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https://www.readbyqxmd.com/read/28728260/-clinical-analysis-of-pacing-therapy-and-treatment-of-complications-during-follow-up-in-children
#1
P J Zhao, Y W Chen, F Li, Y Li, J P Yang, J J Wu
Objective: To analyze characteristics of permanent pacemaker implantation in children as well as treatment and prognosis of complications. Method: Clinical data of children who underwent endocardial or epicardial permanent pacemaker implantation between April 2000 and June 2016 in Shanghai Xinhua Hospital and Shanghai Children's Medical Center were analyzed retrospectively. These patients were discharged 5 days after implantation. Electrocardiogram, chest X ray, echocardiography and pacemaker programming were performed during follow-up...
July 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28728206/-subaxial-cervical-spine-injuries-treatment-recommendations-of-the-german-orthopedic-and-trauma-society
#2
Philipp Schleicher, Matti Scholz, Frank Kandziora, Andreas Badke, Florian Hans Brakopp, Helmut Klaus Friedrich Ekkerlein, Erol Gercek, Rene Hartensuer, Philipp Hartung, Jan-Sven Gilbert Jarvers, Philipp Kobbe, Stefan Matschke, Robert Morrison, Christian W Müller, Miguel Pishnamaz, Maximilian Reinhold, Klaus John Schnake, Gregor Schmeiser, Gregor Stein, Bernhard Ullrich, Thomas Weiß, Volker Zimmermann
In a consensus process during four sessions in 2016, the working group "lower cervical spine" of the German Society for Orthopedic and Trauma Surgery (DGOU), formulated "Therapeutic Recommendations for the Lower Cervical Spine", taking into consideration the current literature. Therapeutic goals are a permanently stable, painless cervical spine and the protection against secondary neurologic damage while retaining the greatest possible amount of motion and spinal profile. Due to its ease of use and its proven good reliability, the AOSpine classification for subaxial cervical injuries should be used...
July 20, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28728078/femoral-head-necrosis-a-finite-element-analysis-of-common-and-novel-surgical-techniques
#3
Myriam Cilla, Sara Checa, Bernd Preininger, Tobias Winkler, Carsten Perka, Georg N Duda, Matthias Pumberger
BACKGROUND: Femoral head necrosis is a common cause of secondary osteoarthritis. At the early stages, treatment strategies are normally based on core decompression techniques, where the number, location and diameter of the drilling holes varies depending on the selected approach. The purpose of this study was to investigate the risk of femoral head, neck and subtrochanteric fracture following six different core decompression techniques. MATERIALS: Five common and a newly proposed techniques were analyzed in respect to their biomechanical consequences using finite element analysis...
July 6, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28727345/-denosumab-in-clinical-practice-beware-before-during-and-after
#4
Olivier Lamy, Elena Gonzalez-Rodriguez, Delphine Stoll, Bérengère Aubry-Rozier
Denosumab is a very effective treatment of osteoporosis, easy to use and very well tolerated. Due to some associated risks, a close clinical follow-up is necessary. Before the first injection, it is necessary to correct hypocalcaemia or vitamin D deficiency when present. Calcemia has to be followed in case of renal insufficiency. Injections of denosumab should be done scrupulously every 6 months (± 3 weeks). Discontinuation of denosumab is associated with a severe rebound effect characterized by increased markers of bone remodeling, a rapid decrease of bone density values, and a risk of multiple spontaneous vertebral fractures...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727344/-to-where-and-until-when-handle-the-osteoporosis
#5
Brigitte Uebelhart, Serge Ferrari
Estrogen replacement therapy, selective modulators of the estrogen receptor (SERMs), bisphophonates and denosumab are antiresorptive therapies which can be used for several years. Teriparatide is still the only bone forming agent available, its use is limited to 24 months. Except the absence of new fragility fractures, there is no well defined target in the treatment of osteoporosis. Nevertheless persistence of high fracture risk (prevalent fractures and/or low BMD) on therapy indicates to maintain or intensify the treatment...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28727341/-use-of-trabecular-bone-score-as-a-complementary-approach-to-dxa-for-fracture-risk-assessment-in-clinical-practice
#6
Didier Hans, Enisa Shevroja, Olivier Lamy
Physicians can assess the risk of fracture based on bone density (BMD) and several risk factors. Some of them and BMD are incorporated into FRAX, an assessment tool that estimates the 10-years probability of fracture. BMD didn't take into account the microarchitecture. TBS is a texture parameter related to bone microarchitecture. A low TBS is associated with a history of fracture and the incidence of new fracture independently of BMD, clinical risk factors and FRAX. TBS is yet integrated in the FRAX tool, and this effect is of greatest utility for individuals who are close to an intervention threshold...
