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Orthopedic trauma

Kiran C Mahabier, Esther M M Van Lieshout, Boyd C Van Der Schaaf, Gert R Roukema, Bas J Punt, Michael H J Verhofstad, Dennis Den Hartog
OBJECTIVES: This study aimed to determine inter-observer reliability and intra-observer reproducibility of the OTA/AO classification for humeral shaft fractures, and to evaluate differences between fracture types, fracture groups, and surgical specializations. METHODS: 30 observers (25 orthopedic trauma surgeons and five general orthopedic surgeons) independently classified 90 humeral shaft fractures according to the OTA/AO classification. Patients of 16 years and older were included...
October 13, 2016: Journal of Orthopaedic Trauma
Chad Turner, Shane Hiatt, Brian Mullis
Commonly accepted dogma is that patients with a long bone fracture due to a penetrating injury (gunshot wound) are less likely to follow up than blunt trauma patients. An institutional trauma database from a Level 1 academic trauma center was utilized to include all patients with long bone fractures from penetrating trauma from 2006-2009 (N = 132). Demographically matched blunt trauma patients with long bone fractures were included as a comparison group (N = 104). The medical records of these 236 patients were reviewed to observe their follow-up at 3, 6, 9, and 12 months...
September 2016: American Journal of Orthopedics
Luis Gerardo Natera Cisneros, Juan Sarasquete Reiriz
INTRODUCTION: Surgical indication for acromioclavicular joint (ACJ) injuries still represents a reason for shoulder and trauma debate. In high-grade injuries, surgery is advocated because some of the non-operatively managed patients may have persistent shoulder pain that could make them unable to return to their previous activity. It has been shown that many of the patients with high-grade ACJ injuries that are managed non-operatively involve the development of scapular dyskinesis, situation that may result in loss of strength and weakness...
October 12, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
E Brooke Lerner, Amy L Drendel, Jeremy T Cushman, Mohamed Badawy, Manish N Shah, Clare E Guse, Arthur Cooper
BACKGROUND: There is limited research on how well the American College of Surgeons/Center for Disease Control and Prevention Guidelines for Field Triage of Injured Patients assist EMS providers in identifying children who need the resources of a trauma center. OBJECTIVE: To determine the accuracy of the Physiologic Criteria (Step 1) of the Field Triage Guidelines in identifying injured children who need the resources of a trauma center. METHODS: EMS providers who transported injured children 15 years and younger to pediatric trauma centers in 3 mid-sized cities were interviewed regarding patient demographics and the presence or absence of each of the Field Triage Guidelines criteria...
October 6, 2016: Prehospital Emergency Care
Raymond W Liu, Katherine K Xie
BACKGROUND: It is unclear whether isolated gastroc/soleus tightness can increase the risk of lower extremity injury in an otherwise healthy child. QUESTIONS/PURPOSES: (1) Is there a difference in gastroc/soleus tightness, as represented by ankle dorsiflexion with the knee extended, in children presenting with upper versus lower extremity complaints? (2) Is there a difference in gastroc/soleus tightness in children presenting with atraumatic versus traumatic lower extremity complaints? METHODS: We performed a cross-sectional study of 206 consecutive walking age children presenting to a county orthopedic clinic with new upper or lower extremity complaints...
October 2016: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
Ali Yeganeh, Mani Mahmodi, Hosein Farahini, Mehdi Moghtadaei
INTRODUCTION: Severe defects in long bones can be caused by several factors such as trauma that lead to open wound and secondary infections after surgery. Induced membrane technique is one of the therapeutic strategies that can be used for these patients. Due to importance of this method and lack of information about this technique in Iran. AIM: this study was performed to investigate technical strengths and weakness of induced membrane technique. MATERIAL AND METHODS: This case series study conducted on 21 patients with bone defects in the femur and tibia and metatarsal bones referred to orthopedic clinic of Rasoul Akram Hospital, Tehran, Iran, for induced membrane surgery in 2012-2015...
