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https://www.readbyqxmd.com/read/29155699/selective-angiographic-embolization-of-blunt-hepatic-trauma-reduces-failure-rate-of-nonoperative-therapy-and-incidence-of-post-traumatic-complications
#1
Han Xu, Li Jie, Sun Kejian, He Xiaojun, Liu Chengli, Zhang Hongyi, Kong Yalin
BACKGROUND Conflict still remains as to the benefit of angioembolization (AE) for non-operative therapy (NOT) of blunt hepatic trauma (BHT). The aim of this study was to determine whether AE could result in lower failure rates in hemodynamically stable BHT patients with high failure risk factors for NOT, and to systematically evaluate the effectiveness of AE for NOT of BHT. MATERIAL AND METHODS Medical records of all BHT patients from January 1, 1998 to December 31, 2015 at a large trauma center were collected and analyzed...
November 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29155062/fusion-failure-fatality-long-term-outcomes-after-surgical-versus-nonoperative-management-of-type-ii-odontoid-fracture-in-octogenarians
#2
Avital Perry, Christopher S Graffeo, Lucas P Carlstrom, Wendy Chang, Grant W Mallory, Ross C Puffer, Michelle J Clarke
INTRODUCTION: Type II odontoid fracture is a highly morbid injury among octogenarians, with 41% one-year mortality. Our objective was to assess long-term fusion, complication, and survival rates. METHODS: Retrospective review of prospective trauma registry. Blinded review of follow-up radiographs. RESULTS: Follow-up cohort included 94 nonoperative and 17 operative patients (median 52 and 79 months). Operative group had significantly higher rates of repeat surgery for primary treatment failure or complication (1% vs...
November 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29153045/treatment-of-clubfoot-with-the-modified-copenhagen-method-a-10-year-follow-up
#3
Elia Utrilla-Rodríguez, Pedro V Munuera-Martínez, Manuel Albornoz-Cabello
BACKGROUND: Clubfoot is one of the most frequent congenital malformations in the world. Non-operative methods follows limiting surgery to a minimum. The modified Copenhagen method has not been studied enough. STUDY DESIGN: longitudinal retrospective study. OBJECTIVES: To evaluate prognostic factors for clinical rehabilitation with the modified Copenhagen method in a 10-year follow-up period. METHODS: A retrospective study was carried out on a 10-year follow-up of 82 children diagnosed with clubfoot at birth and treated with the modified Copenhagen method...
November 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/29152521/isokinetic-strength-deficit-6-months-after-adductor-canal-blockade-for-anterior-cruciate-ligament-reconstruction
#4
James E Christensen, Natalie E Taylor, Scott J Hetzel, John A Shepler, Tamara A Scerpella
Background: Recent evidence shows a delayed return to sport in children and delayed quadriceps recovery in both adults and children who have undergone anterior cruciate ligament (ACL) reconstruction with concomitant femoral nerve blockade (FNB) compared with those who had no blockade. We evaluated the use of adductor canal blockade (ACB), as an alternative to FNB, at the time of ACL reconstruction. Hypothesis: Patients who receive ACB will have greater isokinetic strength at 6 months postoperative compared with patients who receive FNB at the time of ACL reconstruction...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29150368/the-utility-of-ercp-in-pediatric-pancreatic-trauma
#5
Eric H Rosenfeld, Adam M Vogel, Denise B Klinkner, Mauricio Escobar, Barbara Gaines, Robert Russell, Brendan Campbell, Hale Wills, Anthony Stallion, David Juang, Rajan K Thakkar, Jeffrey Upperman, Mubeen Jafri, Randall Burd, Bindi J Naik-Mathuria
BACKGROUND/PURPOSE: Endoscopic retrograde cholangiopancreatography (ERCP) is an adjunct for pediatric pancreatic injury management, but its use and utility in pediatric patients are unclear. We set out to evaluate the use of ERCP and its effects on outcomes. METHODS: A retrospective review was performed for children who had pancreatic injuries at 22 pediatric trauma centers between 2010 and 2015. ERCP details and outcomes were collected. Analysis was performed using descriptive statistics and Wilcoxon rank-sum tests...
