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Fracture management

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https://www.readbyqxmd.com/read/28430746/serial-radiographs-do-not-change-the-clinical-course-of-nonoperative-stable-ota-ao-44-b1-ankle-fractures
#1
Lucas S Marchand, Zachary M Working, Ajinkya A Rane, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To assess radiographic markers of ankle stability in stable OTA/AO 44-B1 ankle fractures. DESIGN: Retrospective review. SETTING: Academic Level-I trauma hospital. PATIENTS: One hundred thirty-four patients with stable OTA/AO 44-B1 (Danis-Weber B, Supination-External Rotation-II) ankle fractures. INTERVENTION: Analysis of mortise view radiographs at the time of initial evaluation and final follow-up...
May 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430721/outcomes-of-reverse-total-shoulder-arthroplasty-for-proximal-humeral-fractures-primary-arthroplasty-versus-secondary-arthroplasty-following-failed-proximal-humeral-locking-plate-fixation
#2
Emilio Sebastia-Forcada, Alejandro Lizaur-Utrilla, Román Cebrian-Gomez, Francisco A Miralles-Muñoz, Fernando A Lopez-Prats
OBJECTIVE: To compare the outcomes of reverse shoulder arthroplasty (RSA) between patients with failed proximal humeral locking plate (PHLP) fixation and those with acute fractures. DESIGN: Matched case-control study. SETTING: University hospital, level I trauma center. PATIENTS: 30 consecutive patients with fracture sequelae due to failed PHLP fixation (mean age 73) were age- and gender-matched to 30 patients with acute fracture (mean age 75)...
April 6, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28430540/demystifying-orbital-emergencies-a-pictorial-review
#3
Viet D Nguyen, Achint K Singh, Wilson B Altmeyer, Bundhit Tantiwongkosi
Imaging of the orbit plays an important role in the workup of orbital emergencies. Orbital imaging is particularly useful in the emergency department, where clinical history and physical examination may be limited or delayed until the exclusion or treatment of more life-threatening conditions. Cross-sectional orbital imaging with multidetector computed tomography (CT) and magnetic resonance (MR) imaging is commonly performed in addition to ultrasonography. In an emergent setting, CT is the preferred modality when evaluating for intraorbital foreign bodies, fractures, or calcifications within a mass lesion...
April 21, 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28430016/the-use-of-intravenous-lidocaine-for-the-management-of-acute-pain-secondary-to-traumatic-ankle-injury
#4
Billy Sin, Diana Gritsenko, Grace Tam, Kimberly Koop, Eva Mok
Sports-related injuries are a frequent cause of visits to the emergency department (ED) across the United States. A majority of these injuries affect the lower extremities with the ankle as the most frequently reported site. Most sports-related injuries are not severe enough to require inpatient hospitalization; however, they often lead to acute distress and pain which require prompt treatment with analgesics. Approximately 22% of patients who presented to the ED required pharmacotherapy for acute pain management...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28429555/management-of-mineral-and-bone-disorders-in-renal-transplant-recipients
#5
Matthew J Damasiewicz, Peter R Ebeling
The management of post-transplantation bone disease is a complex problem that remains under-appreciated in clinical practice. In these patients, pre-existing metabolic bone disorder is further impacted by the use of immunosuppressive medications (glucocorticoids and calcineurin-inhibitors), variable post-transplantation renal allograft function and post-transplantation diabetes mellitus. The treatment of post-transplantation bone loss should begin pre-transplantation. All patients active on transplant waiting lists should be screened for bone disease...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429550/parathyroid-hormone-targets-in-chronic-kidney-disease-and-managing-severe-hyperparathyroidism
#6
Carmel M Hawley, Stephen G Holt
