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https://www.readbyqxmd.com/read/28342739/supervised-physical-therapy-vs-home-exercise-program-for-patients-with-distal-radius-fracture-a-single-blind-randomized-clinical-study
#1
Héctor Gutiérrez-Espinoza, David Rubio-Oyarzún, Cristian Olguín-Huerta, Rodrigo Gutiérrez-Monclus, Sebastian Pinto-Concha, Gonzalo Gana-Hervias
STUDY DESIGN: Randomized clinical study. INTRODUCTION: Supervised physical therapy (PT) and home exercise programs (HEPs) are frequently used in the rehabilitation of patients with distal radius fracture (DRF). However, there is no consensus as to whether unsupervised HEP provides comparable benefits to those achieved by supervised PT. PURPOSE OF THE STUDY: To compare the improvements in pain and functional status between a supervised PT program and unsupervised HEP in DRF patients older than 60 years...
March 22, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28340130/falling-down-on-the-job-evaluation-and-treatment-of-fall-risk-among-older-adults-with-upper-extremity-fragility-fractures
#2
Christine M McDonough, Carrie H Colla, Donald Carmichael, Anna N A Tosteson, Tor D Tosteson, John-Erik Bell, Robert V Cantu, Jonathan D Lurie, Julie P W Bynum
Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: To describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods Subjects: Fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures were studied using Carrier and Outpatient Hospital files...
March 2, 2017: Physical Therapy
https://www.readbyqxmd.com/read/28326303/current-role-and-application-of-teriparatide-in-fracture-healing-of-osteoporotic-patients-a-systematic-review
#3
Sang-Min Kim, Kyung-Chung Kang, Ji Wan Kim, Seung-Jae Lim, Myung Hoon Hahn
BACKGROUND: The use of osteoanabolic agents to facilitate fracture healing has been of heightened interest to the field of orthopaedic trauma. This study aimed to evaluate the evidence of teriparatide for fracture healing and functional recovery in osteoporotic patients. METHODS: We performed a literature search in PubMed, EMBASE, Web of Science, and the Cochrane Library using terms including "Fracture" [tiab] AND "Teriparatide [tiab] OR "PTH" [tiab]. RESULTS: This systematic review included 6 randomized clinical trials, 4 well-controlled retrospective studies, and 1 retrospective post hoc subgroup analysis...
February 2017: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/28325701/evaluation-of-flexor-pollicis-longus-tendon-attrition-using-color-doppler-imaging-after-volar-plate-fixation-for-distal-radius-fracture
#4
Yoshitaka Tanaka, Hiroyuki Gotani, Koichi Yano, Kosuke Sasaki, Yoshitaka Hamada
PURPOSE: Early diagnosis of attritional wear of the flexor pollicis longus (FPL) tendon is essential in preventing subsequent tendon rupture. There are currently few objective methods of assessing FPL attrition. We hypothesized that color Doppler imaging could visibly detect FPL tendon attrition, and analyzed our results. METHODS: We evaluated ultrasound imaging of the contact between the FPL tendon and a volar locking plate using the real-time B-mode and Doppler waveforms of the FPL tendon using the continuous Doppler wave mode in 40 patients who underwent fixation of the distal volar locking plate for distal radius fracture...
March 18, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28325423/stage%C3%A2-iv-kienb%C3%A3-ck-s-disease-proximal-row-carpectomy-and-application-of-rcpi-implant
#5
A Marcuzzi, F Colantonio, G Petrella, H Ozben, A Russomando
Kienböck disease is an aseptic osteonecrosis of the lunate, which gradually leads to total carpal collapse. Lichtman's classification relates radiographic evidence of wrist damage to four different stages and supports surgical decision-making. This study pertains to six patients (2 males and 4 females) affected by stage IV Kienböck's disease who underwent proximal row carpectomy and received an RCPI implant. The clinical outcomes consisted of wrist range of motion (ROM), pain on a VAS scale (0-10), the DASH score and the patient's level of satisfaction...
