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Fracture management

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https://www.readbyqxmd.com/read/28637303/management-of-acute-unilateral-nondisplaced-subaxial-cervical-facet-fractures
#1
Aditya Vedantam, Jared Steven Fridley, Jovany Cruz Navarro, Shankar P Gopinath
BACKGROUND: Few studies have focused on the management of patients with nondisplaced cervical facet fractures. OBJECTIVE: To determine the rate of successful nonoperative management and risk factors for instability in patients with acute traumatic, unilateral, nondisplaced cervical facet fractures. METHODS: We reviewed patients with single or multilevel unilateral nondisplaced or minimally displaced subaxial cervical facet fractures between 2008 and 2014...
June 14, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28635359/thoracic-paravertebral-block-versus-intravenous-patient-controlled-analgesia-for-pain-treatment-in-patients-with-multiple-rib-fractures
#2
Ge Yeying, Yuan Liyong, Chen Yuebo, Zhang Yu, Ye Guangao, Ma Weihu, Zhao Liujun
Objectives To assess the effect of thoracic paravertebral block (PVB) on pain management and preservation of pulmonary function compared with intravenous, patient-controlled analgesia (IVPCA) in patients with multiple rib fractures (MRFs). Methods Ninety patients with unilateral MRFs were included in this prospective study and randomly assigned to the TPVB or IVPCA group. The visual analogue scale (VAS) pain score, blood gas analysis, and bedside spirometry were measured and recorded at different time points after analgesia...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28634743/comminuted-olecranon-fractures-biomechanical-testing-of-locked-versus-minifragment-non-locked-plate-fixation
#3
David S Wellman, Scott M Tucker, Josh R Baxter, Nadine C Pardee, Lionel E Lazaro, Christopher S Smith, Dean G Lorich, David L Helfet
INTRODUCTION: Open reduction and internal fixation has long been accepted as optimal treatment for displaced olecranon fractures based on poor results seen with conservative management. With the presence of comminution, tension-band wiring constructs are contraindicated due to tendency to compress through fragments, thereby shortening the articular segment. Therefore, plate fixation is typically employed. Our hypothesis was that in a comminuted fracture model, 2.7 mm reconstruction plating without locking screws will perform equally to 3...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
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
#4
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/28633147/tranexamic-acid-safely-reduced-blood-loss-in-hemi-and-total-hip-arthroplasty-for-acute-femoral-neck-fracture-a-randomized-clinical-trial
#5
Chad D Watts, Matthew T Houdek, S Andrew Sems, William W Cross, Mark W Pagnano
OBJECTIVES: We aimed to determine whether (1) tranexamic acid (TXA) reduces the incidence of transfusion (2) TXA reduces the calculated blood loss, and (3) there are any observable differences in 30- and 90-day complications with TXA administration during arthroplasty for femoral neck fracture (FNF). DESIGN: Prospective, double-blinded, randomized controlled trial. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: One hundred thirty-eight patients who presented with a low-energy, isolated, FNF (AO 31B) treated with either hemi- or total hip arthroplasty within 72 hours of injury were randomized to either the TXA group (69 patients) or placebo group (69 patients)...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28632657/role-of-computed-tomography-in-the-classification-of-pediatric-pelvic-fractures-revisited
#6
Melissa A Bent, William L Hennrikus, Johan E Latorre, Douglas G Armstrong, Brian Shaw, Kerwyn C Jones, Lee S Segal
OBJECTIVES: To determine the need for computerized tomography (CT) scans in the assessment of pediatric pelvic fractures. DESIGN: Retrospective Chart Review. SETTING: Level-1 Pediatric Trauma Center. PATIENTS/PARTICIPANTS: Thirty pediatric trauma patients with pelvic fractures who have obtained both a radiograph and CT scan. MAIN OUTCOME MEASUREMENTS: Fleiss Kappa coefficient to compare interreliability...
