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Orthopaedic trauma

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https://www.readbyqxmd.com/read/27912932/trauma-surgery-by-general-surgeons-still-an-option-for-proximal-femoral-fractures
#1
Kaij Treskes, Stijn C Voeten, Maria C J M Tol, Wietse P Zuidema, Jefrey Vermeulen, J Carel Goslings, Niels W L Schep
INTRODUCTION: Surgery for proximal femoral fractures in the Netherlands is performed by trauma surgeons, general surgeons and orthopaedic surgeons. The aim of this study was to assess whether there is a difference in outcome for patients with proximal femoral fractures operated by trauma surgeons versus general surgeons. Secondly, the relation between hospital and surgeon volume and postoperative complications was explored. METHODS: Patients of 18 years and older were included if operated for a proximal femoral fracture by a trauma surgeon or a general surgeon in two academic, eight teaching and two non-teaching hospitals in the Netherlands from January 2010 until December 2013...
November 18, 2016: Injury
https://www.readbyqxmd.com/read/27910738/cartilage-repair-in-the-degenerative-ageing-knee
#2
Mats Brittberg, Andreas H Gomoll, José A Canseco, Jack Far, Martin Lind, James Hui
Background and purpose - Cartilage damage can develop due to trauma, resulting in focal chondral or osteochondral defects, or as more diffuse loss of cartilage in a generalized organ disease such as osteoarthritis. A loss of cartilage function and quality is also seen with increasing age. There is a spectrum of diseases ranging from focal cartilage defects with healthy surrounding cartilage to focal lesions in degenerative cartilage, to multiple and diffuse lesions in osteoarthritic cartilage. At the recent Aarhus Regenerative Orthopaedics Symposium (AROS) 2015, regenerative challenges in an ageing population were discussed by clinicians and basic scientists...
December 2, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27904220/pfna-ii-protrusion-over-the-greater-trochanter-in-the-asian-population-used-in-proximal-femoral-fractures
#3
Sun-Jun Hu, Shi-Min Chang, Zhuo Ma, Shou-Chao Du, Liang-Ping Xiong, Xin Wang
BACKGROUND: The treatment of proximal femoral fractures in geriatric osteoporotic patients continues to be a challenge in orthopaedic trauma. Various kinds of cephalomedullary nails, such as gamma nail, InterTan and PFNA were used clinically. The latest generation PFNA II, specially designed for Asian population, is commonly used for geriatric per-/intertrochanteric fractures. The aim of this study was to determine whether the current PFNA-II proximal segment length is suitable for the greater trochanter height, as assessed by postoperative radiograph measurements...
November 2016: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#4
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27895899/oxidatively-degradable-poly-thioketal-urethane-ceramic-composite-bone-cements-with-bone-like-strength
#5
Madison A P McEnery, Sichang Lu, Mukesh K Gupta, Katarzyna J Zienkiewicz, Joseph C Wenke, Kerem N Kalpakci, Daniel Shimko, Craig L Duvall, Scott A Guelcher
Synthetic bone cements are commonly used in orthopaedic procedures to aid in bone regeneration following trauma or disease. Polymeric cements like PMMA provide the mechanical strength necessary for orthopaedic applications, but they are not resorbable and do not integrate with host bone. Ceramic cements have a chemical composition similar to that of bone, but their brittle mechanical properties limit their use in weight-bearing applications. In this study, we designed oxidatively degradable, polymeric bone cements with mechanical properties suitable for bone tissue engineering applications...
2016: RSC Advances
https://www.readbyqxmd.com/read/27895200/demographics-mechanisms-of-injury-and-concurrent-injuries-associated-with-calcaneus-fractures-a-study-of-14-516-patients-in-the-american-college-of-surgeons-national-trauma-data-bank
#6
Daniel D Bohl, Nathaniel T Ondeck, Andre M Samuel, Pablo J Diaz-Collado, Stephen J Nelson, Bryce A Basques, Michael P Leslie, Jonathan N Grauer
: Background This study uses the American College of Surgeons National Trauma Data Bank (NTDB) to update the field on the demographics, injury mechanisms, and concurrent injuries among a national sample of patients admitted to the hospital department with calcaneus fractures. Methods Patients with calcaneus fractures in the NTDB during 2011-2012 were identified and assessed. Results A total of 14 516 patients with calcaneus fractures were included. The most common comorbidity was hypertension (18%), and more than 90% of fractures occurred via traffic accident (49%) or fall (43%)...
