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fractures treatment

William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Efe Levent Aras, Cody Bunger, Ebbe Stender Hansen, Rikke Søgaard
BACKGROUND AND PURPOSE: There is a lack of evidence on the broad health-care costs of treating spine trauma patients without neurological deficits conservatively. The aim of the present study was to estimate the primary and secondary health-care sector costs associated with conservative treatment of spine fractures as well as their determinants. METHODS: Patients were identified between 1999 and 2008 in the hospital's administrative system based on relevant diagnostic codes...
October 21, 2016: European Spine Journal
D Saul, J C Ammon, F August
We report the case of a 15-year-old boy with combined fractures of the scaphoid, capitate, and hamate that represents a rare variation of the well-known Fenton's syndrome. Fixation was performed for the unstable fractures of the scaphoid and capitate with the use of cannulated Herbert screws and K‑wires respectively. K‑wires were removed after 6 months, with subsequent physiotherapy. After 6 months, CT confirmed complete consolidation of the two surgically treated carpal fractures and the conservatively treated fracture of the hamate...
October 21, 2016: Der Unfallchirurg
D E Beaton, M Vidmar, K B Pitzul, R Sujic, N K Rotondi, E R Bogoch, J E M Sale, R Jain, J Weldon
: We evaluated the impact of a more intensive version of an existing post-fracture coordinator-based fracture prevention program and found that the addition of a full-risk assessment improved treatment rates. These findings provide additional support for more intensive programs aimed at reducing the risk of re-fractures. INTRODUCTION: Evidence-based guidelines support coordinator-based programs to improve post-fracture osteoporosis guideline uptake, with more intensive programs including bone mineral density (BMD) testing and/or treatment being associated with better patient outcomes...
October 21, 2016: Osteoporosis International
Christos Karagiannopoulos, Michael Sitler, Susan Michlovitz, Carole Tucker, Ryan Tierney
STUDY DESIGN: Prospective cohort study. INTRODUCTION: The active wrist joint position sense (JPS) test has been determined to be a clinically useful test for assessing wrist sensorimotor (SM) status after distal radius fracture (DRF). Its responsiveness is yet to be determined. PURPOSE OF THE STUDY: Primary study aim was to determine the active wrist JPS test responsiveness to detect change in wrist SM status at 8 and 12 weeks after DRF treatment intervention...
October 18, 2016: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Atsushi Imaizumi, Kunihiro Ishida, Osamu Nishizeki
BACKGROUND: Recent advancements in computed tomography have enabled the diagnosis of naso-orbito-ethmoid (NOE) fractures to be made in much greater detail. Surgical access to the upper nasofrontal buttress in NOE fractures, however, has remained unchanged over the past decades. All approaches to these fractures using skin incisions have individual drawbacks. The transcaruncular approach is free of the drawbacks of the cutaneous approaches. We further extended the transcaruncular approach for the treatment of NOE and Le Fort II fractures...
September 23, 2016: Journal of Cranio-maxillo-facial Surgery
Devin Ganesh, Ben Service, Brian Zirgibel, Kenneth Koval
OBJECTIVES: To assess the utility of the dorsal tangential view (DTV) in detecting intraoperative dorsal screw penetration in distal radius fractures treated with volar locked plating. DESIGN: Retrospective cohort study. SETTING: Academic level 1 trauma center. PATIENTS/PARTICIPANTS: Skeletally mature patients where open reduction internal fixation with volar locked plating was the definitive treatment. A total of twenty-six patients were evaluated...
November 2016: Journal of Orthopaedic Trauma
Michael Maceroli, Lucas E Nikkel, Bilal Mahmood, John P Ketz, Xing Qiu, Joseph Ciminelli, Susan Messing, John C Elfar
OBJECTIVES: To determine if hospital arthroplasty volume affects patient outcomes after undergoing total hip arthroplasty (THA) for displaced femoral neck fractures. METHODS: The Statewide Planning and Research Cooperative System database from the New York State Department of Health was used to group hospitals into quartiles based on overall THA volume from 2000 to 2010. The database was then queried to identify all patients undergoing THA specifically for femoral neck fracture during this time period...
November 2016: Journal of Orthopaedic Trauma
Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
Stephen Matthew Quinnan
Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. External fixation is a third alternative that is less often employed, but provides a very effective means of treatment. Circular external fixation offers great flexibility in obtaining anatomic alignment and stable fixation for even the most challenging distal tibia fractures...
November 2016: Journal of Orthopaedic Trauma
John A Scolaro, Francis H Broghammer, Derek J Donegan
The optimal treatment strategy for distal tibia fractures, especially those with intraarticular extension, remains controversial. Although open reduction and internal fixation with a plate and screw device is commonly performed for these injuries, the risk of soft tissue complications using this approach is significant. Staged treatment protocols and alternative means of fixation have been proposed to address these undesired events. Although potentially more technically demanding than fixation of diaphyseal or extraarticular tibial fractures, intramedullary nail (IMN) fixation of simple intraarticular distal tibia fractures is a viable treatment alternative with unique advantages...
