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Modalities and orthopedic injuries

Ahmed Shams, Mohamed El-Sayed, Osama Gamal, Mohamed ElSawy, Wael Azzam
BACKGROUND: Among the uncommon and frequently missed orthopedics injuries is the posterior shoulder dislocation, accounting for about 2-4 % of all shoulder dislocations. Commonly, it is associated with the well-known reverse Hill-Sachs lesion. Several surgical treatment modalities such as transfer of subscapularis tendon or lesser tuberosity, humeral rotational osteotomy, osteochondral grafts were used to repair this defect. Hemiarthroplasty or total shoulder arthroplasty was used as salvage procedure in non-constructable defect or neglected old dislocation...
August 19, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Ged G Wieschhoff, Scott E Sheehan, Jeremy R Wortman, George S M Dyer, Aaron D Sodickson, Ketan I Patel, Bharti Khurana
Traumatic finger injuries account for a substantial number of emergency visits every year. Imaging plays an important role in diagnosis and in directing management of these injuries. Although many injuries can be managed conservatively, some require more invasive interventions to prevent complications and loss of function. Accurate diagnosis of finger injuries can often be difficult, given the complicated soft-tissue anatomy of the hand and the diverse spectrum of injuries that can occur. To best serve the patient and the treating physician, radiologists must have a working knowledge of finger anatomy, the wide array of injury patterns that can occur, the characteristic imaging findings of different finger injuries, and the most appropriate treatment options for each type of injury...
July 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Zachariah S Logan, John M Redmond, Sarah C Spelsberg, Timothy J Jackson, Benjamin G Domb
The treatment of chondral hip injuries is challenging. However, for young patients with hip disorders, orthopedic surgeons now have the opportunity to intervene early in the development of debilitating joint disease. As understanding of the hip joint continues to evolve, more effective treatment strategies are emerging. There are several reportedly successful options for surgical treatment. This article reviews the clinical presentation of chondral injuries and the surgical modalities, arthroscopic and open, available to treat them...
July 2016: Clinics in Sports Medicine
Andreas F Mavrogenis, George N Panagopoulos, Zinon T Kokkalis, Panayiotis Koulouvaris, Panayiotis D Megaloikonomos, Vasilios Igoumenou, George Mantas, Konstantinos G Moulakakis, George S Sfyroeras, Andreas Lazaris, Panayotis N Soucacos
Vascular injury in orthopedic trauma is challenging. The risk to life and limb can be high, and clinical signs initially can be subtle. Recognition and management should be a critical skill for every orthopedic surgeon. There are 5 types of vascular injury: intimal injury (flaps, disruptions, or subintimal/intramural hematomas), complete wall defects with pseudoaneurysms or hemorrhage, complete transections with hemorrhage or occlusion, arteriovenous fistulas, and spasm. Intimal defects and subintimal hematomas with possible secondary occlusion are most commonly associated with blunt trauma, whereas wall defects, complete transections, and arteriovenous fistulas usually occur with penetrating trauma...
July 1, 2016: Orthopedics
Michael S Crowell, Gail D Deyle, Johnny Owens, Norman W Gill
OBJECTIVES: Severe lower extremity trauma accounts for large healthcare costs and often results in elective amputation and poor long-term outcomes. The purpose of this case series is to describe an orthopedic manual physical therapy (OMPT) approach combined with a return to run (RTR) clinical pathway consisting of high-intensity functional rehabilitation with a custom energy-storing orthosis. METHODS: Three consecutive male patients, aged 21-23 years, with severe lower extremity musculoskeletal injuries were treated with a combined intervention that included a mean (SD) of 12 (2·1) OMPT sessions and 24 (8·7) functional rehabilitation sessions over a mean of 6 weeks (1·0)...
February 2016: Journal of Manual & Manipulative Therapy
Ivan J Golub, Roberto A Garcia, James C Wittig
A 15-year-old boy presented with a mass in his right arm after suffering a minor injury playing baseball. He had been diagnosed with a hematoma. There was no other outstanding medical/surgical history. Magnetic resonance images showed a heterogeneous mass arising from the brachialis muscle that mainly enhanced peripherally with extremely scant internal nodular enhancement. Core needle biopsy cells were positive for CD31 and CD34, markers for atypical endothelial cells, as well as MIB-1 and p53. The final diagnosis was an angiosarcoma of the brachialis muscle...
