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Trauma orthopaedics

Pooya Hosseinzadeh, Clarabelle A DeVries, Ena Nielsen, Lindsay A Andras, Megan Mignemi, Jeffrey R Sawyer, John M Flynn, Stephen A Albanese
BACKGROUND: There has been an increase in the number of the graduates of pediatric orthopaedic fellowship programs over the past decade creating the potential for increased competition in the field. The purpose of this study was to analyze the effect of increased number of pediatric orthopaedic fellowship graduates on case volume as well as the type of procedures performed by recent graduates of pediatric orthopaedic fellowship programs from 2004 to 2014. METHODS: Case logs submitted for the American Board of Orthopaedic Surgery Part II examination by applicants with the self-declared subspecialty of pediatric orthopaedics from 2004 to 2014 were analyzed...
June 18, 2018: Journal of Pediatric Orthopedics
Philipp Niemeyer, Christoph Becher, Matthias Buhs, Stefan Fickert, Kolja Gelse, Daniel Günther, Raphael Kaelin, Peter Kreuz, Jörg Lützner, Stefan Nehrer, Henning Madry, Stefan Marlovits, Julian Mehl, Henning Ott, Matthias Pietschmann, Gunther Spahn, Thomas Tischer, Martin Volz, Markus Walther, Götz Welsch, Johannes Zellner, Wolfgang Zinser, Peter Angele
Surgical principles for treatment of full-thickness cartilage defects of the knee include bone marrow stimulation techniques (i.e. arthroscopic microfracturing) and transplantation techniques (i.e. autologous chondrocyte implantation and osteochondral transplantation). On the basis of increasing scientific evidence, indications for these established therapeutical concepts have been specified and clear recommendations for practical use have been given. Within recent years, matrix-augmented bone marrow stimulation has been established as a new treatment concept for chondral lesions...
June 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Jacob D Gire, Sam Y Jiang, Michael J Gardner, Julius A Bishop
OBJECTIVE: To determine how the utilization of open versus percutaneous treatment of posterior pelvic ring injuries in early career orthopaedic surgeons has changed over time. METHODS: Case log data from surgeons testing in the trauma subspecialty for Part II of the ABOS examination from 2003 to 2015 were evaluated. CPT codes for percutaneous fixation (27216) and open fixation (27218) of the posterior pelvic ring were evaluated using a regression analysis. RESULTS: A total of 377 candidates performed 2,095 posterior ring stabilization procedures (1,626 percutaneous, 469 open)...
May 28, 2018: Journal of Orthopaedic Trauma
Joshua Brice, Eric Lindvall, Nathan Hoekzema, Lisa Husak
OBJECTIVES: To identify the incidence of orthopaedic injuries secondary to dog bites, determine the responsible breeds and assess the severity of injury by dog breed. DESIGN: Retrospective. SETTING: Single Level 1 trauma center. PATIENTS: Ninety-five patients treated for a dog bite that resulted in an orthopaedic injury between January 2010 and July 2016. INTERVENTION: Patients were treated according to their specific orthopaedic injury...
May 28, 2018: Journal of Orthopaedic Trauma
Sanjit R Konda, Ariana Lott, Hesham Saleh, Jordan Gales, Kenneth A Egol
OBJECTIVES: Determine if a novel inpatient mortality risk assessment tool designed to be calculated in the emergency department (ED) setting can risk stratify patient reported functional outcomes and mortality at one year. DESIGN: Prospective cohort SETTING:: Academic level one trauma center PATIENTS:: 685 patients >55 years old who were orthopaedic surgery consults or trauma surgery consults in the ED between 10/1/2014 and 9/30/2015. INTERVENTION: Calculation of validated trauma triage score (STTGMA) using each patient's demographics, injury severity, and functional status MAIN OUTCOME MEASUREMENTS:: mortality, EQ-5D questionnaire, and percent return to baseline function since their hospitalization at one-year post hospitalization...
June 4, 2018: Journal of Orthopaedic Trauma
Basem Ishak, Till Schneider, Valerie Gimmy, Andreas W Unterberg, Karl L Kiening
OBJECTIVES: To assess mid-term safety and efficacy of a modified Goel-Harms technique for the treatment of odontoid instabilities. DESIGN: Longitudinal prospective cohort study. SETTING: Urban Level 1 Trauma Center in Southwest Germany. PATIENTS/PARTICIPANTS: Orthopaedic and neurosurgical trauma patients older than 18 years admitted for ≤ 24 hours. MAIN OUTCOME MEASUREMENTS: The outcome was evaluated with respect to neurological outcome, radiological outcome and surgical complications...
