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Cheng Liu, Chien-Cheng Huang, Chien-Chin Hsu, Hung-Jung Lin, How-Ran Guo, Shih-Bin Su, Jhi-Joung Wang, Shih-Feng Weng
There is no study about cervical herniated intervertebral disc (cervical HIVD) in physicians in the literature; therefore, we conceived a retrospective nationwide, population-based cohort study to elucidate the topic. We identified 26,038 physicians, 33,057 non-physician healthcare providers (HCPs), and identical numbers of non-HCP references (i.e., general population). All cohorts matched a 1:1 ratio with age and gender, and each were chosen from the Taiwan National Health Insurance Research Database (NHIRD)...
October 2016: Medicine (Baltimore)
Chien-Chang Chen, Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: A cross-sectional study to investigate the association of Osteoporosis Self-Assessment Tool for Asians (OSTA) score with clinical presentation and expenditure of hospitalized adult trauma patients with femoral fractures. Methods: According to the data retrieved from the Trauma Registry System between 1 January 2009 and 31 December 2015, a total of 2086 patients aged ≥40 years and hospitalized for treatment of traumatic femoral bone fracture were categorized as high-risk patients (OSTA < -4, n = 814), medium-risk patients (-1 ≥ OSTA ≥ -4, n = 634), and low-risk patients (OSTA > -1, n = 638)...
October 10, 2016: International Journal of Environmental Research and Public Health
Mehmet Akif Öztürk, Rıdvan Mercan, Kevser Gök, Ahmet Mesut Onat, Bünyamin Kısacık, Gezmiş Kimyon, Ayşe Balkarlı, Arif Kaya, Veli Çobankara, Mehmet Ali Balcı, ÖmerNuri Pamuk, Gözde Yıldırım Çetin, Mehmet Sayarlıoğlu, Soner Şenel, Mehmet Engin Tezcan, Adem Küçük, Kemal Üreten, Şafak Şahin, Abdurrahman Tufan
Although gout is potentially curable, the management of this disease is often suboptimal. In this study, we investigated the treatment of gout in Turkey and also compared the management approaches to gout in different clinical specialties. Three hundred and nineteen consecutive patients (mean age 58.60 ± 12.8 years; 44 females, 275 males) were included in this multicenter study. A standardized form was generated to collect data about the patient's first admission to health care, the specialty of the doctor first diagnosed the gout, the treatment options for gout including attack management, patient referral, chronic treatment including medical treatment, and life style modifications...
October 8, 2016: Clinical Rheumatology
Jacob Babu, Robert M Shalvoy, Steve B Behrens
Meniscal injury is a common cause for presentation to the emergency department or primary care physician's office. Meniscal injuries can be the result of a forceful, twisting event in a young athlete's knee or it can insidiously present in the older patient. Many patients with meniscal pathology appropriately undergo conservative management with a primary care physician while some may need referral to an orthopedist for operative intervention. Arthroscopic surgery to address the menisci is the most frequently performed procedure on the knee and one of the most regularly performed surgeries in orthopedic surgery...
October 4, 2016: Rhode Island Medical Journal
Sajni I Khemchandani
INTRODUCTION: Classic bladder exstrophy (BE) is a rare malformation of the genito-urinary tract affecting 1:50,000 to 1:100,000 live births. The surgical reconstruction of the BE-epispadias complex is challenging for the most experienced pediatric urologists, surgeons, and orthopedists. PURPOSE: To assess the success of staged reconstruction of the BE and long-term effects on the upper urinary tract, renal function, and continence. MATERIALS AND METHODS: This is retrospective study; between 1994 and 2013, 30 patients with BE have undergone stage 1 repair at the institute...
October 2016: Journal of Indian Association of Pediatric Surgeons
Randa K Elmallah, Morad Chughtai, Anton Khlopas, Manoshi Bhowmik-Stoker, Kevin J Bozic, Steven M Kurtz, Michael A Mont
BACKGROUND: With the implementation of the Patient Protection and Affordable Care Act, cost-effectiveness analyses are becoming increasingly important for resource allocation, and particularly for the justification of costly procedures, such as total knee and total hip arthroplasties (TKAs and THAs). Therefore, using the Short Form-6D (SF-6D) utility values, the purpose of this study was to determine (1) the quality-adjusted life years (QALYs) gained and (2) and the cost-effectiveness of undergoing THA and TKA...
