little is understood regarding severe injuries and resulting hospital admissions. This study explores surfing-related injuries in the major surfing hub of San Diego presenting in the acute trauma setting. The purpose of this study is to address the void of information regarding severe surfing injuries in the trauma setting, including injury patterns, associated hospitalization course, and risk factors...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28291491/an-augmented-reality-based-approach-for-surgical-telementoring-in-austere-environments
#9
Dan Andersen, Voicu Popescu, Maria Eugenia Cabrera, Aditya Shanghavi, Brian Mullis, Sherri Marley, Gerardo Gomez, Juan P Wachs
Telementoring can improve treatment of combat trauma injuries by connecting remote experienced surgeons with local less-experienced surgeons in an austere environment. Current surgical telementoring systems force the local surgeon to regularly shift focus away from the operating field to receive expert guidance, which can lead to surgery delays or even errors. The System for Telementoring with Augmented Reality (STAR) integrates expert-created annotations directly into the local surgeon's field of view. The local surgeon views the operating field by looking at a tablet display suspended between the patient and the surgeon that captures video of the surgical field...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291468/navy-en-route-care-a-3-year-review-of-428-navy-air-evacuations
#10
Benjamin Walrath, Alejandra Mora, Victoria Ganem, Stephen Harper, Elliot Ross, Chetan Kharod, Gerard Demers, Vikhyat S Bebarta
BACKGROUND: Navy medical personnel have been recording en route care (ERC) missions through Search and Rescue (SAR) reports since the 1970's. Our objective was to report clinical ERC cases treated by Navy operational assets from January 2012 to January 2015. METHODS: The Search and Rescue Model Manager office collects SAR reports for all patient transports involving Navy personnel and equipment. From these reports, descriptive statistics to include total number of patients transported, percentages of Advanced Life Support versus Basic Life Support transports, time of transport, and type of ERC provider for the transport were collected...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291451/prehospital-blood-transfusion-during-aeromedical-evacuation-of-trauma-patients-in-israel-the-idf-csar-experience
#11
Jacob Chen, Avi Benov, Roy Nadler, Daniel N Darlington, Andrew P Cap, Ari M Lipsky, Elon Glassberg
BACKGROUND: Data regarding the effect of prehospital blood administration to trauma patients during short-to-moderate time evacuations is scarce. The Israel Air Force Airborne Combat Search and Rescue is the only organization that deals with aeromedical evacuation for both military and civilian casualties in Israel and the only one with the ability to give blood in the prehospital setting. METHODS: Data on packed red blood cells (PRBCs) administration in the evacuation missions from January 2003 to June 2010 were analyzed and actual transfusion practice was compared to clinical practice guidelines (CPGs)...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291180/dynamic-stress-testing-is-unnecessary-for-unimalleolar-supination-external-rotation-ankle-fractures-with-minimal-fracture-displacement-on-lateral-radiographs
#12
Simo Nortunen, Hannu-Ville Leskelä, Heidi Haapasalo, Tapio Flinkkilä, Pasi Ohtonen, Harri Pakarinen
BACKGROUND: This study aimed to identify factors from standard radiographs that contributed to the stability of the ankle mortise in patients with isolated supination-external rotation fractures of the lateral malleolus (OTA/AO 44-B). METHODS: Non-stress radiographs of the mortise and lateral views, without medial clear space widening or incongruity, were prospectively collected for 286 consecutive patients (mean age, 45 years [range, 16 to 85 years]), including 144 female patients (mean age, 50 years [range, 17 to 85 years]) and 142 male patients (mean age, 40 years [range, 16 to 84 years]) from 2 trauma centers...
March 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28290954/improving-surgical-complications-and-patient-safety-at-the-nation-s-largest-military-hospital-an-analysis-of-national-surgical-quality-improvement-program-data
#13
Steve Maturo, Charlotte Hughes, George Kallingal, Stephen Silvey, A J Johnson, Douglas Soderdahl, Evan Renz, Joseph Brennan
INTRODUCTION: The U.S. Military Health System cares for over 9 million patients and encompasses 63 hospitals and 413 clinics worldwide. Military medicine balances the simultaneous tasks of caring for those patients wounded in military engagements, treating large numbers of families of service men and women, and training the next generation of health care providers and ancillary staff. Similar to civilian health care delivery in the United States, military medicine has also seen increased scrutiny in the areas of cost and quality...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28289942/structured-reporting-of-mri-of-the-shoulder-improvement-of-report-quality
#14
Sebastian Gassenmaier, Marco Armbruster, Florian Haasters, Tobias Helfen, Thomas Henzler, Sedat Alibek, Dominik Pförringer, Wieland H Sommer, Nora N Sommer
OBJECTIVES: To evaluate the effect of structured reports (SRs) in comparison to non-structured narrative free text (NRs) shoulder MRI reports and potential effects of both types of reporting on completeness, readability, linguistic quality and referring surgeons' satisfaction. METHODS: Thirty patients after trauma or with suspected degenerative changes of the shoulder were included in this study (2012-2015). All patients underwent shoulder MRI for further assessment and possible surgical planning...
