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https://www.readbyqxmd.com/read/29330670/treatment-of-partial-thickness-rotator-cuff-tears-in-overhead-athletes
#1
REVIEW
Joseph N Liu, Grant H Garcia, Anirudh K Gowd, Brandon C Cabarcas, Michael D Charles, Anthony A Romeo, Nikhil N Verma
PURPOSE OF REVIEW: To review the etiology, classification, presentation, evaluation, treatment strategy, and outcomes in overhead athletes with partial thickness rotator cuff tears. RECENT FINDINGS: Despite advances in surgical repair techniques, return to play following surgical repair of partial rotator cuff tears remains modest at best. Overhead athletes may be particularly prone to rotator cuff pathology due to the supraphysiological strains within the tendon during the throwing motion, as well as mechanical stress with contact between the undersurface of the rotator cuff and the glenoid...
January 13, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29326772/posterior-elbow-dislocation-with-brachial-artery-thrombosis-treated-non-surgically-a-case-report
#2
S M Lim, G G Chua, F Asrul, M Yazid
The brachial artery is rarely injured in closed posterior dislocation of the elbow, unlike the high rate of vascular injury seen after dislocation of the knee. Despite the anatomical proximity of the brachial artery to the elbow joint, most cases of brachial artery injury after dislocation of the elbow are related to an associated fracture, an open injury or high-energy trauma. A high index of suspicion should be maintained as well as a thorough neurovascular examination with regards this potentially disastrous complication...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29324527/distal-femoral-valgus-and-recurrent-traumatic-patellar-instability-is-an-isolated-varus-producing-distal-femoral-osteotomy-a-treatment-option
#3
Philip L Wilson, Sheena R Black, Henry B Ellis, David A Podeszwa
BACKGROUND: Genu valgum, a risk factor for recurrent patellofemoral instability, can be addressed with a varus producing distal femoral osteotomy (DFO). The purpose of this study is to report 3-year clinical and radiographic outcomes on a series of skeletally mature adolescents with traumatic patellofemoral instability and genu valgum who underwent a varus producing DFO. METHODS: Consecutive patients (n=11) who underwent an isolated DFO for recurrent traumatic patellar instability over a 4-year study period (2009 to 2012) were reviewed...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29323806/spine-and-spinal-cord-injuries-after-falls-from-tree-stands-during-the-wisconsin-deer-hunting-season
#4
Kimberly Hamilton, Brandon Rocque, Nathaniel Brooks
BACKGROUND: Deer hunting is popular in much of the United States. In Wisconsin, use of tree stands for hunting is common. Spine surgeons at a Level 1 Trauma Center observed a high incidence of spine and spinal cord injury due to falls from tree stands while hunting. This study's purpose is to systematically characterize and classify those injuries. METHODS: We reviewed the University of Wisconsin Hospital and Clinics' trauma database for tree stand-related injuries from 1999 to 2013...
November 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322168/patient-preferences-for-surgery-or-antibiotics-for-the-treatment-of-acute-appendicitis
#5
Alexis L Hanson, Ross D Crosby, Marc D Basson
Importance: Studies have compared surgical with nonsurgical therapy for acute uncomplicated appendicitis, but none of these studies have a patient-centered perspective. Objectives: To evaluate how patients might choose between surgical and nonsurgical therapy for acute uncomplicated appendicitis and to identify targets to make antibiotic treatment more appealing. Design, Setting, and Participants: This study comprised an online survey and an in-person sensitivity analysis survey...
January 10, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29319656/isolated-rhabdomyolysis-of-the-infraspinatus-muscle-following-the-crossfit-sissy-test-a-report-of-two-cases
#6
Howard D Routman, Jacob J Triplet, Jennifer Kurowicki, Neil Singh
CASE: Following the completion of a CrossFit-style challenge (the "Sissy Test"), 2 patients presented with severe pain and swelling over the posterior aspect of the scapula. Magnetic resonance imaging demonstrated isolated edema of the infraspinatus muscle in both patients; the compartments were compressible. Neurovascular checks and observation of range of motion were performed. The patients were treated nonoperatively and were discharged with the diagnosis of overuse syndrome with rhabdomyolysis of the infraspinatus muscle...
