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https://www.readbyqxmd.com/read/29781787/evaluating-the-duration-of-prophylactic-post-operative-antibiotic-agents-after-open-reduction-internal-fixation-for-closed-fractures
#1
Brett D Crist, Lasun O Oladeji, Gregory J Della Rocca, David A Volgas, James P Stannard, David D Greenberg
BACKGROUND: The importance of timely pre-operative antibiotic agents for effective surgical prophylaxis has been established but the optimal duration of antimicrobial coverage post-operatively has not yet been defined clearly. The purpose of this study was to determine if prophylactic post- operative cefazolin for 23 hours decreases the risk of surgical site infection (SSI) after open reduction internal fixation (ORIF) of closed extremity fractures. PATIENTS AND METHODS: After Institutional Reviews Board approval, patients undergoing ORIF of closed extremity fractures who had a planned post-operative stay of at least 23 hours were randomly assigned to either receive 23 hours of cefazolin or a placebo...
May 21, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29764298/the-distal-radius-palmar-cortical-angle-in-adolescent-versus-adult-populations
#2
Shane Breheny, Angela Christine Chang, April De Silva, Paul Allcock
PURPOSE: Volar distal radius plates are pre-contoured to aid restoration of anatomy during open reduction internal fixation of distal radius fractures. Incorrectly contoured plates can result in malreduction, leading to malunion, pain, and loss of function. The purpose of this study was to investigate whether adolescent distal radius anatomy on the palmar cortical surface differs from that in adults, in order to determine whether adult plates are suitable for use in adolescents. METHODS: Lateral wrist radiographs were used to measure the distal radius palmar cortical angle (PCA) in adolescent age groups (12-13, 14-15, and 16-17 years old) and compared to a skeletally mature control group (30-50 years old)...
May 2018: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/29762283/five-to-ten-year-outcomes-of-operatively-treated-scapular-fractures
#3
Joscelyn M Tatro, Jeffrey A Gilbertson, Lisa K Schroder, Peter A Cole
BACKGROUND: The purpose of this study was to assess the 5 to 10-year clinical and patient-reported functional outcomes after open reduction and internal fixation (ORIF) of intra-articular and extra-articular scapular fractures. METHODS: We conducted a retrospective review of prospectively collected data on 106 patients who underwent ORIF of a scapular fracture at a single level-I trauma center between January 2005 and December 2010. Eight patients were excluded from the study because they had either severe neurologic injury or an isolated process fracture, and 66 patients (37 with an isolated extra-articular fracture and 29 with an intra-articular fracture) participated in the 5 to 10-year follow-up, yielding a follow-up rate of 67%...
May 16, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29750728/utility-of-postoperative-mandibulomaxillary-fixation-after-rigid-internal-fixation-of-isolated-mandibular-fractures
#4
Silviu C Diaconu, Colton H L McNichols, Yuanyuan Liang, Dennis Orkoulas-Razis, Jhade Woodall, Yvonne M Rasko, Michael P Grant, Arthur J Nam
PURPOSE: The utility of postoperative mandibulomaxillary fixation (MMF) after open reduction and internal fixation (ORIF) of mandible fractures is debated. The purpose of this study is to analyze if patients undergoing ORIF with postoperative MMF have improved outcome compared with those treated with ORIF alone. METHODS: A retrospective study was performed on patients who underwent ORIF of isolated mandibular fractures. Patients were divided into those placed in MMF postoperatively (ORIF with MMF) and those who were not (ORIF only)...
May 10, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29744646/wound-complications-after-open-reduction-and-internal-fixation-of-tibial-plateau-fractures-in-the-elderly-a-multicentre-study
#5
Christopher L Gaunder, Zibin Zhao, Corey Henderson, Brandon R McKinney, Philip F Stahel, Boris A Zelle
PURPOSE: The incidence of wound complications after open reduction with internal fixation (ORIF) of tibial plateau fractures in young patients has been reported to range from approximately 5 to 15%. Reports on wound complication rates in the elderly patients are limited. This study investigates the incidence of post-operative wound complications in elderly patients undergoing ORIF of their tibial plateau fractures. METHODS: A retrospective study was performed within three accredited level 1 trauma centres...
May 9, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29738399/cost-determinants-in-the-90-day-management-of-isolated-ankle-fractures-at-a-large-urban-academic-hospital
#6
Matthew Varacallo, Patrick Mattern, Jonathan Acosta, Nader Toossi, Kevin Denehy, Susan Harding
OBJECTIVES: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. DESIGN: Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. INTERVENTION: none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29721653/-instability-after-operative-and-conservative-treatment-of-isolated-mason-type-ii-fractures
#7
A von Glinski, V Rausch, M Königshausen, M Dudda, T A Schildhauer, D Seybold, J Geßmann
BACKGROUND: Radial head fractures are the most frequent fractures of the elbow joint in adults. For Mason type II fractures without concomitant injuries favorable results have been shown with operative and conservative management. There is insufficient evidence concerning elbow joint stability after conservative treatment compared to open reduction and internal fixation (ORIF). MATERIALS AND METHODS: All patients with isolated Mason type II (two part fracture displaced >2 mm and <5 mm) radial head fractures between 1 January 2003 and 1 April 2013 were retrospectively reviewed...
