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https://www.readbyqxmd.com/read/28633792/nonoperative-treatment-of-a-lesser-toe-plantar-plate-tear-with-serial-mri-follow-up-a-case-report
#1
Martin Jordan, Manfred Thomas, Wolfgang Fischer
With the current data concentrating on different operative treatment options for plantar plate tears, few data can be found on possible nonoperative treatment strategies for this entity and the specifics of such treatment. In the present case report, the successful nonoperative treatment of a patient with a rupture of the plantar plate in a lesser toe metatarsophalangeal joint is presented. The patient was followed up using repeat clinical examinations and high-resolution magnetic resonance imaging scans for 1 year after the imitation of therapy to provide information on the different stages of the healing process...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#2
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632595/plate-fixation-versus-nonoperative-treatment-for-displaced-midshaft-clavicular-fractures-a-meta-analysis-of-randomized-controlled-trials
#3
Sarah Woltz, Pieta Krijnen, Inger B Schipper
BACKGROUND: The aim was to analyze whether patients with a displaced midshaft clavicular fracture are best managed with plate fixation or nonoperative treatment with respect to nonunion, secondary operations, and functional outcome, by evaluating all available randomized controlled trials (RCTs) on this subject. METHODS: A systematic search of electronic databases (PubMed, MEDLINE, Embase, and Web of Science) was performed to identify RCTs comparing nonoperative treatment with plate fixation for displaced midshaft clavicular fractures...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28624030/emergency-department-length-of-stay-in-critical-nonoperative-trauma
#4
Anaar Siletz, Kexin Jin, Marilyn Cohen, Catherine Lewis, Areti Tillou, Henry Magill Cryer, Ali Cheaito
BACKGROUND: Prolonged emergency department (ED) stays correlate with negative outcomes in critically ill nontrauma patients. This study sought to determine the effect of ED length of stay (LOS) on trauma patients. MATERIALS AND METHODS: Two hundred forty-one trauma patients requiring direct intensive care unit (ICU) admission were identified. Patients requiring immediate operative intervention were excluded. Odds ratios (ORs) of outcomes for patients transferred to ICU in ≤90 min were compared with patients transferred in >90 min, adjusting for Injury Severity Score (ISS)...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28624001/diagnosis-and-management-of-the-venous-malformations-of-klippel-tr%C3%A3-naunay-syndrome
#5
REVIEW
S Keisin Wang, Natalie A Drucker, Alok K Gupta, Francis E Marshalleck, Michael C Dalsing
OBJECTIVE: A dearth of information exists in the literature regarding current practice in the management of Klippel-Trénaunay syndrome (KTS), a rare condition. We review and describe the etiology, diagnosis, and treatment of KTS. METHODS: Relevant data were synthesized from a Medline review using a combination of the keyterms "Klippel" and "Trénaunay." The majority of hits described singular case reports and were subsequently excluded. The remaining papers were then reviewed and included on the basis of the quality of evidence and the authors' discretion...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28614274/corrective-osteotomy-for-symptomatic-clavicle-malunion-using-patient-specific-osteotomy-and-reduction-guides
#6
Mathias Haefeli, Matthias Schenkel, Ralf Schumacher, Karim Eid
Midshaft clavicular fractures are often treated nonoperatively with good reported clinical outcome in a majority of patients. However, malunion with shortening of the affected clavicle is not uncommon. Shortening of the clavicle has been shown to affect shoulder strength and kinematics with alteration of scapular position. Whereas the exact clinical impact of these factors is unknown, the deformity may lead to cosmetic and functional impairment as for example pain with weight-bearing on the shoulder girdle...
June 13, 2017: Techniques in Hand & Upper Extremity Surgery
https://www.readbyqxmd.com/read/28612150/single-versus-multiple-solid-organ-injuries-following-blunt-abdominal-trauma
#7
Ayman El-Menyar, Husham Abdelrahman, Ammar Al-Hassani, Ruben Peralta, Hiba AbdelAziz, Rifat Latifi, Hassan Al-Thani
BACKGROUND: We aimed to describe the pattern of solid organ injuries (SOIs) and analyze the characteristics, management and outcomes based on the multiplicity of SOIs. METHODS: A retrospective study in a Level 1 trauma center was conducted and included patients admitted with blunt abdominal trauma between 2011 and 2014. Data were analyzed and compared for patients with single versus multiple SOIs. RESULTS: A total of 504 patients with SOIs were identified with a mean age of 28 ± 13 years...