April 19, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28726429/-osteoprotective-therapy-with-bisphosphonates-or-denosumab-in-patients-with-multiple-myeloma-benefit-and-risks
#7
Zdeněk Adam, Jan Straub, Marta Krejčí, Luděk Pour, Dagmar Brančíková, Lenka Ostřížková, Viera Sandecká, Martin Štork
Bisphosphonates have been used during the complete treatment of multiple myeloma for more than twenty years. They slow osteolysis and thereby contribute to the improvement of quality of life. Their long-term use, however, is related to 2 serious, usually later appearing complications: osteonecrosis of the jaw, occurring in 6-9 % of patients, and rarer atypical bone fractures. Both these complications are very difficult to heal, and all the more emphasis is therefore laid on prevention. This first of all includes discussion about the risk with the patient, followed by a dental checkup before the commencement of therapy and then repeated during its course, as well as reduced use of these drugs for a necessary period of time...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28726191/virtual-experimental-validation-of-dynamic-osteosynthesis-in-the-treatment-of-fractures-of-the-proximal-femur
#8
V E Dubrov, I A Kuz'kin, I M Shcherbakov, A L Matveev, A V Yudin
Volume model of transtrochanteric fracture of the femoral bone fixed by Targon PF dynamic fixator was studied by the finite element analysis. The following parameters were measured: magnitude and direction of displacement of system elements, pressure between fragments, and von Mises stress distribution in the fixator depending on support screw plunging into the sleeve. The results indicate that stability of the bone-nail system increases during fracture union and 10-mm shortening of the femoral neck axis, which is seen from a decrease in system deformation under load by 16...
July 18, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28726121/bone-marrow-oedema-predicts-bone-collapse-in-paediatric-and-adolescent-leukaemia-patients-with-corticosteroid-induced-osteonecrosis
#9
Ashok Joseph Theruvath, Preeti Arun Sukerkar, Shanshan Bao, Jarrett Rosenberg, Sandra Luna-Fineman, Sandhya Kharbanda, Heike Elisabeth Daldrup-Link
OBJECTIVES: Corticosteroid treatment of paediatric leukaemia patients can lead to osteonecrosis (ON). We determined whether bone marrow oedema (BME) is an early sign of progressive ON and eventual bone collapse. METHODS: In a retrospective study, two radiologists reviewed MR imaging characteristics of 47 early stage epiphyseal ON in 15 paediatric and adolescent leukaemia patients. Associations between BME on initial imaging studies and subchondral fracture, disease progression and bone collapse were assessed by Cochran-Mantel-Haenszel tests...
July 19, 2017: European Radiology
https://www.readbyqxmd.com/read/28725919/accurate-guide-wire-of-lag-screw-placement-in-the-intertrochanteric-fractures-a-technical-note
#10
Jiang Li, Liao Wang, Xiaodong Li, Kai Feng, Jian Tang, Xiaoqing Wang
Cephalomedullary fixations are commonly used in the treatment of intertrochanteric fractures. In clinical practice, one of the difficulties is when we exit the guide wire in a wrong position of femoral neck and insert near the hole again, the guide wire often flow into the previous track. This study develops a surgical technique to direct the guide wire to slip away the previous track and slip into a right position. When guide wire is exited to the cortex of femoral, we let the wire in and out at the cortical layer for several times to enlarge the entry hole...
July 19, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28725510/a-critical-appraisal-of-vascularized-bone-grafting-for-scaphoid-nonunion
#11
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Wendy J Mack, Ketan Patel
Background  Vascularized bone grafting (VBG) has the potential to yield reliable results in scaphoid nonunion; however, results across studies have been highly variable. This study critically evaluates surgical techniques, fracture location, and patient selection in relation to radiographic, clinical, and patient-centered outcomes after VBG for scaphoid nonunion. Methods  We conducted a systematic review of the literature for the use of VBG in scaphoid nonunion. Physical examination, radiographic, and patient-centered outcomes were assessed...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725505/long-volar-plating-for-metadiaphyseal-fractures-of-distal-radius-study-comparing-minimally-invasive-plate-osteosynthesis-versus-conventional-approach
#12
Emilie Pire, Juan José Hidalgo Diaz, Santiago Salazar Botero, Sybille Facca, Philippe A Liverneaux
Background  Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods  Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2)...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725504/patients-at-increased-risk-of-major-adverse-events-following-operative-treatment-of-distal-radius-fractures-inpatient-versus-outpatient
#13
Paul S Whiting, Christopher D Rice, Frank R Avilucea, Catherine M Bulka, Michelle S Shen, William T Obremskey, Manish K Sethi
Purpose  The purpose of this study was to compare complication rates following inpatient versus outpatient distal radius fracture ORIF and identify specific complications that occur at increased rates among inpatients. Methods  Using the 2005-2013 ACS-NSQIP, we collected patient demographics, comorbidities, surgical characteristics, and 30-day postoperative complications following isolated ORIF of distal radius fractures. A propensity score matched design using an 8-to-1 "greedy" matching algorithm in a 1:4 ratio of inpatients to outpatients was utilized...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725500/volar-plate-fixation-in-patients-older-than-70-years-with-ao-type-c-distal-radial-fractures-clinical-and-radiologic-outcomes