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
#7
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/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#8
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28631687/-acquired-atresia-and-stenosis-of-the-external-acoustic-meatus
#9
D S Kondratchikov, Kh M Diab, V S Korvyakov, L I Terekhina
Acquired atresia of the external acoustic meatus is a rare pathological condition characterized by obliteration of the medial part of the external acoustic canal by a soft fibrous plug. The present article presents an overview of a series of cases of acquired atresia and stenosis of the external acoustic meatus with the description of etiology, pathogenesis, and methods for the treatment of this condition. In the majority of the cases, atresia develops at the final stage of granulation external otitis with or without an accompanying dermatological pathology...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28631236/use-of-ctx-i-and-pinp-as-bone-turnover-markers-national-bone-health-alliance-recommendations-to-standardize-sample-handling-and-patient-preparation-to-reduce-pre-analytical-variability
#10
P Szulc, K Naylor, N R Hoyle, R Eastell, E T Leary
N-terminal propeptide of type I procollagen and C-terminal telopeptide of type I collagen are the reference standards for bone turnover markers for monitoring osteoporosis treatment. We provide recommendations for standardized sample handling and encompassing aspects of preanalytical variability to improve the reproductibility of their measurements, their reliability, and clinical interpretation. The International Osteoporosis Foundation and International Federation of Clinical Chemistry bone turnover marker standards working group have identified N-terminal propeptide of type I procollagen (PINP) and C-terminal telopeptide of type I collagen (CTX-I) in the blood to be the international reference standards for bone turnover markers for the prediction of fracture risk and monitoring of osteoporosis treatment...
June 19, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28630842/irreducible-subtalar-dislocation-caused-by-sustentaculum-tali-incarceration
#11
Mourad Zaraa, Ismail Jerbi, Sabri Mahjoub, Heithem Sehli, Mondher Mbarek
INTRODUCTION: Subtalar dislocation is an uncommon lesion in traumatology chiefly when it concerns the lateral form. Surgical treatment is required when a fracture is related or the dislocation is irreducible. Even well treated, these dislocations progress unavoidably to subtalar arthrosis, which stays well tolerated. CASE REPORT: A 46-year-old male with irreducible lateral subtalar dislocation caused sustentaculum tali incarceration confirmed on computed tomography (CT)...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630773/functional-treatment-of-a-child-with-extracapsular-mandibular-fracture
#12
Diana Cassi, Marisabel Magnifico, Chiara Di Blasio, Mauro Gandolfini, Alberto Di Blasio
Condylar fractures are among the most frequent fractures in the context of traumatic lesions of the face. The management of condylar fractures is still controversial, especially when fractures occur in children: if overlooked or inappropriately treated, these lesions may lead to severe sequelae, both cosmetic and functional. The therapy must be careful because severe long-term complications can occur. In this case report, the authors present a case of mandibular fracture in which the decision between surgical therapy and functional therapeutic regimen may be controversial due to the particular anatomy of the fracture line and the age of the patient...
2017: Case Reports in Dentistry
https://www.readbyqxmd.com/read/28630762/articular-impaction-injuries-in-the-lower-limb
#13
Ippokratis Pountos, Peter V Giannoudis
The effective management of articular impacted fractures requires the successful elevation of the osteochondral fragment to eliminate joint incongruency and the stable fixation of the fragments providing structural support to the articular surface.The anatomical restoration of the joint can be performed either with elevation through a cortical window, through balloon-guided osteoplasty or direct visualisation of the articular surface.Structural support of the void created in the subchondral area can be achieved through the use of bone graft materials (autologous tricortical bone), or synthetic bone graft substitutes...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28629592/measurement-and-clinical-utility-of-%C3%AE-ctx-in-serum-and-plasma
#14
Stephen A P Chubb, Samuel D Vasikaran
Biochemical markers of bone turnover (BTM) are released during bone remodeling and can be measured in blood or urine as noninvasive surrogate markers for the bone remodeling rate. The C-terminal cross-linked telopeptide of type I collagen (βCTX) is released during bone resorption and is specific to bone tissue. Assays have been developed to measure βCTX in blood and in urine; most current use of βCTX measurement for research and in clinical practice is performed on a blood sample. Method-specific differences for serum and plasma βCTX have led to initiatives to standardize or harmonize βCTX commercial assays...
2017: Advances in Clinical Chemistry
https://www.readbyqxmd.com/read/28628893/one-year-mortality-after-hip-fracture-in-older-individuals-the-effects-of-delirium-and-dementia
#15
Rebecca Mitchell, Lara Harvey, Henry Brodaty, Brian Draper, Jacqueline Close
BACKGROUND: Delirium is common in older hip fracture patients, yet its association with mortality after hip fracture remains uncertain. This study aimed to determine whether delirium was associated with all-cause one-year mortality after hip fracture in older patients and whether the effect of delirium was independent of dementia status. METHOD: A retrospective analysis of linked hospitalisation and mortality data for patients aged ≥65 years with a hip fracture during 1 January 2010 to 30 June 2014 in New South Wales, Australia...