June 4, 2018: Journal of Orthopaedic Trauma
Helmut A Schmelz, Max Geraedts
BACKGROUND: Growing numbers of patients in orthopaedic and trauma surgery are obese. The risks involved are e.g. surgical complications, higher costs for longer hospital stays or special operating tables. It is a moot point whether revenues in the German DRG system cover the individual costs in relation to patients' body mass index (BMI) and in which area of hospital care potentially higher costs occur. MATERIAL AND METHODS: Data related to BMI, individual costs and revenues were extracted from the hospital information system for 13,833 patients of a large hospital who were operated in 2007 to 2010 on their upper or lower extremities...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Alexander Joeris, Christian Knoll, Vasiliki Kalampoki, Andrea Blumenthal, George Gaskell
OBJECTIVE: To gain information about the advantages/disadvantages of an implementation of patient-reported outcome measures (PROM) into the clinical routine of trauma/orthopaedic surgeons, and to identify the technical constraints confronting a successful implementation of PROMs. DESIGN: Online survey. PARTICIPANTS: Surgeons who are members of the AO Foundation. MEASURES: Participants answered questions regarding demographics, their familiarity with specific and generic PROMs and the use of PROMs in clinical routine...
June 11, 2018: BMJ Open
Anuj Agrawal
BACKGROUND: The Orthopaedic Trauma Association (OTA) classification scheme for open fractures has improved precision, validity and reliability over the modified Gustilo classification system. However, it needs to be modified into a simple and practical classification system to gain widespread acceptance and application. MATERIAL AND METHODS: We devised a new "unified" classification of open fractures based on the Gustilo and OTA classification systems...
June 4, 2018: Injury
M Gathen, K G Makridis, P V Giannoudis
No abstract text is available yet for this article.
June 2018: Injury
Simon Décary, Michel Fallaha, Sylvain Belzile, Johanne Martel-Pelletier, Jean-Pierre Pelletier, Debbie Feldman, Marie-Pierre Sylvestre, Pascal-André Vendittoli, François Desmeules
OBJECTIVE: To assess the diagnostic validity of clusters combining history elements and physical examination tests to diagnose partial or complete anterior cruciate ligament (ACL) tears. DESIGN: Prospective diagnostic study. SETTINGS: Orthopaedic clinics (n = 2), family medicine clinics (n = 2) and community-dwelling. PARTICIPANTS: Consecutive patients with a knee complaint (n = 279) and consulting one of the participating orthopaedic surgeons (n = 3) or sport medicine physicians (n = 2)...
2018: PloS One
Sandro Hodel, Tobias Koller, Björn-Christian Link, Marco Rossi, Reto Babst, Frank J P Beeres
INTRODUCTION: Temporary external fixation is a viable option for numerous conditions and fixations in orthopaedic and trauma surgery. If the external fixator is left in place it is necessary to disinfect it prior to surgery, yet the subsequent risk for bacterial contamination of the surgical site originating from the external fixator remains unknown. MATERIAL AND METHODS: In a prospective study, samples were taken at the time of definitive osteosynthesis to assess bacterial contamination of the surgical site and the external fixator in twenty consecutive patients treated with temporary external fixation for closed fractures from October 2016 until March 2017...
June 4, 2018: Injury
Nikita Lakomkin, Aristides I Cruz, Peter D Fabricant, Andrew Georgiadis, J Todd R Lawrence
OBJECTIVE: To assess the risk of glove perforation during common maneuvers or events in trauma-related orthopedic surgical procedures. METHODS: Four investigators executed six high-risk maneuvers in a simulated laboratory setting. Alternative techniques were also performed for most maneuvers. Glove integrity was examined by two standard methods of fluid leak testing. The rates of perforation were compared between techniques using Chi-squared and Fisher's exact tests...
