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Orthopedic trauma

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https://www.readbyqxmd.com/read/29788370/large-traumatic-skull-base-internal-carotid-artery-pseudoaneurysm-managed-with-endovascular-flow-diversion-2-dimensional-operative-video
#1
Gary Rajah, Richard Justin Garling, Leonardo Rangel-Castilla
We present a case of a traumatic skull base internal carotid artery (ICA) pseudoaneurysm treated with endovascular flow diversion stenting. The patient was a 27-year-old male who was involved in a motorcycle accident suffering multiple traumatic injuries including a large skull base fracture that extended through the carotid canal. Computed tomography angiography revealed a 2-cm right ICA pseudoaneurysm. Once the patient was stable, a digital subtraction angiography demonstrated enlargement of the pseudoaneurysm...
May 18, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29765245/the-epidemiology-of-outpatient-pain-treatment-in-pediatrics
#2
Stacy Baldridge, Laura Wallace, Aditi Kadakia
Background: There is limited real-world, population-level data on the prevalence and treatment of pain in children. An understanding of pediatric pain conditions and its management can help inform provider education, treatment guidelines, and design of pediatric pain studies. Therefore, in this study, we aimed to describe the prevalence of conditions associated with acute and chronic pain in pediatric patients and to characterize pediatric pain treatment with nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, opioids (immediate release or extended release), antidepressants, topical analgesics, anticonvulsants, and other therapies based on a large, real-world sample...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29745741/teaching-basic-trauma-validating-fluorosim-a-digital-fluoroscopic-simulator-for-guide-wire-insertion-in-hip-surgery
#3
Kapil Sugand, Robert A Wescott, Richard Carrington, Alister Hart, Bernard H Van Duren
Background and purpose - Simulation is an adjunct to surgical education. However, nothing can accurately simulate fluoroscopic procedures in orthopedic trauma. Current options for training with fluoroscopy are either intraoperative, which risks radiation, or use of expensive and unrealistic virtual reality simulators. We introduce FluoroSim, an inexpensive digital fluoroscopy simulator without the need for radiation. Patients and methods - This was a multicenter study with 26 surgeons in which everyone completed 1 attempt at inserting a guide-wire into a femoral dry bone using surgical equipment and FluoroSim...
May 10, 2018: Acta Orthopaedica
https://www.readbyqxmd.com/read/29744076/a-case-of-methicillin-resistant-staphylococcus-aureus-wound-infection-phylogenetic-analysis-to-establish-if-nosocomial-or-community-acquired
#4
Francesco Cancilleri, Massimo Ciccozzi, Marta Fogolari, Eleonora Cella, Lucia De Florio, Alessandra Berton, Giuseppe Salvatore, Giordano Dicuonzo, Silvia Spoto, Vincenzo Denaro, Silvia Angeletti
Methicillin-resistant Staphylococcus aureus (MRSA) infection is rapidly increasing in both hospital and community settings. A 71-year-old man admitted at the Department of Orthopaedics and Trauma Surgery, University Campus Bio-Medico of Rome, with MRSA wound infection consequent to orthopedic surgery was studied and the MRSA transmission evaluated by phylogenetic analysis.
May 2018: Clinical Case Reports
https://www.readbyqxmd.com/read/29742633/nonsurgical-admissions-with-traumatic-injury-medical-patients-are-trauma-patients-too
#5
Laura Nelson, Sally Kuzniewski, Michael Grossman, Jay A Yelon, Lisa Szydziak
Nontrauma service (NTS) admissions are an increasing problem as ground-level falls in elderly patients become more common. The admission and evaluation of trauma patients to nontrauma services in trauma centers seeking American College of Surgeons (ACS) verification, must follow the ACS mandates for performance improvement requiring some method of evaluating this population when admitted to services other than trauma, orthopedics, and neurosurgery. The purpose of this study and performance improvement project was to improve our process for the definition and evaluation of trauma patients who were being admitted to nontrauma services...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29740525/a-survey-of-current-practices-and-preferences-for-internal-fixation-of-trochanteric-fractures-of-the-femur-in-brazil
#6
Vincenzo Giordano, Denner N Ribeiro, Rafael G Tinoco, Thiago A Alvim, Marcos Giordano, Anderson Freitas, Hilton A Koch
Objective The primary aim of this study was to survey current practices and preferences behind internal fixation of trochanteric femoral fractures among Brazilian orthopedic surgeons. The secondary aim was to identify the main reason for these preferences. Methods A survey containing 20 images of trochanteric fractures of the femur was presented to a group of 62 orthopedists, all members of the Brazilian Society of Orthopedics and Traumatology (SBOT). The first part of the questionnaire was created to identify the surgeons' degree of professional experience, type of practice, and areas of greatest interest and performance within the specialty...
