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A Achtnich, S Rosslenbroich, K Beitzel, A B Imhoff, W Petersen
OBJECTIVE: Arthroscopic assisted suture anchor refixation combined with microfracturing of the femoral ACL insertion zone in cases of acute proximal anterior cruciate ligament (ACL) rupture to restore anatomical and biomechanical properties of the native ACL. INDICATIONS: Acute proximal ACL rupture/avulsion, multiligament injury of the knee CONTRAINDICATIONS: Chronic (>6 weeks) proximal ACL rupture, intraligamentary rupture, as well as previous ACL surgery. SURGICAL TECHNIQUE: Arthroscopic examination of the knee joint, debridement of the femoral insertion zone, examination of the ligament quality by a probe, insertion of a curved lasso through the ACL to place the sutures and use of a drill guide to place the anchor in the middle of the femoral ACL insertion...
October 21, 2016: Operative Orthopädie und Traumatologie
Kristy Bultema, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike Beck
INTRODUCTION: In the treatment of patients with symptomatic irreversible pulpitis, endodontic debridement is a predictable method to relieve pain. However, there are clinical situations in which emergency care cannot be provided immediately. An unexplored treatment option in these cases may be the use of a long-acting anesthetic to reduce pain in untreated irreversible pulpitis. Some medical studies have shown potential for infiltrations of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, San Diego, CA) to prolong pain relief and reduce opioid use postoperatively...
October 18, 2016: Journal of Endodontics
M Aurich, D Albrecht, P Angele, C Becher, S Fickert, J Fritz, P E Müller, P Niemeyer, M Pietschmann, G Spahn, M Walther
Background: Osteochondral lesions (OCL) of the ankle are a common cause of ankle pain. Although the precise pathophysiology has not been fully elucidated, it can be assumed that a variety of factors are responsible, mainly including traumatic events such as ankle sprains. Advances in arthroscopy and imaging techniques, in particular magnetic resonance imaging (MRI), have improved the possibilities for the diagnosis of OCLs of the ankle. Moreover, these technologies aim at developing new classification systems and modern treatment strategies...
October 21, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Sumeja Zahirovic, Faizah Siddique
A 55 year-old African American man presented to the Emergency Room with acute-onset fevers, chills, and bilateral thumb pain, swelling, and redness. MRI revealed extensive cellulitis involving bilateral hands and wrists, along with fluid collection and carpal bone erosion on the left. Given concerns for septic arthritis and osteomyelitis, patient underwent surgical debridement revealing an abscess in the wrist without osteomyelitis. Blood cultures grew Pasteurella multocida. Subsequently, patient noted two pet dogs at home, but no history of bites...
October 21, 2016: Arthritis Care & Research
Dnyaneshwar D Athavale, Robin Jones, Brett A O'Donnell, Martin Forer, Nigel Biggs
PURPOSE: To describe the non-exenteration management of sino-orbital fungal infection, a life-threatening condition for which orbital exenteration is generally considered a first-line treatment. METHODS: A retrospective case series is presented of 7 orbits in 6 consecutive patients admitted and treated at 2 major metropolitan tertiary teaching hospitals in Sydney, New South Wales, Australia. RESULTS: Seven orbits in 6 consecutive patients with sino-orbital fungal infection were treated conservatively with surgical debridement and intravenous antifungal agents...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Kristin E Hirabayashi, Evan Kalin-Hajdu, Frank L Brodie, Robert C Kersten, Matthew S Russell, M Reza Vagefi
A 68-year-old immunocompromised man with rhino-orbital-cerebral mucormycosis was treated with retrobulbar injections of amphotericin B deoxycholate in conjunction with intravenous antifungals and endoscopic sinus debridement. Transient episodes of orbital inflammation were noted after retrobulbar injections, but progression of orbital infection was halted and visual acuity restored with eventual hospital discharge. To the authors' knowledge, clearance of orbital mucormycosis with retrobulbar amphotericin B injections has not been previously reported...
October 20, 2016: Ophthalmic Plastic and Reconstructive Surgery
Vincenzo Vindigni, Carlotta Scarpa, Erica Dalla Venezia, Franco Bassetto
INTRODUCTION: Fournier's gangrene is a rare disease that affects the genital, abdominal, and perineal regions and leads to death if not treated promptly. CASE REPORT: A 42-year-old, obese woman presented to the authors' department affected by Fournier's gangrene. In order to treat her abdominal and genital regions, the authors performed a surgical debridement followed by combined therapy with antibiotics and topical negative pressure wound therapy (NPWT) with instillation plus saline solution...
October 2016: Wounds: a Compendium of Clinical Research and Practice
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
Ramesh Kumar, Frederic W B Deleyiannis, Corbett Wilkinson, Brent R O'Neill
OBJECTIVE The authors' goals in this study were to describe a series of dog attacks on children that required neurosurgical consultation and to better understand the pattern of injuries inflicted, the circumstances that place children at risk for attack, and the dog breeds involved. In addition, the authors review the surgical and medical management of these patients. METHODS The authors performed a retrospective review of all children requiring neurosurgical consultation for dog bite at a regional Level 1 pediatric trauma center over a 15-year period...
October 21, 2016: Journal of Neurosurgery. Pediatrics
Karina A F S Miller, Luciana S Branco-de-Almeida, Sandra Wolf, Nicole Hovencamp, Tina Treloar, Peter Harrison, Ikramuddin Aukhil, Yan Gong, Luciana M Shaddox
AIM: To evaluate long-term clinical response to periodontal therapy and maintenance in localized aggressive periodontitis (LAP). MATERIALS AND METHODS: One hundred forty-one African-Americans diagnosed with LAP, aged 5-25 years, were enrolled. Patients underwent periodontal mechanical debridement plus one week of amoxicillin/metronidazole. Mechanical therapy was repeated as needed and clinical parameters were recorded at baseline, 3, 6, 12, 18, and 24 months, and 2 additional annual follow-up visits after treatment...
