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damage control orthopaedic surgery

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https://www.readbyqxmd.com/read/29115207/self-evaluated-competence-in-trauma-reception
#1
Kristin Julia Steinthorsdottir, Peter Svenningsen, Rasmus Fabricius, Lars Bo Svendsen, Jens Hillingsø, Martin Sillesen
INTRODUCTION: No formal training requirements exist for trauma teams in Denmark. The aim of this study was to investigate the point prevalence level of training and the self-evaluated competence of doctors involved in trauma care. METHODS: On two nights, all doctors on call at departments involved in trauma care were interviewed and answered a structured questionnaire pertaining to their level of training and self-evaluated level of competence in relevant skills...
November 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/29112467/meniscectomy-and-resultant-articular-cartilage-lesions-of-the-knee-among-prospective-national-football-league-players-an-imaging-and-performance-analysis
#2
Jorge Chahla, Mark E Cinque, Jonathan A Godin, George Sanchez, George F Lebus, James M Whalen, Mark D Price, Nicholas I Kennedy, Gilbert Moatshe, Robert F LaPrade, Matthew T Provencher
BACKGROUND: The effect of prior meniscectomy and the resulting reduction in meniscal tissue on a potential National Football League (NFL) player's articular cartilage status and performance remain poorly elucidated. Purpose/Hypothesis: (1) To determine the epidemiology, imaging characteristics, and associated articular cartilage pathology of the knee among players with a previous meniscectomy who were participating in the NFL Combine and (2) to evaluate the effect of these injuries on performance as compared with matched controls...
November 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28985633/role-of-negative-pressure-therapy-as-damage-control-in-soft-tissue-reconstruction-for-open-tibial-fractures
#3
Mario Cherubino, Luigi Valdatta, Pierluigi Tos, Salvatore D'Arpa, Luigi Troisi, Pellegatta Igor, Federica Corradi, Umraz Khan
The concept of damage control orthopaedics (DCO) is a strategy that focuses on managing orthopaedic injuries in polytrauma patients who are in an unstable physiological state. The concept of DCO is an extension of damage control surgery or damage limitation surgery (DCS/DLS). Recently, it has become clear that certain patients, following extensive soft tissue trauma, could benefit from the idea of DCS. In the management of severe lower extremity trauma with exposed fracture sites, aggressive early wound excision debridement, early internal fixation, and vascularized wound coverage within a few days after trauma were proposed...
October 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28933334/-damage-control-surgery-in-polytrauma-patients-with-pelvic-fractures-is-it-possible-to-use-internal-fixation
#4
L Havlůj, V Džupa, R Gürlich
Current polytrauma management is multidisciplinary, with Damage Control Surgery (DCS), Damage Control Orthopaedics (DCO) and Damage Control Resuscitation (DCR) being applied in the first few hours after injury. The most severe group of polytrauma patients are those with circulatory instability and massive blood loss as a consequence of unstable pelvic fractures. In treating these patients, of crucial importance is the speed and quality of stabilisation of pelvic fracture fragments. The authors present two case reports of polytrauma patients with unstable pelvic fractures, in whom open reduction and internal fixation was performed on the anterior fracture segment through extended laparotomy in order to stop bleeding into the abdominopelvic cavity as part of the DCS approach...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28904652/-role-of-trauma-damage-control-orthopaedic-in-polytraumas-a-case-of-pelvic-disjunction-associated-with-hip-dislocation-with-vascular-injury
#5
Tarik Madani, El Mehdi El Alouani, Younes Mhammdi, Mohammed Kharmaz, Mohamed El Ouadghiri, Abdou Lahlou, Lamrani Moulay Omar, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
The knowledge of the pathophysiology of patients with severe trauma and the hemodynamic and inflammatory consequences of initial surgical management has led many surgeons to change their approach to the treatment of patients with severe polytraumas associated with lesions of the pelvis or of limbs by integrating the principles of sequential treatment or Trauma Damage Control Orthopaedic (TDCO). We report the case of a patient involved in a public road accident, admitted to hospital in a state of shock with pelvic disjunction and hip dislocation complicated by vascular injury in the same limb...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28893227/damage-control-surgery-experiences-from-a-level-i-trauma-center
#6
Bernhard Gasser, Thomas M Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer
BACKGROUND: There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both. METHODS: Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed...