March 7, 2018: Curēus
https://www.readbyqxmd.com/read/29739182/combining-extracorporeal-membrane-oxygenation-and-in-line-hemofiltration-for-acute-hyperkalemic-cardiac-arrest-in-a-patient-with-duchenne-muscular-dystrophy-following-orthopedic-surgery
#7
Sang Hun Kim, Ji Ho Song, Ki Tae Jung
Duchenne muscular dystrophy (DMD) is the most common childhood muscular dystrophy that anesthesiologists can encounter in the operation room, and patients with DMD are susceptible to complications such as rhabdomyolysis, hyperkalemic cardiac arrest, and hyperthermia during the perioperative period. Acute onset of hyperkalemic cardiac arrest is a crisis because of the difficulty in achieving satisfactory resuscitation owing to the sustained hyperkalemia accompanied by rhabdomyolysis. We here report a case of a 13-year-old boy who had multiple leg fractures and other trauma after a car accident and who had suffered from acute hyperkalemic cardiac arrest...
May 9, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29738399/cost-determinants-in-the-90-day-management-of-isolated-ankle-fractures-at-a-large-urban-academic-hospital
#8
Matthew Varacallo, Patrick Mattern, Jonathan Acosta, Nader Toossi, Kevin Denehy, Susan Harding
OBJECTIVES: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. DESIGN: Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. INTERVENTION: none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29736575/nanoparticles-based-systems-for-osteochondral-tissue-engineering
#9
Isabel Oliveira, Sílvia Vieira, J Miguel Oliveira, Rui L Reis
Osteochondral lesions represent one of the major causes of disabilities in the world. These defects are due to degenerative or inflammatory arthritis, but both affect the articular cartilage and the underlying subchondral bone. Defects from trauma or degenerative pathology frequently cause severe pain, joint deformity, and loss of joint motion. Osteochondral defects are a significant challenge in orthopedic surgery, due to the cartilage complexity and unique structure, as well as its exposure to high pressure and motion...
2018: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29722119/development-of-mesoporous-bioactive-glass-nanoparticles-and-its-use-in-bone-tissue-engineering
#10
REVIEW
Chee Hoe Kong, Chris Steffi, Zhilong Shi, Wilson Wang
The incidence of bone disorders, from trauma, tissue degeneration due to ageing, pathological conditions to cancer, has been increasing. The pursuit for bone graft substitutes to assist in regenerating large bone defects is ever growing as a result of the shortage in conventional autografts and allografts, in addition to the associated risks of disease transmission. However, the use of alloplastic biomaterials is limited in clinical settings, as further investigations are required to address the properties of synthetic grafts to mimic the native bone tissue and deliver desirable biomolecules to facilitate bone regeneration...
May 2, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/29719605/-in-vivo-safety-and-efficacy-testing-of-a-thermally-triggered-injectable-hydrogel-scaffold-for-bone-regeneration-and-augmentation-in-a-rat-model
#11
Abbey A Thorpe, Christine Freeman, Paula Farthing, Jill Callaghan, Paul V Hatton, Ian M Brook, Chris Sammon, Christine Lyn Le Maitre
Bone loss resulting from degenerative diseases and trauma is a significant clinical burden which is likely to grow exponentially with the aging population. In a number of conditions where pre-formed materials are clinically inappropriate an injectable bone forming hydrogel could be beneficial. The development of an injectable hydrogel to stimulate bone repair and regeneration would have broad clinical impact and economic benefit in a variety of orthopedic clinical applications. We have previously reported the development of a Laponite® crosslinked pNIPAM-co-DMAc (L-pNIPAM-co-DMAc) hydrogel delivery system, loaded with hydroxyapatite nanoparticles (HAPna), which was capable of inducing osteogenic differentiation of mesenchymal stem cells (MSCs) without the need for additional growth factors in vitro ...
April 6, 2018: Oncotarget
https://www.readbyqxmd.com/read/29704954/a-systematic-review-of-opioid-use-after-extremity-trauma-in-orthopedic-surgery
#12
REVIEW
Rikki M Koehler, Ugochi C Okoroafor, Lisa K Cannada
BACKGROUND: The United States is in a prescription opioid crisis. Orthopedic surgeons prescribe more opioid narcotics than any other surgical specialty. The purpose of this study was to evaluate the state of opioid use after extremity trauma in orthopedic surgery. METHODS: A computerized literature search of PubMed/MEDLINE was conducted to evaluate the status of opioids after extremity fractures. Six articles were identified and included in the review. RESULTS: Patients who consume more opioids communicate greater pain intensity and less satisfaction with pain control...
April 12, 2018: Injury
https://www.readbyqxmd.com/read/29696140/harnessing-nanotopography-to-enhance-osseointegration-of-clinical-orthopedic-titanium-implants-an-in-vitro-and-in-vivo-analysis
#13
Vitali Goriainov, Gry Hulsart-Billstrom, Terje Sjostrom, Douglas G Dunlop, Bo Su, Richard O C Oreffo
Despite technological advancements, further innovations in the field of orthopedics and bone regeneration are essential to meet the rising demands of an increasing aging population and associated issues of disease, injury and trauma. Nanotopography provides new opportunities for novel implant surface modifications and promises to deliver further improvements in implant performance. However, the technical complexities of nanotopography fabrication and surface analysis have precluded identification of the optimal surface features to trigger osteogenesis...
