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https://www.readbyqxmd.com/read/28731937/an-adapted-clavien-dindo-scoring-system-in-trauma-as-a-clinically-meaningful-nonmortality-endpoint
#1
David N Naumann, Laura E Vincent, Nicola Pearson, Alastair Beaven, Iain M Smith, Kieran Smith, Emma Toman, Helen R Dorrance, Keith Porter, Charles E Wade, Bryan A Cotton, John B Holcomb, Mark J Midwinter
BACKGROUND: There is no consensus on reporting nonmortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery and requires adaptation to provide meaningful data for trauma patients. In particular, the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and nonoperatively. METHODS: A combined prospective and retrospective international multicenter observational study was undertaken to apply the ACDiT scale to 484 trauma patients at three university teaching hospitals (Birmingham, England (n = 303); Houston, Texas (n = 113); and Glasgow, Scotland (n = 68))...
August 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28728829/short-term-double-natural-orifice-catheterization-nonoperative-management-of-hydrocolpos-in-persistent-cloaca-patients-case-series
#2
Stjepan Višnjić, Mislav Bastić, Mateja Marčec, Marko Mesić
PURPOSE: Management of hydrocolpos in cloaca patients is of clinical importance. We report a nonoperative method for the management of hydrocolpos in the form of initial catheter decompression, followed by an endoscopy with catheters placement into both the bladder and vagina, and leaving these catheters for 9 and 14days respectively. METHODS: The medical records of six cloaca patients with hydrocolpos in the last 12years were reviewed. The outcomes measured were the renal function, bladder emptying, the presence/resolution of hydronephrosis, and the recurrence of hydrocolpos...
June 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28728786/the-slippery-slope-of-nonoperative-therapy-in-early-stage-lung-cancer
#3
EDITORIAL
Lara W Schaheen, Jonathan D'Cunha
No abstract text is available yet for this article.
June 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#4
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#5
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#6
John G Coury, Zachary C Lum, Nicholas P O'Neill, Joseph A Gerardi
BACKGROUND: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach. METHODS: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28720040/distal-radius-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-level-i-trauma-center
#7
James C Kyriakedes, Eugene Y Tsai, Douglas S Weinberg, Charles C Yu, Harry A Hoyen, Kevin Malone, Blaine T Bafus
BACKGROUND: The aim of this study is to determine whether the American Academy of Orthopaedic Surgeons' (AAOS) Appropriate Use Criteria (AUC) for distal radius fractures correlates with actual treatment by orthopedic hand surgeons at a level I trauma center. METHODS: ICD-9 codes were used to retrospectively identify patients who presented with wrist fractures over 1 year. Patients with isolated distal radius fractures were evaluated using the AAOS AUC application for distal radius fractures...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719982/deep-friction-massage-versus-steroid-injection-in-the-treatment-of-lateral-epicondylitis
#8
Rosemary Yi, Walter W Bratchenko, Virak Tan
BACKGROUND: The aim of the study was to determine the efficacy of deep friction massage in the treatment of lateral epicondylitis by comparing outcomes with a control group treated with splinting and therapy and with an experimental group receiving a local steroid injection. METHODS: A randomized clinical trial was conducted to compare outcomes after recruitment of consecutive patients presenting with lateral epicondylitis. Patients were randomized to receive one of 3 treatments: group 1: splinting and stretching, group 2: a cortisone injection, or group 3: a lidocaine injection with deep friction massage...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719566/midshaft-clavicle-fractures-the-saga-continues-commentary-on-articles-by-marcel-jun-sugawara-tamaoki-md-phd-et-al-treatment-of-displaced-midshaft-clavicle-fractures-figure-of-eight-harness-versus-anterior-plate-osteosynthesis-a-randomized-controlled-trial-and
#9
https://www.readbyqxmd.com/read/28719555/the-influence-of-shortening-on-clinical-outcome-in-healed-displaced-midshaft-clavicular-fractures-after-nonoperative-treatment
#10
E B Goudie, N D Clement, I R Murray, C R Lawrence, M Wilson, A J Brooksbank, C M Robinson
BACKGROUND: We aimed to evaluate the effect of clavicular shortening, measured with 3-dimensional computed tomography (3DCT), on functional outcomes and satisfaction in patients with healed displaced midshaft clavicular fractures up to 1 year following injury. METHODS: The data used in this study were collected as part of a multicenter, prospective randomized controlled trial of open reduction and plate fixation compared with nonoperative treatment for acute, displaced midshaft clavicular factures...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28719548/forearm-pronation-osteotomy-for-supination-contracture-secondary-to-obstetrical-brachial-plexus-palsy-a-retrospective-cohort-study
#11
Aharon Z Gladstein, Brant Sachleben, Emily S Ho, Alison Anthony, Howard M Clarke, Sevan Hopyan
BACKGROUND: Obstetrical brachial plexus palsy can lead to fixed forearm supination contracture. Fixed supination may lead to functional deficits as the affected hand cannot be positioned optimally for activities on a desk such as writing and typing, or for using tools including utensils, which require a neutral or pronated forearm. Forearm pronation osteotomy has been used to address this problem, although the functional benefit over nonoperative management has not been clearly defined...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28717840/nonoperative-management-of-perforated-acute-diverticulitis-with-extraluminal-air-results-and-risk-factors-of-failure
#12
Alberto Titos-García, Jose M Aranda-Narváez, Laura Romacho-López, Antonio J González-Sánchez, Isaac Cabrera-Serna, Julio Santoyo-Santoyo
AIM: The aim of this study was to analyze the results of nonoperative management of patients with perforated acute diverticulitis with extraluminal air and to identify risk factors that may lead to failure and necessity of surgery. METHODS: Methods included observational retrospective cohort study of patients between 2010 and 2015 with diagnosis of diverticulitis with extraluminal air and with nonoperative management initial. Patient demographics, clinical, and analytical data were collected, as were data related with computed tomography...
