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Orthopedic review

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https://www.readbyqxmd.com/read/28206933/use-of-antibiotic-impregnated-absorbable-beads-and-tissue-coverage-of-complex-wounds
#1
Terris L White, Alfred T Culliford, Martin Zomaya, Gary Freed, Christopher P Demas
The treatment of complex wounds is commonplace for plastic surgeons. Standard management is debridement of infected and devitalized tissue and systemic antibiotic therapy. In cases where vital structures are exposed within the wound, coverage is obtained with the use of vascularized tissue using both muscle and fasciocutaneous flaps. The use of nondissolving polymethylmethacrylate and absorbable antibiotic-impregnated beads has been shown to deliver high concentrations of antibiotics with low systemic levels of the same antibiotic...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28205483/plate-fixation-versus-percutaneous-pinning-for-unstable-metacarpal-fractures-a-meta-analysis
#2
Eitan Melamed, LiJin Joo, Edward Lin, Donato Perretta, John T Capo
BACKGROUND: Whether percutaneous pinning or plate fixation is more appropriate for metacarpal fractures is still open to debate. Our study purpose was to review the current literature in an attempt to determine the optimal treatment modality for metacarpal fractures on the basis of functional outcomes, radiographic outcome and rates of complications. METHODS: We selected Pubmed, Cochrane library, EMBASE and the relevant English orthopedic journals and pooled data from eligible trials including four comparative studies and one retrospective review...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28203271/a-review-of-the-epidemiology-and-treatment-of-orthopaedic-injuries-after-earthquakes-in-developing-countries
#3
REVIEW
James S MacKenzie, Bibek Banskota, Norachart Sirisreetreerux, Babar Shafiq, Erik A Hasenboehler
BACKGROUND: Earthquakes in developing countries are devastating events. Orthopaedic surgeons play a key role in treating earthquake-related injuries to the extremities. We describe orthopaedic injury epidemiology to help guide response planning for earthquake-related disasters. METHODS: Several databases were searched for articles reporting primary injury after major earthquakes from 1970 to June 2016. We used the following key words: "earthquake" AND "fracture" AND "injury" AND "orthopedic" AND "treatment" AND "epidemiology...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28197894/anterior-cruciate-ligament-reconstruction-mr-imaging-findings
#4
REVIEW
M Zappia, R Capasso, D Berritto, N Maggialetti, C Varelli, G D'Agosto, M T Martino, M Carbone, L Brunese
More than two million people tear their anterior cruciate ligament (ACL) each year, and ACL reconstruction occupies a significant proportion of everyday orthopedic practice, being one of the most commonly performed sports medicine surgical procedures. Patients with postoperative symptoms are frequently imaged to monitor ligament grafts and to identify complications. Given the number of patients undergoing ACL reconstruction, knowledge of the potential complications of this surgery is essential for radiologists...
February 14, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28195608/proximal-hamstring-tendinosis-and-partial-ruptures
#5
Ashley N Startzman, Oliver Fowler, Dominic Carreira
Proximal hamstring tendinosis and partial hamstring origin ruptures are painful conditions of the proximal thigh and hip that may occur in the acute, chronic, or acute on chronic setting. Few publications exist related to their diagnosis and management. This systematic review discusses the incidence, treatment, and prognosis of proximal hamstring tendinosis and partial hamstring ruptures. Conservative treatment measures include nonsteroidal anti-inflammatory drugs, physical therapy, rest, and ice. If these measures fail, platelet-rich plasma or shockwave therapy may be considered...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195606/use-of-articulating-spacer-technique-in-revision-total-knee-arthroplasty-complicated-by-sepsis-a-systematic-meta-analysis
#6
John C Spivey, George N Guild, Giles R Scuderi
Periprosthetic infection after total knee arthroplasty is a devastating complication, and 2-stage exchange is the standard of care in North America. Articulating spacers are effective in treating periprosthetic joint infections, but the optimal articulating spacer construct has yet to be identified. The authors performed a systematic review using MEDLINE, MEDLINE In-Process, EMBASE, BIOSIS, ClinicalTrials.gov, and Cochrane Database of Systematic Reviews. They identified 34 articles meeting inclusion criteria, producing 1016 spacers for comparison...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195605/the-implications-of-inaccuracy-comparison-of-coding-in-heterotopic-ossification-and-associated-trauma
#7
Matt Fury, Mitchell John, Stuart Schexnayder, Harry Molligan, Olivia Lee, Peter Krause, Vinod Dasa
Retrospective studies using large databases serve a major purpose in providing evidence in the current literature. However, the quality of medical coding is highly variable. This retrospective cohort study aimed to evaluate the documentation regarding the diagnosis of heterotopic ossification (HO) and the implications it may have for conducting retrospective research using electronic medical records (EMRs). A retrospective chart review using the EMR was performed to identify all patients with a diagnosis of HO within 7 university-affiliated hospital facilities...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28195604/early-postoperative-displacement-of-combined-pelvic-ring-injury-with-acetabular-fracture
#8
Arthur E Hess, Herman S Johal, Robert V O'Toole, Jason W Nascone
Combined pelvic ring and acetabular injuries present a management challenge. The literature on this topic is scarce, with few outcomes studies available. This retrospective study assessed whether the incidence of postoperative displacement and loss of reduction is higher with combined injuries compared with isolated pelvic ring injuries and isolated acetabular fractures. The charts and radiographs of 33 patients with combined pelvic ring and acetabular fractures treated operatively during a 7-year period at a single institution were reviewed...