November 2016: Journal of Orthopaedic Trauma
Marina Magnani, Giovanni Trisolino, Stefano Stilli
INTRODUCTION: Idiopathic posttraumatic nonunion is a rare condition in children; the treatment of this complication is still controversial in this peculiar population. CASE REPORT: We report a case of a subcapital type II femoral neck fracture, in a 12-year-old boy, which was initially treated by internal fixation and subsequently went on to a nonunion at the femoral neck, in absence of infection or other disease.1 year after index surgery we performed surgical debridement and refixation with plate and bone allograft, added with autologous bone marrow aspiration concentrate (BMAC) and platelet-rich fibrin (PRF)...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Giulia R Mosele, Gianfilippo Caggiari, Roberto M Scarpa, Carlo Doria
BACKGROUND: Renal cell carcinoma (RCC) is among the 10 most common cancers in both men and women. It comprises 2-3% of all malignancies. The most common site for metastasis from RCC is the lung (50% of patients), followed by the skeleton (20% to 50% of patients). METHODS: We retrospectively reviewed our consecutive series of 63 patients surgically treated for spinal metastases from RCC. The surgical treatment for spinal metastases varied in each patient. Factors influencing the choice of surgery included age, disease status, symptoms, morbidity of the patient, the location, the number of repetitive lesions and the existence of extra-osseous metastases...
October 21, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Joerg Schiller, Christoph Korallus, Matthias Bethge, Matthias Karst, Marie-Lena Schmalhofer, Christoph Gutenbrunner, Matthias Georg Fink
: In this sham-controlled study, 53 patients received 10 sessions of acupuncture treatment over 5 weeks to investigate the effects of acupuncture on the pain and quality of life of patients with osteoporosis. The results showed significant favorable effects of verum acupuncture on quality of life. Both interventions showed sustained and clinically relevant effects on pain. PURPOSE: Standard analgesic treatment is associated with adverse events in patients with osteoporosis, especially elderly and/or comorbid patients...
December 2016: Archives of Osteoporosis
Gherardo Mazziotti, Anna Maria Formenti, Robert A Adler, John P Bilezikian, Ashley Grossman, Emilia Sbardella, Salvatore Minisola, Andrea Giustina
Glucocorticoid-induced osteoporosis is the most frequent form of secondary osteoporosis caused by chronic exposure to glucocorticoid excess. Pathogenesis of glucocorticoid-induced osteoporosis is multifactorial including direct effects of glucocorticoids on bone cells and indirect effects of glucocorticoids on several neuroendocrine and metabolic pathways. Fragility fractures occur early in glucocorticoid-induced osteoporosis and anti-osteoporotic drugs along with calcium and vitamin D should be started soon after exposure to glucocorticoid excess...
October 20, 2016: Endocrine
A R Vosoughi, M J Emami, B Pourabbas, H Mahdaviazad
OBJECTIVES: Hip fracture is one of the most common public health problems with a significant financial burden on the patient and on the healthcare system. This study was conducted to assess the 3-month and 1-year mortality rates of patients with operated hip fractures and to determine the influence of predictors of mortality. METHODS: In this prospective cross-sectional study, all admitted patients aged more than 50 years with hip fracture at Chamran Hospital from January 2008 to August 2013 were enrolled...
October 20, 2016: Musculoskeletal Surgery
M Belhassen, C B Confavreux, B Cortet, L Lamezec, M Ginoux, E Van Ganse
: Limited information is available on anti-osteoporotic treatment initiation patterns in France. In 2006-2013, the most frequently prescribed first-line treatment class for osteoporosis was represented by bisphosphonates (alendronic acid and risedronic acid), followed by strontium ranelate. Persistence with anti-osteoporotic treatment was low, with high proportions of treatment discontinuations and switches. INTRODUCTION: This epidemiological, longitudinal study described first-line treatment initiation, persistence, switches to second-line treatment, and medical care consumption in osteoporotic patients in France during the 2007-2013 period...
October 20, 2016: Osteoporosis International
M Burnier, T Awada, F Marin Braun, P Rostoucher, M Ninou, L Erhard
: The primary aim of this study was to assess the clinical and radiological results after hemi-hamate resurfacing arthroplasty in patients with acute or chronic unstable fractures of the base of the middle phalanx and to describe technical features that can facilitate the surgical procedure. Hemi-hamate arthroplasties were done in 19 patients (mean age 39 years) with an isolated fracture at the base of the middle phalanx that involved more than 40% of the articular surface. We assessed ten chronic cases (treated >6 weeks after fracture) and nine acute ones (<6 weeks) at a mean of 24 months...
October 19, 2016: Journal of Hand Surgery, European Volume
C Huxley, J Achten, M L Costa, F Griffiths, X L Griffin
OBJECTIVES: The annual incidence of hip fracture is 620 000 in the European Union. The cost of this clinical problem has been estimated at 1.75 million disability-adjusted life years lost, equating to 1.4% of the total healthcare burden in established market economies. Recent guidance from The National Institute for Health and Clinical Excellence (NICE) states that research into the clinical and cost effectiveness of total hip arthroplasty (THA) as a treatment for hip fracture is a priority...
October 2016: Bone & Joint Research
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