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Utah orthopaedics

Joel E Holman, Gregory J Stoddard, Daniel S Horwitz, Thomas F Higgins
OBJECTIVE: The prudent use of prescription opiates is a central aspect of current postsurgical pain management, but surgeons have no guidelines on appropriate duration of opiate treatment. Furthermore, there are no established data on the effect of physician counseling on the duration of opiate use postoperatively. DESIGN: Retrospective surgeon-controlled cohort study. SETTING: Level I regional academic trauma center. PATIENTS: All Utah residents admitted to the orthopaedic trauma service with isolated operative musculoskeletal injury...
September 2014: Journal of Orthopaedic Trauma
Joel E Holman, Gregory J Stoddard, Thomas F Higgins
BACKGROUND: The prudent use of prescription opiate medications is a central aspect of postoperative pain management. The mortality associated with prescription opiate overdose is reaching epidemic proportions nationally, and is the leading cause of accidental death in greater than half the states in the United States. This study sought to determine the rates of preinjury opiate use in patients with orthopaedic trauma and the risk factors for prolonged use postinjury. METHODS: The Utah Controlled Substance Database was queried to determine the use of prescription opiates by all patients admitted to the orthopaedic trauma service for a two-year period with isolated musculoskeletal injuries...
June 19, 2013: Journal of Bone and Joint Surgery. American Volume
Curtis B DeFriez, David A Morton, Daniel S Horwitz, Christine M Eckel, K Bo Foreman, Kurt H Albertine
A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months for all of its residents. The primary purpose of the course is to renew competencies in basic science disciplines so that incoming residents more quickly reach a level of functional proficiency and to afford senior residents a platform to teach their junior colleagues...
September 2011: Anatomical Sciences Education
Marcella R Woiczik, Jacques L D'Astous
BACKGROUND: Navajo Familial Neurogenic Arthropathy is a disease identified in Navajo children, primarily residing in Arizona, New Mexico, and Utah. To date, there are no reports in the orthopaedic literature regarding this disorder, particularly the clinical manifestations and treatment considerations. METHODS: We carried out a retrospective chart and radiographic review of 2 patients with Navajo familial neurogenic arthropathy. We present these 2 patients as representative of the orthopaedic manifestations of Navajo familial neurogenic arthropathy...
April 2010: Journal of Pediatric Orthopedics
Brad Crick, Soong Chua, James Canty, Keith McCullough
BACKGROUND: There has been an anecdotal shift away from screw banks in orthopaedic surgery in preference for individually wrapped screws. Our hypothesis is that opening individually wrapped items introduces a possible source of contamination of the surgical set-up and repeated opening compounds this potential. Theoretically, this could pose a greater infection risk to the patient than the alternative of a screw bank. METHODS: One hundred screws were double wrapped in an identical fashion to the standard practice at our hospital...
April 2008: ANZ Journal of Surgery
John G Skedros, Kenneth J Hunt, Todd C Pitts
BACKGROUND: Variations in corticosteroid/anesthetic doses for injecting shoulder conditions were examined among orthopaedic surgeons, rheumatologists, and primary-care sports medicine (PCSMs) and physical medicine and rehabilitation (PMRs) physicians to provide data needed for documenting inter-group differences for establishing uniform injection guidelines. METHODS: 264 surveys, sent to these physicians in our tri-state area of the western United States, addressed corticosteroid/anesthetic doses and types used for subacromial impingement, degenerative glenohumeral and acromioclavicular arthritis, biceps tendinitis, and peri-scapular trigger points...
July 6, 2007: BMC Musculoskeletal Disorders
John G Skedros, Joshua D Holyoak, Todd C Pitts
BACKGROUND: With the exponential increase in osteoporotic fractures, orthopaedic surgeons are in a logical position to become more involved in the medical treatment of this disease. However, it has been hypothesized that surgeons may not be inclined to initiate such treatment if they do not view medical interventions as an extension of their surgical opportunities. The objective of this study was to determine the knowledge and opinions of orthopaedic surgeons with regard to their opportunities for initiating medical treatment of patients with an osteoporotic fracture...
January 2006: Journal of Bone and Joint Surgery. American Volume
H M Frost
Besides bringing problems, aging can let the mind's eye see more clearly than before, and it can let us express ourselves better. As age, experience and common sense examine today's skeletal medicine and surgery two questions keep popping up: A) How did we fail?; B) How to make it better? The Utah paradigm of skeletal physiology and the seminal ISMNI offer some answers, but exploiting them faces problems. Problem #1: By 1960 all clinicians and physiologists 'knew' (as the ancients 'knew' this world is flat) that effector cells controlled solely by nonmechanical agents explain all skeletal physiology and disorders ('effector cells' include osteoblasts, osteoclasts, chondroblasts and fibro-blasts)...
September 2000: Journal of Musculoskeletal & Neuronal Interactions
John G Skedros
Patients who suffer osteoporotic fractures do not typically receive medical/pharmaceutical treatment for osteoporosis. Orthopedic surgeons are concerned about, but not always diligent in following up on, the medical treatment of their fracture patients. The objective of this study was to determine whether orthopedic surgeons could effectively and consistently refer patients with osteoporotic fractures to a primary care provider (PCP) for possible work-up and treatment of osteoporosis. Fourteen orthopedic surgeons participated in the program...
May 2004: Osteoporosis International
H M Frost
Efforts to understand our anatomy and physiology can involve four often overlapping phases. We study what occurs, then how, then ask why, and then seek clinical applications. In that regard, in 1960 views, bone's effector cells (osteoblasts and osteoclasts) worked chiefly to maintain homeostasis under the control of nonmechanical agents, and that physiology had little to do with anatomy, biomechanics, tissue-level things, muscle, and other clinical applications. But it seems later-discovered tissue-level mechanisms and functions (including biomechanical ones, plus muscle) are the true key players in bone physiology, and homeostasis ranks below the mechanical functions...
April 1, 2001: Anatomical Record
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