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Bones joints soft tissues

H Claude Sagi, David Donohue, Seth Cooper, David P Barei, Justin Siebler, Michael T Archdeacon, Marcus Sciadini, Michelle Romeo, Patrick F Bergin, Thomas Higgins, Hassan Mir
OBJECTIVES: The current literature focuses on wound severity, time to debridement and antibiotic administration with respect to risk of infection after open fracture. The purpose of this analysis was to determine if either the incidence of post-traumatic infection or causative organism varies with treating institution or the season in which the open fracture occurred. DESIGN: Retrospective review. SETTING: Seven level-one regional referral trauma centers located in each of the seven climatic regions of the continental United States (Northwest; High Plains; Midwest/Ohio Valley; New England/Mid-Atlantic; Southeast; South; and Southwest)...
October 7, 2016: Journal of Orthopaedic Trauma
Chad M Teven, Julie Mhlaba, Annemarie O'Connor, Lawrence J Gottlieb
The majority of surgical burn care involves the use of skin grafts. However, there are cases when flaps are required or provide superior outcomes both in the acute setting and for postburn reconstruction. Rarely discussed in the context of burn care, the perforator-based propeller flap is an important option to consider. We describe our experience with perforator-based propeller flaps in the acute and reconstructive phases of burn care. We reviewed demographics, indications, operative details, and outcomes for patients whose burn care included the use of a perforator-based propeller flap at our institution from May 2007 to April 2015...
October 7, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
G Suleyman, R Kenney, M J Zervos, A Weinmann
WHAT IS KNOWN AND OBJECTIVE: Outpatient parenteral therapy (OPAT) has become a safe and effective modality for patients requiring intravenous or prolonged antimicrobial therapy since the 1970s. It is being increasingly utilized in various settings; however, studies evaluating the safety and efficacy of clinic-based OPAT are limited. Since 2012, patients being considered for OPAT have required an infectious disease (ID) consultation at our institution. Candidates receiving once-daily antimicrobials who were ineligible for home infusion or nursing home placement as determined by their insurance companies and those who preferred the clinic over nursing home or home infusion were referred to the ID clinic...
October 16, 2016: Journal of Clinical Pharmacy and Therapeutics
A Dangin, N Tardy, M Wettstein, O May, N Bonin
With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors concern hip joint bone architecture or peri-articular soft tissues. Bone abnormalities are identified on hip assessment parameters. Soft tissues also play a key role in the static and dynamic stability of the hip: the joint capsule, labrum, ligamentum teres and adjacent myotendinous structures affect joint coaptation; any abnormality or iatrogenic lesion concerning these structures may constitute a risk factor for microinstability...
October 12, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Bradley Schoch, Jean-David Werthel, John W Sperling, Robert H Cofield, Joaquin Sanchez-Sotelo
INTRODUCTION: Charcot arthropathy is a rare cause of debilitating joint destruction. Shoulder arthroplasty for Charcot arthropathy is challenging secondary to local bone and soft tissue loss, lack of protective sensation, and altered muscle control. The purpose of this study is to review the outcomes, complications, and survivorship of shoulder arthroplasty for Charcot arthropathy. METHODS: Between January 2000 and December 2011, ten shoulders with Charcot arthropathy were treated with shoulder arthroplasty at our Institution (six hemiarthroplasty, one total shoulder arthroplasty, three reverse shoulder arthroplasty)...
October 14, 2016: International Orthopaedics
Marco Ritelli, Silvia Morlino, Edoardo Giacopuzzi, Giulia Carini, Valeria Cinquina, Nicola Chiarelli, Silvia Majore, Marina Colombi, Marco Castori
Filamin A is an X-linked, ubiquitous actin-binding protein whose mutations are associated to multiple disorders with limited genotype-phenotype correlations. While gain-of-function mutations cause various bone dysplasias, loss-of-function variants are the most common cause of periventricular nodular heterotopias with variable soft connective tissue involvement, as well as X-linked cardiac valvular dystrophy (XCVD). The term "Ehlers-Danlos syndrome (EDS) with periventricular heterotopias" has been used in females with neurological, cardiovascular, integument and joint manifestations, but this nosology is still a matter of debate...