September 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28806822/-multiple-myeloma-current-status-in-diagnostic-testing-and-therapy
#7
Michael Kehrer, Sebastian Koob, Andreas Strauss, Dieter Christian Wirtz, Jan Schmolders
Background Multiple myeloma is a haematological blood cancer of the bone marrow and is classified by the World Health Organisation (WHO) as a plasma cell neoplasm. In multiple myeloma, normal plasma cells transform into malignant myeloma cells and produce large quantities of an abnormal immunoglobulin called monoclonal protein or M protein. This ultimately causes multiple myeloma symptoms such as bone damage or kidney problems. The annual worldwide incidence of multiple myeloma is estimated to be 6 - 7/100,000 and accounts for 1% of all cancer...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28501719/colliding-jets-provide-depth-control-for-water-jetting-in-bone-tissue
#8
S den Dunnen, J Dankelman, G M Kerkhoffs, G Tuijthof
In orthopaedic surgery, water jet drilling provides several advantages over classic drilling with rigid drilling bits, such as the always sharp cut, absence of thermal damage and increased manoeuvrability. Previous research showed that the heterogeneity of bone tissue can cause variation in drilling depth whilst water jet drilling. To improve control over the drilling depth, a new method is tested consisting of two water jets that collide directly below the bone surface. The expected working principle is that after collision the jets will disintegrate, with the result of eliminating the destructive power of the coherent jets and leaving the bone tissue underneath the focal point intact...
May 6, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27383299/the-use-of-damage-control-orthopaedics-to-minimize-negative-sequelae-of-surgery-delay-in-elderly-comorbid-patients-with-hip-fracture
#9
C-H Dong, Z-M Wang, X-L Zhao, A-M Wang
Hip surgeries count to the most frequent orthopaedic operations in older patients. Nonelective surgeries for hip fractures cause substantial economic burden because of high costs of medical treatment and high associated mortality. Surgery for hip fracture in the elderly comorbid patient still presents a challenge to orthopaedic surgeons. It is recommended that this surgery is performed within 48 hours after sustaining the hip fracture to decrease mortality. Yet the recommended early surgery (i.e. 48 hours after the incident) is not always feasible due to the frequent overall frailty of the patients or conditions of concomitant disease...
June 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/27340256/osteochondral-autograft-transfer-combined-with-cancellous-allografts-for-large-cystic-osteochondral-defect-of-the-talus
#10
Yuan Zhu, Xiangyang Xu
BACKGROUND: Large cystic osteochondral defects of the talus can be challenging to treat. This retrospective control study looked at the use of osteochondral autograft transfer combined with cancellous allograft in patients with advanced cartilage and subchondral bone damage of the talus. METHODS: Thirteen patients were treated with large cystic osteochondral defect of the talus between February 2010 and July 2013. All of these cystic osteochondral defects were larger than 15 mm in diameter...
October 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27335224/thermally-induced-osteocyte-damage-initiates-pro-osteoclastogenic-gene-expression-in-vivo
#11
Eimear B Dolan, David Tallon, Wing-Yee Cheung, Mitchell B Schaffler, Oran D Kennedy, Laoise M McNamara
Bone is often subject to harsh temperatures during orthopaedic procedures resulting in thermally induced bone damage, which may affect the healing response. Postsurgical healing of bone is essential to the success of surgery, therefore, an understanding of the thermally induced responses of bone cells to clinically relevant temperatures in vivo is required. Osteocytes have been shown to be integrally involved in the bone remodelling cascade, via apoptosis, in micro-damage systems. However, it is unknown whether this relationship is similar following thermal damage...
June 2016: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/27254280/optimization-of-process-parameters-for-drilled-hole-quality-characteristics-during-cortical-bone-drilling-using-taguchi-method
#12
Gurmeet Singh, Vivek Jain, Dheeraj Gupta, Aman Ghai
Orthopaedic surgery involves drilling of bones to get them fixed at their original position. The drilling process used in orthopaedic surgery is most likely to the mechanical drilling process and there is all likelihood that it may harm the already damaged bone, the surrounding bone tissue and nerves, and the peril is not limited at that. It is very much feared that the recovery of that part may be impeded so that it may not be able to sustain life long. To achieve sustainable orthopaedic surgery, a surgeon must try to control the drilling damage at the time of bone drilling...
September 2016: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/27246485/functional-cortical-reorganization-in-cases-of-cervical-spondylotic-myelopathy-and-changes-associated-with-surgery
#13
Indira Devi Bhagavatula, Dhaval Shukla, Nishanth Sadashiva, Praveen Saligoudar, Chandrajit Prasad, Dhananjaya I Bhat
OBJECTIVE The physiological mechanisms underlying the recovery of motor function after cervical spondylotic myelopathy (CSM) surgery are poorly understood. Neuronal plasticity allows neurons to compensate for injury and disease and to adjust their activities in response to new situations or changes in their environment. Cortical reorganization as well as improvement in corticospinal conduction happens during motor recovery after stroke and spinal cord injury. In this study the authors aimed to understand the cortical changes that occur due to CSM and following CSM surgery and to correlate these changes with functional recovery by using blood oxygen level-dependent (BOLD) functional MRI (fMRI)...