February 13, 2017: Orthopedics
https://www.readbyqxmd.com/read/28194376/one-year-mortality-of-elderly-patients-with-hip-fracture-surgically-treated-at-a-hospital-in-southern-brazil
#9
Marcelo Teodoro Ezequiel Guerra, Roberto Deves Viana, Liégenes Feil, Eduardo Terra Feron, Jonathan Maboni, Alfonso Soria-Galvarro Vargas
OBJECTIVE: To analyze the mortality rate at one-year follow-up of patients with hip fracture who underwent surgery at the university hospital of this institution. METHOD: The authors reviewed 213 medical records of hospitalized patients aged 65 years or older, following to the order they were admitted to the orthopedics and traumatology service from January 2012 to August 2013. RESULTS: One-year mortality rate was 23.6%. Mortality was higher among women, with a 3:1 ratio...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28191766/concise-review-mesenchymal-stem-cell-therapy-for-pediatric-disease-perspectives-on-success-and-potential-improvements
#10
Christopher R Nitkin, Tracey L Bonfield
Mesenchymal stem cells (MSCs) represent a potentially revolutionary therapy for a wide variety of pediatric diseases, but the optimal cell-based therapeutics for such diversity have not yet been specified. The published clinical trials for pediatric pulmonary, cardiac, orthopedic, endocrine, neurologic, and hematologic diseases provide evidence that MSCs are indeed efficacious, but the significant heterogeneity in therapeutic approaches between studies raises new questions. The purpose of this review is to stimulate new preclinical and clinical trials to investigate these factors...
February 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28190582/correlation-of-parameters-on-preoperative-ct-images-with-intra-articular-soft-tissue-injuries-in-acute-tibial-plateau-fractures-a-review-of-132-patients-receiving-arif
#11
Hao-Che Tang, I-Jung Chen, Yu-Cheng Yeh, Chun-Jui Weng, Shih-Sheng Chang, Alvin Chao-Yu Chen, Yi-Sheng Chan
INTRODUCTION: Tibial plateau fractures often occur in conjunction with soft-tissue injuries of knees. The hypothesis of this study is that parameters of CT imaging can predict intra-articular soft-tissue injuries. PATIENTS AND METHODS: Patients who underwent arthroscopically assisted reduction and internal fixation (ARIF) for acute tibial plateau fractures performed by a single orthopedic surgeon between 2005 and 2015 were included in this retrospective study. Patients with concomitant ipsilateral femoral fractures, who had received revision surgery or who had undergone index surgery more than 30days from the event were excluded...
January 30, 2017: Injury
https://www.readbyqxmd.com/read/28188003/current-status-of-simulation-based-training-tools-in-orthopedic-surgery-a-systematic-review
#12
Michael Morgan, Abdullatif Aydin, Alan Salih, Shibby Robati, Kamran Ahmed
OBJECTIVE: To conduct a systematic review of orthopedic training and assessment simulators with reference to their level of evidence (LoE) and level of recommendation. DESIGN: Medline and EMBASE library databases were searched for English language articles published between 1980 and 2016, describing orthopedic simulators or validation studies of these models. All studies were assessed for LoE, and each model was subsequently awarded a level of recommendation using a modified Oxford Centre for Evidence-Based Medicine classification, adapted for education...