#14
Nicolas S Piuzzi, Ezequiel E Zaidenberg, Matias Pereira Duarte, Jorge G Boretto, Agustin Donndorff, Gerardo Gallucci, Pablo De Carli
Introduction  Treatment of unstable distal radial fractures (DRFs) in elderly patients is controversial, and considering the increasing life expectancy, their appropriate treatment is of growing importance. Our aim was to analyze the clinical and radiologic outcomes in the elderly patients with AO type C DRF treated with volar locking plate (VLP). Materials and Methods  Between 2007 and 2011, 572 DRFs were operated on in our hospital with open reduction and internal fixation with VLP. Of these, only 64 patients (66 DRFs) met the selection criteria (AO type C DRF, age > 70 years, minimum 12-month follow-up)...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725496/volar-distal-radius-anatomy-applied-to-the-treatment-of-distal-radius-fracture
#15
Junya Imatani, Keiichi Akita
Volar locking plate (VLP) fixation has become the standard surgical treatment for distal radius fractures. However, flexor tendon rupture is one of the major complications following volar plating. This detailed review on the anatomy and morphology of the volar distal radius might facilitate appropriate placement of the volar plate and thereby avoid flexor tendon rupture. We introduce safe and secure VLP fixation along standard surgical procedures to avoid complications based on anatomy of the volar surface of the distal radius...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28724849/the-ilizarov-mini-external-fixator-for-the-treatment-of-first-metatarsal-fracture-a-case-report
#16
Tatsunori Kataoka, Norie Kodera, Shinro Takai
Forefoot fractures are frequently accompanied by severe soft tissue damage. Therefore, treatment should focus not only on fractures but also on soft tissue damage, for which external fixation can be used as a surgical option. A 63-year-old woman presented to the emergency clinic of our hospital with forefoot pain after a motorcycle accident. Comminuted fracture of the proximal part of the metatarsal was diagnosed. Because of the swollen foot and fracture comminution, an operation using the Ilizarov mini external fixator was performed to prevent further damage to the soft tissue...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/28724387/risk-factors-for-acute-surgical-site-infections-after-lumbar-surgery-a-retrospective-study
#17
Qi Lai, Quanwei Song, Runsheng Guo, Haidi Bi, Xuqiang Liu, Xiaolong Yu, Jianghao Zhu, Min Dai, Bin Zhang
BACKGROUND: Currently, many scholars are concerned about the treatment of postoperative infection; however, few have completed multivariate analyses to determine factors that contribute to the risk of infection. Therefore, we conducted a multivariate analysis of a retrospectively collected database to analyze the risk factors for acute surgical site infection following lumbar surgery, including fracture fixation, lumbar fusion, and minimally invasive lumbar surgery. METHODS: We retrospectively reviewed data from patients who underwent lumbar surgery between 2014 and 2016, including lumbar fusion, internal fracture fixation, and minimally invasive surgery in our hospital's spinal surgery unit...
July 19, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28724382/activation-of-cannabinoid-receptor-type-2-attenuates-surgery-induced-cognitive-impairment-in-mice-through-anti-inflammatory-activity
#18
Lingling Sun, Rui Dong, Xin Xu, Xi Yang, Mian Peng
BACKGROUND: Neuroinflammation plays a major role in postoperative cognitive dysfunction (POCD). Accumulated evidence indicates that cannabinoid receptor type 2 (CB2R) can mediate anti-inflammatory and immunomodulatory effects in part by controlling microglial activity. However, the impact of CB2R on postoperative cognition has not been investigated. We hypothesized that CB2R is involved in surgery-induced cognitive impairment in adult mice. METHODS: Adult C57BL/6 mice were subjected to intramedullary fixation surgery for tibial fracture under isoflurane anesthesia and CB2R agonist (JWH133) or CB2R antagonist (AM630) treatment...
July 19, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/28723807/can-patients-with-femoral-neck-fracture-benefit-from-preoperative-thromboprophylaxis-a-prospective-randomized-controlled-trial
#19
Qiangqiang Li, Bingyang Dai, Jiacheng Xu, Yao Yao, Kai Song, Haojun Zhang, Dongyang Chen, Qing Jiang
BACKGROUND: The effectiveness of preoperative thromboprophylaxis remains obscure in patients with femoral neck fracture. The purpose of the current study was to investigate whether these patients benefit from preoperative thromboprophylaxis. METHODS: In this prospective, randomized controlled trial, a total of 80 patients with femoral neck fracture were randomly assigned to receive either rivaroxaban or conservative treatment before surgery. For all patients, color Doppler ultrasound of both lower extremities was performed immediately after admission...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#20
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
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