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https://www.readbyqxmd.com/read/28918266/nanomedicine-for-safe-healing-of-bone-trauma-opportunities-and-challenges
#1
REVIEW
Shahed Behzadi, Gaurav A Luther, Mitchel B Harris, Omid C Farokhzad, Morteza Mahmoudi
Historically, high-energy extremity injuries resulting in significant soft-tissue trauma and bone loss were often deemed unsalvageable and treated with primary amputation. With improved soft-tissue coverage and nerve repair techniques, these injuries now present new challenges in limb-salvage surgery. High-energy extremity trauma is pre-disposed to delayed or unpredictable bony healing and high rates of infection, depending on the integrity of the soft-tissue envelope. Furthermore, orthopedic trauma surgeons are often faced with the challenge of stabilizing and repairing large bony defects while promoting an optimal environment to prevent infection and aid bony healing...
September 4, 2017: Biomaterials
https://www.readbyqxmd.com/read/28913381/is-it-fractured-or-broken-a-patient-survey-study-to-assess-injury-comprehension-after-orthopaedic-trauma
#2
Mohammad Ghorbanhoseini, Matthew D Riedel, Tyler Gonzalez, Poopak Hafezi, John Y Kwon
BACKGROUND: Patients who sustain orthopaedic trauma in the form of fractures commonly ask treating providers whether the bone is "fractured" or "broken". While orthopaedic surgeons consider these terms synonymous, patients appear to comprehend the terms as having different meanings. Given the commonality of this frequently posed question, it may be important for providers to assess patients' level of understanding in order to provide optimal care. The purpose of this study is to evaluate patients' comprehension and understanding regarding the use of the terms fractured and broken...
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28906304/comparison-of-expert-opinion-majority-rule-and-a-clinical-prediction-rule-to-estimate-distal-radius-malalignment
#3
Toni Luokkala, Tapio Flinkkilä, Juha Paloneva, Teemu V Karjalaine
OBJECTIVES: To investigate the ability of individual surgeons (expert opinion [EO]) to predict distal radius fracture healing above a threshold malalignment compared with the majority prediction of the group of surgeons ("majority rule," [MR]) and a statistically derived clinical prediction formula (Edinburgh wrist calculator [EWC]). DESIGN: Comparative diagnostic study from prospectively collected data of consecutive patients. SETTING: Two academic level 1 and one academic level 2 trauma centers...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28904652/-role-of-trauma-damage-control-orthopaedic-in-polytraumas-a-case-of-pelvic-disjunction-associated-with-hip-dislocation-with-vascular-injury
#4
Tarik Madani, El Mehdi El Alouani, Younes Mhammdi, Mohammed Kharmaz, Mohamed El Ouadghiri, Abdou Lahlou, Lamrani Moulay Omar, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
The knowledge of the pathophysiology of patients with severe trauma and the hemodynamic and inflammatory consequences of initial surgical management has led many surgeons to change their approach to the treatment of patients with severe polytraumas associated with lesions of the pelvis or of limbs by integrating the principles of sequential treatment or Trauma Damage Control Orthopaedic (TDCO). We report the case of a patient involved in a public road accident, admitted to hospital in a state of shock with pelvic disjunction and hip dislocation complicated by vascular injury in the same limb...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28898729/evaluation-of-the-multi-slice-computed-tomography-outcomes-in-diaphragmatic-injuries-related-to-penetrating-and-blunt-trauma
#5
REVIEW
Mehmet Turmak, Muhammed Akif Deniz, Cihan Akgül Özmen, Aydın Aslan
PURPOSE: Traumatic diaphragmatic rupture is a diagnostic challenge for both surgeons and radiologists and generally occurs secondary to blunt and penetrating trauma of thoracoabdominal region. MATERIAL AND METHODS: 56 patients who underwent surgical procedure due to blunt or penetrating trauma were included to the study. RESULTS: There were 37 diaphragmatic ruptures in the left side and 19 patients in the right side. The most common radiological finding was "the direct monitoring of defect" (54,3%)...
September 6, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28894837/dental-occlusion-ties-a-rapid-safe-and-non-invasive-maxillo-mandibular-fixation-technology
#6
Alan W Johnson
OBJECTIVES: For decades, Erich arch bars have been a standard in establishing maxillo-mandibular fixation (MMF). While reliable, the approach risks sharps injury, consumes operating room time, and inflicts gingival trauma. Newer technologies including screw-based techniques and "hybrid" techniques have improved MMF by reducing sharps injuries and operating room time, but risk injury to tooth roots, nerves, and gingiva. This study aims to establish the application, strengths, and limitations of dental occlusion ties as a novel alternative in maxillo-mandibular fixation...