June 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28609119/risk-factors-for-tear-progression-in-symptomatic-rotator-cuff-tears-a-prospective-study-of-174-shoulders
#8
Nobuyuki Yamamoto, Mitsuyoshi Mineta, Jun Kawakami, Hirotaka Sano, Eiji Itoi
BACKGROUND: The risk factors for tear progression in symptomatic rotator cuff tears have not been clarified yet. It is important for orthopaedic surgeons to know the natural course of tear progression when nonoperative management is to be chosen. HYPOTHESIS: Tears in younger patients, high-activity patients, or heavy laborers would progress in size more than those in older patients, low-activity patients, or light laborers. STUDY DESIGN: Case-control study; Level of evidence, 3...
June 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28607845/interbrachial-pinch-by-trapezius-transfer-in-amyoplasia-congenita-a-case-report
#9
Alessandro Thione, Pedro C Cavadas, Alberto Perez Espadero, Carlo G Rubi
Amyoplasia congenita, or "classic distal arthrogryposis," is the most common disorder among the congenital, non-progressive, multiple joint contractural conditions named arthrogryposis. The cause remains unknown, and it occurs sporadically. Abnormal neurological examination indicates that movement in utero was diminished as a result of an abnormality of the central or peripheral nervous system, the motor end plate, or muscle. The absence of central neural pathology indicates the origin in akinetic fetal condition...
May 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28606790/unstable-open-posterior-subtalar-dislocation-treated-with-a-ring-external-fixator-a-case-report-and-review-of-the-literature
#10
Alex Quok An Teo, Fucai Han, Yu Han Chee, Gavin Kane O'Neill
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, with open true posterior dislocation an even rarer injury. We describe our treatment of a young motorcyclist who was brought into hospital after a road traffic accident, having sustained an open posterior subtalar dislocation. After initial reduction and resuscitation in the emergency department, he was taken to the operating theater for emergent wound debridement and external fixation of his ankle using a unilateral external fixator device...
June 9, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28606789/plate-fixation-with-autogenous-calcaneal-dowel-grafting-proximal-fourth-and-fifth-metatarsal-fractures-technique-and-case-series
#11
Chad L Seidenstricker, Edward G Blahous, Richard T Bouché, Amol Saxena
Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can have problems with healing. In particular, those involving the fifth metatarsal have been associated with a high nonunion rate with nonoperative treatment. Although intramedullary screw fixation results in a high union rate, delayed healing and complications can occur. We describe an innovative technique to treat both acute and chronic injuries involving the metatarsal base from the metaphysis to the proximal diaphyseal bone of the fourth and fifth metatarsals...
June 9, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28604373/blunt-hepatic-and-splenic-trauma-a-single-center-experience-using-a-multidisciplinary-protocol
#12
Paolo Ruscelli, Farncesco Buccoliero, Susanna Mazzocato, Giulio Belfiori, Claudio Rabuini, Pierluigi Sperti, Massimiliano Rimini
AIM: The aim of this retrospective study was to describe more than 10 years experience of a single Trauma Center about non operative management of abdominal organ injuries in hemodynamically stable patients MATERIAL OF STUDY: Between January 2001 and December 2014 ,732 consecutive patients were admitted with blunt abdominal trauma, involving liver and/or spleen and/or kidney, at the Bufalini Cesena Hospital .Management of patients included a specific institutional developed protocol :hemodynamic stability was evaluated in shock room according to the patients response to fluid challenge and the patients were classified into three categories A,B,and C...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28600009/the-case-for-deformity-correction-in-the-management-of-radiculopathy-with-concurrent-spinal-deformity
#13
REVIEW
Sigurd Berven, Anthony DiGiorgio
The management of adult deformity varies significantly. Options range from nonoperative care to limited decompression to decompression with limited or extensive fusion. The appropriate surgical management is the approach that optimizes the likelihood of improvement in health-related quality of life, while limiting risks of complications and costs. Decompression alone is unreliable in the setting of significant deformity contributing to radiculopathy. Decompression with limited fusion is most appropriate for patients with age-appropriate global alignment of the spine, and decompression with more extensive fusion is most appropriate for patients with progressive deformity or with global sagittal or coronal malalignment...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28593062/elastic-intramedullary-nailing-of-a-medial-clavicle-fracture-in-a-pediatric-patient
#14
Michael J Stark, Michael J DeFranco
INTRODUCTION: Injuries to the medial clavicle in pediatric patients typically involve the physis and/or sternoclavicular joint. Clavicle fractures are one of the most common injuries in children, but ones at its medial end are rare. Most medial clavicle fractures are treated nonoperatively, but surgery is indicated in some cases. This original case report is unique in describing the use of an elastic intramedullary nail for fixation of a completely displaced medial clavicle fracture in a pediatric patient...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28591014/is-an-rct-the-best-way-to-investigate-the-effectiveness-of-nonoperative-management-of-pediatric-appendicitis
#15
Peter C Minneci, Katherine J Deans
No abstract text is available yet for this article.