May 1, 2016: Orthopedics
Razia Rehmani, Yoshimi Endo, Phillip Bauman, William Hamilton, Hollis Potter, Ronald Adler
BACKGROUND: Altered biomechanics from repetitive microtrauma, such as long practice hours in en pointe (tip of the toes) or demi pointe (balls of the feet) predispose ballet dancers to a multitude of musculoskeletal pathologies particularly in the lower extremities. Both ultrasound and magnetic resonance imaging (MRI) are radiation-sparing modalities which can be used to confidently evaluate these injuries, with ultrasound (US) offering the added utility of therapeutic intervention at the same time in experienced hands...
October 2015: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Lianyang Li, Mattia F Pagnotta, Xianghong Arakaki, Thao Tran, David Strickland, Michael Harrington, George Zouridakis
In this study, we compared the brain activation profiles obtained from resting state Electroencephalographic (EEG) and Magnetoencephalographic (MEG) activity in six mild traumatic brain injury (mTBI) patients and five orthopedic controls, using power spectral density (PSD) analysis. We first estimated intracranial dipolar EEG/MEG sources on a dense grid on the cortical surface and then projected these sources on a standardized atlas with 68 regions of interest (ROIs). Averaging the PSD values of all sources in each ROI across all control subjects resulted in a normative database that was used to convert the PSD values of mTBI patients into z-scores in eight distinct frequency bands...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Matthew J Smith, Michael J Reiter, Brett D Crist, Loren G Schultz, Theodore J Choma
Patient-reported outcome measures are helping clinicians to use evidence-based medicine in decision making. The use of computer-based questionnaires to gather such data may offer advantages over traditional paper-based methods. These advantages include consistent presentation, prompts for missed questions, reliable scoring, and simple and accurate transfer of information into databases without manual data entry. The authors enrolled 308 patients over a 16-month period from 3 orthopedic clinics: spine, upper extremity, and trauma...
January 2016: Orthopedics
Ahmad Oryan, Soodeh Alidadi, Ali Moshiri
INTRODUCTION: Successful healing of large bone defects (LBDs) is a complicated phenomenon because the body's natural ability often fails to effectively repair the LBDs. New modalities should be utilized to increase the quality and accelerate bone healing. Platelet concentrates in different forms can be considered an attractive option for such purpose. AREAS COVERED: Platelets as a natural source of growth factors, cytokines, and other micro and macromolecules are hypothesized to improve bone healing...
2016: Expert Opinion on Biological Therapy
Ismar Dizdarevic, Meghan Bishop, Nicole Sgromolo, Sommer Hammoud, Alfred Atanda
Back pain in a pediatric patient can present a worrisome and challenging diagnostic dilemma for any physician. Although most back pain can be attributed to muscle strains and poor mechanics, it is necessary to appreciate the full differential of etiologies causing back pain in the pediatric population. The physician must recognize areas of mechanical weakness in the skeletally immature spine and the sport specific forces that can predispose a patient to injury. A comprehensive history involves determining the onset, chronicity, and location of the pain...
November 2015: Physician and Sportsmedicine
Tricia Majewski-Schrage, Kelli Snyder
CLINICAL SCENARIO: Managing edema after trauma or injury is a primary concern for health care professionals, as it is theorized that delaying the removal of edema will increase secondary injury and result in a longer recovery period. The inflammatory process generates a series of events, starting with bleeding and ultimately leading to fluid accumulation in intercellular spaces and the formation of edema. Once edema is formed, the lymphatic system plays a tremendous role in removing excess interstitial fluid and returning the fluid to the circulatory system...
February 2016: Journal of Sport Rehabilitation
Lauren Salci, Olufemi Ayeni, Forough Farrokhyar, Dyda Dao, Rick Ogilvie, Devin Peterson
Prolonged surgical wait times have been associated with reduced quality of life (QoL) in patients requiring orthopedic surgery. However, the effects on patients awaiting anterior cruciate ligament (ACL) reconstruction surgery remains to be established. Here, it is determined that being on a waitlist for ACL reconstruction surgery reduces patients' QoL through negatively impacting disability, physical, and emotional health. A survey assessing patients' disability, physical, and emotional health was administered to 50 patients on the waitlist for ACL reconstruction surgery...