June 13, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28628868/an-overview-on-exploration-and-environmental-impact-of-unconventional-gas-sources-and-treatment-options-for-produced-water
#16
REVIEW
Tânia L S Silva, Sergio Morales-Torres, Sérgio Castro-Silva, José L Figueiredo, Adrián M T Silva
Rising global energy demands associated to unbalanced allocation of water resources highlight the importance of water management solutions for the gas industry. Advanced drilling, completion and stimulation techniques for gas extraction, allow more economical access to unconventional gas reserves. This stimulated a shale gas revolution, besides tight gas and coalbed methane, also causing escalating water handling challenges in order to avoid a major impact on the environment. Hydraulic fracturing allied to horizontal drilling is gaining higher relevance in the exploration of unconventional gas reserves, but a large amount of wastewater (known as "produced water") is generated...
June 16, 2017: Journal of Environmental Management
https://www.readbyqxmd.com/read/28628487/do-toddler-s-fractures-of-the-tibia-require-evaluation-and-management-by-an-orthopaedic-surgeon-routinely
#17
John S Adamich, Mark W Camp
OBJECTIVE: The majority of uncomplicated toddler fractures of the tibia (toddler's fractures) do not need an orthopaedic surgeon's intervention or follow-up. However, inexperienced emergency room physicians, general practitioners and orthopaedic trainees and surgeons understandably defer to a cautious approach of referral and subsequent frequent clinical and radiographic follow-up. An evidence-based pathway can help prevent this overtreatment, reduce unnecessary radiation exposure and decrease the financial burden on families and the healthcare system...
June 16, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28626621/simultaneous-bilateral-intertrochanteric-fractures-of-the-femur-a-case-report-and-review-of-the-literature
#18
Raju Vaishya, Amit Kumar Agarwal, Ifeanyi C Nwagbara, Vipul Vijay
Simultaneous bilateral intertrochanteric fractures are very rare, and only a few cases have been reported in the literature. They usually result from severe trauma. They are serious injuries with high morbidity and mortality rates. Successful management of these patients involves adequate resuscitation, treatment of associated injuries, early single-stage stable fixation, and good rehabilitation. We report the case of a 47-year-old male who presented with a simultaneous bilateral intertrochanteric fracture along with associated injuries following a car crash...
May 9, 2017: Curēus
https://www.readbyqxmd.com/read/28625708/-algorithms-for-the-identification-of-hospital-stays-due-to-osteoporotic-femoral-neck-fractures-in-european-medical-administrative-databases-using-icd-10-codes-a-non-systematic-review-of-the-literature
#19
P Caillet, P Oberlin, E Monnet, L Guillon-Grammatico, P Métral, M Belhassen, P Denier, L Banaei-Bouchareb, M Viprey, D Biau, A-M Schott
BACKGROUND: Osteoporotic hip fractures (OHF) are associated with significant morbidity and mortality. The French medico-administrative database (SNIIRAM) offers an interesting opportunity to improve the management of OHF. However, the validity of studies conducted with this database relies heavily on the quality of the algorithm used to detect OHF. The aim of the REDSIAM network is to facilitate the use of the SNIIRAM database. The main objective of this study was to present and discuss several OHF-detection algorithms that could be used with this database...
June 15, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/28625198/determining-the-clinical-significance-of-errors-in-pediatric-radiograph-interpretation-between-emergency-physicians-and-radiologists
#20
Jonathan Taves, Steve Skitch, Rahim Valani
OBJECTIVES: Emergency physicians (EPs) interpret plain radiographs for management and disposition of patients. Radiologists subsequently conduct their own interpretations, which may differ. The purposes of this study were to review the rate and nature of discrepancies between radiographs interpreted by EPs and those of radiologists in the pediatric emergency department, and to determine their clinical significance. METHODS: We conducted a retrospective review of discrepant radiology reports from a single-site pediatric emergency department from October 2012 to December 2014...
June 19, 2017: CJEM
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