July 27, 2016: Medical Archives
Nader S Alkenani, Mariam A Alosfoor, Abdulaziz K Al-Araifi, Hala A Alnuaim
INTRODUCTION: This is a case report of extreme lengthening of the tibia of about 14.5cm using bone transport technique following road traffic accident trauma to the lower limbs. The management of the subsequent massive skeletal defects was challenging to orthopedic surgeons. Based on reported cases, the highest tibial lengthening was 22cm using bifocal transport, while the highest unifocal tibial lengthening reached 14.5cm. CASE PRESENTATION: A 20-year-old male driver was brought to the emergency department after a road traffic accident...
September 3, 2016: International Journal of Surgery Case Reports
Madison M Hunt, Austin M Stevens, Kristine W Hansen, Stephen J Fenton
PURPOSE: To expedite flow of injured children suspected to require operative intervention, a "trauma 1 OP" (T1OP) activation classification was created. The purpose of this study was to review this strategy at a level 1 pediatric trauma center. METHODS: A retrospective review of T1OP activations between 2003 and 2015 was performed. Children suspected of requiring neurosurgical intervention were classified as trauma 1 OP neuro (T1OP(N)). Comparisons were made to trauma 1 (T1) patients who required emergent operative intervention, excluding orthopedic injuries...
September 14, 2016: Journal of Pediatric Surgery
Erich M Gauger, Lauren L Casnovsky, Erica J Gauger, Deborah C Bohn, Ann E Van Heest
This study reviewed the clinical history and management of acquired growth arrest in the upper extremity in pediatric patients. The records of all patients presenting from 1996 to 2012 with radiographically proven acquired growth arrest were reviewed. Records were examined to determine the etiology and site of growth arrest, management, and complications. Patients with tumors or hereditary etiology were excluded. A total of 44 patients (24 boys and 20 girls) with 51 physeal arrests who presented at a mean age of 10...
September 29, 2016: Orthopedics
Justin Stull, Suneel Bhat, Andrew J Miller, Ryan Hoffman, Mark L Wang
Compartment syndrome is an orthopedic emergency with a multitude of etiologies. Although it is most commonly associated with trauma to the extremity, hematoma and infection are 2 rare etiologies of insidious compartment syndrome. Proteus mirabilis is an opportunistic gram-negative species that can infect the respiratory tract, urinary tract, and open wounds. The authors present the case of a 69-year-old woman who developed tissue necrosis and compartment syndrome secondary to an untreated hematoma infected by P mirabilis...
September 29, 2016: Orthopedics
David Dreizin, Jason Nascone, Derik L Davis, Daniel Mascarenhas, Nikki Tirada, Haoxing Chen, Uttam K Bodanapally
OBJECTIVE: Pelvic binders may hinder radiologic assessment of pelvic instability after trauma, and avulsive injuries can potentially unmask instability in this setting. We compare the performance of MDCT for the detection of pelvic disruptions in patients with binders to a matched cohort without binders, and we assess the utility of avulsive injuries as signs of pelvic instability. MATERIALS AND METHODS: MDCT examinations of 56 patients with binders were compared with MDCT examinations of 54 patients without binders...
September 28, 2016: AJR. American Journal of Roentgenology
Flavia Coroian, Bertrand Coulet, Claire Jourdan, Olivier Choquet, Isabelle Laffont
OBJECTIVE: The musculotendinous retractions are common complications of central neurological damage with consequences for comfort and function. Treatment of uncomfortable retractions is often surgical, mainly based on tendon gestures. The objective of this study was to evaluate the efficiency of percutaneous needle tenotomy in these indications. MATERIAL/PATIENTS AND METHODS: The indication was accepted at a medical-surgical consultation. Tenotomy was performed using an 18 Gauge needle...
September 2016: Annals of Physical and Rehabilitation Medicine
Nathaly Quintero-Prigent, Frédéric Clavier, Naima Brennetot, Colina Martinot-Lagarde
Upper limbs birth defects are rare. There is an international classification of these malformations. The most frequent cause is the stop in the cross development of the forearm. The announcement of the malformation is a strong psychological trauma for parents, whether it occurs before the birth or if we find out when the baby is born. Beyond the grief of the perfect child, parents are very worried about activities of daily living, about the future of the child and his relationships with others. We have to inform and to support them during to the development and growth of the child...