May 2016: Journal of Knee Surgery
D Shrestha, D Dhoju, R Shrestha, V Sharma
BACKGROUND: With the development of better imaging modalities including 3D CT scan and availability of technical expertise, operative management is increasingly performed for acetabular fracture but many patients in developing countries like Nepal, are still being treated with prolonged skeletal traction. OBJECTIVE: To analyses epidemiology, types of acetabular fracture and functional and radiological outcome of patients with acetabular fracture treated with open reduction and internal fixation (ORIF)...
October 2014: Kathmandu University Medical Journal (KUMJ)
Scott E Sheehan, Jeffrey Y Shyu, Michael J Weaver, Aaron D Sodickson, Bharti Khurana
Each year, more than 250,000 hip fractures occur in the United States, resulting in considerable patient mortality and morbidity. The various types of adult proximal femoral fractures require different treatment strategies that depend on a variety of considerations, including the location, morphologic features, injury mechanism, and stability of the fracture, as well as the patient's age and baseline functional status. The authors discuss femoral head, femoral neck, intertrochanteric, and subtrochanteric fractures in terms of injury mechanisms, specific anatomic and biomechanical features, and important diagnostic and management considerations, including the diagnostic utility of imaging modalities...
September 2015: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Danielle M McCarthy, Michael S Wolf, Ryan McConnell, Jill Sears, Allison Chevrier, Eric Ahlstrom, Kirsten G Engel, Kenzie A Cameron, James G Adams, D Mark Courtney
OBJECTIVES: The use of opioid analgesics in the United States has significantly increased in recent years. However, there is minimal consensus on what discharge counseling should accompany these high-risk prescriptions and large variations in what is done in practice. The objective of this study was to evaluate the effect of a dual-modality (written and spoken) literacy-appropriate educational strategy on patients' knowledge of and safe use of opioid analgesics. METHODS: This was a prospective, randomized controlled trial...
March 2015: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Ponnada A Narayana, Xintian Yu, Khader M Hasan, Elisabeth A Wilde, Harvey S Levin, Jill V Hunter, Emmy R Miller, Vipul Kumar S Patel, Claudia S Robertson, James J McCarthy
Multi-modal magnetic resonance imaging (MRI) that included high resolution structural imaging, diffusion tensor imaging (DTI), magnetization transfer ratio (MTR) imaging, and magnetic resonance spectroscopic imaging (MRSI) were performed in mild traumatic brain injury (mTBI) patients with negative computed tomographic scans and in an orthopedic-injured (OI) group without concomitant injury to the brain. The OI group served as a comparison group for mTBI. MRI scans were performed both in the acute phase of injury (~24 h) and at follow-up (~90 days)...
2015: NeuroImage: Clinical
Susanne M Stieger-Vanegas, Sri Kumar Jamie Senthirajah, Sarah Nemanic, Wendy Baltzer, Jennifer Warnock, Katelyn Hollars, Scott S Lee, Gerd Bobe
OBJECTIVE: To determine, using 3 groups of evaluators of varying experience reading orthopedic CT studies, if 3-dimensional computed tomography (3D-CT) provides a more accurate and time efficient method for diagnosis of canine sacral and pelvic fractures, and displacements of the sacroiliac and coxofemoral joints compared with 2-dimensional computed tomography (2D-CT). STUDY DESIGN: Retrospective clinical and prospective study. ANIMALS: Dogs (n = 23): 12 dogs with traumatic pelvic fractures, 11 canine cadavers with pelvic trauma induced by a lateral impactor...
August 2015: Veterinary Surgery: VS
Penny Broadley, Amaka C Offiah
An increasing number of children are taking up sporting activities and at more competitive levels. For this reason (pediatric) radiologists should expect to receive greater numbers of requests from their orthopedic colleagues to image the athletic child who presents with hip or groin pain: "athletic pubalgia."Lower limb sports-related pathology is particularly common in sports such as ballet, football, hockey, rugby, and running. Injuries to the hip and groin may account for up to a quarter of injuries seen in athletic children and may be acute or chronic, osseous, cartilaginous, ligamentous, or muscular...
November 2014: Seminars in Musculoskeletal Radiology
Paul S Pipitone, Saqib Rehman
Segmental bone loss represents a difficult clinical entity for the treating orthopedic surgeon. This article discusses the various treatment modalities available for limb reconstruction, with a focus on the indications, potential complications, and the outcomes of available treatment options.
October 2014: Orthopedic Clinics of North America
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