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Orthopedic injuries

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https://www.readbyqxmd.com/read/28107310/the-renin-inhibitor-aliskiren-protects-rat-lungs-from-the-histopathologic-effects-of-fat-embolism
#1
Amanda N Fletcher, Agostino Molteni, Rakesh Ponnapureddy, Chirag Patel, Mark Pluym, Alan M Poisner
BACKGROUND: Fat embolism (FE) and the consequent FE syndrome occurring after trauma or surgery can lead to serious pulmonary injury, including ARDS and death. Current treatment of FE syndrome is limited to supportive therapy. We have shown in a rat model that the renin angiotensin system plays a significant role in the pathophysiology of FE because drugs interfering with the renin angiotensin system, captopril and losartan reduce the histopathologic pulmonary damage. The purpose of the current study was to determine if inhibition of renin by aliskiren, an FDA-approved drug for treating hypertension, would produce effective protection in the same model...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28104094/patient-reported-outcomes-measurement-information-system-promis-in-the-upper-extremity-the-future-of-outcomes-reporting
#2
REVIEW
Eric C Makhni, Molly Meadows, Jason T Hamamoto, John D Higgins, Anthony A Romeo, Nikhil N Verma
Patient reported outcomes (PROs) serve an integral role in clinical research by helping to determine the impact of clinical care as experienced by the patient. With recent initiatives in health care policy and pay for performance, outcome reporting is now recognized as a policy-driven requirement in addition to a clinical research tool. For outcome measures to satisfy these regulatory requirements and provide value in understanding disease outcomes, they must be responsive and efficient. Recent research has uncovered certain concerns regarding traditional PROs in patients with upper extremity disability and injury...
February 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28099278/recurrent-median-nerve-injury-in-a-weight-lifter
#3
Michael A Worobel, Bobby Alexander, Mark Hirsch, Vu Nguyen
Recurrent median neuropathy is an uncommon injury that can be commonly mistaken for other pathological causes. It is important to be aware of the potential causes and symptoms of injury as delay in diagnosis can lead to permanent decrease in hand function and disability. This case is a description of a 33-year-old male patient who previously presented with radicular symptoms and had complete resolution of his pain after a C7 selective nerve root block. Several months after presentation, he developed significant thenar atrophy, localized pain, and weakness associated with weight lifting activities...
February 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28099187/a-comparative-study-of-anterior-decompression-with-fusion-and-posterior-decompression-with-laminoplasty-for-the-treatment-of-cervical-spondylotic-myelopathy-patients-with-large-anterior-compression-of-the-spinal-cord
#4
Takashi Hirai, Toshitaka Yoshii, Yoshiyasu Arai, Kenichiro Sakai, Ichiro Torigoe, Hidetsugu Maehara, Masaki Tomori, Takashi Taniyama, Hirokazu Sato, Atsushi Okawa
STUDY DESIGN: This is a retrospective observational single-center study. OBJECTIVES: To compare anterior decompression and fusion (ADF) and laminoplasty (LAMP) for the treatment of cervical spondylotic myelopathy (CSM) patients with large anterior compression in terms of clinical and radiologic outcomes. SUMMARY OF BACKGROUND DATA: We have reported that insufficient posterior decompression could be often seen after laminoplasty for CSM patients with preoperative anterior clearance of the spinal cord, defined as an interval <4 mm between the preoperative the modified K-line and anterior structure of the spinal canal at most compressive segment on sagittal T1-weighted magnetic resonance imaging...
January 17, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28097423/rehabilitation-of-achilles-tendon-ruptures-is-early-functional-rehabilitation-daily-routine
#5
B Frankewycz, W Krutsch, J Weber, A Ernstberger, M Nerlich, Christian G Pfeifer
INTRODUCTION: Ruptures of the Achilles tendon are the most common tendon injuries of the lower extremities. Besides the initial operative or non-operative treatment, rehabilitation of patients plays a crucial role for tendon healing and long-term outcome. As only limited evidence is available for optimized rehabilitation regimen and guidelines for the initial (e.g., first 6 weeks) rehabilitation are limited, this study investigated the current rehabilitation concepts after Achilles tendon rupture...
January 17, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28093363/alignment-of-collagen-fiber-in-knitted-silk-scaffold-for-functional-massive-rotator-cuff-repair
#6
Zefeng Zheng, Jisheng Ran, Weishan Chen, Yejun Hu, Ting Zhu, Xiao Chen, Zi Yin, Boon Chin Heng, Gang Feng, Huihui Le, Chenqi Tang, Jiayun Huang, Yangwu Chen, Yiting Zhou, Pioletti Dominique, Weiliang Shen, Hong-Wei Ouyang
: Rotator cuff tear is one of the most common types of shoulder injuries, often resulting in pain and physical debilitation. Allogeneic tendon-derived decellularized matrices do not have appropriate pore size and porosity to facilitate cell infiltration, while commercially-available synthetic scaffolds are often inadequate at inducing tenogenic differentiation. The aim of this study is to develop an advanced 3D aligned collagen/silk scaffold (ACS) and investigate its efficacy in a rabbit massive rotator cuff tear model...