November 28, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27875491/assessing-the-efficacy-of-prothrombin-complex-concentrate-in-multiply-injured-patients-with-high-energy-pelvic-and-extremity-fractures
#7
Bellal Joseph, Mazhar Khalil, Caitlyn Harrison, Tianyi Swartz, Narong Kulvatunyou, Ansab A Haider, Tahereh O Jokar, David Burk, Ali Mahmoud, Rifat Latifi, Peter Rhee
OBJECTIVES: Prothrombin complex concentrate (PCC) is being increasingly used for reversing induced coagulopathy of trauma. However, the use of PCC for reversing coagulopathy in multiply injured patients with pelvic and/or lower extremity fractures remains unclear. The aim of our study was to assess the efficacy of PCC for reversing coagulopathy in this group of patients. DESIGN: Two-year retrospective analysis. SETTING: Our level I trauma center...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870675/comanagement-and-gainsharing-opportunities-for-independent-physicians
#8
Chris McBride, Peter L Althausen
Gainsharing and comanagament programs are both successful means of achieving physician buy-in for all cost containment programs in Orthopaedic Trauma. Under comanagement agreements, physicians are reimbursed for their time and intellectual efforts in program and algorithm creation. The cost is minimal for the hospital in return for the millions of dollars in savings they achieve. Gainsharing models can incentivize physicians to quickly adopt cost-effective implant choices, care plans, and program development...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870674/impact-of-hospital-employed-physician-assistants-on-a-level-ii-community-based-orthopaedic-trauma-system
#9
Peter L Althausen, Steven Shannon, Brianne Owens, Daniel Coll, Michael Cvitash, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: The American Academy of Orthopedic Surgeons and the Orthopedic Trauma Association have released guidelines for the provision of orthopedic trauma services such as adequate stipends, designated operating rooms, ancillary staff, and guaranteed reimbursement for indigent care. One recommendation included a provision for hospital-based physician assistants (PAs). Given current reimbursement arrangements, PA collections for billable services may not meet their salary and benefit expenses...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#10
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870671/surgeon-attitudes-regarding-the-use-of-generic-implants-an-ota-survey-study
#11
Justin A Walker, Peter L Althausen
OBJECTIVES: To determine the role of generic orthopaedic trauma implants in the current orthopaedic trauma market, as perceived by OTA members, and investigate potential hurdles to the use of generic implants and other cost-containment measures. DESIGN: Survey study. SETTING: Not applicable. PARTICIPANTS: All active OTA members with valid e-mail addresses were invited to participate. INTERVENTION: Participants completed a brief online survey with questions regarding participation in cost-containment and incentive programs, industry relationships, generic implant use, and the role of surgeons in cost containment...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870670/operating-room-supply-costs-in-orthopaedic-trauma-cost-containment-opportunities
#12
Taylor P Gurnea, Wesley P Frye, Peter L Althausen
In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870669/operating-room-efficiency-benefits-of-an-orthopaedic-traumatologist-at-a-level-ii-trauma-center
#13
Peter L Althausen, Justin R Kauk, Steven Shannon, Minggen Lu, Timothy J O'Mara, Timothy J Bray
OBJECTIVES: Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. DESIGN: Retrospective review...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870668/cost-savings-opportunities-in-perioperative-management-of-the-patients-with-orthopaedic-trauma
#14
Alastair E Moody, Catriona E Moody, Peter L Althausen
Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27870667/the-role-of-dedicated-musculoskeletal-urgent-care-centers-in-reducing-cost-and-improving-access-to-orthopaedic-care
#15
Travis J Anderson, Peter L Althausen