April 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28323765/misuse-of-opioids-in-orthopaedic-postoperative-patients
#6
Anup Gangavalli, Ajith Malige, George Terres, Saqib Rehman, Chinenye Nwachuku
OBJECTIVE: In light of the recent uptrend in the prescription of opioids, this study seeks to identify patterns of opioid misuse among orthopaedic postoperative patients and principal external sources in obtaining these medications. DESIGN: Ten-month survey-based study. SETTING: Two Level I trauma centers (urban and suburban). PATIENTS/PARTICIPANTS: Two hundred seven patients between the ages of 18 and 89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28296780/type-iii-monteggia-fracture-with-posterior-interosseous-nerve-injury-in-a-child-a-case-report
#7
Jing Wang, Min Chen, Jiang Du
RATIONALE: Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail. PATIENT CONCERNS: Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Activity in his elbow was restricted, and his ability to extend his wrist and fingers was impaired. DIAGNOSES: Type III Monteggia elbow fracture-dislocation consisting of radial head dislocation and malunion of the ulna associated with posterior interosseous nerve palsy were confirmed, which requiring surgical treatment...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28291522/fractures-and-dislocations-of-the-hand-in-polytrauma-patients-incidence-injury-pattern-and-functional-outcome
#8
Steven Ferree, Quirine M J van der Vliet, Mark van Heijl, Roderick M Houwert, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. METHODS: A single centre retrospective cohort study was performed at a level 1 trauma centre...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28291431/is-it-possible-to-avoid-intra-articular-screw-penetration-with-minimal-use-of-fluoroscopy-in-the-application-of-distal-radius-volar-plate
#9
Cengiz Aldemir, Fatih Duygun
OBJECTIVES: This study aims to investigate whether or not it is possible to avoid intra-articular screw penetration in the application of distal radius volar plate with minimal use of fluoroscopy and thereby reduce to a minimum the risk of exposure of the surgical team to radiation. PATIENTS AND METHODS: Volar plate with distal screw application with minimal use of fluoroscopy was performed in a total of 50 patients (22 males, 28 females; mean age 43.52 years; range 18 to 76 years) with unstable distal radius fracture following reduction of fracture between June 2014 and May 2016...
April 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/28288232/-tenofovir-associated-fanconi-s-syndrome-and-rickets-in-a-hiv-infected-girl
#10
Marcela Zúñiga, Armando Galindo, María Isabel Galaz, Maritza Vivanco, Patricio Romero, Paulina Balboa, Claudia Torrejón
Tenofovir (TDF) is an inhibitor of reverse transcriptase nucleotide analogue, although it has good tolerability and high anti-retroviral activity, its effect on the kidney has been a concern. OBJECTIVE: To describe a girl infected with HIV who presented Fanconi syndrome during antiretroviral therapy with TDF. CLINICAL CASE: We describe a HIV-1-infected girl, who after 18 months treatment with TDF presented loss of strength and pain of the lower extremities with functional impairment...
February 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#11
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28274883/efficacy-of-vitamin-c-in-preventing-complex-regional-pain-syndrome-after-wrist-fracture-a-systematic-review-and-meta-analysis
#12
Florence Aim, Shahnaz Klouche, Aurélien Frison, Thomas Bauer, Philippe Hardy
BACKGROUND: Complex regional pain syndrome type I (CRPS-I), previously known as reflex sympathetic dystrophy, is common after conservatively or surgicallytreatedwrist fractures. Several studies support the efficacy of vitamin C in preventing CRPS-I, although the data are somewhat conflicting. The primary objective of this systematic literature review and meta-analysis was to assess the efficacy of vitamin C therapy in preventing CRPS-I after a wrist fracture. METHODS: Randomised, placebo-controlled trials of vitamin C to prevent CRPS-I after wrist fractureswere sought in the three main databases: PubMed (1980 to December 2015), CENTRAL (Central 2015, number 12), andEmbase (1980 to December 2015)...
March 5, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28274009/unstable-distal-radius-fractures-treated-by-volar-locking-anatomical-plates
#13
Anto Jose, Shishir Murugharaj Suranigi, Pascal Noel Deniese, Abey Thomas Babu, Kanagasabai Rengasamy, Syed Najimudeen
INTRODUCTION: Fracture of the distal end of radius represents the most common fracture of the upper extremity accounting for 16-20% of all fractures. Plating is now emerging as the gold standard for management of distal radius fractures due to increased rate of complications such as malunion, subluxation/dislocation of distal radio-ulnar joint or late collapse of fracture. Procedures such as closed reduction and cast immobilization, ligamentotaxis with external fixator and percutaneous pin fixation are no longer acceptable...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28273677/-first-results-with-a-resorbable-mgyrezr-compression-screw-in-unstable-scaphoid-fractures-show-extensive-bone-cysts
#14
Reinhard Meier, Martin Panzica
Osteosynthesis with headless compression screws is an established treatment option for unstable scaphoid fractures. Common implants are made of titanium alloy or steel and usually remain in place. Due to implant density and ferromagnetic properties, artefacts are common in postoperative imaging procedures, e.g. MRI. Now resorbable implants made of magnesium alloy (MgYREZr) have become available. They have biomechanical properties equivalent to human bone and may be used as an alternative to the nonresorbable screw systems...
