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https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#1
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28534159/arthroscopic-treatment-successfully-treats-posterior-elbow-impingement-in-an-athletic-population
#2
Jason L Koh, Brad A Zwahlen, David W Altchek, Todd A Zimmerman
PURPOSE: Posterior elbow impingement can cause disabling pain and limited motion during activities involving elbow extension. Less understood is whether arthroscopic treatment, compared to open surgery, can result in effective management of pain, loss of range of motion, and return athletes to previous levels of activity. This study determined whether arthroscopic debridement is a safe and effective treatment for posterior elbow impingement and whether it enables athletes to return to a previous level of function...
May 22, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28533933/negative-wound-pressure-therapy-is-safe-and-useful-in-pediatric-burn-patients
#3
Yanhan Ren, Philip Chang, Robert L Sheridan
INTRODUCTION: Negative Pressure Wound Therapy (NPWT) has proven to be a powerful tool in facilitating healing of difficult wounds of a variety of etiologies. The pediatric experience with NPWT has been limited due to concerns about vascular compression and pain associated with treatment. METHOD: A retrospective review was performed to evaluate the therapeutic effect of NPWT on children with difficult wounds due to burns or soft-tissue trauma. NPWT was instituted in the operating room under general anesthesia using a commercially available system...
2017: International Journal of Burns and Trauma
https://www.readbyqxmd.com/read/28532175/patient-presenting-with-frontal-subperiosteal-abscess-and-headache-a-case-of-pott-s-puffy-tumour
#4
Hakan Şimşek
Chronic sinusitis can be complicated with erosion of anterior or posterior wall of the sinus; causing Pott's puffy tumour in the anterior, or epidural abscess in the posterior communication. A 65-year old man with a painful swelling in his forehead is presented. Pott's puffy tumour was diagnosed. CT, MRI, and DTI studies were obtained. Epidural or dural involvement was not present. In the first operation, anterior wall of the frontal sinus wall was opened. Osteomyelitis debridement was performed and the frontonasal duct was enlarged endoscopically...
May 22, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28531982/study-of-the-keratin-based-therapeutic-dermal-patches-for-the-delivery-of-bioactive-molecules-for-wound-treatment
#5
Kush Kumar Nayak, Pratima Gupta
In the present study, dressing materials were fabricated in the form of dermal patches. The keratin based biocompatible materials, namely Keratin/Alginate, Keratin/Agar, and Keratin/Gellan were developed as therapeutic dermal patches. The patches were coated with green synthesized silver nanoparticles to prevent the microbial infection and were found to be antimicrobial against pathogens. Papain was used in the patches to acquire the enzymatic cell debridement and its activity was measured by reduction rate of benzoyl-l-arginine ethyl ester...
August 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#6
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28530851/chondral-injuries-and-irreparable-meniscal-tears-among-adolescents-with-anterior-cruciate-ligament-or-meniscal-tears-are-more-common-in-patients-with-public-insurance
#7
Ariel A Williams, Nickolas S Mancini, Matthew J Solomito, Carl W Nissen, Matthew D Milewski
BACKGROUND: Access to health care services is a critical component of health care reform and may differ among patients with different types of insurance. Hypothesis/Purpose: The purpose was to compare adolescents with private and public insurance undergoing surgery for anterior cruciate ligament (ACL) and/or meniscal tears. We hypothesized that patients with public insurance would have a delayed presentation from the time of injury and therefore would have a higher incidence of chondral injuries and irreparable meniscal tears and lower preoperative International Knee Documentation Committee (IKDC) scores than patients with private insurance...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28529867/efficacy-of-antibiotic-suppressive-therapy-in-patients-with-a-prosthetic-joint-infection
#8
Marjan Wouthuyzen-Bakker, Jasperina M Nijman, Greetje A Kampinga, Sander van Assen, Paul C Jutte
Introduction: For chronic prosthetic joint infections (PJI), complete removal of the infected prosthesis is necessary in order to cure the infection. Unfortunately, a subgroup of patients is not able to undergo a revision surgery due to high surgical risk. Alternatively, these patients can be treated with antibiotic suppressive therapy (AST) to suppress the infection. Aim: To evaluate the efficacy and tolerability of AST. Methods: We retrospectively collected data (period 2009-2015) from patients with a PJI (of hip, knee or shoulder) who were treated with AST at the University Medical Center Groningen, the Netherlands...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529864/allograft-bone-as-antibiotic-carrier
#9
REVIEW
Heinz Winkler, Peter Haiden
The treatment of chronic bone and joint infections is characterized by obstinate persistency of the causing microorganisms and resulting long term disability to patients, associated with remarkable costs for the health care system. Difficulties derive from biofilm formed on dead bone and eventual implants, with resistance against immunological defences and antimicrobial substances. Biofilm embedded bacteria require up to 1000 times the antibiotic concentration of planktonic bacteria for elimination. Systemic antibiotic treatment alone cannot provide the concentrations required and surgical intervention is always prerequisite for potentially providing a cure...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529863/ceramic-biocomposites-as-biodegradable-antibiotic-carriers-in-the-treatment-of-bone-infections
#10
REVIEW
Jamie Ferguson, Michael Diefenbeck, Martin McNally
