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https://www.readbyqxmd.com/read/28210402/interdisciplinary-management-of-minimally-displaced-orbital-roof-fractures-delayed-pulsatile-exophthalmos-and-orbital-encephalocele
#1
Austin Y Ha, William Mangham, Sarah A Frommer, David Choi, Petra Klinge, Helena O Taylor, Adetokunbo A Oyelese, Stephen R Sullivan
Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. They are typically associated with severe mechanisms of injury and may be associated with significant neurologic or ophthalmologic compromise including traumatic brain injury and vision loss. Rarely, traumatic encephalocele or pulsatile exophthalmos may be present at the time of injury or develop in delayed fashion, necessitating close observation of these patients. In this article, we describe two patients with minimally displaced blow-in type orbital roof fractures that were later complicated by orbital encephalocele and pulsatile exophthalmos, prompting urgent surgical intervention...
March 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28205261/stent-placement-prior-to-initiation-of-chemotherapy-in-patients-with-obstructive-nonoperative-left-sided-tumors-is-associated-with-fewer-stomas
#2
Javier Suárez, Gabriel Marín, Ruth Vera, Dorin Colibaseanu, Juan J Vila, Miguel A Ciga, Begoña Oronoz
BACKGROUND AND OBJETIVES: Due to the potential risks associated with stent placement, European Society Gastrointestinal Endoscopy does not recommend prophylactic insertion of stents in patients without symptoms. The aim was to compare complication rates, need of surgery, colostomy formation, and survival between stent placement prior to start of chemotherapy (SEMS group) and upfront ChT (ChT group) in patients with endoscopically non-transverable metastatic left-sided colorectal cancer...
February 15, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28198795/presence-of-failed-fracture-implants-in-association-with-lower-extremity-long-bone-nonunion-does-not-portend-worse-outcome-following-nonunion-repair
#3
Deirdre K Regan, Roy I Davidovitch, Sanjit Konda, Arthur Manoli, Philipp Leucht, Kenneth A Egol
OBJECTIVE: The purpose of this study was to determine whether the finding of failed fracture implants in association with lower extremity long bone fracture nonunion portends worse clinical or functional outcome following surgical nonunion repair. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Academic Medical Center. PATIENTS: One hundred eighty-one patients who presented to our institution over a 10-year period and underwent surgical repair of a lower extremity fracture nonunion...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28196031/smoking-increases-the-rate-of-reoperation-for-infection-within-90-days-after-primary-total-joint-arthroplasty
#4
Eric H Tischler, Laura Matsen Ko, Antonia F Chen, Mitchell G Maltenfort, Jacob Schroeder, Matthew S Austin
BACKGROUND: The relationship between smoking and complications after total joint arthroplasty is unclear. Prior studies have been limited by relatively small sample sizes or investigation of select cohorts. The purpose of this study was to investigate the association between smoking and readmission and/or reoperation within 90 days of total joint arthroplasty in a large, non-select cohort of patients. METHODS: Using our institutional database, we retrospectively identified patients who underwent primary total joint arthroplasty between 2000 and 2014...
February 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28193544/current-approach-to-liver-traumas
#5
Levent Kaptanoglu, Necmi Kurt, Hasan Ediz Sikar
INTRODUCTION: Liver injuries remain major obstacle for successful treatment, due to size and location of the liver. Requirement for surgery should be determined by clinical factors, most notably hemodynamical state. In this present study we tried to declare our approach to liver traumas. We also tried to emphasize the importance of conservative treatment, since surgeries for liver traumas carry high mortality rates. PRESENTATION OF CASE: Patients admitted to the Department of Emergency Surgery at Kartal Research and Education Hospital, due to liver trauma were retrospectively analyzed between 2003-2013...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28193139/the-relationship-between-radiological-alignment-of-united-distal-radius-fractures-and-functional-and-patient-perceived-outcomes-in-elderly-patients
#6
Erik Hohmann, Mahendrakumar Meta, Vasudev Navalgund, Kevin Tetsworth
PURPOSE: The purpose of this study was to investigate the relationship between radiological alignment and functional outcomes including strength, range of motion (ROM), and disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores in elderly patients with united distal radius fractures. METHODS: We reviewed 118 patients (mean age of 76.2 ± 9.5 years, mean follow-up 36.3 ± 17.6 months). Outcome measures included the DASH and PRWE scores, ROM, and grip and pinch strength were measured using a validated mobile hand-held dynamometer...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28173947/cost-analysis-of-nonoperative-management-of-acute-appendicitis-in-children
#7
Martina Mudri, Kamary Coriolano, Andreana Bütter
PURPOSE: The purpose of this study was to determine if nonoperative management of acute appendicitis in children is more cost effective than appendectomy. METHODS: A retrospective review of children (6-17years) with acute appendicitis treated nonoperatively (NOM) from May 2012 to May 2015 was compared to similar patients treated with laparoscopic appendectomy (OM) (IRB#107535). Inclusion criteria included symptoms ≤48h, localized peritonitis, and ultrasound confirmation of acute appendicitis...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28173939/outcome-and-management-of-endoscopic-retrograde-cholangiopancreatography-perforations-a-community-perspective
#8
Mallory S Bray, Andrew J Borgert, Milan E Folkers, Shanu N Kothari
BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) carries a small but significant risk of perforation. Recent data suggest that select patients can be managed non-operatively. We sought to evaluate the management of ERCP perforations at our community medical center. METHODS: ERCPs performed from 2004 to 2015 were reviewed. RESULTS: Twenty-one of 2423 patients who underwent ERCP had a perforation (0.9%). ERCP procedures included balloon sweep with/without sphincterotomy and pancreatic duct stent (71%), common bile duct brushing (10%), and pancreatic duct stenting (5%)...