March 8, 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
https://www.readbyqxmd.com/read/28271081/qualitative-evaluation-of-digital-hand-x-rays-is-not-a-reliable-method-to-assess-bone-mineral-density
#15
Andrew J Miller, Christopher Jones, Frederick Liss, Jack Abboudi, William Kirkpatrick, Pedro Beredjiklian
BACKGROUND: The gold standard for evaluating bone mineral density is dual energy x-ray absorptiometry (DEXA). Prior studies have shown poor reliability using analog wrist X-rays in diagnosing osteoporosis. Our goal was to investigate if there was improved diagnostic value to visual assessment of digital hand X-rays in osteoporosis screening. We hypothesized that similar to analog counterparts, digital hand X-rays have poor correlation and reliability in determining bone mineral density (BMD) relative to DEXA...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28262985/smith-s-fracture-generally-occurs-after-falling-on-the-palm-of-the-hand
#16
Yusuke Matsuura, Tomoyuki Rokkaku, Kazuki Kuniyoshi, Kazuhisa Takahashi, Takane Suzuki, Aya Tanaka, Tomoyo Akasaka, Naoya Hirosawa, Maki Iwase, Atsuro Yamazaki, Sumihisa Orita, Seiji Ohtori
Orthopedic trauma surgeons often encounter Smith's fracture in patients who report that they have fallen on the palms of their hands. The aim of this study was to clarify the pathogenesis of Smith's fracture in basic clinical aspects. First, a survey was conducted for investigating the mechanism of injury and arm position at the time of injury among patients with Smith's fractures who consulted at our outpatient clinic. Second, we created three-dimensional finite element models (FEMs) to predict the influence of arm position on the type of injury resulting from a fall...
March 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/28262282/a-survey-of-extensor-pollicis-longus-tendon-injury-at-the-time-of-distal-radius-fractures
#17
Kiyohito Naito, Yoichi Sugiyama, Thitinut Dilokhuttakarn, Mayuko Kinoshita, Kenji Goto, Kentaro Aritomi, Yoshiyuki Iwase, Kazuo Kaneko
BACKGROUND: The purpose of this study is to investigate the presence or absence, incidence, and degree of extensor pollicis longus (EPL) tendon injury by visual confirmation of the EPL at the time of osteosynthesis for distal radius fractures. METHODS: The subjects were 25 patients (5 males and 20 females; mean age: 56 years) with distal radius fracture that had a dorsal roof fragment. During osteosynthesis using a volar locking plate, the third compartment was exposed in order to determine the EPL injury...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28260179/treatment-of-extra-articular-proximal-and-middle-phalangeal-fractures-of-the-hand-a-systematic-review
#18
REVIEW
D Verver, L Timmermans, R A Klaassen, C H van der Vlies, D I Vos, N W L Schep
The aim of the study was to systematically review the patient reported and functional outcomes of treatment for extra-articular proximal or middle phalangeal fractures of the hand in order to determine the best treatment options. The review methodology was registered with PROSPERO. A systematic literature search was conducted in electronic bibliographic databases. Two independent reviewers performed screening and data extraction. The evaluation of quality of the included studies was performed using the Structured Effectiveness Quality Evaluation scale...
March 4, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28260178/combined-open-bipolar-monteggia-and-galeazzi-fracture-a-case-report-with-a-1-year-follow-up
#19
Christos Koutserimpas, Georg Tsironis, Antonios Salasidis, Phillipp Swatoch, Konstantin Tsironis
Monteggia and Galeazzi fractures account for 1-5% of total forearm fractures. A combined Monteggia and Galeazzi fracture is an extremely rare injury. We present a case of a Gustillo-Henderson type 2 open combined bipolar Monteggia and Galeazzi fracture, as well as fracture of the ulnar coronoid process in a 49-year old male. The patient was treated surgically, with open reduction and internal fixation. At 6 months postoperative, he was diagnosed with pseudarthrosis and underwent surgery with autologous bone grafting from the iliac crest...
March 4, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28260129/validity-of-computed-tomography-in-predicting-scaphoid-screw-prominence-a-cadaveric-study
#20
Clare E Griffis, Cara Olsen, Leon Nesti, C Frank Gould, Michael Frew, Patricia McKay
BACKGROUND: Studies of hardware protrusion into joint spaces following fracture fixation have been performed to address whether or not there is discrepancy between the actual and radiographic appearance of screw prominence. The purpose of our study was to prove that, with respect to the scaphoid, prominence as visualized on CT scan is real and not a result of metal artifact. METHODS: Forty-two cadaveric wrists were separated into four allotted groups with 21 control specimens and 21 study specimens...
March 4, 2017: Archives of Orthopaedic and Trauma Surgery
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