January 13, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28092213/cellular-and-molecular-factors-influencing-tendon-repair
#7
Sushmitha Durgam, Matthew Stewart
Tendons are complex, hierarchically organized connective tissues that transmit tensile forces between muscles and tendons. Tendon injuries are among the most common orthopedic problems with long-term disability as a frequent consequence due to prolonged healing time. Further, the repair tissue is of inferior quality, predisposing patients to high rates of recurrence following initial injury. Co-ordinated cellular processes and biological factors under the influence of mechanical loading are involved in tendon healing and our understanding of these events lags behind other musculoskeletal tissues...
January 16, 2017: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/28089796/correlationbetweenobesity-and-severity-of-distal-radius-fractures
#8
Carlos Acosta-Olivo, Juan C Gonzalez-Saldivar, Gregorio Villarreal-Villarreal, Alejandro Torres-Botello, Eduardo Gomez-Garcia, Yadira Tamez-Mata, Victor Peña-Martinez
INTRODUCTION: The incidence of obesity has increased significantly worldwide. Our hypothesis was that patients with obesity have a more severe distal radius fracture andwe realized a study to evaluate this correlation between obesity and severity of distal radius fractures caused by low-energy injuries. MATERIALS AND METHODS: A total of 114 patients with distal radius fracture were examined in a cross-sectional, observational study. Fractures were classified according to the international AO-Müller/Orthopedic Trauma Association (AO/OTA) classification in order to determine the severity...
January 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28073376/treatment-and-outcome-prognosis-of-patients-with-high-energy-transsyndesmotic-ankle-fracture-dislocation-the-logsplitter-injury
#9
Zhe Wang, Xin Tang, Shenglong Li, Xiuhui Wang, Liangfeng Gong, Tao Zhong, Kunzheng Wang
BACKGROUND: This study aimed to retrospectively review the clinical efficacy of open reduction and internal fixation (ORIF) for treatment of high-energy transsyndesmotic ankle fracture dislocation-the "Logsplitter" injury. METHODS: Between December 2006 and December 2014, 41 patients (29 males and 12 females; mean age, 41.46 ± 13.42 years) with Logsplitter injury were treated by ORIF procedure. Patients were grouped as typical injury (mainly vertical axial stress) and untypical injury (mainly rotational stress) according to the injury mechanism and the degree of the talus wedged into the distal tibiofibular joint...
January 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28064351/orthopedic-trauma-surgery-and-hospital-cost-analysis-in-refugees-the-effect-of-the-syrian-civil-war
#10
Altuğ Duramaz, Mustafa Gökhan Bilgili, Berhan Bayram, Nezih Ziroğlu, Alkan Bayrak, Mustafa Cevdet Avkan
PURPOSE: The aim of this study was to evaluate the musculoskeletal injury types, injury mechanisms, surgical techniques and treatment costs of Syrian refugees. METHODS: Totally 158 patients (67 female, 91 male) treated in our clinic in 34 months period between January 2012 and October 2014 were included in the study. The mean age of the patients was 39.3 years (range: 18-82 years). The patients were evaluated for age, gender, mechanism of injury, location and type of fracture, presence of accompanying injuries, injury severity score, surgical technique, complications, mortality/morbidity and treatment cost...
January 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28062353/indentation-across-interfaces-between-stiff-and-compliant-tissues
#11
Oliver E Armitage, Michelle L Oyen
Bone-tendon, bone-ligament and bone-cartilage junctions are multi-tissue interfaces that connect materials that differ by two orders of magnitude in mechanical properties, via gradual variations in mineral content and matrix composition. These sites mediate load transfer between highly dissimilar materials and are consequently a primary site of injury during orthopedic failure. Given the large incidence rate and the lack of suitable surgical solutions for their regeneration or repair, characterization of their natural structure and subsequent replication through tissue engineering is important...
January 3, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28061863/prognostic-indicators-for-perioperative-survival-after-diaphragmatic-herniorrhaphy-in-cats-and-dogs-96-cases-2001-2013
#12
Claire Legallet, Kelley Thieman Mankin, Laura E Selmic
BACKGROUND: To determine associations between perioperative mortality after surgery for traumatic diaphragmatic hernia, medical records of 17 cats and 79 dogs that underwent diaphragmatic herniorrhaphy were reviewed. RESULTS: The combined perioperative survival rate was 81.3% (88.2% in cats and 79.8% in dogs). Data from acute and chronic cases was assessed separately. Of the acute cases (12 cats and 48 dogs), 10 cats (83.3%) and 38 dogs (79.2%) survived to discharge...