January 30, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28167056/managing-complications-of-calcaneus-fractures
#9
REVIEW
Michael P Clare, William S Crawford
Calcaneus fractures remain among the most complicated fractures for orthopedic surgeons to manage because of the complexity of various fracture patterns, the limited surrounding soft tissue envelope, and the prolonged rehabilitation issues impacting function after successful treatment. Despite this, appropriate management of complications associated with calcaneus fractures is critical for the complete care of this injury, whether treated operatively or nonoperatively. The authors present the common complications encountered with fractures of the calcaneus and management thereof...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28166172/cost-and-cost-effectiveness-analysis-of-treatment-options-for-sanders-ii-and-iii-calcaneus-fractures-in-laborers
#10
R Carter Clement, Pamela J Lang, Brett J Pettett, Robert A Overman, Robert F Ostrum, Josh N Tennant
OBJECTIVE: This study compares the cost and cost-effectiveness of treatments options for Sanders II/III displaced intra-articular calcaneus fractures (DIACF's) in laborers. METHODS: Literature on Sanders type II and III fractures was reviewed to determine complication rates and utility values for each treatment option. Costs were calculated using Medicare reimbursement and implant prices from our institution. Monte Carlo simulations were used to analyze a decision-tree to determine the cost and cost-effectiveness of each treatment from a societal perspective...
January 30, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28162264/nonfunctioning-small-incidental-pancreatic-neuroendocrine-tumors-results-of-a-nonoperative-approach-cohort
#11
Catalina Uribe Galeano, Joan Fabregat Prous, Juli Busquets Barenys, Nuria Pelaez Serra, Lluís Secanella Medayo, Emilio Ramos Rubio, Sandra Ruiz Osuna, Carlos Villabona Artero
OBJECTIVE: The availability of new imaging techniques has conditioned an increase in the incidental diagnosis of small nonfunctioning pancreatic neuroendocrine tumors (PNET-NF). The best treatment is controversial, some authors advise a conservative approach in selected cases. Our aim is to analyze the evolution of incidental, small size PNET-NF, treated with clinical follow-up without surgery. METHODS: We performed a retrospective analysis of a prospective database of patients diagnosed incidentally with PNET-NF since November 2007 to September 2015...
February 2, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28155059/outcomes-and-financial-implications-of-intra-articular-distal-radius-fractures-a-comparative-study-of-open-reduction-internal-fixation-orif-with-volar-locking-plates-versus-nonoperative-management
#12
Dong Hao Toon, Rex Antony Xavier Premchand, Jane Sim, Rajaratnam Vaikunthan
BACKGROUND: To evaluate the functional and radiographic outcomes, as well as the treatment costs, of closed displaced intra-articular distal radius fractures treated with either open reduction internal fixation (ORIF) with volar locking plates or nonoperative treatment with plaster cast immobilisation. MATERIALS AND METHODS: A total of 60 patients (32 receiving ORIF, 28 receiving nonoperative treatment) with closed intra-articular distal radius fractures were included...
February 2, 2017: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/28152148/evaluation-of-a-minimally-disruptive-treatment-protocol-for-frontal-sinus-fractures
#13
Sapna A Patel, Angelique M Berens, Karthik Devarajan, Mark E Whipple, Kris S Moe
Importance: Despite common goals of frontal sinus fracture treatment (restoring forehead contour and creating a safe sinus), there remains significant variability in evaluation and treatment. Objective: To describe our experience with a minimally disruptive treatment protocol for the treatment of frontal sinus fractures. Design, Setting, and Participants: Analysis of prospectively collected data from 2010 through 2015 at a level 1 trauma center...
