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Orthopedic injuries

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https://www.readbyqxmd.com/read/27922501/an-overview-of-congenital-myopathies
#1
Jean K Mah, Jeffrey T Joseph
PURPOSE OF REVIEW: This article uses a case-based approach to highlight the clinical features as well as recent advances in molecular genetics, muscle imaging, and pathophysiology of the congenital myopathies. RECENT FINDINGS: Congenital myopathies refer to a heterogeneous group of genetic neuromuscular disorders characterized by early-onset muscle weakness, hypotonia, and developmental delay. Congenital myopathies are further classified into core myopathies, centronuclear myopathies, nemaline myopathies, and congenital fiber-type disproportion based on the key pathologic features found in muscle biopsies...
December 2016: Continuum: Lifelong Learning in Neurology
https://www.readbyqxmd.com/read/27916579/distal-patellar-tendon-avulsion-in-association-with-high-energy-knee-trauma-a-case-series-and-review-of-the-literature
#2
Brian Capogna, Eric Strauss, Sanjit Konda, Alan Dayan, Michael Alaia
BACKGROUND: Patellar tendon rupture is rare in the general population. Typically, failure occurs proximally or at the mid-substance. Distal avulsion from the tibial tubercle in adults is rare and not well described in the orthopedic literature. METHODS: We present the largest series of patients with distal patellar tendon injury with associated multi-ligamentous disruption of the knee. A series of six patients with distal patellar tendon avulsion were identified at a single institution...
December 1, 2016: Knee
https://www.readbyqxmd.com/read/27915133/novel-reconstruction-technique-for-an-isolated-plantar-calcaneonavicular-spring-ligament-tear-a-5-case-series-report
#3
Ezequiel Palmanovich, Shay Shabat, Yaron S Brin, Sabri Massrawe, Iftach Hestroni, Meir Nyska
BACKGROUND: It is usually accepted that acquired flatfoot deformity after injury is usually due to partial or complete tear of the posterior tibial tendon (PTT), with secondary failure of the other structures which maintain the medial longitudinal arch, such as the plantar calcaneo-navicular (SPRING) ligament. It is unusual to find an isolated Spring Ligament (SL) tear, with an intact TP tendon. METHODS: The medial arch reconstruction technique of an isolated SL tear in 5 patients is presented discussed in this paper...
November 18, 2016: Foot
https://www.readbyqxmd.com/read/27908650/musculoskeletal-conditions-in-a-pediatric-population-with-ehlers-danlos-syndrome
#4
Courtney M Stern, Michael J Pepin, Joan M Stoler, Dennis E Kramer, Samantha A Spencer, Cynthia J Stein
OBJECTIVE: To describe musculoskeletal conditions in children with Ehlers-Danlos syndrome (EDS). STUDY DESIGN: A retrospective medical record review was performed, which evaluated 205 patients with EDS (ages 6-19 years) seen in sports medicine or orthopedic clinic at a large pediatric hospital over a 5-year period. RESULTS: Female (n = 147) and male (n = 57) patients were identified (mean age 12.7 years). The most common EDS subtype (55...
November 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#5
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27904790/current-concepts-in-the-treatment-of-gross-patellofemoral-instability
#6
Grant Buchanan, LeeAnne Torres, Brian Czarkowski, Charles E Giangarra
: Patellofemoral instability is a painful and commonly recurring condition, which often must be managed surgically. Diagnosis can be aided by the use of a variety of physical exam signs, such as the Q angle, Beighton hypermobility score, glide test, J sign, patellar tilt test, and apprehension test. Imaging modalities including x-ray, CT, and MRI guide both diagnosis and management by revealing trochlear dysplasia, bony malalignment, and ligamentous injury that contribute to instability...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27900711/lacertus-fibrosus-augmentation-for-distal-biceps-brachii-rupture-repair-surgical-technique
#7
M Fontana, A Trimarchi, A Colozza
BACKGROUND: Repair of distal biceps tendon ruptures has become widely accepted. Unfortunately, care of retracted-degenerated injuries remains a challenge for orthopedic surgeons. Complication rates appear to increase when surgery is performed in chronic cases compared to those operated acutely. Multiple techniques for chronic reconstruction with the use of grafts have been described. Recently Morrey, from the Mayo Clinic, proposed a direct anatomic repair of retracted distal biceps tendon ruptures in extreme flexion (60°-90°) to avoid grafting...