October 13, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29148017/outcomes-and-mortality-after-hip-fractures-treated-in-kazakhstan
#6
Sultan Amrayev, Ussama AbuJazar, Justinas Stucinskas, Alfredas Smailys, Sarunas Tarasevicius
INTRODUCTION: Patients with hip fractures are usually treated operatively in Western Europe. However, in Mid-Asia different indications are used to decide whether this patient is suitable for operative treatment and those are related to specific traditions and rules in hospital. Thus, traditions and surgeon/patient fears seem to affect treatment choices in hip fractures and subsequent outcomes. The aim of our study was to investigate patients with hip fractures and compare outcome at 1-year follow-up in the operated and nonoperated patient groups...
October 16, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/29146455/successful-nonoperative-management-of-uncomplicated-appendicitis-predictors-and-outcomes
#7
Tyler J Loftus, Scott C Brakenridge, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Our objective was to identify predictors of successful nonoperative management (NOM) of uncomplicated appendicitis. We hypothesized that the absence of diabetes, absence of an appendicolith, short duration of symptoms, absence of systemic inflammation, and low modified Alvarado score would predict successful NOM. METHODS: We performed a retrospective cohort analysis of 81 consecutive patients who underwent NOM of uncomplicated appendicitis. Successful NOM was defined as resolution of appendicitis with antibiotics alone and no recurrent appendicitis within 180 days...
November 13, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29146160/posterolateral-corner-injuries-of-the-knee-at-the-national-football-league-combine-an-imaging-and-outcomes-analysis
#8
Jorge Chahla, Nicholas I Kennedy, Mark E Cinque, George Sanchez, Catherine Logan, Bryan G Vopat, Brendin Beaulieu-Jones, Mark Price, Jim Whalen, Robert F LaPrade, Matthew T Provencher
PURPOSE: (1) To determine the epidemiology, examination findings, imaging findings, and associated injuries of posterolateral corner (PLC) injuries in players participating in the National Football League (NFL) Combine and (2) to evaluate the impact of PLC injuries on performance compared with matched controls. METHODS: All PLC injuries identified at the NFL Combine between 2009 and 2015 were reviewed. The inclusion criteria were any player who had clinical findings or a previous surgical procedure consistent with a PLC injury and who participated in medical and performance testing at the NFL Combine...
November 13, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29146096/ten-year-review-of-isolated-spontaneous-mesenteric-arterial-dissections
#9
Courtney E Morgan, Neel A Mansukhani, Mark K Eskandari, Heron E Rodriguez
OBJECTIVE: Isolated spontaneous dissection of the superior mesenteric artery (SMA) and celiac artery (CA) remains a rare condition; however, it has been increasingly noted incidentally on diagnostic imaging. The purpose of this study was to examine the natural history and outcomes of patients presenting with isolated spontaneous mesenteric artery dissection (SMAD). We hypothesized that most SMADs can be treated nonoperatively. METHODS: This was a single-center retrospective review of patients presenting with the diagnosis of SMAD between 2006 and 2016...
November 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29135565/pediatric-and-adolescent-anterior-shoulder-instability-clinical-management-of-first-time-dislocators
#10
Kenneth M Lin, Evan W James, Elad Spitzer, Peter D Fabricant
PURPOSE OF REVIEW: The purpose of this review is to discuss the epidemiology, pathoanatomy, diagnosis, and clinical management of pediatric and adolescent patients following a first-time shoulder dislocation. RECENT FINDINGS: Shoulder instability is becoming increasingly common as pediatric and adolescent patients engage in earlier organized sports competition. Recommended treatment following a first-time glenohumeral dislocation event in adolescents depends on several factors, but surgical stabilization is becoming more frequently performed...