June 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27025984/how-formative-courses-about-damage-control-surgery-and-non-operative-management-improved-outcome-and-survival-in-unstable-politrauma-patients-in-a-mountain-trauma-center
#14
Giovanni Bellanova, Francesco Buccelletti, Riccardo Berletti, Marco Cavana, Giorgio Folgheraiter, Francesca Groppo, Chiara Marchetti, Amelia Marzano, Alessandro Massè, Antonio Musetti, Tina Pelanda, Nicola Ricci, Gregorio Tugnoli, Damiano Papadia, Claudio Ramponi
AIM: Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. MATERIAL OF STUDY: We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27023640/demystifying-damage-control-in-musculoskeletal-trauma
#15
REVIEW
P Bates, P Parker, I McFadyen, I Pallister
Trauma care has evolved rapidly over the past decade. The benefits of operative fracture management in major trauma patients are well recognised. Concerns over early total care arose when applied broadly. The burden of additional surgical trauma could constitute a second hit, fuelling the inflammatory response and precipitating a decline into acute respiratory distress syndrome, sepsis and multiple organ dysfunction syndrome. Temporary external fixation aimed to deliver the benefits of fracture stabilisation without the risk of major surgery...
May 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27009147/curved-versus-straight-stem-uncemented-total-hip-arthroplasty-osteoarthritis-multicenter-trial-custom-design-of-a-prospective-blinded-randomised-controlled-multicentre-trial
#16
RANDOMIZED CONTROLLED TRIAL
Loes W A H van Beers, Jakob van Oldenrijk, Vanessa A B Scholtes, Carel H Geerdink, Bob B A M Niers, Wouter Runne, Mohit Bhandari, Rudolf W Poolman
INTRODUCTION: Answering the demands of an increasingly young and active patient population, recent developments in total hip arthroplasty (THA) have shifted towards minimising tissue damage. The Collum Femoris Preserving (CFP) stem was developed to preserve the trochanteric region of the femur, which potentially preserves the insertion of the gluteus musculature. This might accelerate early postoperative rehabilitation and improve functional outcome. Currently the functional results of the CFP stem have not been compared with conventional straight stems in a randomised controlled trial (RCT)...
March 23, 2016: BMJ Open
https://www.readbyqxmd.com/read/26797912/greater-tuberosity-fractures-does-fracture-assessment-and-treatment-recommendation-vary-based-on-imaging-modality
#17
COMPARATIVE STUDY
Stein J Janssen, Hugo H Hermanussen, Thierry G Guitton, Michel P J van den Bekerom, Derek F P van Deurzen, David Ring
BACKGROUND: For greater tuberosity fractures, 5-mm displacement is a commonly used threshold for recommending surgery; however, it is unclear if displacement can be assessed with this degree of precision and reliability using plain radiographs. It also is unclear if CT images provide additional information that might change decision making. QUESTION/PURPOSES: We asked: (1) Does interobserver agreement for assessment of the amount and direction of fracture-fragment displacement vary based on imaging modality (radiographs only; 2-dimensional [2-D] CT images and radiographs; and 3-dimensional [3-D] and 2-D CT images and radiographs)? (2) Does the likelihood of recommending surgery vary based on imaging modality? (3) Does the level of confidence regarding the decision for treatment vary based on imaging modality? METHODS: We invited 791 orthopaedic surgeons to complete a survey on greater tuberosity fractures...
May 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/26679393/optimising-musculoskeletal-care-for-patients-with-haemophilia
#18
REVIEW
Manuel Carcao, Pamela Hilliard, Miguel A Escobar, Luigi Solimeno, Johnny Mahlangu, Elena Santagostino
Despite recent improvements in the quality of care and treatment outcomes for haemophilia, joint disease remains a major concern for patients with and without inhibitors. Most bleeding episodes occur in the musculoskeletal system, and recurrent bleeding may result in progressive joint damage, leading to haemophilic arthropathy. Consequently, early identification and management of musculoskeletal bleeding episodes are important to prevent crippling deformities and dysfunction. Management strategies should aim at optimising joint function by reducing the frequency of, and preventing, joint bleeds...
December 2015: European Journal of Haematology
https://www.readbyqxmd.com/read/26585736/ultrasound-assisted-external-fixation-a-technique-for-austere-environments
#19
Max Talbot, E J Harvey, R Reindl, P Martineau, P Schneider
INTRODUCTION: Ultrasound-assisted external fixation of long bones has the potential to enhance extremity damage control surgery in locations without fluoroscopy, such as forward surgical elements, the intensive care unit, and spacecraft. This pre-clinical study specifically sought to evaluate orthopaedic surgeons' ability to sonographically define fracture patterns and the associated zone of injury in order to improve surgical decision-making and safely insert Schanz pin percutaneously...
December 2016: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/26297520/successful-total-meniscus-reconstruction-using-a-novel-fiber-reinforced-scaffold-a-16-and-32-week-study-in-an-ovine-model
#20
Aaron R Merriam, Jay M Patel, Brian M Culp, Charles J Gatt, Michael G Dunn
BACKGROUND: Meniscus injuries in the United States result in an estimated 850,000 surgical procedures each year. Although meniscectomies are the most commonly performed orthopaedic surgery, little advancement has been made in meniscus replacement and regeneration, and there is currently no total meniscus replacement device approved by the Food and Drug Administration. HYPOTHESIS: A novel fiber-reinforced meniscus scaffold can be used as a functional total meniscus replacement...
October 2015: American Journal of Sports Medicine
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