OBJECTIVES: Over the past few years, the United States has seen the rapid growth of dedicated musculoskeletal urgent care centers owned and operated by individual orthopaedic practices. In June of 2014, our practice opened the first dedicated orthopaedic urgent care in the region staffed by physician assistants and supervised by orthopaedic surgeons. Our hypothesis is that such centers can safely improve orthopaedic care for ambulatory orthopaedic injuries, decrease volume for overburdened emergency departments (EDs), reduce wait times and significantly decrease the cost of care while improving access to orthopaedic specialists...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27857497/the-indications-for-major-limb-amputations-8-years-retrospective-study-in-a-private-orthopaedic-and-trauma-centre-in-the-south-east-nigeria
#16
Thaddeus Chika Agu, Mathew Emeka Ojiaku
BACKGROUND: Major limb amputation is a common orthopaedic trauma procedure and it is indicated mainly for traumatic gangrene and for trauma related limb conditions. The loss of a limb is devastating to the patient even when it is done to save life. The aims of the study are to highlight the indications for major limb amputations and to find out if there are any concurrent pattern changes. PATIENTS AND METHODS: This is a retrospective study analysing medical records of all the patients, who had major limb amputations over a period of 8 years, between October 2007 and September 2015 in a private orthopaedic and trauma centre in the south-east sub-region of Nigeria...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27852916/the-2015-aoa-north-american-traveling-fellowship
#17
REVIEW
Addisu Mesfin, Xinning Li, Jonathan F Dickens, Bashar Alolabi, Anna N Miller
The North American Traveling Fellowship (NATF) is one of the flagship tours of the American Orthopaedic Association (AOA). NATF is geared toward advancing the careers of young orthopaedic surgeons through the promotion of clinical, scientific, and social exchange. The 2015 tour had a major emphasis on the development of leadership in the field of orthopaedics through close interactions and meetings with departmental chairs and administrators, as well as with hospital and medical school leaders. The 2015 NATF tour was in the Midwest corridor of Canada and the United States...
November 16, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27849456/the-bridging-advanced-developments-for-exceptional-rehabilitation-bader-consortium-reaching-in-partnership-for-optimal-orthopaedic-rehabilitation-outcomes
#18
Steven J Stanhope, Jason M Wilken, Alison L Pruziner, Christopher L Dearth, Marilynn Wyatt, Gregg W Ziemke, Rachel Strickland, Suzanne A Milbourne, Kenton R Kaufman
The Bridging Advanced Developments for Exceptional Rehabilitation (BADER) Consortium began in September 2011 as a cooperative agreement with the Department of Defense (DoD) Congressionally Directed Medical Research Programs Peer Reviewed Orthopaedic Research Program. A partnership was formed with DoD Military Treatment Facilities (MTFs), U.S. Department of Veterans Affairs (VA) Centers, the National Institutes of Health (NIH), academia, and industry to rapidly conduct innovative, high-impact, and sustainable clinically relevant research...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27833687/application-of-circumferential-compression-device-binder-in-pelvic-injuries-room-for-improvement
#19
Rahul Vaidya, Matthew Roth, Bradley Zarling, Sarah Zhang, Christopher Walsh, Jessica Macsuga, John Swartz
INTRODUCTION: The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve pelvic stabilization by both decreasing pelvic volume and limiting inter-fragmentary motion has become commonplace, and is a well-established component of Advanced Trauma Life Support (ATLS) protocol in the treatment of pelvic ring injuries. The purpose of this study was to evaluate the following: 1) how consistently a PCCD was placed on patients who arrived at our hospital with unstable pelvic ring injuries; 2) if they were placed in a timely manner; and 3) if hemodynamic instability influenced their use...
November 2016: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27811349/prevalence-and-characteristics-of-surgical-site-infections-caused-by-gram-negative-rod-shaped-bacteria-from-the-family-enterobacteriacae-and-gram-positive-cocci-from-the-genus-staphylococcus-in-patients-who-underwent-surgical-procedures-on-selected-surgical
#20
Małgorzata Tomaszewska-Kowalska, Krzysztof Kołomecki, Maria Wieloch-Torzecka
: Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections...
October 1, 2016: Polski Przeglad Chirurgiczny
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