January 10, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29319655/superior-capsular-reconstruction-with-a-partial-rotator-cuff-repair-a-case-report
#7
John M Tokish, Amit Momaya, Troy Roberson
CASE: Chronic massive irreparable rotator cuff tears remain challenging to treat. We present the case of a 70-year-old active and healthy woman who presented with 6 months of worsening shoulder pain and function; she had experienced considerable deterioration over the past 2 months. Nonoperative management of the massive rotator cuff tear was not successful. Superior capsule reconstruction (SCR) was performed with a partial rotator cuff repair. CONCLUSION: SCR is an exciting advancement for the chronic massive irreparable rotator cuff tear, one of the more challenging problems encountered by shoulder surgeons...
January 10, 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29319651/proper-education-on-spinal-orthotics-a-way-to-minimize-associated-complications
#8
Christopher Elia, Katie Huynh, Fanglong Dong, Dan Miulli
Spinal orthotic bracing is a common modality for treating nonoperative spinal fractures with risks. This study aimed to assess the effect of an intervention on critical care nurses to improve their clinical knowledge and comfort level of managing patients. A literature review was conducted regarding common complications associated with spinal orthotics. This information was compiled and used to create a questionnaire and spinal orthotic course for nurses. Pre- and postassessments of nurses' knowledge regarding spinal orthotics were conducted...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29312844/new-insights-in-the-treatment-of-acromioclavicular-separation
#9
REVIEW
Christiaan J A van Bergen, Annelies F van Bemmel, Tjarco D W Alta, Arthur van Noort
A direct force on the superior aspect of the shoulder may cause acromioclavicular (AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types I and II are treated nonoperatively, while types IV, V and VI are generally treated operatively. Controversy exists regarding the optimal treatment of type III dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially...
December 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29305287/endoscopic-repair-of-partial-thickness-undersurface-tears-of-the-abductor-tendon-clinical-outcomes-with-minimum-2-year-follow-up
#10
David E Hartigan, Itay Perets, Sherwin W Ho, John P Walsh, Leslie C Yuen, Benjamin G Domb
PURPOSE: To report the minimum 2-year outcomes of transtendinous repair of partial-thickness undersurface tears of the abductor tendon using patient-reported outcomes (PROs), visual analog scale (VAS) scores, and patient satisfaction scores. METHODS: All patients who underwent endoscopic transtendinous gluteus medius repair between October 2009 and May 2013 at 1 institution were prospectively evaluated. The exclusion criteria consisted of less than 2 years' follow-up, previous hip surgery, inflammatory arthritis, open surgery, full-thickness abductor tear, and Workers' Compensation patients...
January 2, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29305097/the-inter-teres-approach-to-glenoid-neck-fractures-an-alternative-approach-to-glenoid-fixation
#11
Carl W Jones, Vinu M George, Thin F Hong
BACKGROUND: Scapula fractures are rare injuries that are generally treated nonoperatively. When surgery is performed, it is commonly undertaken through the posterior approach, which can be invasive and unforgiving on the soft tissues. We describe an alternative safe approach between teres major and minor that remains deep to a fascial sling formed by the combined infraspinatus and teres minor fasciae and deep to the primary nerve to teres minor, which is a terminal branch of the axillary nerve...
January 2, 2018: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29304985/editorial-commentary-the-partial-thickness-rotator-cuff-tear-is-acromioplasty-without-repair-ever-indicated
#12
EDITORIAL
Frank A Cordasco
I believe that arthroscopic repair is the treatment of choice for patients with partial thickness rotator cuff tears when nonoperative methods have been exhausted. Excluding overhead athletes and patients in whom long head biceps tendon pathology is the primary concern, I do not believe that a significant role exists for debridement with or without acromioplasty in the majority of patients with partial thickness tears. Regarding the repair technique, I prefer in situ repair for bursal-sided tears because the superior capsule is intact and completion of the tear with repair for articular-sided tears...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304968/editorial-commentary-the-amsterdam-achilles-tendinopathy-endoscopic-treatment-should-we-start-booking-our-patients-for-surgery
#13
EDITORIAL
Sameh A Labib
Mid-portion Achilles tendinopathy remains an elusive clinical and pathologic condition, with only a limited treatment algorithm to guide us. Although the risk factors and natural history have been documented, the exact etiology and source of pain generation remains unclear in the literature. Several Level I studies have shown reasonable success with a myriad of nonoperative treatments over the long term. Surgery is often reserved as the last resort for those who have failed nonoperative treatment, with mixed techniques and results...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29304958/editorial-commentary-proximal-hamstring-syndrome-another-pain-in-the-buttock
#14
EDITORIAL
Dean K Matsuda
Proximal hamstring injuries cause buttock pain and may result in significant weakness and sciatic neuralgia. Avulsion ruptures involving 2 or more tendons with >2-cm retraction may benefit from early open surgical repair. More chronic equivalents may benefit from Achilles allograft reconstruction. Chronic proximal hamstring syndrome causing posterior thigh and sit pain may occur from less severe, often repetitive injury to the proximal hamstring origin with secondary sciatic neuralgia from local adhesions or scar entrapment...