October 14, 2016: American Journal of Medical Genetics. Part A
Rachel M Frank, Anthony A Romeo, Matthew T Provencher
Anterior glenoid bone loss is present in nearly all cases of recurrent anterior glenohumeral instability. Treating glenoid bone loss in the setting of recurrent instability is challenging, and often, soft tissue stabilization procedures in isolation are inadequate. The nonanatomic, incongruous joint resulting from most bony augmentation procedures has motivated investigators to find an alternative solution. Recently, the use of fresh distal tibia allograft has been reported as an anatomic, osteoarticular reconstructive option for restoring the glenoid arc and maintaining glenohumeral congruency...
October 13, 2016: Orthopedics
David Wasylynko
OBJECTIVE: To present a case of chronic elbow pain as a result of a hidden underlying osteochondral defect. CLINICAL FEATURES: A 17-year old baseball player presented with chronic lateral elbow pain. Examination revealed swelling of the elbow with signs of possible ligament, muscle, and tendon injury. DIAGNOSIS AND TREATMENT: Although there was apparent soft-tissue injury, the elbow swelling created immediate suspicion of a more serious underlying condition...
September 2016: Journal of the Canadian Chiropractic Association
Nicholas Manolios, Marina Ali, Bradley Camden, Elham Aflaky, Katrina Pavic, Andrew Markewycz, Robert De Costa, Socrates Angelides
OBJECTIVE: To evaluate the clinical utility of a novel radiotracer, (99m)Tc-glucosamine, in assessing disease activity of both rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Material and Methods: Twenty-five patients with RA (nine males and 16 females) and 12 patients with AS (all male) at various stages of disease were recruited for the study. A clinical history and examination was performed, followed by the measurement of hematological, biochemical, and autoimmune serological parameters to assess disease activity...
June 2016: Eur J Rheumatol
Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
Aditya Arora, Anjaney Kothari, Dhirendra S Katti
: Matrix stiffness is known to play a pivotal role in cellular differentiation. Studies have shown that soft scaffolds (<2-3kPa) promote cellular aggregation and chondrogenesis, whereas, stiffer ones (>10kPa) show poor chondrogenesis in vitro. In this work we investigated if fibrin matrix from clotted blood can act as a soft surrogate which nullifies the influence of the underlying stiff scaffold, thus promoting chondrogenesis irrespective of bulk scale scaffold stiffness. For this we performed in vitro chondrogenesis on soft (∼1...
September 28, 2016: Acta Biomaterialia
Tomohiro Hikata, Nobuyuki Fujita, Akio Iwanami, Kota Watanabe, Masaya Nakamura, Morio Matsumoto, Ken Ishii
STUDY DESIGN: Case report and systematic review of the literature. OBJECTIVE: To describe a rare case of remodeling of the cervical facet joint after the microendoscopic resection of an osteoid osteoma. SUMMARY OF BACKGROUND DATA: Osteoid osteoma, the third most common benign bone tumor, is often treated by image-guided percutaneous removal of the nidus. However, percutaneous resection poses technical difficulties when the tumor is located near the spinal cord or nerve roots...
October 1, 2016: Spine
Yuki Makino, Minoru Shigekawa, Tadashi Kegasawa, Takahiro Suda, Teppei Yoshioka, Kiyoshi Iwahashi, Kenji Ikezawa, Ryotaro Sakamori, Takayuki Yakushijin, Jun Kajihara, Yoshito Tomimaru, Hidetoshi Eguchi, Yoshinori Imura, Hidetatsu Outani, Norifumi Naka, Keiichiro Honma, Eiichi Morii, Tomohide Tatsumi, Naoki Hiramatsu, Tetsuo Takehara
INTRODUCTION: Synovial sarcoma is a malignant soft tissue sarcoma which arises near joints. The most frequent metastasis sites of synovial sarcoma are the lungs, lymph nodes, and bone. Pancreatic metastasis is quite rare; only 3 cases have been reported worldwide to date. We herein present the 4th case of pancreatic metastasis from synovial sarcoma. METHODS AND RESULTS: A 32-year-old man underwent extended excision of synovial sarcoma in the left pelvis and femur in 2009...