March 13, 2017: European Radiology
https://www.readbyqxmd.com/read/28286621/variability-in-trauma-case-volume-in-orthopedic-surgery-residents
#15
Travis D Blood, Joseph A Gil, Christopher T Born, Alan H Daniels
Orthopedic trauma surgery is a critical component of resident education. Surgical case logs obtained from the Accreditation Council of Graduate Medical Students from 2009 to 2013 for orthopedic surgery residents were examined for variability between the 90(th) and 10(th) percentiles in regards to the volume of cases performed. There was an upward trend in the mean number of cases performed by senior residents from 484.4 in 2009 to 534.5 in 2013, representing a 10.3% increase. There was a statistically significant increase in the number of cases performed for humerus/elbow, forearm/wrist, and pelvis/hip during this period (P<0...
February 20, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28286389/impacted-mandibular-third-molars-a-retrospective-study-of-1198-cases-to-assess-indications-for-surgical-removal-and-correlation-with-age-sex-and-type-of-impaction-a-single-institutional-experience
#16
Shital Patel, Saloni Mansuri, Faizan Shaikh, Taksh Shah
AIM: To study the incidence of mandibular third molar impaction in relation to type and side of impaction, age and sex of patients and indications for its surgical removal through data collected from a single institute over a period of 3 and half years. METHODS: The records of 1198 patients who underwent the surgical removal of impacted mandibular third molars were reviewed retrospectively. Records were divided into groups according to sex, age, type and side of impaction...
March 2017: Journal of Maxillofacial and Oral Surgery
https://www.readbyqxmd.com/read/28285473/a-modern-case-series-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-an-out-of-hospital-combat-casualty-care-setting
#17
Justin D Manley, Benjamin J Mitchell, Joseph J DuBose, Todd E Rasmussen
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used to mitigate bleeding and sustain central aortic pressure in the setting of shock. The ER-REBOA™ catheter is a new REBOA technology, previously reported only in the setting of civilian trauma and injury care. The use of REBOA in an out-of-hospital setting has not been reported, to our knowledge. METHODS: We present a case series of wartime injured patients cared for by a US Air Force Special Operations Surgical Team at an austere location fewer than 3km (5-10 minutes' transport) from point of injury and 2 hours from the next highest environment of care-a Role 2 equivalent...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28281430/provision-of-an-emergency-theatre-in-tertiary-hospitals-is-cost-effective-audit-and-cost-of-cancelled-planned-elective-general-surgical-operations-at-pietersburg-hospital-limpopo-province-south-africa
#18
M M Z U Bhuiyan, R Mavhungu, A Machowski
BACKGROUND: Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. OBJECTIVES: To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. METHODS: We did a prospective descriptive study of cancellations of elective general surgical operations over the 1-year period January - December 2014 in the main theatre at Pietersburg (PTB) Hospital, Limpopo Province, South Africa...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28277589/medical-missions-in-the-middle-east-an-orthopaedic-surgeon-s-experience-of-a-series-of-lower-extremity-cases
#19
Aiman Rifai, Todd P Pierce, Kimona Issa, Yasmine Rifai, Bartlomiej Szczech
Orthopaedic trauma accounts for a great deal of disability worldwide. There are many impoverished nations affected by war wherein victims suffer blast injuries associated with mines, missiles, high-powered gunshots, and bombings. One way to address this is through international medical missions sponsored by industrialized nations. It is imperative that practitioners have a basic understanding of the type of injuries that may be encountered in these nations impacted by war and conflict. Therefore, we described a small number of various lower extremity injuries seen by one orthopaedic surgeon during his volunteer medical mission to Jordan...
March 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28277467/high-energy-pediatric-scapula-fractures-and-their-associated-injuries
#20
Steven F Shannon, Nicholas M Hernandez, Stephen A Sems, Annalise N Larson, Todd A Milbrandt
OBJECTIVES: The purpose of this study was to evaluate pediatric scapula fractures occurring in high-energy motorized vehicle accidents and their associated injury patterns in a pediatric patient population. METHODS: One thousand nine hundred sixty-eight pediatric patients who presented after either on-road or off-road motorized vehicle accidents between 1996 and 2015 were retrospectively reviewed. Thirty-eight patients were found to have scapula fractures and the remaining 1930 were identified as controls...
March 8, 2017: Journal of Pediatric Orthopedics
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