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https://www.readbyqxmd.com/read/28509822/fracture-prevention-in-the-orthopaedic-environment-outcomes-of-a-coordinator-based-fracture-liaison-service
#1
Earl R Bogoch, Victoria Elliot-Gibson, Dorcas Beaton, Joanna Sale, Robert G Josse
BACKGROUND: Fracture liaison services focus on secondary fracture prevention by identifying patients at risk for future fracture and initiating appropriate evaluation, risk assessment, education, and therapeutic intervention. This study describes key clinical outcomes including bone mineral densitometry, physician assessment, and pharmacotherapy initiation in pharmacotherapy-naïve patients undergoing treatment for fragility fracture in a Canadian fracture liaison service. METHODS: We determined rates of post-fracture investigation and treatment for inpatients and outpatients with a fragility fracture seen in a coordinator-based fracture liaison service at an urban university trauma hospital...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28507861/absence-of-ulnar-artery-inflow-detected-by-allen-s-test-prior-to-radial-forearm-free-flap
#2
Benjamin A Taylor, Faisal Alzahrani, Eric Levi, S Mark Taylor, Matthew H Rigby, Jonathan Trites, Robert D Hart
Radial forearm free flaps are commonly used for soft-tissue reconstruction after resection of head and neck cancer. It is perfused by the radial artery, leaving the ulnar artery for perfusion of the hand and digits. The absence of distal ulnar artery and associated superficial palmar arch, however, has not been reported in cadaveric dissection. We report a case of unilateral ulnar artery flow absence, detected by Allen's test, during preoperative preparation for a radial forearm free flap. Based on the simplicity, safety, and ease, we recommend Allen's test to be performed preoperatively on every patient for whom such a flap is a consideration...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28506490/early-range-of-motion-exercise-in-pediatric-patients-with-olecranon-fractures-treated-with-tension-band-suture-with-double-loops-and-double-knots
#3
Tae Hun Kim, Doo-Hyung Lee, Kyeong Jin Han, Wan Sun Choi, Jae Ho Cho
BACKGROUND: Pediatric patients with olecranon fractures are uncommon. The tension band suture technique was introduced to reduce the burden of implant removal and other complications. However, to our knowledge, early range of motion (ROM) exercise has not been introduced in this population of patients. Double Vicryl loops and knots with 2 cross-pins are used to maintain the benefits of the tension band suture technique and to enhance fixation tensile strength. We believe that early ROM exercises could be achieved without nonunion or fixation failure...
May 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28495573/spatial-mapping-of-humeral-head-bone-density
#4
Hamidreza Alidousti, Joshua W Giles, Roger J H Emery, Jonathan Jeffers
BACKGROUND: Short-stem humeral replacements achieve fixation by anchoring to the metaphyseal trabecular bone. Fixing the implant in high-density bone can provide strong fixation and reduce the risk of loosening. However, there is a lack of data mapping the bone density distribution in the proximal humerus. The aim of the study was to investigate the bone density in proximal humerus. METHODS: Eight computed tomography scans of healthy cadaveric humeri were used to map bone density distribution in the humeral head...
May 8, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28490685/-ruptured-c2-aneurysm-of-the-internal-carotid-artery-with-ipsilateral-unruptured-giant-internal-carotid-artery-aneurysm-a-case-report
#5
Saya Ozaki, Hideo Tanaka, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Noriyuki Fumoto, Hajime Miyazaki, Kanehisa Kohno
A giant intracranial internal carotid artery(ICA)aneurysm is difficult to treat. We encountered a case with an unruptured giant intracranial ICA aneurysm with a ruptured C2 aneurysm of the ipsilateral ICA. In this case report, we describe how the treatment and review the literature. A 59-year-old man presented with sudden-onset headache and vomiting. He was diagnosed at a local neurosurgical unit as having a subarachnoid hemorrhage and admitted to our hospital. Cerebral angiogram revealed an unruptured giant ICA C3-4 aneurysm with a ruptured aneurysm of the ipsilateral ICA C2...
May 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28489627/radial-head-ingrowth-anatomic-implant-vs-smooth-stem-monoblock-implant-in-acute-terrible-triad-injury-a-prospective-comparative-study
#6
David Rodriguez-Quintana, David Beaton, Natalie Rodriguez-Quintana, Francisco Lopez-Gonzalez
OBJECTIVE: This study aimed to compare clinical outcomes and radiographic findings between patients who received two different implants (smooth stemmed modular implant or an anatomic press fit implant) on patients with acute terrible triad injuries. DESIGN: Prospective cohort SETTING:: Level II Trauma center, University hospitalPatients/Participants: 34 patients with an isolated terrible triad injury were divided into two study groups (n= 17 each) with different set of radial head implants and followed for 2 years...