May 2, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29720142/evaluation-of-three-patient-reported-outcome-measures-following-operative-fixation-of-closed-ankle-fractures
#8
Andrew M Garratt, Markus G Naumann, Ulf Sigurdsen, Stein Erik Utvåg, Knut Stavem
BACKGROUND: Several patient reported outcome measures (PROMs) are available for assessing the outcomes of ankle fracture but few have been compared for recommended measurement properties. This study compares the measurement properties of the Lower Extremity Function Scale (LEFS), Olerud Molander Ankle Score (OMAS) and Self-Reported Foot and Ankle Score (SEFAS) following ankle surgery. METHODS: The retrospective cohort study included 959 patients aged 18 years and over who underwent surgical treatment (ORIF) for unstable and closed ankle fractures in SE Norway...
May 2, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29715227/comparison-of-direct-perioperative-costs-in-treatment-of-unstable-distal-radial-fractures-open-reduction-and-internal-fixation-versus-closed-reduction-and-percutaneous-pinning
#9
Sreeharsha V Nandyala, Aviram M Giladi, Amber M Parker, Tamara D Rozental
BACKGROUND: As the United States transitions to value-based insurance, bundled payments, and capitated models, it is paramount to understand health-care costs and resource utilization. The financial implications of open reduction and internal fixation (ORIF) with a volar locking plate for management of unstable distal radial fractures have not been established. We aimed to elucidate cost differences between ORIF and closed reduction and percutaneous pinning (CRPP). Our hypothesis was that ORIF has greater direct perioperative costs than CRPP but that the costs equilibrate over time...
May 2, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29706246/cross-sectional-area-measurement-of-the-central-tarsometatarsal-articulation-a-review-of-computed-tomography-scans
#10
John Randolph Clements, Kelley Whitmer, Hoa Nguyen, Matthew Rich
Currently, disagreement exists regarding the superior method for repairing a ligamentous Lisfranc injury regarding whether to use arthrodesis or open reduction internal fixation. The 2 procedures differ in the amount of articular cartilage destroyed. Arthrodesis removes all the articular cartilage, and open reduction internal fixation places transarticular screws, essentially destroying a portion of cartilage. We performed a review of 30 consecutive computed tomography scans that included both foot length and undamaged first, second, and third tarsometatarsal joints to quantify the amount of articular surface area destroyed by placement of standardized 4-mm diameter screws...
April 26, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29703458/operatively-treated-talus-fractures-complications-and-survivorship-in-a-large-patient-sample
#11
Michael A Stone, Russell R Flato, William Pannell, Jeremiah R Cohen, Jeffrey C Wang, Geoffrey S Marecek
Talus fractures are relatively uncommon; however, the sequelae of talus fractures can cause significant morbidity. Although avascular necrosis has been a consistently reported complication, the reported rates of subsequent arthrodesis have varied widely. The purpose of the present study was to report the complications in a large patient sample of operatively treated talus fractures and to describe the survivorship of open reduction internal fixation (ORIF) of the talus. Patients undergoing talus ORIF for closed or open fractures from 2007 to 2011 were identified in the United Healthcare System database by International Classification of Diseases, 9th revision, code 825...
April 24, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29687005/medium-long-term-radiographic-and-clinical-outcomes-after-surgical-treatment-of-intra-articular-tibial-pilon-fractures-by-three-different-techniques
#12
Carlo Biz, Andrea Angelini, Marco Zamperetti, Filippo Marzotto, Silvano Pierluigi Sperotto, Diego Carniel, Claudio Iacobellis, Pietro Ruggieri
Introduction: The goal of this retrospective, observational, case series study was to evaluate the medium-long-term clinical and radiographic results of the three most common surgical osteosynthesis techniques used for the treatment of articular tibial pilon fractures: ORIF, MIPO, and EF. Materials and Methods: A consecutive series of patients with articular pilon fractures who underwent surgery at our institution were enrolled in this study. Fractures were classified according to the Müller AO classification system...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29672340/open-reduction-and-internal-fixation-versus-non-surgical-treatment-in-displaced-midshaft-clavicle-fractures-a-meta-analysis
#13
Abdulaziz F Ahmed, Motasem Salameh, Nidal AlKhatib, Aissam Elmhiregh, Ghalib O Ahmed
OBJECTIVES: To compare open reduction and internal fixation (ORIF) and non-surgical treatment outcomes in displaced midshaft clavicle fractures. DATA SOURCES: PubMed, MEDLINE, EMBASE, Web of Science, Cochrane Library, and ClinicalTrials.gov were searched in September 2017. STUDY SELECTION: Inclusion criteria were randomized controlled trials reporting nonunion, shoulder functional outcomes, and subsequent surgery rates or pain scores. We excluded studies with patients younger than 16 years, maximum follow-up less than nine months, and inaccessible full text...