September 2016: Medicine (Baltimore)
Iwona Sudoł-Szopińska, Elżbieta Grochowska, Piotr Gietka, Mateusz Płaza, Grzegorz Pracoń, Fadhil Saied, Marta Walentowska-Janowicz
Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals in the developmental age. Radiography, which was described in the first part of this publication, is the standard modality in the assessment of this condition. Ultrasound and magnetic resonance imaging enable early detection of the disease which affects soft tissues, as well as bones. Ultrasound assessment involves: joint cavities, tendon sheaths and bursae for the presence of synovitis, intraand extraarticular fat tissue to visualize signs of inflammation, hyaline cartilage, cartilaginous epiphysis and subchondral bone to detect cysts and erosions, and ligaments, tendons and their entheses for signs of enthesopathies and tendinopathies...
September 2016: Journal of Ultrasonography
Iwona Sudoł-Szopińska, Genowefa Matuszewska, Piotr Gietka, Mateusz Płaza, Marta Walentowska-Janowicz
Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals at the developmental age. Radiography is the primary modality employed in the diagnostic imaging in order to identify changes typical of this disease entity and rule out other bone-related pathologies, such as neoplasms, posttraumatic changes, developmental defects and other forms of arthritis. The standard procedure involves the performance of comparative joint radiographs in two planes...
September 2016: Journal of Ultrasonography
Boris Dousteyssier, Jérôme Molimard, Chafiaa Hamitouche, Woo Suck Han, Eric Stindel
OBJECTIVE: With cartilage physiopathology, knee stability and therefore the subsequent loadings on ligaments have a strong impact in the development of knee osteoarthritis. To understand this phenomenon, authors are proposing different knee models. Most of them are without any flexion, some have been introduced by controlling actively muscular groups. In this case, the forces used to achieve the flexion may not be physiological, and the pressure on the articulation can be questioned. We propose a mixed approach, both using medical imaging (MRI, EOS X-ray system) and force platform in conjunction with a finite element model...
September 2016: Annals of Physical and Rehabilitation Medicine
Rodrigo Díaz Fernández
BACKGROUND: Percutaneous surgery to correct deformities of the forefoot presents the advantages of using a minimal incision, which involves less soft tissue damage and less risk of wound complications. For severe deformities, percutaneous techniques have not been proven as effective. We propose a technique for the treatment of severe hallux valgus. METHODS: In a sample of 52 feet operated on 48 patients, we performed a double percutaneous osteotomy (closure proximal osteotomy and a distal Akin) or triple when a Reverdin-Isham osteotomy was added...
September 23, 2016: Foot & Ankle International
Hyun Ho Han, Byung Yeun Kwon, Sung No Jung, Suk-Ho Moon
Occupational injuries to digits due to hydrofluoric acid (HFA) are frequently encountered. They have distinctive features, including intense pain, progressive tissue necrosis, and possible bone erosion. To minimize tissue damage, it is of great importance to execute prudent preoperative assessment and determine the correct surgical modality to reconstruct and maintain the function of the hand. However, proper protocols for fingers have not been presented in previous studies. Eight cases with HFA burn to digits were presented to the emergency room...
September 17, 2016: Burns: Journal of the International Society for Burn Injuries
W Hong, D Raunig, B Lundin
INTRODUCTION: Most previous joint imaging scales for haemophilia have focused on earlier disease stages observed in younger patients. AIM: We sought to demonstrate that the 45-item extended magnetic resonance imaging (eMRI) scale is a valid instrument for measuring joint status in adults with severe haemophilia A. METHODS: Six scale categories (effusion/haemarthrosis, synovial hypertrophy, hemosiderin, erosion, subchondral cysts and cartilage loss) in two domains (soft tissue [range = 0-9] and osteochondral [range = 0-36]) were evaluated for each joint...
September 19, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
M A Clara-Altamirano, D Y García-Ortega, J L Martínez-Tlahuel, H Martínez-Said, C H S Caro-Sánchez, G C García-Ruíz, C R Mejía-Salazar, M Cuellar-Hubbe
Osteosarcoma is the most frequent primary malignant bone tumor. It is characterized by osteoid production by tumor cells. Its most frequent location is in the metaphyses of long bones, but a purely diaphyseal presentation is reported in 10% of cases. We report the case of a female 25 year-old patient whose symptoms of pain and swelling of the right mid thigh started four months before, without an apparent cause. Femur X-rays showed a tumor in the femoral shaft. The MRI showed extension to soft tissues with no compromise of the neurovascular bundle...
January 2016: Acta Ortopédica Mexicana
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