August 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28892944/endoscopic-endonasal-approach-of-blow-out-fracture-reduction-a-novel-technique
#7
Vinod Felix, Narendrakumar Veerasigamani
Blunt trauma to orbit can lead to orbital blow out fracture. Computerized tomography of paranasal sinuses plays the main role in diagnosing it. Repairing the defect and restoring the orbital contents is a challenging task for the surgeon. Endoscopic endonasal approach in reduction of blow out fracture provides good cosmetic outcomes and grossly minimize surgical complications. We report a case of 18-year-old male presented with diplopia, restriction of eye movements and enophthalmos due to Road traffic accident...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28891913/the-assignment-of-american-society-of-anesthesiologists-physical-status-classification-for-adult-polytrauma-patients-results-from-a-survey-and-future-considerations
#8
Catherine M Kuza, George Hatzakis, Jeffry T Nahmias
BACKGROUND: The American Society of Anesthesiologists (ASA) physical status (PS) classification system assesses the preoperative health of patients. Previous studies demonstrated poor interrater reliability and variable ASA PS scores, especially in trauma scenarios. There are few studies that evaluated the assignment of ASA PS scores in trauma patients and no studies that evaluated ASA PS assignment in severely injured adult polytrauma patients. Our objective was to assess interrater reliability and identify sources of discrepancy among anesthesiologists and trauma surgeons in designating ASA PS scores to adult polytrauma patients...
September 7, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#9
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28885440/is-orbital-floor-reconstruction-with-titanium-mesh-safe
#10
Omar Bakr Hazm Al-Khdhairi, Saif Saadedeen Abdulrazaq
To reconstruct the orbital floor defects there are a lot of reconstruction materials, the surgeon must choose one of them. The authors share their experience with 10 patients suffering from orbital trauma causing orbital floor fracture; those fractures were reconstructed using titanium mesh. No complications were encountered postoperatively apart from 1 patient with ectropion. Titanium mesh is a perfect material for the reconstruction of the orbital fractures, eliminating the need for autogenous bone graft.
September 6, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28885126/utility-and-costs-of-radiologist-interpretation-of-perioperative-imaging-in-patients-with-traumatic-single-level-thoracolumbar-fractures
#11
Michael H Weber, Lojan Sivakumaran, Maryse Fortin, Alisson R Teles, Jeff D Golan, Carlo Santaguida, Peter Jarzem, Thierry Pauyo
OBJECTIVE The cost of spine management is rising. As diagnostic imaging accounts for approximately 10% of total patient care spending, there is interest in determining if economies could be made with regard to the routine consultation of radiology for image interpretation. In the context of spine trauma, both the spine surgeon and the radiologist interpret perioperative imaging. Authors of the present study investigated the impact of radiologist interpretation of perioperative imaging from patients with traumatic single-level thoracolumbar fractures given that spine surgeons are expected to be comfortable interpreting pathologies of the musculoskeletal system...
September 8, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28884097/perilunate-carpal-dislocation-clinical-evaluation-of-patients-operated-with-reduction-and-percutaneous-fixation-without-capsular-ligament-repair
#12
Adriano Bastos Pinho, Roberto Luiz Sobania
OBJECTIVE: To qualitatively assess surgeries performed in patients with perilunate dislocations without associated fractures, who were operated using the closed reduction and percutaneous fixation method. The follow-up time ranged from one to seven years. METHODS: 628 patient records with traumatic wrist injuries, operated by the same group of Hand Surgeons between 2008 and 2014 due to acute trauma were collected, with a mean follow-up of 3.2 years. Of these, 51 were cases of perilunate fracture-dislocations, and 38 were pure perilunate dislocations without associated fractures; of these, only 32 underwent percutaneous fixation without ligamentous repair, thus meeting the inclusion criteria...
June 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28883214/the-incidence-of-atypical-femoral-fractures-in-patients-with-rheumatic-disease-yamagata-prefectural-committee-of-atypical-femoral-fractures-yamacafe-study
#13
Yuya Takakubo, Daichi Ohta, Masaji Ishi, Juji Ito, Hiroharu Oki, Yasushi Naganuma, Tomohiro Uno, Akiko Sasaki, Takeru Akabane, Katsuyuki Dairaku, Shinichi Goto, Yasuo Goto, Yumiko Kanauchi, Shinji Kobayashi, Taku Nakajima, Keiji Masuda, Michiharu Matsuda, Nariyuki Mura, Kenji Takenouchi, Hiroyuki Tsuchida, Yasushi Onuma, Junichirou Shibuya, Mitsuyoshi Seino, Osamu Yamaguchi, Ken Hiragami, Yasuhiro Urayama, Takashi Furukawa, Shouta Okuda, Ken Ogura, Takeshi Nakamura, Kan Sasaki, Tsuneo Konta, Michiaki Takagi
Atypical femoral fractures (AFFs) have been reported to occur with minimal or spontaneous subtrochanteric and femoral shaft fractures with a characteristic transverse pattern, compared with typical femoral fractures in young patients with high-energy trauma. AFFs are related to long-term use of bisphosphonates (BPs), glucocorticoids and rheumatic diseases. We have estimated a blind analysis of AFFs in rheumatic patients receiving BPs and glucocorticoids ordinary over a long time in all Yamagata prefectural area through radiographic examination...
