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Orthopedic injuries

Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
Philippe P Van Overschelde, David A Fitch
BACKGROUND: Patient dissatisfaction following total knee replacement (TKR) has been reported as high as 24%. Most previous studies have focused on satisfaction for TKR overall, with few reporting satisfaction for specific implant designs. The purpose of this study was to assess patient satisfaction for TKRs performed using a second generation medial-pivot system (EVOLUTION(®), MicroPort Orthopedics Inc., Arlington, TN, USA). METHODS: Of a single surgeon's first 250 consecutive TKRs performed using the subject system, 224 completed a patient satisfaction assessment, the Knee Injury and Osteoarthritis Outcome Score (KOOS), range of motion, and radiographs at 2 months follow-up...
September 2016: Annals of Translational Medicine
Mhamad Faour, Joshua T Anderson, Arnold R Haas, Rick Percy, Stephen T Woods, Uri M Ahn, Nicholas U Ahn
The use of opioids among patients with workers' compensation claims is associated with tremendous costs, especially for patients who undergo spinal surgery. This study compared return-to-work rates after single-level cervical fusion for degenerative disk disease between patients who received opioids before surgery and patients who underwent fusion with no previous opioid use. All study subjects qualified for workers' compensation benefits for injuries sustained at work between 1993 and 2011. The study population included 281 subjects who underwent single-level cervical fusion for degenerative disk disease with International Classification of Diseases, Ninth Revision, and Current Procedural Terminology code algorithms...
October 18, 2016: Orthopedics
Steven T Hendrix, Austin M Barrett, Bopha Chrea, William H Replogle, Josie M Hydrick, Gene R Barrett
Is there a correlation between increased posterior-inferior tibial slope angle and noncontact anterior cruciate ligament (ACL) injury? Does increasing the posterior-inferior tibial slope angle increase the risk of bilateral ACL injury? A computerized relational database (Access 2007; Microsoft Inc, Redmond, Washington) was used to conduct a retrospective review of patients undergoing bilateral or unilateral ACL reconstruction surgery or treatment by a single surgeon between 1995 and 2013. Included in the study were patients with bilateral and unilateral ACL injuries and patellofemoral pain syndrome with no associated ACL deficiency...
October 18, 2016: Orthopedics
Oren Schwartz, Tal Libenson, Nadav Astman, Lavon Haim
No abstract text is available yet for this article.
October 2016: Military Medicine
Sung Il Wang
In symptomatic discoid medial meniscus, partial meniscectomy is the principal treatment method and can yield promising short-term results. However, unlike the nondiscoid meniscus, discoid medial meniscus is frequently associated with horizontal cleavage tears, attributable to the presence of myxoid degeneration in the intrameniscal substance, in that it may potentially occur deteriorating long-term results because of re-tearing of remaining meniscus or secondary degeneration of cartilage of the medial compartment after meniscectomy...
October 14, 2016: Acta Orthopaedica et Traumatologica Turcica
Xudong Miao, Yongping Wu, Huimin Tao, Disheng Yang, Lu Huang
BACKGROUND: Transfer of a flexor hallucis longus (FHL) tendon can not only reconstruct the Achilles tendon but also provide ischemic tendinous tissues with a rich blood supply to enhance wound healing. This retrospective study aims to investigate clinical outcomes in patients who underwent repair of Kuwada grade IV chronic Achilles tendon rupture with long hallucis longus tendons harvested using a minimally invasive technique. MATERIALS AND METHODS: 35 patients who were treated for Kuwada grade IV Achilles tendon injuries from July 2006 to June 2011 were included in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Chad Turner, Shane Hiatt, Brian Mullis
Commonly accepted dogma is that patients with a long bone fracture due to a penetrating injury (gunshot wound) are less likely to follow up than blunt trauma patients. An institutional trauma database from a Level 1 academic trauma center was utilized to include all patients with long bone fractures from penetrating trauma from 2006-2009 (N = 132). Demographically matched blunt trauma patients with long bone fractures were included as a comparison group (N = 104). The medical records of these 236 patients were reviewed to observe their follow-up at 3, 6, 9, and 12 months...
September 2016: American Journal of Orthopedics
Eric C McCarty, Matthew J Kraeutler, Paula Langner, Shane Cook, Byron Ellis, Jenna M Godfrey
We conducted a study to identify and contrast patterns in the treatment of common injuries that occur in National Football League (NFL) players and National Collegiate Athletic Association (NCAA) Division I football players. Orthopedic team physicians for all 32 NFL and 119 NCAA Division I football teams were asked to complete a survey regarding demographics and preferred treatment of a variety of injuries encountered in football players. Responses were received from 31 (97%) of the 32 NFL and 111 (93%) of the 119 NCAA team physicians...
September 2016: American Journal of Orthopedics
Xinning Li, Antonio Cusano, Josef Eichinger
Shoulder dislocations are a common injury, with anterior shoulder dislocation among male patients being the most common presentation. A patient with recurrent shoulder instability, anterior-superior escape, and chronic subscapularis tendon rupture following multiple shoulder stabilization surgeries presents the surgeon with a complex and challenging case. This report describes a 40-year-old man with an extensive left shoulder history that included a failed Latarjet procedure, an irreparable, chronic subscapularis tear with grade 4 Goutallier fatty infiltration, and associated anterior-superior escape...