November 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29128376/radial-head-replacement-with-a-bipolar-system-an-average-10-year-follow-up
#11
Robert A Sershon, Timothy J Luchetti, Mark S Cohen, Robert W Wysocki
BACKGROUND: We report the long-term results of a cohort of patients after radial head replacement with a bipolar design and a smooth cementless stem at a mean follow-up of 10.4 years. METHODS: Of 17 possible patients from a previous minimum 2-year follow-up study, 16 were available for review. Patients were assessed using clinical and radiographic examination and with standardized outcome measures. Range of motion, stability, and radiographic evaluation of implant loosening and joint degeneration were assessed...
November 8, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29122433/anterior-cruciate-ligament-graft-removal-versus-retention-in-the-setting-of-septic-arthritis-after-reconstruction-a-systematic-review-and-expected-value-decision-analysis
#12
REVIEW
Nicholas Kusnezov, Emmanuel D Eisenstein, John C Dunn, Aaron J Wey, David R Peterson, Brian R Waterman
PURPOSE: To provide further guidance on the optimal decision between anterior cruciate ligament (ACL) graft removal versus retention in the setting of septic arthritis following reconstruction using an expected value decision analysis. METHODS: A systematic review and expected value decision analysis and sensitivity analyses were performed to quantify the clinical decision. A decision tree was created with 5 outcomes of interest: nonoperative complications, revision surgery, early reoperation, late reoperation, and "well...
November 6, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29110516/minimally-invasive-distal-metatarsal-diaphyseal-osteotomy-dmdo-for-chronic-plantar-diabetic-foot-ulcers
#13
Carlo Biz, Stefano Gastaldo, Miki Dalmau-Pastor, Marco Corradin, Andrea Volpin, Pietro Ruggieri
BACKGROUND: The aims of this prospective study were first to evaluate the safety and effectiveness of minimally invasive distal metatarsal diaphyseal osteotomies (DMDOs) for treating a consecutive series of diabetic patients with chronic plantar diabetic foot ulcers (CPDFUs) and second to assess their clinical-functional and radiographic outcomes. METHODS: A consecutive series of patients affected by diabetes mellitus with CPDFUs, not responsive to previous nonoperative management, underwent DMDO...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29108520/a-proposed-classification-system-and-therapeutic-strategy-for-chyle-leak-after-laparoscopic-living-donor-nephrectomy-a-single-center-experience-and-review-of-the-literature
#14
Zi Qin Ng, Bulang He
OBJECTIVES: Chyle leak or chylous ascites remains a rare complication after laparoscopic living-donor nephrectomy. Its cause and management have not been well elucidated in the literature. Thus, the aim of this study was to review the incidence of chyle leak/chylous ascites after laparoscopic living-donor nephrectomy in our institute and in the literature to propose a classification system with its associated treatment strategy. MATERILAS AND METHODS: In this retrospective review of laparoscopic living-donor nephrectomy patients from January 2005 to April 2016, we identified patients with chyle leak/chylous ascites along with the care performed...
October 31, 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/29106811/epidemiology-and-impact-on-performance-of-lower-extremity-stress-injuries-in-professional-basketball-players
#15
Moin Khan, Kim Madden, M Tyrrell Burrus, Joseph P Rogowski, Jeff Stotts, Marisa J Samani, Robby Sikka, Asheesh Bedi
BACKGROUND: Professional basketball players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during both regular-season and off-season training. Little is known about the incidence of lower extremity bony stress injuries and their impact on return to play and performance in these athletes. HYPOTHESIS: Stress injuries of the lower extremity will have significant impact on performance. STUDY DESIGN: Case series...