February 2, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28144574/current-management-of-talar-osteochondral-lesions
#14
REVIEW
Arianna L Gianakos, Youichi Yasui, Charles P Hannon, John G Kennedy
Osteochondral lesions of the talus (OLT) occur in up to 70% of acute ankle sprains and fractures. OLT have become increasingly recognized with the advancements in cartilage-sensitive diagnostic imaging modalities. Although OLT may be treated nonoperatively, a number of surgical techniques have been described for patients whom surgery is indicated. Traditionally, treatment of symptomatic OLT have included either reparative procedures, such as bone marrow stimulation (BMS), or replacement procedures, such as autologous osteochondral transplantation (AOT)...
January 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28144210/intestinal-intussusception-etiology-diagnosis-and-treatment
#15
REVIEW
Priscilla Marsicovetere, S Joga Ivatury, Brent White, Stefan D Holubar
Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. Idiopathic ileocolic intussusception is the most common form in children and is typically managed with nonoperative reduction via pneumatic and/or hydrostatic enemas. In the adult population, intussusception is uncommon and occurs more often in the small intestine than in the colon. It is associated with lead point pathology in most symptomatic cases presenting as bowel obstruction. When lead point pathology is present in adult small bowel intussusception, it is usually benign, though when malignant it is most frequently due to diffuse metastatic disease, for example, melanoma...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144206/functional-disorders-rectoanal-intussusception
#16
REVIEW
Kristen Blaker, Joselin L Anandam
Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. Patients may present with constipation, incomplete evacuation, incontinence, or may be asymptomatic. Defecography has been the gold standard for detection. Magnetic resonance imaging defecography and dynamic anal endosonography are alternatives to conventional defecography. However, both methods are not as sensitive as conventional defecography. Treatment options range from conservative/medical treatment such as biofeedback to surgical procedures such as Delorme, rectopexy, and stapled transanal rectal resection...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28141953/interposition-dermal-matrix-xenografts
#17
Julie A Neumann, Miltiadis H Zgonis, Kathleen D Rickert, Kendall E Bradley, Thomas J Kremen, Blake R Boggess, Alison P Toth
BACKGROUND: Management of massive rotator cuff tears in shoulders without glenohumeral arthritis remains problematic for surgeons. Repairs of massive rotator cuff tears have failure rates of 20% to 94% at 1 to 2 years postoperatively as demonstrated with arthrography, ultrasound, and magnetic resonance imaging. Additionally, inconsistent outcomes have been reported with debridement alone of massive rotator cuff tears, and limitations have been seen with other current methods of operative intervention, including arthroplasty and tendon transfers...
January 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28141687/what-are-the-indications-for-spinal-fusion-surgery-in-scheuermann-kyphosis
#18
David W Polly, Charles G T Ledonio, Beverly Diamond, Hubert Labelle, Daniel J Sucato, M Timothy Hresko, John B Emans, Michael G Vitale, Mark A Erickson, A Noelle Larson
BACKGROUND: Surgical indications for Scheuermann kyphosis are variable. We sought to evaluate the characteristics of patients undergoing operative versus nonoperative treatment of Scheuermann kyphosis to better understand current practices and the factors which contribute to the decision for surgical management. METHODS: Multicenter prospective cohort study. We evaluated consecutive patients presenting with Scheuermann kyphosis. Patients underwent either surgical or nonoperative management according to surgeon and patient discretion...
January 30, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28139385/nonoperative-management-versus-reverse-shoulder-arthroplasty-for-treatment-of-3-and-4-part-proximal-humeral-fractures-in-older-adults
#19
Troy A Roberson, Charles M Granade, Quinn Hunt, James T Griscom, Kyle J Adams, Amit M Momaya, Adam Kwapisz, Michael J Kissenberth, Stefan J Tolan, Richard J Hawkins, John M Tokish
BACKGROUND: The treatment of 3- and 4-part proximal humeral fractures in the older adult is controversial. No study has directly compared reverse shoulder arthroplasty (RSA) with nonoperative treatment for these fractures. The purpose of this study was to compare clinical and patient-reported outcomes between RSA and nonoperative treatment groups. METHODS: A retrospective review was performed on all 3- and 4-part proximal humeral fractures treated with either RSA or nonoperative treatment with minimum 1-year follow-up...
January 27, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28139383/olecranon-physeal-nonunion-in-the-adolescent-athlete-identification-of-two-patterns
#20
Rachel M Frank, Brett A Lenart, Mark S Cohen
BACKGROUND: This study aimed to present the outcomes of patients undergoing surgical management of persistent, symptomatic olecranon physes. METHODS: Consecutive patients undergoing surgical management for symptomatic persistent olecranon physeal abnormalities were reviewed. Preoperative data, intraoperative findings, and postoperative clinical outcomes including physical examination findings, radiographs, complications, and reoperations were analyzed. RESULTS: A total of 13 elbows in 12 patients (100% male; average age, 18 ± 4 years) were identified...
January 27, 2017: Journal of Shoulder and Elbow Surgery
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