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Davis C Woodworth, Langston T Holly, Emeran A Mayer, Noriko Salamon, Benjamin M Ellingson
BACKGROUND: Advanced cervical spondylosis (CS) can cause structural damage to the spinal cord resulting in long-term neurological impairment including neck pain and motor weakness. We hypothesized long-term structural reorganization within the brain in patients with CS. OBJECTIVE: To explore the associations between cortical thickness, subcortical volumes, neurological symptoms, and pain severity in CS patients with or without myelopathy and healthy controls (HCs)...
March 14, 2018: Neurosurgery
Olivier Barbier, Maelle Racle
Introduction: The current evolution of surgical practices is increasingly trending toward hyper-specialization. For military surgeons, their practice in France does not differ from their civilian counterparts. In contrast, in external operations, they have to deal with specific war injuries in austere conditions. They are also required to take care of local populations. Therefore, specific training is necessary, and the French Military Health Service Academy (Ecole du Val-de-Grâce) Paris has set up a specific training called Advanced Course for Deployment Surgery (ACDS) in 2007...
March 14, 2018: Military Medicine
Oren Schwartz, Boris Kanevsky, M A J Sergey Kutikov, Cara H Olsen, Israel Dudkiewicz
Introduction: Attrition from training is associated with substantial financial and personnel loss. There is a plethora of medical literature and research of attrition rates related to initial/phase 1 training (basic combat training); however, the analysis of second phase training (commanders training, consisting of schools that qualify junior commanders and officers for infantry and non-infantry combat units) is limited. The purpose of this study is to perform a comprehensive survey regarding to medical attrition from commanders training in the IDF (Israeli Defense Forces) in order to present the commanders of the IDF a detailed situation report that will serve as an evidence-based platform for future policy planning and implementation...
March 14, 2018: Military Medicine
Yun Bai, Chuan Liu, Lei Fu, Xiaoshan Gong, Ce Dou, Zhen Cao, Hongyu Quan, Jianmei Li, Fei Kang, Jingjin Dai, Chunrong Zhao, Shiwu Dong
Endochondral ossification is crucial for bone formation in both adult bone repair process and embryo long-bone development. In endochondral ossification, bone marrow-derived mesenchymal stem cells (BMSCs) first differentiate to chondrocyte, BMSC-derived chondrocyte then endure a hypertrophic process to generate new bone. Endochondral ossification-based bone repair is a promising strategy to cure massive bone defect, which is a major clinical issue in orthopedics. However, challenges still remain for this novel strategy...
March 16, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Yang Xiong, Lin Xu, Xing Yu, Yongdong Yang, Dingyan Zhao, Zhengguo Hu, Chuanhong Li, He Zhao, Lijun Duan, Bingbing Zhang, Sixue Chen, Tao Liu
STUDY DESIGN: A retrospective study. OBJECTIVE: To compare the mid-term outcomes of hybrid surgery and anterior cervical discectomy and fusion for the treatment of contiguous 2-segment cervical degenerative disc diseases. SUMMARY OF BACKGROUND DATA: Hybrid surgery has become one of the most controversial subjects in spine communities, and the comparative studies of hybrid surgery and anterior cervical discectomy and fusion in the mid- and long-term follow-up are rarely reported...
March 15, 2018: Spine
Jeroen G V Habets, Roel H L Haeren, Suen A N Lie, Noel J C Bauer, Jim T A Dings
BACKGROUND: We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery (ACoA) aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported...
March 12, 2018: World Neurosurgery
David J Tennent, Stefanie M Shiels, Jessica A Jennings, Warren O Haggard, Joseph C Wenke
BACKGROUND: Contaminated traumatic open orthopedic wounds are frequently complicated by polymicrobial contamination and infection. In high-risk wounds, the standard of care comprises debridement and irrigation combined with antibiotics which can be applied directly or combined with systemic antibiotics. Recently, bioabsorbable chitosan sponges have been shown to be an effective single-agent delivery device for local antibiotics with and without negative pressure wound therapy (NPWT). Severely contaminated orthopedic wounds, however, are often complicated by polymicrobial infections, necessitating multiple antibiotic agents...