August 2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28882380/differences-between-orthopaedic-evaluation-and-radiological-reports-of-conventional-radiographs-in-patients-with-minor-trauma-admitted-to-the-emergency-department
#14
Michele Catapano, Domenico Albano, Grazia Pozzi, Riccardo Accetta, Sergio Memoria, Fabrizio Pregliasco, Carmelo Messina, Luca Maria Sconfienza
INTRODUCTION: During night and on weekends, in our emergency department there is no radiologist on duty or on call: thus, X-ray examinations (XR) are evaluated by the orthopaedic surgeon on duty and reported the following morning/monday by radiologists. The aim of our study was to examine the discrepancy rate between orthopaedists and radiologists in the interpretation of imaging examinations performed on patients in our tertiary level orthopaedic institution and the consequences of delayed diagnosis in terms of patient management and therapeutic strategy...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28882373/a-paradigm-shift-in-surgical-planning-and-simulation-using-3dgraphy-experience-of-first-50-surgeries-done-using-3d-printed-biomodels
#15
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
https://www.readbyqxmd.com/read/28882372/reduced-survival-for-uncemented-compared-to-cemented-total-hip-arthroplasty-after-operatively-treated-acetabular-fractures
#16
John Clarke-Jenssen, Marianne Westberg, Olav Røise, Stein Arne Øvre Storeggen, Tone Bere, Ingunn Silberg, Jan Erik Madsen
BACKGROUND: Post traumatic arthritis and avascular necrosis of the femoral head are common complications after operatively treated acetabular fractures. This may cause severe disabilities for the patient, necessitating a total hip arthroplasty. Even though an arthroplasty may provide good symptomatic relief, the long-term results are more uncertain and no consensus exists according to preferred prosthetic designs. With this cohort study, we aimed to investigate the medium to long term arthroplasty survival and clinical results of total hip arthroplasty after operatively treated acetabular fractures...
September 4, 2017: Injury
https://www.readbyqxmd.com/read/28879556/we-are-operating-too-much
#17
EDITORIAL
Nicola Maffulli
With the increase of superspecialisation, there has been a recent trend for a rising number of operations for both trauma and orthopaedic ailments. This flies against the results of properly planned, well performed, adequately powered, with clinically relevant outcome measures and long enough follow-up level I studies which challenge the received wisdom that surgery is actually superior to conservative management or even supervised neglect. This editorial outlines some of these issues, and suggests that orthopaedic and trauma surgeons should actually think twice before operating on anything that comes our way...
September 6, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28876667/evaluation-of-thoracoscopy-in-the-diagnosis-of-diaphragmatic-injuries-in-penetrating-thoracoabdominal-trauma-without-lung-deflation-at-dr-george-mukhari-academic-hospital
#18
L Nsakala
BACKGROUND: With a mortality estimated at 25% when missed, diaphragmatic injuries due to penetrating thoracoabdominal trauma present a diagnostic challenge for both the radiologist and the surgeon. In the current literature, chest x-ray has a sensitivity of 27-60% for left-sided injuries and only 17% for right-sided injuries while, CT scan has a sensitivity of 14-61% and a specificity of 76-99%. Thoracoscopy using a single lung ventilation is one of the modalities of choice for the diagnosis of these injuries with a specificity of 100% and a sensitivity of 87...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876662/the-role-of-laparoscopy-in-blunt-abdominal-trauma-diagnostic-therapeutic-or-both
#19
M Z Koto, F Mosai, O Y Matsevych
BACKGROUND: The use of laparoscopy in blunt abdominal trauma is gaining popularity as a useful diagnostic tool to avoid unnecessary laparotomies where there is diagnostic dilemma. But the feasibility of using laparoscopy for therapeutic intervention in these patients has been debated. Even though recent case reports seem to suggest that these patients can be managed using laparoscopy, the practice is not yet wildly adopted. METHOD: A retrospective analysis of a prospectively collected data was done...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876605/trauma-laparoscopy-teaching-an-old-dog-new-tricks
#20
O Matsevych, M Koto, C Aldous
BACKGROUND: Diagnostic laparoscopy is well-accepted in management of penetrating abdominal trauma (PAT) with the rate of missed injuries below 1%. However, there is a reluctance to accept therapeutic laparoscopy in trauma society. The main reason is the lack of laparoscopic skills by trauma surgeons. Moreover, no formal laparoscopy training program for trauma exists. The aim of this study was to discuss the trauma laparoscopy training at our institution. METHOD: All patients managed laparoscopically for PAT from January 2012 to December 2015 were included in the study...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
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