October 21, 2016: Journal of Clinical Periodontology
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
Sven Reuter, Andreas B Imhoff, Frank Martetschläger
BACKGROUND: The aim of this study was to systematically review the literature for the impact of rotator cuff tear (RCT) surgery on postoperative sporting activity in professional and recreational athletes. METHODS: To identify any published clinical study on return to sports data for athletes following rotator cuff surgery a systematic search in literature was conducted. Inclusion criteria were partial- and full-thickness rotator cuff tears and any open or arthroscopic RCT surgery in sports participating people...
October 20, 2016: Journal of Sports Medicine and Physical Fitness
J Tayierjiang, N Waresijiang, H Wang
Objective: To evaluate the clinical results of the patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar had been treated by one stage posterior surgical procedure to debriment of lesion and titian mesh bone fusion with internal fixation by pedicle screw system. Method: From May 2008 to March 2014, there were total 30 patients with severe kyphosis and paraplegia in different spine segment due to tuberculosis of thoracic and lumbar in Department of Orthopaedics, the People's Hospital of Xinjiang Uygur Autonoumy Region...
October 11, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Gaku Tsuji, Tomoyo Matsuda, Akari Shigyo, Tetsuo Matsuda, Masutaka Furue
No abstract text is available yet for this article.
October 19, 2016: European Journal of Dermatology: EJD
Or Friedman, Ehud Arad, Oded Ben Amotz
In the pursuit of success in sports, some athletes are not deterred by health risks associated with the (mis)use of black market preparations of dubious origin as performance-enhancing agents. Several studies published in the recent years demonstrated that anabolic-androgenic steroids, but also stimulants and growth hormones, are misused by numerous recreational athletes from all over the world. Trenbolone is an anabolic steroid routinely used in the finishing phase of beef production to improve animal performance and feed efficiency...
September 2016: Plastic and Reconstructive Surgery. Global Open
Daniel W Griffin, Matthew J Kinnard, Peter M Formby, Michael P McCabe, Terrence D Anderson
BACKGROUND: The indications for hip preservation surgery have expanded to include treatment of hip pathology in older adults. While several studies have examined the efficacy of hip arthroscopy in the setting of osteoarthritis, there has been no review of outcomes in older adults. PURPOSE: To review the outcomes of hip arthroscopy in older adults and identify factors associated with treatment failures. STUDY DESIGN: Systematic review. METHODS: PubMed, EMBASE, and the Cochrane Library were searched through March 2016 for studies reporting outcomes of primary hip arthroscopy in patients older than 40 years...
October 18, 2016: American Journal of Sports Medicine
Miguel Bouzas, Vincent Tchana-Sato, Jean Paul Lavigne
Early diagnosis of infected abdominal aortic aneurysm (IAAA) is still a medical challenge due to its diverse and non-specific symptoms and signs. The most common responsible pathogens are Salmonella, Staphylococcus, Campylobacter and Streptococcus species. The authors report the case of a 67-year-old man, admitted for high fever and finally diagnosed with Escherichia coli (E.coli)-related IAAA. The IAAA ruptured during the general anaesthesia induction, leading to an emergency surgery. The authors successfully proceeded to an open aneurysmectomy with extensive debridement and in situ graft replacement...
October 19, 2016: Acta Chirurgica Belgica
H Claude Sagi, David Donohue, Seth Cooper, David P Barei, Justin Siebler, Michael T Archdeacon, Marcus Sciadini, Michelle Romeo, Patrick F Bergin, Thomas Higgins, Hassan Mir
OBJECTIVES: The current literature focuses on wound severity, time to debridement and antibiotic administration with respect to risk of infection after open fracture. The purpose of this analysis was to determine if either the incidence of post-traumatic infection or causative organism varies with treating institution or the season in which the open fracture occurred. DESIGN: Retrospective review. SETTING: Seven level-one regional referral trauma centers located in each of the seven climatic regions of the continental United States (Northwest; High Plains; Midwest/Ohio Valley; New England/Mid-Atlantic; Southeast; South; and Southwest)...
October 7, 2016: Journal of Orthopaedic Trauma
Fernando Cobo, Gemma Jiménez, Javier Rodríguez-Granger, Antonio Sampedro
We report a case of posttraumatic skin and soft-tissue infection in a patient with a left thigh wound after a traffic accident. Pseudomonas fulva was isolated from a wound aspirate and was identified to the species level by Maldi-tof. The patient responded to drainage, debridement of wound, and two weeks of intravenous antibiotic therapy. Follow-up after 3 weeks was satisfactory with healthy cover of the injured area.
2016: Case Reports in Infectious Diseases
Yosuke Takahashi, Yasuyuki Sasaki, Yasuyuki Bito, Manabu Motoki, Takashi Murakami, Toshihiko Shibata
We herein report two cases of perigraft effusion mimicking graft infection after debranching thoracic endovascular repair for an anastomotic pseudoaneurysm of the distal ascending aorta. Both patients presented with a bulging tumor on the sternum. Enhanced computed tomography showed no endoleak, but extension of periprosthetic graft fluid to a subcutaneous sternal wound was present. We suspected a deep sternal wound infection; however, cultures of débrided tissues were negative. After drainage of the subcutaneous fluid or negative pressure wound therapy, both patients were doing well without recurrence of effusion...
October 14, 2016: Journal of Vascular Surgery
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