May 28, 2018: Journal of Orthopaedic Trauma
Shaun F Steeby, William H Harvin, John R Worley, Gregory J Della Rocca, David A Volgas, James P Stannard, Brett D Crist
OBJECTIVE: To assess the "Dedicated Orthopaedic Trauma Operating Room" (DOTOR) effect on management and outcomes of open tibia and femur fractures. DESIGN: Retrospective chart review LOCATION:: University Level I Trauma Center METHODS:: Patients categorized into those managed in the DOTOR versus those managed in a standard on-call operating room (OCOR). Data collected includes patient and injury characteristics, time to debridement, and patient outcomes...
May 28, 2018: Journal of Orthopaedic Trauma
Kevin R Green, Jarelys M Hernandez-Jimenez, Carmen Liliana Isache, Rafik Jacob
A 33-year-old woman with history of HIV presented with 4 months of gradually progressing right hip pain and was found to have avascular necrosis (AVN) of both femoral heads. She had no other risk factors for AVN including sickle cell disease, systemic lupus erythematosus, prolonged steroid used or trauma. She initially failed conservative management and ultimately had bilateral hip core decompressions. After decompression therapy, the left femoral head collapsed and patient underwent a left total hip arthroplasty...
June 6, 2018: BMJ Case Reports
David R Tribble, Louis R Lewandowski, Benjamin K Potter, Joseph L Petfield, Daniel J Stinner, Anuradha Ganesan, Margot Krauss, Clinton K Murray
OBJECTIVES: We assessed osteomyelitis risk factors in U.S. military personnel with combat-related open tibia fractures (2003-2009). METHODS: Patients with open tibia fractures who met diagnostic criteria of osteomyelitis were identified as cases using Military Health System data and verified through medical record review. Controls were patients with open tibia fractures who did not meet osteomyelitis criteria. Gustilo-Andersen (GA) fracture classification scheme was modified to include transtibial amputations (TTAs) as the most severe level...
May 24, 2018: Journal of Orthopaedic Trauma
Matthias Münzberg, Miriam Rüsseler, Martin Egerth, Anna Katharina Doepfer, Manuel Mutschler, Richard Stange, Bertil Bouillon, Bernd Kladny, Reinhard Hoffmann
INTRODUCTION: The development of a new safety culture in orthopaedics and trauma surgery needs to be based on the knowledge of the status quo. The objective of this research was therefore to perform a survey of orthopaedic and trauma surgeons to achieve a subjective assessment of the frequency and causes of "insecurities" or errors in daily practice. METHODS: Based on current literature, an online questionnaire was created by a team of experts (26 questions total) and was sent via e-mail to all active members of a medical society (DGOU) in April 2015...
June 5, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
M Sheehan, Deasy McFadden
Farming is the most dangerous occupation in Ireland1 and the incidence of farm accidents is rising. This study examines major farm animal-related trauma treated at Cork University Hospital over a 5 year period. There were 54 patients admitted to Cork University Hospital (C.U.H.) with major farm animal-related trauma. The median age was 56 years, 85% were male and the median hospital length of stay was four days. Older patients had longer lengths of stay; 5.5 vs 4 days (p=0.026). Tibia/fibula fractures were the most common injuries (N=13, 24%); head injury occurred in six patients (11%)...
January 10, 2018: Irish Medical Journal
Giuseppe Filardo, Luca Andriolo, Giorgio di Laura Frattura, Francesca Napoli, Stefano Zaffagnini, Christian Candrian
PURPOSE: During anterior cruciate ligament (ACL) injury, the large external forces responsible for ligament rupture cause a violent impact between tibial and femoral articular cartilage, which is transferred to bone resulting in bone bruise detectable at MRI. Several aspects remain controversial and await evidence on how this MRI finding should be managed while addressing the ligament lesion. Thus, the aim of the present review was to document the evidence of all available literature on the role of bone bruise associated with ACL lesions...
June 5, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
John M Ibrahim, Devin Conway, Billy T Haonga, Edmund N Eliezer, Saam Morshed, David W Shearer
BACKGROUND: Little data exists on the negative impact of orthopaedic trauma on quality of life (QOL) in low- and middle-income countries (LMICs). The goal of this study is to investigate the factors associated with lower QOL after operative fixation of femoral shaft fractures in adult patients in a low-resource setting. METHODS: This prospective cohort study followed 272 factures in adults undergoing operative fixation for diaphyseal femur fractures at Tanzania...
May 23, 2018: Injury
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