January 7, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/28060209/catechol-o-methyltransferase-genotypes-and-parenting-influence-on-long-term-executive-functioning-after-moderate-to-severe-early-childhood-traumatic-brain-injury-an-exploratory-study
#13
Brad G Kurowski, Amery Treble-Barna, Huaiyu Zang, Nanhua Zhang, Lisa J Martin, Keith Owen Yeates, H Gerry Taylor, Shari L Wade
OBJECTIVES: To examine catechol-O-methyltransferase (COMT) rs4680 genotypes as moderators of the effects of parenting style on postinjury changes in parent behavior ratings of executive dysfunction following moderate to severe early childhood traumatic brain injury. SETTING: Research was conducted in an outpatient setting. PARTICIPANTS: Participants included children admitted to hospital with moderate to severe traumatic brain injury (n = 55) or orthopedic injuries (n = 70) between ages 3 and 7 years...
January 5, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28056159/obturator-artery-injury-resulting-in-massive-hemorrhage-from-a-low-energy-pubic-ramus-fracture
#14
Mark K Solarz, Justin M Kistler, Saqib Rehman
Pelvic ring fractures are common in the elderly population and are usually a result of low-energy trauma, such as falls from standing. In most cases, low-energy pelvic ring injuries can be treated with appropriate analgesia and early mobilization. Arterial injury resulting in hemodynamic instability from a low-energy pelvic ring injury is rare but, given the poor compliance of vessels in the elderly population, possible. These patients must be carefully monitored after the initial injury. The purpose of this report is to describe an elderly patient who sustained a superior pubic ramus fracture and arterial injury following a low-energy fall from standing that required angiographic intervention...
January 5, 2017: Orthopedics
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#15
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031505/z-plasty-of-the-flexor-hallucis-longus-tendon-at-tarsal-tunnel-for-checkrein-deformity
#16
Jae Hoon Lee, Young Jun Kim, Jong Hun Baek, Dong Hee Kim
PURPOSES: To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients. METHODS: Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. All patients had undergone 3 months of conservative treatment. The mean time from injury to surgical treatment was 8...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28030491/severe-injuries-associated-with-skiing-and-snowboarding-a-national-trauma-data-bank-study
#17
Amory de Roulet, Kenji Inaba, Aaron Strumwasser, Konstantinos Chouliaras, Demetrios Demetriades
BACKGROUND: Injuries following skiing and snowboarding accidents lead to an estimated 7,000 hospital admissions annually and present a significant burden to the health care system. The epidemiology, injury patterns, hospital resource utilization, and outcomes associated with these severe injuries need further characterization. METHODS: The National Trauma Data Bank was queried for the period 2007-2014 for admissions with injury severity score (ISS) >15 and ICD-9 codes 885...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28030489/the-mangled-extremity-score-and-amputation-time-for-a-revision
#18
Melissa N Loja, Amanda Sammann, Joseph DuBose, Chin-Shang Li, Yu Liu, Stephanie Savage, Thomas Scalea, John B Holcomb, Todd E Rasmussen, M Margaret Knudson
BACKGROUND: The Mangled Extremity Severity Score (MESS) was developed 25 years ago in an attempt to utilize the extent of skeletal and soft tissue injury, limb ischemia, shock, and age to predict the need for amputation after extremity injury. Subsequently, there have been mixed reviews as to the utility of this score. We hypothesized that the MESS, when applied to a data set collected prospectively in modern times, would not correlate with the need for amputation. METHODS: We applied the MESS to patient data collected in the American Association for the Surgery of Trauma PROspective Vascular Injury Treatment (PROOVIT) registry...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027385/a-novel-screening-technique-for-ulnar-sided-carpometacarpal-dislocations
#19
Vishnu C Potini, Peter D Gibson, Kaicheng Wu, Kang Li, Virak Tan
Diagnosing ulnar-sided carpometacarpal joint dislocation is difficult, and more than half of injuries are missed on initial examination. The authors hypothesized that measuring the angle between the capitate and the metacarpals (capitate-metacarpal angle) on a plain radiograph would provide a simple, reliable tool to aid in the diagnosis of ulnar-sided carpometacarpal dislocation. This study retrospectively reviewed patients who underwent surgery for ulnar-sided carpometacarpal dislocation (study group). Two authors identified the contour of the capitate and the second, fourth, and fifth metacarpals on plain radiographs...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28027384/an-anatomical-study-on-the-safe-placement-of-orthopedic-hardware-for-syndesmosis-fixation
#20
Franklin D Shuler, Daniel Woods, Zach Tankersley, Clint McDaniel, Jacob Hamm, Justin Jones, James Denvir, Brian Czarkowski
Articular cartilage and bony contact at the distal tibiofibular cartilage contact zone (TFCCZ) is variable. The appropriate placement of syndesmotic hardware would benefit from a more accurate characterization of the proximal extent of the TFCCZ allowing surgeons to place hardware that simultaneously improves biomechanical stability and decreases the risk of iatrogenic cartilage damage. In addition, Ilizarov wire fixation through the distal fibula and tibia can pass through the syndesmosis recess. Anatomically defining the proximal extent of this recess can help decrease the risk of inadvertent capsular penetration...
December 27, 2016: Orthopedics
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