April 17, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29669383/total-knee-arthroplasty-versus-osteochondral-allograft-prevalence-and-risk-factors-following-tibial-plateau-fractures
#14
Lasun O Oladeji, Tina K Dreger, Eli L Pratte, Charles A Baumann, James P Stannard, David A Volgas, Gregory J Della Rocca, Brett D Crist
Orthopaedic surgeons commonly have the misconception that patients with tibial plateau fractures will likely go on to posttraumatic knee arthritis requiring total knee arthroplasty (TKA). In younger patients, osteochondral allograft (OCA) transplantation is an alternative method to address posttraumatic knee arthritis. The purpose of this study was (1) to identify our institutional failure rate following tibial plateau open reduction and internal fixation (ORIF) (failure was defined as conversion to TKA or OCA); (2) to determine if there are patient- or injury-related risk factors predictive of failure; and (3) to characterize differences between patients treated with TKA versus those treated with OCA transplantation...
April 18, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29657453/periprosthetic-hip-fractures-a-review-of-the-economic-burden-based-on-length-of-stay
#15
Rebecca F Lyons, Robert P Piggott, William Curtin, Colin G Murphy
Introduction: With the increasing rates of total hip replacements being performed worldwide, there is an increasing incidence of periprosthetic fractures. As our patients' demographics change to include older patients with multiple medical co-morbidities, there is a concurrent increase in morbidity and mortality rates. This leads to longer hospital stays and increasing hospital costs. In the current economic climate, the cost of treating periprosthetic fractures must be addressed and appropriate resource and funding allocation for future provision of services should be planned...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29657444/radial-axial-interosseous-load-rail-test-for-essex-lopresti-type-injuries
#16
REVIEW
Zachary C Lum, Eric G Huish, Marc A Trzeciak
Background: When approaching radial head and neck fractures, the decision for ORIF, resection, or arthroplasty is often performed intraoperatively. Factors that contribute include ligamentous and bony stability, cartilage injury, mechanical alignment as well as patient factors. Recent data has suggested conventional methods may not be sufficiently sensitive in detecting Essex Lopresti injuries. Here we describe an intraoperative technique that could objectively assess proximal radio-ulnar stability with subsequent disruption of the ligamentous structures...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29655591/open-reduction-and-internal-fixation-in-a-one-stage-anterior-cruciate-ligament-reconstruction-surgery-for-the-treatment-of-tibial-plateau-fractures-a-case-report-and-literature-review
#17
Yiqun Wang, Lianyou Wang, Tongtong Zhu, Zhongguo Liu, Guangyao Liu
Treatment of tibial plateau fractures associated with anterior cruciate ligament (ACL) injuries can be challenging. Maintaining the joint surface and axis are two main principles for the management of patients with tibial plateau fractures. Herein, we describe a patient with tibial plateau fracture of Schatzker type VI associated with complete ACL rupture. Although in a two-stage reconstruction surgery for treatment of its rupture seem to be accepted by most orthopaedic surgeons in cases of ACL injuries, we treated our patient with ORIF in a one-stage ACL reconstruction surgery...
March 15, 2018: Injury
https://www.readbyqxmd.com/read/29652013/changing-trends-in-maxillofacial-trauma-a-15-years-retrospective-study-in-the-southern-part-of-haryana-india
#18
Ashish Gupta, Aby K Babu, Pankaj Bansal, Rahul Sharma, Sneha D Sharma
Objective: The aim is to analyze the pattern of maxillofacial injuries and treatment outcomes in the past 15 years (2002-2016). Materials and Methods: One thousand eight hundred and fifty patients from two tertiary referral center hospitals were studied retrospectively in which the age, sex, etiology, site of fracture, and treatment modality was recorded. Results: One thousand two hundred and twenty-eight males and 622 females were operated between 2002 and 2016...
March 2018: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
https://www.readbyqxmd.com/read/29644304/trans-triquetral-perilunate-fracture-dislocation
#19
John-Henry Rhind, Abhinav Gulihar, Andrew Smith
Perilunate dislocations and perilunate fracture dislocations are rare and serious injuries. Perilunate dislocations represent less than 10% of all carpal injuries of which 61% represent transcaphoid fractures. Because of their rarity, up to 25% of perilunate dislocations are initially missed on first assessment. We present the case of a 66-year-old-gentleman who sustained an isolated trans-triquetral perilunate fracture dislocation while walking his dog. This was diagnosed in the emergency department and he underwent open reduction internal fixation after failed attempts at closed reduction in the ED and in theatre under general anaesthesia...
April 2018: Trauma Case Reports
https://www.readbyqxmd.com/read/29644296/bilateral-posterior-fracture-dislocation-of-the-shoulder-after-epileptic-seizure
#20
Michele Dario Gurzì, Daniele De Meo, Mattia Pugliese, Luigi Di Giorgio, Pietro Persiani, Ciro Villani
We present a case of a 61 year-old woman who suffered a bilateral posterior fracture-dislocation of the shoulder after an isolated episode of epileptic seizure. The patient was diagnosed at our Emergency department with x-rays and CT scans after being found unconscious. An indication for bilateral shoulder hemiprosthesis implant was initially given. However, given the peculiar pattern of the fracture, the hemiprosthesis was implanted on one side only, while the other side was treated with ORIF with four cannulated screws...
February 2018: Trauma Case Reports
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