February 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28185011/continuous-intraoperative-epidural-infusions-affect-recovery-room-length-of-stay-and-analgesic-requirements-a-single-center-observational-study
#13
Aalap C Shah, Bala G Nair, Charles F Spiekerman, Laurent A Bollag
PURPOSE: Continuous intraoperative epidural analgesia may improve post-operative pain control and decrease opioid requirements. We investigate the effect of epidural infusion initiation before or after arrival in the post-anesthesia care unit on recovery room duration and post-operative opioid use. METHODS: We performed a retrospective chart review of abdominal, thoracic and orthopedic surgeries where an epidural catheter was placed prior to surgery at the University of Washington Medical Center during a 24 month period...
February 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28183145/minimally-invasive-microscopic-posterior-cervical-decompression-simple-safe-and-effective
#14
Pierluigi Vergara
Background and Study Aims Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM. Materials and Methods A retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28180954/magnetic-resonance-imaging-appearance-of-soft-tissue-metastases-our-experience-at-an-orthopedic-oncology-center
#15
Jennifer Sammon, Abhishek Jain, Robert Bleakney, Rakesh Mohankumar
OBJECTIVE: To assess the prevalence and magnetic resonance imaging appearance of metastasis presenting as a soft-tissue mass. MATERIALS AND METHODS: A retrospective chart review was performed on 51 patients who presented to an orthopedic oncology center with soft-tissue masses, with a histology-proven diagnosis of soft-tissue metastasis, over a 14-year period. Their magnetic resonance imaging, primary origin, and follow-up have been assessed. RESULTS: Soft-tissue metastasis was identified in patients ranging from 18 to 85 years old...
February 8, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28177939/review-of-the-evidence-on-the-efficacy-of-dexamethasone-on-postoperative-analgesic-consumption
#16
Chrysanthi Batistaki, Evagelia Kaminiotis, Thomas Papadimos, Georgia Kostopanagiotou
OBJECTIVES: The effect of dexamethasone on analgesic consumption has not been adequately studied. The aim of this review was to investigate recent literature regarding the possible effect of dexamethasone on postoperative analgesic consumption. METHODS: Critical review of randomized trials, and prospective consecutive studies, investigating the post-operative analgesic effect of dexamethasone was performed. Only studies published during 2006-2015 were included. RESULTS: Forty-one studies met the inclusion criteria; 33 in adults and 8 in children (9 in general surgery, 8 in gynecological/breast surgery, 8 in orthopedic/spinal surgery, 8 in head/neck surgery, 7 in children's tonsillectomy, and 1 in children's orchiopexy)...
February 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#17
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167064/syndesmosis-stabilisation-screws-versus-flexible-fixation
#18
REVIEW
Matthew C Solan, Mark S Davies, Anthony Sakellariou
Orthopedic surgery is not short of situations where there is controversy regarding optimum management. Treating ankle syndesmosis injuries is an example where practice varies widely and there are many questions that remain unsatisfactorily answered. When addressing the type of syndesmosis stabilization that is required it is essential to ascertain the extent of instability. Only then can a logical approach to restoring the ankle mortise be achieved. Fixation of fibula shaft fractures and posterior malleolus fractures can restore sufficient stability to render syndesmosis stabilization unnecessary...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28166159/fdg-pet-ct-assesses-the-risk-of-femoral-pathological-fractures-in-patients-with-metastatic-breast-cancer
#19
Gary A Ulaner, Alexandra M Zindman, Junting Zheng, Tae Won B Kim, John H Healey
PURPOSE: Assessment of pathological fracture risk is critical to optimize the use of prophylactic orthopedic fixation to prevent pathological fractures. Better prediction of pathological fracture risk is needed. We evaluated if quantitative measures of FDG avidity can assess femoral pathological fracture risk in patients with metastatic breast cancer (MBC). PATIENTS AND METHODS: A Health Insurance Portability and Accountability Act-compliant retrospective case-control study was performed under institutional review board waiver...
February 3, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28159606/recent-coating-developments-for-combination-devices-in-orthopedic-and-dental-applications-a-literature-review
#20
Eric J Tobin
Orthopedic and dental implants have been used successfully for decades to replace or repair missing or damaged bones, joints, and teeth, thereby restoring patient function subsequent to disease or injury. However, although device success rates are generally high, patient outcomes are sometimes compromised due to device-related problems such as insufficient integration, local tissue inflammation, and infection. Many different types of surface coatings have been developed to address these shortcomings, including those that incorporate therapeutic agents to provide localized delivery to the surgical site...
January 31, 2017: Advanced Drug Delivery Reviews
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