September 2016: Annals of Physical and Rehabilitation Medicine
Marion Prigent, Sylvain Brochard, Mathias Thepaut, Christian Lefèvre, Dominique Le Nen, Thierry Cornic, Marie-Thérèse Cariou, Catherine Le Rouzic, Phlippe Le Moine, Christelle Pons, Laetitia Houx
OBJECTIVE: Traumatic lower limb amputation is rare in pediatric population, and surgeons always try limb salvage. But rarely, later amputation occurred when the traumatic limb is painful. It is a difficult and irreversible decision needed a multidisciplinary approach. We report how we managed a programmed trans-tibial amputation on 13-years-old boy, 20 months after a foot trauma. OBSERVATIONS: Our patient is an adolescent victim of a left foot crash. The first checkup showed a degloving injury, dislocation of the interphalangeal joints and of all toes...
September 2016: Annals of Physical and Rehabilitation Medicine
Johanna Morgounovski, Philippe Vuistiner, Bertrand Léger, François Luthi
OBJECTIVE: The fear-avoidance model (FAM) is commonly used in musculoskeletal chronic pain (Vlaeyen 2012). Nevertheless, only few prospective studies have been conducted, especially on return to work (RTW). This study lays the hypothesis that the components of the FAM (catastrophizing, kinesiophobia and depression) can predict RTW 1 year after a vocational rehabilitation for orthopedic trauma patients. MATERIAL/PATIENTS AND METHODS: A total of 323 rehab orthopedic trauma inpatients (average time after accident: 9 months) were included...
September 2016: Annals of Physical and Rehabilitation Medicine
Maria E Linnaus, Rebecca L Ragar, Erin M Garvey, Jason D Fraser
PURPOSE: To identify injuries and outcomes from Recreational/Off-Highway Vehicles (RV/OHV) accidents at a pediatric trauma center. METHODS: A retrospective review of a prospective pediatric trauma registry was performed to identify patients sustaining injuries from an RV/OHV between January 2007 and July 2015. Vehicles included: all-terrain vehicles (ATV), dirt bikes, utility-terrain vehicles (UTV), golf carts, go-karts, and dune buggies. RESULTS: Five hundred twenty-eight patients were injured while on an RV/OHV: 269 ATV, 135 dirt bike, 42 UTV, 38 golf cart, 34 go-kart, and 10 dune buggy...
September 14, 2016: Journal of Pediatric Surgery
Kevin J McGurk, Bryan R Collier, Eric H Bradburn, Katie M Love, Daniel I Lollar, Christopher C Baker, Mark E Hamill
No abstract text is available yet for this article.
September 2016: American Surgeon
Michel Taylor, Wilma Hopman, Jeff Yach
BACKGROUND: In September 2011, Kingston General Hospital (KGH) opened a dedicated orthopedic weekend trauma room. Previously, 1 weekend operating room (OR) was used by all surgical services. We assessed the impact this dedicated weekend trauma room had on hospital length of stay (LOS), time to surgery and 30-day mortality for patients with hip fractures. METHODS: Patients admitted between Oct. 1, 2009, and Sept. 30, 2012, were identified through our trauma registry, representing the 2 years before and 1 year after the opening of the orthopedic weekend trauma room...
September 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Andrea T Borchers, M Eric Gershwin
The management of patients with chronic pain is a nearly daily challenge to rheumatologists, neurologists, orthopedic surgeons, pain specialists and indeed a issue in nearly every clinical practice. Among the myriad of causes of pain are often included a unique syndrome, generally referred to as complex regional pain syndrome type I (CRPS). Unfortunately this CRPS I has become a catch all phase and there are serious questions on whether it exist at all; this has led to an extraordinary number of poorly defined diagnostic criteria...
September 23, 2016: Autoimmunity Reviews
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