August 20, 2016: Journal of Arthroplasty
Mohammadreza Golbakhsh, Mirmostafa Sadaat, Fatemeh Noughani, Ahmadreza Mirbolook, Amirmohammad Gholizadeh, Sadegh Abedi
BACKGROUND: Implant removal is a common procedure in orthopedic surgery which can be associated with many complications such as scar formation, hematoma, nerve injury, infection, and refracture. Indications for orthopedic implant removal have declined in recent years. Most studies have considered orthopedic hardware removal as an unnecessary procedure in the absence of severe complications such as nonunion. Some studies have reported the complications of orthopedic hardware removal to be 24% to 50% dependent on their types and locations as well as on other factors such as patient's condition and the orthopedist's experience...
May 2016: Trauma Monthly
William R VanWye, Donald L Hoover, Sean Willgruber
BACKGROUND AND PURPOSE: Elbow pain can originate from many sources yet have similar signs and symptoms, thereby presenting differential diagnostic challenges. The elbow is commonly injured, thus requiring all clinicians to possess excellent diagnostic skills. CASE DESCRIPTION: A 24-year-old woman slipped and fell on her outstretched left hand, experiencing immediate elbow pain. The same day radiographs were deemed negative by her orthopedist, who referred her to physical therapy with the diagnoses of elbow sprain and contusion...
October 2016: Physiotherapy Theory and Practice
Matthew Lilley, Michael Krosin, Tennyson L Lynch, Jeremi Leasure
Despite significant research documenting the detrimental effects of tobacco, the orthopedic literature lacks evidence regarding how surgeons alter their management of elective surgery when patients use nicotine. To better understand how patients' use of nicotine influences orthopedic surgeons' pre- and postoperative management of elective surgery, a 9-question paper survey was distributed at the 2012 annual meeting of the American Academy of Orthopaedic Surgeons among attending US orthopedic surgeons, including general orthopedists and specialty-trained orthopedic surgeons...
September 8, 2016: Orthopedics
Timothy L Miller, Thomas M Best
Stress fractures and other bony stress injuries occur along a spectrum of severity which can impact treatment and prognosis. When treating these injuries, it should be borne in mind that no two stress fractures behave exactly alike. Given that they are not a consistent injury, standardized treatment protocols can be challenging to develop. Treatment should be individualized to the patient or athlete, the causative activity, the anatomical site, and the severity of the injury. A holistic approach to the treatment of the most difficult stress fractures should be taken by orthopedists and sports medicine specialists...
2016: Journal of Orthopaedic Surgery and Research
Hoejeong Chung, Yeo-Seung Yoon, Ji-Soo Shin, John Junghun Shin, Doosup Kim
Shoulder dislocation is frequently encountered by orthopedists, and closed manipulation is often sufficient to treat the injury in an acute setting. Although most dislocations are diagnosed and managed promptly, there are rare cases that are missed or neglected, leading to a chronically dislocated state of the joint. They are usually irreducible and cause considerable pain and functional disability in most affected patients, prompting the need to find a surgical method to reverse the worsening conditions caused by the dislocated joint...
September 2016: Clinics in Orthopedic Surgery
Wojciech Kiebzak, Arkadiusz Żurawski, Michał Dwornik
BACKGROUND: Developmental dysplasia of the hip joint is one of the most common congenital defects and often results in functional and structural disorders. Such cases particularly demand optimizing therapeutic effects and maximally reducing the duration of therapy. PURPOSE: The aim of this case report is to present the therapeutic process in a child with developmental hip dysplasia. CASE REPORT: This is a case report of a female child with a birth weight of 2,800 g and an Apgar score of 9 points born to a gravida 3 para 3 mother at 37 weeks...
2016: Therapeutics and Clinical Risk Management
Hui-Mei Hsu, I-Chiu Chang, Ta-Wei Lai
OBJECTIVES: Using Computer-assisted orthopedic navigation surgery system (CAOS) has many advantages but is not mandatory to use during an orthopedic surgery. Therefore, opinions obtained from clinical orthopedists with this system are valuable. This paper integrates technology acceptance model and theory of planned behavior to examine the determinants of continued CAOS use to facilitate user management. METHODS: Opinions from orthopedists who had used a CAOS for at least two years were collected through a cross-sectional survey to verify the research framework...