January 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29303450/subcutaneous-bone-flap-storage-after-emergency-craniectomy-cost-effectiveness-and-rate-of-resorption
#15
Griffin Ernst, Fares Qeadan, Andrew P Carlson
OBJECTIVE Decompressive craniectomy is used for uncontrolled intracranial pressure in traumatic brain injury and malignant hemispheric stroke. Subcutaneous preservation of the autologous bone flap in the abdomen is a simple, portable technique but has largely been abandoned due to perceived concerns of resorption. The authors sought to characterize their experience with subcutaneous preservation of the bone flap and cranioplasty. METHODS The authors performed a retrospective single-institution review of subcutaneous preservation of the autologous bone flap after decompressive craniectomy from 2005 to 2015...
January 5, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29300225/articular-cartilage-injury-pathways-and-treatment-options
#16
Timothy M Simon, Douglas W Jackson
Articular cartilage injury and degeneration is a frequent occurrence in synovial joints. Treatment of these articular cartilage lesions are a challenge because this tissue is incapable of quality repair and/or regeneration to its native state. Nonoperative treatments endeavor to control symptoms, and include anti-inflammatory medication, viscosupplementation, bracing, orthotics, and activity modification. Techniques to stimulate the intrinsic repair (fibrocartilage) process include drilling, abrasion, and microfracture of the subchondral bone...
March 2018: Sports Medicine and Arthroscopy Review
https://www.readbyqxmd.com/read/29299491/evaluation-of-radiocapitellar-arthritis-in-patients-with-a-second-radiograph-at-least-2-years-after-nonoperative-treatment-of-an-isolated-radial-head-fracture
#17
Amir R Kachooei, David Ring
Background: To study if patients that have a second radiograph 2 or more years after nonoperative treatment of an isolated radial head fracture have radiocapitellar osteoarthritis (RC OA). Methods: We used the database of 3 academic hospitals in one health system from 1988 to 2013 to find patients with isolated radial head fractures (no associated ligament injury or fracture) that had a second elbow radiograph after more than 2 years from the initial injury. Of 887 patients with isolated radial head fractures, 54 (6%) had an accessible second radiograph for reasons of a second injury (57%), pain (30%), or follow-up visit (13%)...
November 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29290493/interhospital-vascular-surgery-transfers-to-a-tertiary-care-hospital
#18
Sheena K Harris, Dale G Wilson, Enjae Jung, Amir-Farzin Azarbal, Gregory J Landry, Timothy K Liem, Gregory L Moneta, Erica L Mitchell
OBJECTIVE: Interhospital transfers (IHTs) to tertiary care centers are linked to lower operative mortality in vascular surgery patients. However, IHT incurs great health care costs, and some transfers may be unnecessary or futile. In this study, we characterize the patterns of IHT at a tertiary care center to examine appropriateness of transfer for vascular surgery care. METHODS: A retrospective review was performed of all IHT requests made to our institution from July 2014 to October 2015...
December 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29289391/acute-diverticulitis-in-renal-transplant-patients-should-we-treat-them-differently
#19
Jeremy Sugrue, Joanna Lee, Christina Warner, Sany Thomas, Ivo Tzvetanov, Winnie Mar, Anders Mellgren, Johan Nordenstam
BACKGROUND: Current guidelines suggest that transplant patients with acute diverticulitis should be managed aggressively with early operative intervention to reduce morbidity and mortality. This study compared the treatment choices and clinical outcomes between renal transplant patients and immunocompetent patients with acute diverticulitis. METHODS: A retrospective review was performed of all patients who were admitted with acute diverticulitis between 2002 and 2015 at a single academic institution...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29286969/simultaneous-ipsilateral-dislocation-of-the-hip-and-the-knee-a-case-report
#20
Antonio Arenas Miquelez, Filippo Familiari, Lucas Arbeloa, Andrea D'Arrigo Azzarelli
CASE: A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome. CONCLUSION: Simultaneous ipsilateral hip and knee dislocations are rare and complex injuries that usually result from high-energy trauma...
October 2017: JBJS Case Connector
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