October 13, 2016: Orthopedics
Ryan Urchek, Eric Miller
The typical injury pattern of a posterior hip dislocation includes posterior wall fracture, capsular injury, and muscular strain. This report presents an example of a posterior wall acetabulum fracture-dislocation associated with complete hip abductor tendon and capsular avulsion from the femur. The patient was found to have an unstable hip despite a small posterior wall fragment due to the extensive soft tissue injury. This was repaired. The patient had improvement in function initially, but ultimately required repair of the hip abductor tendons...
October 13, 2016: Orthopedics
Luis Gerardo Natera Cisneros, Juan Sarasquete Reiriz
INTRODUCTION: Surgical indication for acromioclavicular joint (ACJ) injuries still represents a reason for shoulder and trauma debate. In high-grade injuries, surgery is advocated because some of the non-operatively managed patients may have persistent shoulder pain that could make them unable to return to their previous activity. It has been shown that many of the patients with high-grade ACJ injuries that are managed non-operatively involve the development of scapular dyskinesis, situation that may result in loss of strength and weakness...
October 12, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthop├ędie Traumatologie
Megan K Mills, Colin D Strickland, Mary K Jesse, Peter A Lowry, Omer Mei-Dan, Jonathan A Flug
Osteoarthritis of the hip remains a prevalent disease condition that influences ever-changing treatment options. Procedures performed to correct anatomic variations, and, in turn, prevent or slow the progression of osteoarthritis, are aptly referred to as types of hip preservation surgery (HPS). Conditions that predispose individuals to femoroacetabular impingement (FAI), including pincer- and cam-type morphology, and hip dysplasia are specifically targeted in HPS. Common surgical interventions include acetabuloplasty, osteochondroplasty, periacetabular osteotomy (PAO), and derotational femoral osteotomy (DFO)...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
Jelle P van der List, Gregory S DiFelice
Over the last century, many surgical treatments have been developed in the orthopedic field, including treatments of anterior cruciate ligament (ACL) injuries. These treatments ideally evolve in a process of trial and error with prospective comparison of new treatments to the current treatment standard. However, these evolutions are sometimes not linear and periodically undergo paradigm shifts. In this article, we review the evolution of ACL treatment and explain how it underwent a paradigm shift. Open primary ACL repair was the most common treatment in the 1970s and 1980s, but because multiple studies noted deterioration of outcomes at mid-term follow-up, in addition to several randomized clinical trials (RCTs) that noted better outcomes following ACL reconstruction, the open primary repair technique was abandoned...
October 6, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
David Wasylynko
OBJECTIVE: To present a case of chronic elbow pain as a result of a hidden underlying osteochondral defect. CLINICAL FEATURES: A 17-year old baseball player presented with chronic lateral elbow pain. Examination revealed swelling of the elbow with signs of possible ligament, muscle, and tendon injury. DIAGNOSIS AND TREATMENT: Although there was apparent soft-tissue injury, the elbow swelling created immediate suspicion of a more serious underlying condition...
September 2016: Journal of the Canadian Chiropractic Association
Jacob Babu, Robert M Shalvoy, Steve B Behrens
Meniscal injury is a common cause for presentation to the emergency department or primary care physician's office. Meniscal injuries can be the result of a forceful, twisting event in a young athlete's knee or it can insidiously present in the older patient. Many patients with meniscal pathology appropriately undergo conservative management with a primary care physician while some may need referral to an orthopedist for operative intervention. Arthroscopic surgery to address the menisci is the most frequently performed procedure on the knee and one of the most regularly performed surgeries in orthopedic surgery...
October 4, 2016: Rhode Island Medical Journal
Raymond W Liu, Katherine K Xie
BACKGROUND: It is unclear whether isolated gastroc/soleus tightness can increase the risk of lower extremity injury in an otherwise healthy child. QUESTIONS/PURPOSES: (1) Is there a difference in gastroc/soleus tightness, as represented by ankle dorsiflexion with the knee extended, in children presenting with upper versus lower extremity complaints? (2) Is there a difference in gastroc/soleus tightness in children presenting with atraumatic versus traumatic lower extremity complaints? METHODS: We performed a cross-sectional study of 206 consecutive walking age children presenting to a county orthopedic clinic with new upper or lower extremity complaints...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Katarzyna Siennicka, Aleksandra Zolocinska, Karolina Stepien, Natalia Lubina-Dabrowska, Marzena Maciagowska, Ewa Zolocinska, Anna Slysz, Renata Piusinska-Macoch, Slawomir Mazur, Urszula Zdanowicz, Robert Smigielski, Adam Stepien, Zygmunt Pojda
Although mesenchymal stem cells are used in numerous clinical trials, the safety of their application is still a matter of concern. We have analysed the clinical results of the autologous adipose-derived stem cell treatment (stromal vascular fraction (SVF) containing adipose-derived stem cells, endothelial progenitors, and blood mononuclear cells) for orthopedic (cartilage, bone, tendon, or combined joint injuries) and neurologic (multiple sclerosis) diseases. Methods of adipose tissue collection, cell isolation and purification, and resulting cell numbers, viability, and morphology were considered, and patient's age, sex, disease type, and method of cell administration (cell numbers per single application, treatment numbers and frequency, and methods of cell implantation) were analysed and searched for the unwanted clinical effects...
2016: Stem Cells International
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