May 10, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28471917/radial-neck-dilatory-remodeling-following-radial-head-arthroplasty-with-an-uncemented-press-fit-fully-chemically-etched-stem-design
#7
Matthew P Sullivan, Reza Firoozabadi, Stephen A Kennedy, Julie Agel, Eric Magnusson, Brett Schiffman, Matthew Folchert, Daphne Beingessner
OBJECTIVES: To compare the radiographic outcomes of two widely used side loading, press fit, radial head arthroplasty implants used to reconstruct complex elbow trauma. DESIGN: Retrospective cohort study SETTING:: Level 1 Academic trauma center PARTICIPANTS:: Patients undergoing radial head arthroplasty INTERVENTION:: Cohort 1 received Synthes Radial Head Prosthesis. Cohort 2 received Biomet ExploR Radial Head Replacement. MAIN OUTCOME MEASUREMENTS: Radial neck dilatory remodeling RESULTS:: 82 subjects were included in final analysis, 63 from the Biomet Cohort and 19 from Synthes cohort...
April 27, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28468144/microvascular-tissue-transfers-for-midfacial-and-anterior-cranial-base-reconstruction
#8
Ali Emre Aksu, Hakan Uzun, Ozan Bitik, Gökhan Tunçbilek, Tunç Şafak
Reconstruction of a midfacial defect can represent a difficult challenge for the plastic surgeon. Although many midfacial deformities have traumatic or congenital origins, the vast majority of head and neck defects occur after resection of malignant head and neck neoplasms. Autogenous reconstruction is now routinely performed for larger, complex defects resulting from surgical resection or trauma. In this study, the authors present 27 patients with midfacial defects reconstructed with free flaps. Twenty-two of the defects were created by surgical ablation of cancer (maxillectomy) and the others were traumatic...
May 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28465039/use-of-couplers-for-vascular-anastomoses-in-601-free-flaps-for-reconstruction-of-defects-of-the-head-and-neck-technique-and-two-year-retrospective-clinical-study
#9
A Assoumane, L Wang, K Liu, Z-J Shang
We describe our experience with the use of 854 couplers for venous or arterial anastomoses, or both, in 601 free flaps for reconstruction of defects of the head and neck. We reviewed 601 patients who had had free flaps (with the microvascular anastomoses being made with couplers in 519) between July 2013 and December 2015. Personal details, and clinical data including the site of the defect, the tumour excised, the types of flaps, the size of the couplers, the method of anastomosis (venous or arterial) in which the coupler was used, and postoperative complications were recorded...
April 29, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28449824/primary-mucosal-melanoma-of-the-palatine-tonsil-report-of-a-case-and-review-of-the-literature
#10
Marcela Osorio, Sami P Moubayed, Juan Hernandez-Prera, John C Scott, Mark L Urken
BACKGROUND: Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment. METHODS: A 62-year-old female presented with a deeply pigmented and exophytic lesion in the left tonsillar fossa. The patient underwent a partial pharyngectomy through a midline labio-mandibulotomy approach along with a left level I-V neck dissection. Reconstruction with a left radial forearm free flap and a pharyngeal constrictor advancement pharyngoplasty was performed...
April 21, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28449475/a-non-randomized-retrospective-observational-study-on-the-subcutaneous-esophageal-reconstruction-after-esophagectomy-is-it-feasible-in-high-risk-patients
#11
Jae Ho Chung, Sung Ho Lee, Eunjue Yi, Jae Seung Jung, Jung Wook Han, Tae Sik Kim, Ho Sung Son, Kwang Taik Kim
BACKGROUND: Esophageal reconstruction after esophagectomy is a complex procedure with high morbidity and mortality. Anastomotic leakage is more severe and frequent in patients with preoperative comorbidities and may present with septic conditions. Considering the possibility of an easier management of such cases, we evaluated the safety and feasibility of subcutaneous esophageal reconstruction in patients with high operative risks. METHODS: We performed a non-randomized retrospective observational study on the 75 (subcutaneous: 21, intrathoracic: 54) esophageal cancer patients who underwent esophageal reconstruction either through subcutaneous or intrathoracic route between January 2003 and February 2015...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28439432/posterior-interosseous-nerve-palsy-caused-by-a-ganglion-conservative-treatment-with-ultrasound-guided-needle-aspiration
#12
Yasuhiro Seki
Posterior interosseous nerve palsy caused by a ganglion is not common and most previous patients were treated with excisional surgery. We treated a case conservatively with needle aspiration using ultrasonography, after a nerve conduction study. A 77-year-old man presented with impaired active finger extension of the left metacarpophalangeal joints. The nerve conduction study revealed conduction block of the left radial nerve near the elbow. Ultrasonography demonstrated a hypoechoic mass anterior to the radial neck compressing the posterior interosseous nerve...