December 2016: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/27899200/-mucoadhesive-buccal-films-of-tramadol-for-effective-pain-management
#8
Xiao-Qin Li, Zhao-Ming Ye, Jian-Bing Wang, Cai-Rong Fan, Ai-Wu Pan, Cong Li, Ren-Bing Zhang
BACKGROUND AND OBJECTIVES: Tramadol hydrochloride is a centrally-acting synthetic opioid analgesic binding to specific opioid receptors. It is used in the management of chronic pain and is recommended as first line drug in the treatment of postoperative or orthopedic injury induced acute pain. The present work is designed to prepare and evaluate mucoadhesive buccal film of tramadol hydrochloride as a novel form of prolonged analgesia for patients with orthopedic injuries. METHODS: Buccal films of tramadol hydrochloride were prepared by solvent casting method...
November 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27895107/long-noncoding-rna-h19-accelerates-tenogenic-differentiation-and-promotes-tendon-healing-through-targeting-mir-29b-3p-and-activating-tgf-%C3%AE-1-signaling
#9
Ying-Fei Lu, Yang Liu, Wei-Ming Fu, Jia Xu, Bin Wang, Yu-Xin Sun, Tian-Yi Wu, Liang-Liang Xu, Kai-Ming Chan, Jin-Fang Zhang, Gang Li
Tendon injures are common orthopedic conditions, but tendon development and the pathogenesis of tendon injures, such as tendinopathy, remain largely unknown and have limited the development of clinical therapy. Studies on tenogenic differentiation at the molecular level may help in developing novel therapeutic strategies. As novel regulators, long noncoding RNAs (lncRNAs) have been found to have widespread biological functions, and emerging evidence demonstrates that lncRNAs may play important regulatory roles in cell differentiation and tissue regeneration...
November 28, 2016: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
https://www.readbyqxmd.com/read/27894329/efficacy-of-early-controlled-motion-of-the-ankle-compared-with-no-motion-after-non-operative-treatment-of-an-acute-achilles-tendon-rupture-study-protocol-for-a-randomized-controlled-trial
#10
Kristoffer Weisskirchner Barfod, Maria Swennergren Hansen, Per Holmich, Anders Troelsen, Morten Tange Kristensen
BACKGROUND: Early controlled ankle motion is widely used in the non-operative treatment of acute Achilles tendon rupture, though its safety and efficacy have never been investigated in a randomized setup. The objectives of this study are to investigate if early controlled motion of the ankle affects functional and patient-reported outcomes. METHODS/DESIGN: The study is performed as a blinded, randomized, controlled trial with patients allocated in a 1:1 ratio to one of two parallel groups...
November 29, 2016: Trials
https://www.readbyqxmd.com/read/27892447/a-study-on-variations-of-nutrient-foramen-of-humerus-with-its-clinical-implications
#11
D I Mansur, P Manandhar, M K Haque, D K Mehta, S Duwal, B Timalsina
Background Nutrient foramen is an opening into shaft of humerus which gives passage to the blood vessels of medullary cavity. The knowledge of nutrient foramen is important in surgical procedures like bone grafting and more recently in microsurgical vascularized bone transplantation. Objective To determine the number, location and direction of nutrient foramen and whether the nutrient foramens obey the rule of ossification, that is directed away from the growing end of the bone or not. Method The present study consisted of 253 (108 right and 145 left) dried humeri excluding any fracture or pathological abnormalities during the period of 15th December 2014 - 14th February 2015...
January 2016: Kathmandu University Medical Journal (KUMJ)
https://www.readbyqxmd.com/read/27890214/-pathology-of-the-triangular-fibrocartilaginous-complex-in-distal-radius-fractures
#12
D Fontès
Distal radius fracture is actually quite rarely isolated and triangular fibrocartilaginous complex (TFCC) is often involved with the same mechanism of injury. A contemporary management of the treatment of the initial fracture is ideal and so benefits from a routine arthroscopic management. Nevertheless, in the absence of diagnosis and therefore early treatment, the symptoms may be located at the ulnar crossroads and justify specific treatment of TFCC. It is generally conducted after an accurate arthroscopic lesion classification guiding a procedure, depending on the lesion vascularization as well as its possible destabilization potential (debridement, capsular suture or foveal reattachment)...
December 2016: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/27886835/shoulder-injuries-in-the-overhead-throwing-athlete
#13
REVIEW
Ryan A Mlynarek, Simon Lee, Asheesh Bedi
The overhead pitching motion is a coordinated sequence of movements that subjects the shoulder to extreme forces. The ultimate goal of this complex, dynamic activity is to generate high ball velocity and accuracy. In doing so, repetitive throwing can cause adaptive and pathologic changes in the thrower's shoulder. This article reviews the relevant shoulder anatomy, the kinetic chain, and throwing mechanics, as well as common shoulder injuries and surgical options for the treating orthopedic surgeon.