Appropriate targets for parathyroid hormone (PTH) in patients with chronic kidney disease (CKD) stages 3-5D are controversial, as are the means by which these targets might be achieved. Secondary hyperparathyroidism is linked to symptoms like bone pain and itch, in addition to less clinically overt issues like bone fragility as well as vascular and soft tissue calcification which may lead to adverse hard endpoints, particularly fracture and death. Recognized therapies for managing a rising PTH include vitamin D analogues, with or without calcimimetic (where available), in addition to management of serum mineral concentrations with diet, binders and dialysis...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429549/is-there-a-practical-role-for-a-virtual-bone-biopsy-using-high-resolution-imaging-of-bone-in-patients-with-chronic-kidney-disease
#7
Ashish K Sharma, Nigel D Toussaint
Renal osteodystrophy (ROD) refers to alterations in bone turnover, mineralisation, mass and microarchitecture in patients with chronic kidney disease (CKD) and represents the skeletal component of 'CKD-mineral and bone disorder'. Changes in bone structure lead to impaired bone quality, compromised bone strength and increased susceptibility to fractures with associated significant morbidity, mortality and financial cost. Diagnosis and management of ROD is hindered by the inadequacy of currently available diagnostic methods to interpret the complex pathophysiology...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429547/the-use-of-bone-turnover-markers-in-chronic-kidney-disease-mineral-and-bone-disorders
#8
Cherie Chiang
Bone turnover markers assist in fracture risk prediction, management and monitoring of osteoporosis in patients without chronic kidney disease (CKD). The use in CKD-mineral bone disorder (MBD) has been limited as many of these markers and breakdown products are renally excreted, including the most commonly used and well standardized procollagen type I N propeptide and C-terminal cross-linking telopeptide of type I collagen. Of the markers unaffected by renal function, bone specific alkaline phosphatase is associated with mortality and fracture rate in CKD subjects and is now available on several automated analysers...
March 2017: Nephrology
https://www.readbyqxmd.com/read/28429336/effects-of-a-curcumin-based-supplementation-in-asymptomatic-subjects-with-low-bone-density-a-preliminary-24-week-supplement-study
#9
A Riva, S Togni, L Giacomelli, F Franceschi, R Eggenhoffner, B Feragalli, G Belcaro, M Cacchio, H Shu, M Dugall
OBJECTIVE: Osteopenia is a chronic bone condition characterized by decreased calcification, density, or bone mass that, if untreated, can lead to osteoporosis and bone fractures. Although its increasing prevalence, nowadays osteopenia is not adequately prevented and managed. In this study, we evaluated the efficacy, in term of changes in bone density, and safety of an oral formulation based on turmeric phytosome (Meriva®), in subjects suffering from low bone density. PATIENTS AND METHODS: 57 otherwise healthy subjects with low bone density were enrolled in this pilot, supplement study...
April 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28427975/surgical-management-of-vertex-epidural-hematoma-technical-case-report-and-literature-review
#10
David T Fernandes-Cabral, Ali Kooshkabadi, Sandip S Panesar, Emrah Celtikci, Hamid Borghei-Razavi, Pinar Celtikci, Juan C Fernandez-Miranda
BACKGROUND: Vertex epidural hematoma (VEH) is an uncommon presentation of extra-axial hematomas. It can represent a surgical dilemma regarding when and how to operate, particularly considering the potential implication of the superior sagittal sinus (SSS). OBJECTIVE: Here, we illustrate the surgical technique for VEH as well as review of the existing literature. METHODS: A 60-year-old male sustained a ground level fall resulting in complete diastasis of the sagittal suture with underlying large VEH causing significant mass effect on the SSS and bi-hemispheric convexities...
April 17, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28427871/arthroscopic-assisted-coracoclavicular-ligament-reconstruction-for-acute-acromioclavicular-dislocation-using-2-clavicular-and-1-coracoid-cortical-fixation-buttons-with-suture-tapes
#11
Sang-Jin Shin, Yoon Sang Jeon, Rag Gyu Kim
PURPOSE: To introduce an arthroscopically assisted coracoclavicular (CC) fixation technique using a cortical fixation button device and to evaluate the clinical and radiologic outcomes in patients with acute acromioclavicular (AC) dislocation who were treated with the technique. METHODS: Twenty-one consecutive patients with grade III and V acute AC dislocation who underwent arthroscopically assisted CC ligament reconstruction using a cortical fixation button device were prospectively enrolled...