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28585997/diagnosis-and-management-of-traumatic-patellar-instability-in-the-pediatric-patient
#16
Steven F DeFroda, Joseph A Gil, Alex Boulos, Aristides I Cruz
Instability of the patella is a common cause of knee pain and dysfunction in pediatric and adolescent patients and can be due to several factors. Although some patients will recall a specific traumatic event others may not, requiring the diagnosis to be made on the basis of physical examination and imaging. Congenital dislocation and connective tissue disorders should also be considered, even in the setting of trauma. There are radiographic parameters that may identify causes of instability such as trochlear and patellar abnormalities, and magnetic resonance imaging can identify signs of trauma such as bony edema, loose osteochondral fragments, and increased tibial tubercle-trochlear groove distance...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584502/laparoscopic-splenectomy-in-hemodynamically-stable-blunt-trauma
#17
Gregory S Huang, Elisha A Chance, Barbara M Hileman, Eric S Emerick, Emily A Gianetti
BACKGROUND AND OBJECTIVES: No criteria define indications for laparoscopic splenectomy in trauma. This investigation compared characteristics of trauma patients and outcomes between laparoscopic and open splenectomies. METHODS: Patients were identified retrospectively by using ICD-9 codes. Included patients were 18 or older, with a blunt splenic injury from January 1, 2011, through December 31, 2014, and required splenectomy. Excluded patients had penetrating trauma, successful nonoperative management, or successful embolization...
April 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28580348/impact-of-high-grade-obstruction-on-outcomes-in-patients-with-appendiceal-inflammatory-masses-managed-by-nonoperative-treatment
#18
Mi Sung Kim, Hyuk Jung Kim, Hae Won Park, Heon-Ju Kwon, So-Yeon Lee, Shin Ho Kook, Hee-Jin Park, Yoon Jung Choi
PURPOSE: To retrospectively assess the impact of high-grade obstructions identified on initial CT on outcomes of patients with appendiceal inflammatory masses managed by nonoperative treatment. METHODS: Institutional Review Boards approved this retrospective study and informed consent was waived. Included were 52 consecutive patients diagnosed with appendiceal inflammatory masses by CT scan and managed by nonoperative treatment. The main outcome measure was treatment failure and secondary outcomes were complications and initial and total hospital stay...
June 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28580255/arthroscopy-assisted-fabella-excision-surgical%C3%A2-technique
#19
Matthew T Provencher, George Sanchez, Márcio B Ferrari, Gilbert Moatshe, Jorge Chahla, Ramesses Akamefula, Robert F LaPrade
The fabella is an anatomic variant not seen in all individuals and can potentially be a source of chronic knee pain due to chondromalacia, osteoarthritis, fractures, or biomechanical pressure against the lateral femoral condyle. It is situated intra-articular, close to the lateral femoral condyle, the lateral gastrocnemius head tendon, and the fabellofibular ligament. Given its rarity, the diagnosis of a symptomatic fabella is often overlooked when evaluating patients with persistent posterolateral knee pain...
April 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28580253/arthroscopic-patellar-lateral-facetectomy
#20
Marcio B Ferrari, George Sanchez, Jorge Chahla, Gilbert Moatshe, Robert F LaPrade
Isolated patellofemoral osteoarthritis is relatively prevalent, with the lateral facet of the patella being the most commonly affected portion. This pathology can be a result of a patellar maltracking syndrome, patella instability, or idiopathic degenerative changes. A thorough diagnostic work-up with a physical examination and imaging studies are mandatory for a proper diagnosis and to rule out other causes of patellofemoral knee pain. These patients are often treated nonoperatively with exercises for patella mobility, intra-articular injections, braces, patellar tracking, quadriceps balance and strength, and activity modification...
April 2017: Arthroscopy Techniques
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