February 2017: Hand Clinics
https://www.readbyqxmd.com/read/27886680/timing-of-operative-debridement-in-open-fractures
#14
REVIEW
Joshua C Rozell, Keith P Connolly, Samir Mehta
The optimal treatment of open fractures continues to be an area of debate in the orthopedic literature. Recent research has challenged the dictum that open fractures should be debrided within 6 hours of injury. However, the expedient administration of intravenous antibiotics remains of paramount importance in infection prevention. Multiple factors, including fracture severity, thoroughness of debridement, time to initial treatment, and antibiotic administration, among other variables, contribute to the incidence of infection and complicate identifying an optimal time to debridement...
January 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/27876583/treatment-ofpediatric-forearm-midshaft-fractures-is-there-a-difference-between-types-of-orthopedic-surgeon
#15
Di Lu, Zhou Lin, Jing-Dong Zhang, Hua Chen, Liao-Jun Sun
PURPOSE OF THE STUDY: The objective of this study was tocompare the clinical and radiological outcomes of pediatric forearmmidshaft fractures treated operatively with titanium elastic nails (TENs) bypediatric orthopedists and non-pediatric orthopedists. MATERIAL AND METHODS: We conducted a prospective cohort study of 88 childrenofforearmmidshaft fractures, who were randomized to operative stabilization eitherby pediatric orthopedists (Group A, 44 cases) or by non-pediatric orthopedists (Group B, 44 cases) from April 2013 to February 2014...
November 19, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27876383/helmet-use-and-injury-severity-among-pediatric-skiers-and-snowboarders-in-colorado
#16
Melissa Milan, Sandeep Jhajj, Camille Stewart, Laura Pyle, Steven Moulton
INTRODUCTION: Skiing and snowboarding are popular winter recreational activities that are commonly associated with orthopedic type injuries. Unbeknownst to most parents, however, are the significant but poorly described risks for head, cervical spine and solid organ injuries. Although helmet use is not mandated for skiers and snowboarders outside of resort sponsored activities, we hypothesized that helmet use is associated with a lower risk of severe head injury, shorter ICU stay and shorter hospital length of stay...
November 6, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27871591/continuous-intra-articular-local-anesthetic-drug-instillation-versus-discontinuous-sciatic-nerve-block-after-total-knee-arthroplasty
#17
Johannes Cip, Hedwig Erb-Linzmeier, Peter Stadlbauer, Christian Bach, Arno Martin, Reinhard Germann
STUDY OBJECTIVE: Sciatic nerve block (SNB) is commonly used as adjunct to femoralis nerve block (FNB) to achieve high-quality pain relief after total knee arthroplasty (TKA). However, this combination is associated with considerable muscle weakness, foot drop and surgically related nerve injuries may be masked. The purpose of this study was to assess whether low risk continuous intra-articular anesthetic drug instillation is an adequate alternative to SNB when adding to FNB after TKA...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871515/perioperative-antiplatelet-therapy-and-cardiovascular-outcomes-in-patients-undergoing-joint-and-spine-surgery
#18
Nathaniel R Smilowitz, Brandon S Oberweis, Swetha Nukala, Andrew Rosenberg, Steven Stuchin, Richard Iorio, Thomas Errico, Martha J Radford, Jeffrey S Berger
STUDY OBJECTIVE: Perioperative thrombotic complications after orthopedic surgery are associated with significant morbidity and mortality. The use of aspirin to reduce perioperative cardiovascular complications in certain high-risk cohorts remains controversial. Few studies have addressed aspirin use, bleeding, and cardiovascular outcomes among high-risk patients undergoing joint and spine surgery. DESIGN/SETTING/PATIENTS: We performed a retrospective comparison of adults undergoing knee, hip, or spine surgery at a tertiary care center during 2 periods between November 2008 and December 2009 (reference period) and between April 2013 and December 2013 (contemporary period)...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870687/when-is-it-ok-to-use-a-splint-versus-cast-and-what-remodeling-can-one-expect-for-common-pediatric-forearm-fractures
#19
Robert S Runyon, Shevaun M Doyle
PURPOSE OF REVIEW: The purpose of this review is to provide an overview of common pediatric forearm fractures, clarify the descriptions used to identify and thereby appropriately treat them with a splint or cast, and explain osseous remodeling that is unique to the skeletally immature. RECENT FINDINGS: Recent literature addresses the gap in standard treatment protocols. There is variability in the management of pediatric forearm fractures because of the multiple subspecialty physicians that care for children's fractures and a lack of well established guidelines...
November 18, 2016: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#20
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
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