March 15, 2018: Journal of Orthopaedic Surgery and Research
Annika Selvick, Rita Lloyd
The Nuss procedure has become the predominant reason for the use of metal implants by pediatric general and thoracic surgeons. Current guidelines recommend preimplant testing for all patients undergoing the Nuss procedure, which differs from the guidelines for all other orthopedic procedures. This review was done to further evaluate this discrepancy.
February 28, 2018: Dermatitis
Ahmad Nazmi Bin Ahmad Fuad, Kamal Deep, Wei Yao, Philip Rowe
This article presents the construction of a flexible drill which is designed to cut a curved canal in the bone or remove bone materials, to improve the outcome of orthopedic surgery and to facilitate minimally invasive. This article reports the design of the flexible drill and uses it in an experimental rig to evaluate the drilling force generated when cutting bovine bone. The experiments facilitate the measurement of action forces between the mill bits when moving the tip toward or across a bone sample in various configurations caused by bending the flexible drill sheath to enable cutting of a curved path of variable radius in the bone...
March 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Michael A Mazzeffi, John M See, Brittney Williams, Justin Richards, Darin Zimmerman, Samuel Galvagno, Magali Fontaine, Kenichi Tanaka
BACKGROUND: Red blood cell (RBC) transfusion can be life-saving; however, the risks of RBC transfusion have been increasingly recognized, and current guidelines recommend restrictive transfusion in most patients. We hypothesized that RBC transfusions are decreasing in surgical patients. STUDY DESIGN AND METHODS: A retrospective review of the National Surgical Quality Improvement Program database was performed from 2011 to 2015. Index cases in five surgical specialties were studied: neurosurgery, thoracic surgery, gynecologic surgery, orthopedic surgery, and vascular surgery...
March 14, 2018: Transfusion
Manabu Hoshi, Naoto Oebisu, Tadashi Iwai, Makoto Ieguchi, Yoshitaka Ban, Hiroaki Nakamura
Circumscribed solid nodules are common in pulmonary metastases from sarcoma, but cystic pulmonary metastases from sarcomas are extremely rare. An unusual case of a 33-year-old man presenting with left spontaneous pneumothorax in association with cystic pulmonary metastases from an epithelioid sarcoma in the left forearm was discussed in the present study. The patient underwent wide resection of an epithelioid sarcoma in the left forearm 6 years prior. Periodical computed tomography revealed a gradual increase in the number and size of bilateral multiple cystic pulmonary metastases despite repeated chemotherapy treatment...
April 2018: Oncology Letters
Marc-Etienne Parent, François Vézina, Nathalie Carrier, Ariel Masetto
OBJECTIVE: To analyze the indications for and clinical procedures resulting from knee magnetic resonance imaging (MRI) in older patients. DESIGN: We retrospectively analyzed 215 medical records of patients 50 years of age and older who had undergone a unilateral knee MRI in 2009. SETTING: Centre hospitalier universitaire de Sherbrooke in Quebec. PARTICIPANTS: Patients 50 years of age and older who underwent a knee MRI in 2009...
March 2018: Canadian Family Physician Médecin de Famille Canadien
Katarina Bojanić, Ruža Grizelj, Jurica Vuković, Lana Omerza, Marina Grubić, Tomislav Ćaleta, Toby N Weingarten, Darrell R Schroeder, Juraj Sprung
BACKGROUND: Patients with congenital diaphragmatic hernia (CDH) have a high residual morbidity rate. We compared self-reported health-related quality of life (HRQoL) between patients with CDH and healthy children. METHODS: Forty-five patients with CDH who were born from January 1, 1990, through February 15, 2015, were matched to healthy, age-matched control participants at a 1:2 ratio. The health records of the study participants were reviewed to determine comorbid conditions, and HRQoL was assessed by both the participants and their parents with the Pediatric Quality of Life Inventory (PedsQL)...