March 2017: Journal of Ultrasonography
https://www.readbyqxmd.com/read/28434539/evolutionary-anatomy-of-the-neandertal-ulna-and-radius-in-the-light-of-the-new-el-sidr%C3%A3-n-sample
#13
Laura Pérez-Criado, Antonio Rosas
This paper aims to improve our understanding of the phylogenetic trait polarity related to hominin forearm evolution, in particular those traits traditionally defined as "Neandertal features." To this aim, twelve adult and adolescent fragmented forelimb elements (including ulnae and radii) of Homo neanderthalensis recovered from the site of El Sidrón (Asturias, Spain) were examined comparatively using three-dimensional geometric and traditional morphometrics. Mean centroid size and shape comparisons, principal components analysis, and phylogenetic signal analysis were undertaken...
May 2017: Journal of Human Evolution
https://www.readbyqxmd.com/read/28430347/hypopharyngeal-squamous-cell-carcinoma-and-laryngeal-neuroendocrine-carcinoma-colliding-in-the-aryepiglottic-fold-a-case-report
#14
Roberta Marangoni, Simone Mauramati, Giulia Bertino, Antonio Occhini, Marco Benazzo, Patrizia Morbini
PURPOSE: A collision tumor consists of 2 different histologically distinct and topographically independent tumors merging in the same mass. In the head and neck region they are rare, with only 4 cases reported in the larynx. CASE REPORT: A 60-year-old heavy smoker complained of a left submandibular lesion in October 2014. The lesion was excised and showed a poorly differentiated carcinoma, suggestive for adenocarcinoma. After a positron emission tomography-computed tomography scan showed increased metabolic activity in the left laterocervical region and right vocal cord, the patient underwent endoscopic biopsy of the lesion of the left piriform sinus, which was positive for moderately differentiated squamous cell carcinoma (SCC)...
April 14, 2017: Tumori
https://www.readbyqxmd.com/read/28416188/a-giraffe-neck-sign-of-the-medial-meniscus-a-characteristic-finding-of-the-medial-meniscus-posterior-root-tear-on-magnetic-resonance-imaging
#15
Takayuki Furumatsu, Masataka Fujii, Yuya Kodama, Toshifumi Ozaki
BACKGROUND: The posterior root ligament of the medial meniscus (MM) has a critical role in regulating the MM movement. An accurate diagnosis of the MM posterior root tear (MMPRT) using magnetic resonance imaging (MRI) is important for preventing sequential osteoarthritis following the MMPRT. However, diagnosis of the MMPRT is relatively difficult even after using several characteristic MRI findings. The aim of this study was to identify a useful meniscal body sign of the MMPRT for improving diagnostic MRI reading...
April 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#16
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
May 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28403069/using-a-pedicle-pectoralis-major-musculocutaneous-flap-in-head-and-neck-reconstruction-after-modified-radical-mastectomy-a-case-report
#17
Jen-Wu Huang, Nai-Yuan Wu, Yi-Ying Lin
RATIONALE: A pedicle pectoralis major musculocutaneous (PMMC) flap is one of the strategies for head and neck reconstruction. Seldom studies reported the case in which the skin area of previous modified radical mastectomy (MRM) had been used as a PMMC flap in head and neck reconstruction. PATIENT CONCERNS: An 84-year-old female who had suffered from left breast cancer and undergone a left modified radical mastectomy (MRM) more than 20 years earlier. DIAGNOSES: She had squamous cell carcinoma of the tongue and had undergone partial glossection and left modified radial neck dissection...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28389760/surgical-treatment-of-monteggia-variant-fracture-dislocations-of-the-elbow-in-adults-surgical-technique-and-clinical-outcomes
#18
Hosam E Matar, Pavel I Akimau, David Stanley, Amjid A Ali
PURPOSE: Monteggia variant defined as Monteggia fracture dislocation with radial head or neck fracture, coronoid fracture, ulnohumeral joint dislocation or combination of these injuries. The aim of this study was to evaluate clinical outcomes of surgical treatment of Monteggia variant fracture dislocations with focus on the operative technique and management of associated radial head fractures. METHODS: Between January 2008 and January 2014, 22 patients (7 men, 15 women) with a mean age of 58...
April 7, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28389291/a-word-of-caution-for-extra-large-self-expandable-nitinol-stents
#19
Andrés Reyes Valdivia, Africa Duque Santos, Francisco Alvarez Marcos, Asunción Romero Lozano, Julia Ocaña Guaita, Claudio Gandarias Zúñiga
PURPOSE: To report an unsuccessful use of large nitinol stent to prevent proximal endoleak in endograft treatment for juxtarenal aortic aneurysm. CASE REPORT: Male of 82 years old, with coronary disease and severe chronic obstructive pulmonary disease (COPD) requiring oxygen support. A large 80 mm. juxtarenal aneurysm was found on routine urological examination. Neck features were as follows: 7mm and high anterior-posterior angulation. ASA IV was given. Patient wanted to be treated...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28342884/oral-cancer-reconstruction-using-the-supraclavicular-artery-island-flap-comparison-to-free-radial-forearm-flap
#20
Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L Spiegel, Bernhard G Weiss, Yiannis Pilavakis
PURPOSE: To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery. PATIENTS AND METHODS: The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed...
March 2, 2017: Journal of Oral and Maxillofacial Surgery
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