July 17, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28716327/surgical-management-of-neurogenic-lower-urinary-tract-dysfunction
#13
REVIEW
Ronak A Gor, Sean P Elliott
Surgery for patients with neurogenic urinary tract dysfunction (nLUTD) is indicated when medical therapy fails, to correct conditions affecting patient safety, or when surgery can enhance the quality of life better than nonoperative management. Examples include failure of maximal medical therapy, inability to perform or aversion to clean intermittent catheterization, refractory incontinence, and complications from chronic, indwelling catheters. Adults with nLUTD have competing risk factors, including previous operations, obesity, poor nutritional status, complex living arrangements, impaired dexterity/paralysis, and impaired executive and cognitive function...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28710510/surgical-reconstruction-is-a-cost-efficient-treatment-option-for-isolated-pcl-injuries
#14
Christian Owesen, Eline Aas, Asbjørn Årøen
PURPOSE AND HYPOTHESIS: The main purpose of the study is to put focus on the costs related to treating posterior cruciate ligament (PCL) injuries and the possible implications of chosen treatment strategy to the respective institutions and society. METHODS: Costs of treating PCL injuries nonoperatively and for both single-bundle (SB) and double-bundle (DB) reconstruction were estimated. These costs were translated into equivalent quality-adjusted life years (QALY) given a threshold value of Euro (€) 70,000 per QALY...
July 14, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28706847/endoscopic-synovectomy-of-peroneal-tendon-sheath
#15
Tun Hing Lui
Peroneal tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of peroneal tenosynovitis may lead to progression of the tenosynovitis to peroneal tendon rupture, ultimately limiting the benefit of nonoperative treatment. For refractory cases, endoscopic tenosynovectomy is indicated. The purpose of this Technical Note is to report a minimally invasive approach to perform a synovectomy of zones 1 and 2 of the peroneal tendon sheath...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706833/latarjet-technique-for-treatment-of-anterior-shoulder-instability-with-glenoid-bone-loss
#16
Kevin J McHale, George Sanchez, Kyle P Lavery, William H Rossy, Anthony Sanchez, Marcio B Ferrari, Matthew T Provencher
Anterior glenohumeral instability is a common clinical entity, particularly among young athletic patient populations. Nonoperative management and arthroscopic treatment of glenohumeral instability have been associated with high rates of recurrence, particularly in the setting of glenohumeral osseous defects. Coracoid transfer, particularly the Latarjet procedure, has become the treatment of choice for recurrent anterior glenohumeral instability in the setting of osseous deficiencies greater than 20% to 30% of the glenoid surface area and may also be considered for the primary treatment of recurrent instability in the high-risk contact athlete, even in the setting of limited osseous deficiency...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706832/iliotibial-band-lengthening-an-arthroscopic-surgical-technique
#17
Todd P Pierce, Samuel J Mease, Kimona Issa, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Iliotibial (IT) band syndrome is a common cause of lateral knee pain in runners and cyclists. Many can be treated nonoperatively; however, some may require surgical lengthening of their IT band to achieve optimal pain relief and a return to preinjury level of activity. Several studies have been published detailing surgical lengthening procedures and satisfactory outcomes after these procedures. However, it is important to continue to improve on and optimize outcomes. We present our arthroscopic IT band-lengthening procedure...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706827/surgical-technique-for-arthroscopic-resection-of-painful-bipartite-patella
#18
Thais D Vieira, Mathieu Thaunat, Adnan Saithna, Olivier Carnesecchi, Eric Choudja, Maxime Cavalier, Jose Roberto Benites Vendrame, Andrew Charles Ockuly, Bertrand Sonnery-Cottet
Bipartite patella (BP) is uncommon and is usually an incidental finding. Painful BP occurs rarely and is usually associated with post-traumatic anterior knee pain. When nonoperative treatment fails, fragment resection is indicated. A systematic review shows a potentially increased risk of complications with open surgery. The purpose of this Technical Note is to demonstrate a simple arthroscopic technique for treating painful BP through resection of the bone fragment.
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28706822/endoscopic-fasciotomy-of-the-superficial-and-deep-posterior-compartments-of-the-leg
#19
Tun Hing Lui
Chronic exertional compartment syndrome is a rare cause of lower leg pain incurred during sports activities and typically affects young athletes who need to return to their activity level as quickly as possible. Nonoperative treatments are often unsuccessful and fasciotomy of the involved compartment is the treatment of choice. Endoscopically assisted release of the anterior and deep compartments is proven to be safe and effective. Endoscopically assisted deep posterior compartment release via an incision 1 to 3 cm behind the medial tibial border has high risk of injury to the great saphenous and perforating veins and the saphenous nerve...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28700494/a-novel-classification-for-atypical-hangman-fractures-and-its-application-a-retrospective-observational-study
#20
Guangzhou Li, Dejun Zhong, Qing Wang
Atypical Hangman fractures (AHF) were first formally reported and considered to be more often associated with neurologic deficit in 1993. However, there is a paucity of literature focusing on these fractures. The purpose of the retrospective study was to introduce a new classification scheme for AHF and its application.Sixty-two patients with Hangman fractures were identified. There were 46 (74.2%, 46/62) AHF patients, including 29 type I, 9 type II, 5 type IIa, and 3 type III fractures (Levine-Edwards classification)...
July 2017: Medicine (Baltimore)
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