October 2016: International Journal of Medical Informatics
Bryan M Saltzman, Benjamin D Kuhns, Alexander E Weber, Adam Yanke, Shane J Nho
The use of biologic adjuvants in the treatment of operative and nonoperative orthopedic injuries continues to expand in concert with our understanding of the acute and chronic healing process of musculoskeletal injuries. Stem cell treatments in orthopedics are among the most commonly explored options, and have found varying levels of success in promoting osseous and soft tissue healing. Basic science and translational studies have demonstrated the potential for broad application of stem cells in the treatment of a growing number of musculoskeletal injuries...
July 2016: American Journal of Orthopedics
Hidenori Suzuki, Tsukasa Kanchiku, Yasuaki Imajo, Yuichiro Yoshida, Norihiro Nishida, Toshihiko Taguchi
STUDY DESIGN: Cross sectional data from the Yamaguchi low back pain study conducted in Yamaguchi prefecture, Japan, was used for this analysis. METHODS: A total of 320 patients were recruited from walk-in orthopedic clinics in Yamaguchi Prefecture, Japan. Patients visited the clinics primarily for low back pain (LBP) and sought treatment between April and May 2015. A self-questionnaire was completed by patients, while radiographic testing and neurological and physical examination was performed by the orthopedist in each hospital...
2016: PloS One
Kelms Amoo-Achampong, Benedict U Nwachukwu, Frank McCormick
BACKGROUND: The utilization of musculoskeletal ultrasound has expanded within the setting of the orthopedic clinic as a cost-effective, point-of-care diagnostic tool for shoulder pathology. In experienced hands, ultrasound exhibits capabilities equivalent to that of magnetic resonance imaging in the diagnosis of many shoulder diseases including full-thickness and partial-thickness rotator cuff tears. Although similarly effective in identifying additional shoulder disease processes, major obstacles to its widespread use include user dependence and intrinsic limitation to extra-articular diagnosis...
August 22, 2016: Physician and Sportsmedicine
William R VanWye, Jase Pinerola, Karen Craig Ogle, Harvey W Wallmann
BACKGROUND AND PURPOSE: Screening for referral, regardless of setting, is the responsibility of all physical therapists. A serious condition that sports physical therapists may encounter is upper extremity (UE) deep venous thrombosis (DVT), which can result in the important and sometimes fatal complication of pulmonary embolism. CASE DESCRIPTION: A 22 year-old male right-hand dominant collegiate pitcher was referred for physical therapist evaluation and treatment secondary to acute right UE pain and swelling...
August 2016: International Journal of Sports Physical Therapy
M J Rivlin, J H Kan, E K Schallert, S P Jadhav, W Zhang, S B Rosenfeld
PURPOSE: Spica magnectic resonance imaging (MRI) is an established technique for postoperative determination of hip reduction in patients treated for developmental dysplasia of the hip (DDH). A hip abduction angle >55° is considered excessive and has been associated with epiphyseal osteonecrosis. Our purpose was to establish objective criteria for measuring hip abduction angles on MRI after hip reduction and spica casting in patients with DDH, and evaluate reproducibility and reliability of angle measurement using these criteria...
October 2016: Journal of Children's Orthopaedics
Hye-Young Jung, Judy Wawira Gichoya, Joshua R Vest
BACKGROUND: An increasing number of technologies allow providers to access the results of imaging studies. This study examined differences in access of radiology images compared with text-only reports through a health information exchange system by health care professionals. METHODS: The study sample included 157,256 historical sessions from a health information exchange system that enabled 1,670 physicians and non-physicians to access text-based reports and imaging over the period 2013 to 2014...
July 28, 2016: Journal of the American College of Radiology: JACR
Ying Jiang, Yong-Fei Guo, Ya-Ke Meng, Lei Zhu, Ai-Ming Chen
INTRODUCTION: The refractory post-operative diaphyseal femur fracture (DFF) non-union is extremely difficult to treat and remains severe challenges for orthopedists. Although several traditional internal fixations and novel biomedical techniques have been used in managing this complication, its treatment is still fraught with severe challenges. PATIENTS AND METHODS: Starting from 1999, 5 patients after three previous internal fixation operations showing refractory DFF non-union underwent the comprehensive fibular autograft with double metal locking plates fixation (cFALP) surgery...
October 2016: Injury
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