March 14, 2018: Health and Quality of Life Outcomes
Lindsay L Warner, Paul A Warner, Jason S Eldrige
No abstract text is available yet for this article.
March 9, 2018: International Journal of Medical Education
Alan Blank, Norman Otsuka, Timothy Rapp
Bone abnormalities on pediatric radiographs are not uncommon findings for both the general orthopedist as well as the specialist. Although the majority of lesions encountered are benign, the treating physician should also be aware of more concerning diagnoses. General orthopedists and pediatric orthopedists should exhibit a basic level of comfort with working up and diagnosing these benign lesions. When evaluating the pediatric patient with a bone lesion it is crucial to keep in mind important aspects of the clinical history, physical exam, and radiographic findings...
March 2018: Bulletin of the Hospital for Joint Diseases
Aldo Riesgo, Frank Liporace
Periprosthetic joint infection (PJI) is one of the most catastrophic and difficult to manage complications following total hip and total knee arthroplasty. As the number of total joint arthroplasties continues to increase, the burden of PJI will continue to further strain resources. As such, orthopedic surgeons consider four principles crucial in appropriately managing difficult or complex cases of PJI: identification, debridement, antibiotics, and patience. Indications and techniques for nonoperative treatment, debridement with implant retention, and one- and two-stage exchange arthroplasty are reviewed...
March 2018: Bulletin of the Hospital for Joint Diseases
Michael Sobieraj, Scott Marwin
Total joint arthroplasty of the hip and knee are successful orthopedic procedures that reduce pain and improve mobility in patients. As the implanted materials used in these procedures have improved, the lifetime of the implants has now reached more than 20 years. Younger patients are undergoing total joint arthroplasty at increasing rates, which has increased the need for improvements in materials for extended implant longevity. In this review, we aim to provide historical perspective on the evolution of ultra-high-molecular-weight polyethylene in total joint arthroplasty...
March 2018: Bulletin of the Hospital for Joint Diseases
Mark Gage, Frank Liporace, Kenneth Egol, Toni McLaurin
Treatment of traumatic bone defects is dictated by a multitude of clinical factors including the defect size, patient comorbidities, soft tissue condition, and the possibility of infection present in the defect. With a variety of treatment strategies described, it is critical to choose the approach that will maximize outcomes in addressing this difficult problem. When addressing small-scale defects, bone grafting is the primary treatment. For large-scale defects, there are two major options to consider: induced membrane technique and distraction osteogenesis...
March 2018: Bulletin of the Hospital for Joint Diseases
Teng-Fei Zhu, Wen-Guo Zhao, Han-Lin Zheng, Jia-Xiang Wu
OBJECTIVE: To investigate the application effect of damage control orthopedics for the treatment of severe multiple fractures. METHODS: From January 2014 to December 2016, 23 patients with severe multiple fractures were treated with the damage control orthopedics (DCO), included 14 males and 9 females with an average age of (41.57±8.29) years old ranging from 28 to 60 years old; the NISS averaged(27.70±5.44) points ranging from 18 to 40 points. As the control group, 27 patients with severe multiple fractures were treated by the early total care(ETC) technology from Jan...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Bao-Lin Zhao, Cheng Ji, Jia-Jia Jiang, Ruo-Feng Yin
OBJECTIVE: To explore the clinical effectiveness of various posterior decompression surgeries in the treatment of upper thoracic spinal stenosis combined with multilevel cervical spinal stenosis. METHODS: From January 2010 to December 2015, 22 consecutive patients with combined upper thoracic spinal stenosis and multilevel cervical spinal stenosis were treated with two different approaches of posterior decompression surgeries. In group A with 10 patients, both cervical and thoracic spinal decompression surgeries were performed simultaneously (one-stage surgery); in group B with 8 patients, cervical and thoracic spinal decompression surgeries were performed separately within three months (two-stage surgery)...
March 10, 2018: International Journal of Surgery
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