2018: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/29692940/lymph-drainage-of-posttraumatic-edema-of-lower-limbs
#14
Ana Carolina Pereira de Godoy, Rodrigo Ocampos Troitino, Maria de Fátima Guerreiro Godoy, José Maria Pereira de Godoy
Objective: The present study was aimed at evaluating the use of mechanical and manual lymphatic therapy as a treatment for lymphedema resulting from orthopedic surgery that became painful after an episode of erysipelas. Case Report: A 70-year-old male patient suffered direct trauma resulting in a compound fracture of the tibia and fibula of the left leg. He was treated with an external fixator for four months followed by plaster cast immobilization for three weeks...
2018: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/29685821/3d-printed-scaffolds-with-calcified-layer-for-osteochondral-tissue-engineering
#15
Zhengyu Li, Shuaijun Jia, Zhuo Xiong, Qianfa Long, Shaorong Yan, Fu Hao, Jian Liu, Zhi Yuan
Treating full-layer injury of bone and cartilage is currently a significant challenge in orthopedic trauma repair. Joint damage typically includes chondral defects, and the underlying subchondral defect sites are difficult to repair. Tissue engineering technology could potentially be used to treat such injuries; however, results to date been unsatisfactory. The aim of this study was to design a multilayer composite scaffold containing cartilage, bone, and calcified layers to simulate physiological full-thickness bone-cartilage structure...
April 21, 2018: Journal of Bioscience and Bioengineering
https://www.readbyqxmd.com/read/29678686/trends-in-vena-cava-filter-insertions-and-prophylactic-use
#16
John R Power, Kenneth R Nakazawa, Ageliki G Vouyouka, Peter L Faries, Natalia N Egorova
BACKGROUND: Prophylactic vena cava filter (VCF) use in patients without venous thromboembolism is common practice despite ongoing controversy. Thorough analysis of the evolution of this practice is lacking. We describe trends in VCF use and identify events associated with changes in practice. METHODS: Using the National Inpatient Sample, we conducted a retrospective observational study of U.S. adult hospitalizations from 2000 to 2014. Trends in prophylactic VCF insertion were analyzed both across the entire study population and within subgroups according to trauma status and type of concurrent surgery...
April 17, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29678427/the-psychological-impact-of-adult-traumatic-brachial-plexus-injury
#17
Zoe A Landers, Rishabh Jethanandani, Steve K Lee, Carol A Mancuso, Mavis Seehaus, Scott W Wolfe
PURPOSE: There is a high incidence of posttraumatic stress disorder (PTSD), depression, suicide risk, and psychological distress after orthopedic trauma and hand and upper-extremity injury. Although patients with traumatic adult brachial plexus injury are particularly vulnerable to psychologic distress, minimal clinical data exist about this cohort of patients. In this study, we sought to discover the prevalence of depression, PTSD, suicidal ideation, and substance abuse. METHODS: Between February, 2013 and July, 2014, during scheduled preoperative and/or postoperative appointments, the social worker at a metropolitan brachial plexus center conducted psychosocial assessments and questionnaire assessments of 21 patients evaluating for PTSD, depression, and substance use using 3 validated scales: PTSD Checklist-Specific, Patient Health Questionnaire-8, and National Institute on Drug Abuse Quick Screen...
April 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29673398/assessment-of-orthotic-needs-in-iranian-veterans-with-ankle-and-foot-disorders
#18
Kamiar Ghoseiri, Mostafa Allami, Mohammad Reza Soroush
BACKGROUND: War-related traumas can lead to orthopedic and neurological disorders in victims. However, the scope of such disorders may expand months or even years after the trauma. Orthotic treatment as a rehabilitation process aims to enable people with disabilities to reach and maintain their optimal physical, sensory, intellectual, psychological, and social functional levels. This study aimed to investigate the rate of using orthoses among Iranian veterans with neuromuscular and skeletal disorders of the ankle and foot...
April 20, 2018: Military Medical Research
https://www.readbyqxmd.com/read/29672392/the-effect-of-hyperoxygenated-fatty-acids-in-preventing-skin-lesions-caused-by-surgical-pneumatic-tourniquets
#19
Beatriz Castillo Martín, Juan Ignacio Castillo Martín, Jesús Lago Oliver, Jorge Diz Gómez
OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs). METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29668808/factors-associated-with-changes-in-creatine-phosphokinase-cpk-in-trauma-patients-submitted-to-the-red-wave-with-evolution-to-rhabdomyolysis
#20
Mario Pastore Neto, Rafael Valério Gonçalves, Carla Jorge Machado, Vivian Resende
OBJECTIVE: to identify and analyze factors associated with plasma creatine phosphokinase (CPK) levels in trauma victims with progression to rhabdomyolysis. METHODS: we conducted a prospective, longitudinal study, with 50 patients submitted to the "Red Wave" protocol, with evolution to rhabdomyolysis after hospital admission. We studied the variables age, gender, trauma scores, mechanism and outcome, CPK at admission and final, intervals of days between laboratory evaluations, surgery and complications...
2018: Revista do Colégio Brasileiro de Cirurgiões
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