April 17, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#12
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28427333/the-experiences-of-physiotherapists-treating-people-with-dementia-who-fracture-their-hip
#13
A J Hall, R Watkins, I A Lang, R Endacott, V A Goodwin
BACKGROUND: It is estimated that people with dementia are approximately three times more likely to fracture their hip than sex and age matched controls. A report by the Chartered Society of Physiotherapy found that this population have poor access to rehabilitation as inpatients and in the community. A recent scoping review found a paucity of research in this area, indeed there has been no qualitative research undertaken with physiotherapists. In order to address this evidence gap, the aim of this current study was to explore the experiences of physiotherapists treating this population...
April 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28427053/growing-skull-fracture-and-the-orbitocranial-variant-nuances-of-surgical-management
#14
Vikram Singh, Gopalakrishnan M Sasidharan, Dhananjaya Ishwar Bhat, Bhagavatula Indira Devi
AIMS: Growing skull fracture (GSF) is a rare complication resulting from diastatic enlargement of a pediatric skull fracture. Orbitocranial GSF is a distinct variant with more complex management issues due to the displacement of the globe. This study aims to discuss surgical considerations in the management of GSF, with particular reference to orbitocranial variants. METHODS: We conducted a retrospective analysis of 7 children operated for GSFs at our institute from 2008 to 2015...
April 21, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28426619/committee-opinion-no-698-hormone-therapy-in-primary-ovarian-insufficiency
#15
(no author information available yet)
Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426614/committee-opinion-no-698-summary-hormone-therapy-in-primary-ovarian-insufficiency
#16
(no author information available yet)
Primary ovarian insufficiency describes a spectrum of declining ovarian function and reduced fecundity due to a premature decrease in initial follicle number, an increase in follicle destruction, or poor follicular response to gonadotropins. The sequelae of primary ovarian insufficiency include vasomotor symptoms, urogenital atrophy, osteoporosis and fracture, cardiovascular disease, and increased all-cause mortality. In women with primary ovarian insufficiency, systemic hormone therapy (HT) is an effective approach to treat the symptoms of hypoestrogenism and mitigate long-term health risks if there are no contraindications to treatment...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28426444/fracture-liaison-services
#17
Karine Briot
PURPOSE OF REVIEW: The purpose of this review is to report the evidence of beneficial effects of Fracture Liaison Service (FLS) including data regarding their impact on subsequent fracture, mortality risk and cost-effectiveness. This review also discusses the limitations of these data and the challenges faced during the implementation of FLS. RECENT FINDINGS: Recent studies showed the beneficial impact of implementation of FLS on the prevention of subsequent fracture risk, reduced mortality and cost-effectiveness...
April 19, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28426259/the-sernbo-score-predicts-1-year-mortality-after-displaced-femoral-neck-fractures-treated-with-a-hip-arthroplasty
#18
Carl Mellner, Thomas Eisler, Johannes Börsbo, Cyrus Brodén, Per Morberg, Sebastian Mukka
Background and purpose - Displaced femoral neck fractures (FNFs) are associated with high rates of mortality during the first postoperative year. The Sernbo score (based on age, habitat, mobility, and mental state) can be used to stratify patients into groups with different 1-year mortality. We assessed this predictive ability in patients with a displaced FNF treated with a hemiarthroplasty or a total hip arthroplasty. Patients and methods - 292 patients (median age 83 (65-99) years, 68% female) with a displaced FNF were included in this prospective cohort study...
April 20, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28425085/uk-clinical-guideline-for-the-prevention-and-treatment-of-osteoporosis
#19
J Compston, A Cooper, C Cooper, N Gittoes, C Gregson, N Harvey, S Hope, J A Kanis, E V McCloskey, K E S Poole, D M Reid, P Selby, F Thompson, A Thurston, N Vine
INTRODUCTION: In 2008, the UK National Osteoporosis Guideline Group (NOGG) produced a guideline on the prevention and treatment of osteoporosis, with an update in 2013. This paper presents a major update of the guideline, the scope of which is to review the assessment and management of osteoporosis and the prevention of fragility fractures in postmenopausal women and men age 50 years or over. METHODS: Where available, systematic reviews, meta-analyses and randomised controlled trials were used to provide the evidence base...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#20
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
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