November 1, 2017: Sports Health
https://www.readbyqxmd.com/read/29103784/expanding-the-inclusion-criteria-for-nonoperative-management-of-uncomplicated-appendicitis-outcomes-and-cost
#16
Steven L Lee, Lara Spence, Kyle Mock, James X Wu, Huan Yan, Daniel A DeUgarte
BACKGROUND: Carefully selected children with early appendicitis may be managed nonoperatively. However, it is unknown whether nonoperative management (NOM) is applicable to all patients with uncomplicated appendicitis. The purpose of this study was to evaluate the outcomes of NOM of uncomplicated appendicitis with expanded inclusion criteria. METHODS: A prospective, nonrandomized patient-preference study comparing NOM versus laparoscopic appendectomy (LA) was performed in children with radiographic/clinical evidence of uncomplicated appendicitis...
October 9, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29103156/treatment-for-recurrent-lumbar-disc-herniation
#17
REVIEW
Randall J Hlubek, Gregory M Mundis
PURPOSE OF REVIEW: Recurrent lumbar disc herniation (RLDH) is the most common indication for reoperation after a lumbar discectomy. The purpose of this manuscript is to review the incidence, risk factors, and treatment for RLDH. RECENT FINDINGS: Patients who require revision surgery for RLDH improved significantly compared to baseline; however, the magnitude of improvement is less than in primary discectomy patients. Treatment with either repeat discectomy or instrumented fusion has comparable clinical outcomes...
December 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29101666/laparoscopic-appendectomy-vs-antibiotic-therapy-for-acute-appendicitis-a-propensity-score-matched-analysis-from-a-multicenter-cohort-study
#18
Gaetano Poillucci, Lorenzo Mortola, Mauro Podda, Salomone Di Saverio, Laura Casula, Chiara Gerardi, Nicola Cillara, Luigi Presenti
Acute appendicitis (AA) is among the most common causes of acute lower abdominal pain leading patients to the emergency department. Significant debate remains on whether AA should be operated or not. A propensity score-matched analysis was performed in seven Italian Hospitals, with the aim to assess safety and feasibility both nonoperative management with antibiotics (AT) and surgical therapy with appendectomy (ST) for patients with AA. Data regarding all patients discharged from the participating centers with a diagnosis of appendicitis from January 1st, 2014 to December 31st, 2014 were collected retrospectively...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/29099471/is-an-operation-always-needed-for-pediatric-triplane-fractures-preliminary-results
#19
Seung Min Ryu, Jae Woo Park, Se Dong Kim, Chul Hyun Park
We compared the outcomes of nonoperative and operative treatments of triplane fractures. Thirty-three patients with triplane fractures were treated conservatively (n=19) or surgically (n=14). Bone union and postoperative complications were radiographically examined. The mean American Orthopedic Foot and Ankle Society scores were 100 (nonoperative group) and 98.1 (operative group) (P=0.304). The modified Weber protocol scores were excellent in both groups. One patient in each group showed a leg-length discrepancy of more than 10 mm at the last follow-up...
November 2, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/29095407/serious-adverse-events-significantly-reduce-patient-reported-outcomes-at-2-year-follow-up-nonoperative-multicenter-prospective-nih-study-of-105-patients
#20
Andrew J Pugely, Michael P Kelly, Christine R Baldus, Yubo Gao, Lukas Zebala, Christopher Shaffrey, Steven Glassman, Oheneba Boachie-Adjei, Stefan Parent, Stephen Lewis, Tyler Koski, Charles Edwards, Frank Schwab, Keith H Bridwell
STUDY DESIGN: This is an analysis of a prospective 2-year study on nonoperative patients enrolled in the Adult Symptomatic Lumbar Scoliosis (ASLS) National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) trial. OBJECTIVE: The purpose was to evaluate the impact of serious adverse events (SAEs) on patient-reported outcomes (PROs) in nonoperative management of ASLS as measured by Scoliosis Research Society-22r (SRS-22r), Oswestry Disability Index (ODI) and Short Form-12 (SF-12) at 2-year follow-up...
October 31, 2017: Spine
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