Local release of antibiotic has advantages in the treatment of chronic osteomyelitis and infected fractures. The adequacy of surgical debridement is still key to successful clearance of infection but local antibiotic carriers seem to afford greater success rates by targeting the residual organisms present after debridement and delivering much higher local antibiotic concentrations compared with systemic antibiotics alone. Biodegradable ceramic carriers can be used to fill osseous defects, which reduces the dead space and provides the potential for subsequent repair of the osseous defect as they dissolve away...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529859/treatment-of-periprosthetic-joint-infection-using-antimicrobials-dilute-povidone-iodine-lavage
#11
REVIEW
John A Ruder, Bryan D Springer
Periprosthetic joint infections (PJI) remain a challenge for the orthopaedic surgeon to treat and remain a leading cause of failure of both primary and revision total joint arthroplasty. Once a PJI develops, surgical treatment is generally indicated and includes an aggressive irrigation and debridement. One component of the irrigation and debridement involves the use of an antiseptic irrigating solution. In primary and revision TJA, dilute povidone-iodine lavage can be performed prior to wound closure. Approximately 17...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529858/hydrogen-peroxide-wound-irrigation-in-orthopaedic-surgery
#12
REVIEW
Min Lu, Erik Nathan Hansen
As the burden of deep hardware infections continues to rise in orthopaedics, there is increasing interest in strategies for more effective debridement of colonized tissues and biofilm. Hydrogen peroxide has been used medically for almost a century, but its applications in orthopaedic surgery have yet to be fully determined. The basic science and clinical research on the antiseptic efficacy of hydrogen peroxide have demonstrated its efficacy against bacteria, and it has demonstrated potential synergy with other irrigation solutions such as chlorhexidine and povidone-iodine...
2017: J Bone Jt Infect
https://www.readbyqxmd.com/read/28529812/diabetic-muscle-infarction-masquerading-as-necrotizing-fasciitis
#13
Kalyana C Janga, Ankur Sinha, Perry Wengrofsky, Phone Oo, Sheldon Greenberg, Regina Tarkovsky, Kavita Sharma
A 43-year-old male patient with past medical history of diabetes mellitus (DM), end stage renal disease (ESRD) on hemodialysis (HD), congestive heart failure (CHF), obstructive sleep apnea (OSA), and chronic anemia presented with complaints of left thigh pain. A computerized tomogram (CT) of the thigh revealed evidence of edema with no evidence of a focal collection or gas formation noted. The patient's clinical symptoms persisted and he underwent magnetic resonance imaging (MRI) of his thigh which was reported to show small areas of muscle necrosis with fluid collection...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28528048/real-time-autofluorescence-imaging-to-diagnose-lvad-driveline-infections
#14
Jack B Keenan, Taufiek Konrad Rajab, David G Armstrong, Zain Khalpey
A 64-year-old man experienced a driveline infection that was treated with serial debridements and antibiotics. When the wound clinically appeared ready for closure, a handheld fluorescence imaging device still revealed a margin of red fluorescence around the wound edges consistent with a subclinical infection. Therefore, a wider margin was made and additional specimens for wound culture were taken, which demonstrated a vancomycin-resistant enterococcal infection. The autofluorescence signals of common bacteria can be detected with a fluorescence camera in subclinical wound infections without clinical signs...
June 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28526996/improved-outcomes-with-arthroscopic-repair-of-partial-thickness-rotator-cuff-tears-a-systematic-review
#15
J Christoph Katthagen, Gabriella Bucci, Gilbert Moatshe, Dimitri S Tahal, Peter J Millett
PURPOSE: The optimum treatment strategy for the surgical management of partial-thickness rotator cuff tears (PTRCT) is evolving. In this study, two research questions were sought to be answered: "Does the repair technique for PTRCTs involving >50% of the tendon thickness have an effect on structural and functional outcomes of arthroscopic repair?" and "Is there a difference in outcomes of arthroscopically treated articular- and bursal-sided PTRCTs?". METHODS: A systematic review according to the PRISMA statement was conducted to identify all literature published reporting on outcomes of arthroscopic treatment of PTRCTs classified with the Ellman classification with minimum 2-year follow-up...
May 19, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28526612/histomorphological-observation-of-surgical-debridement-combined-with-negative-pressure-therapy-in-treatment-of-diabetic-foot
#16
Jiao-Yun Dong, Fei Song, Chun Qing, Shu-Liang Lu
PURPOSE: To further study the mechanism of epithelization on the fascia side of the flap after surgical incision and the treatment of the negative pressure therapy. METHODS: With the patients' informed consent, parts of tissue samples were obtained from a 51-year-old diabetic patient who was suffering lower extremity ulcers. The samples were processed with hematoxylin and eosin (HE) staining and Masson trichrome staining. The keratin 19, keratin 15 and carcino-embryonic antigen (CEA) were immunohistochemically detected...
April 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28526569/total-joint-replacement-for-neglected-posterior-knee-dislocation-following-septic-arthritis-after-arthroscopy
#17
Yusuf Öztürkmen, Yunus Emre Akman, Ethem Ayhan Ünkar, Erhan Şükür
This report presents the first case of a knee dislocation following septic arthritis after arthroscopy. A 65-year-old woman had an arthroscopy with irrigation and debridement (I&D) of the joint and microfracture for the chondral lesions. She had complaints of postarthroscopic infection but non-steroidal anti-inflammatory medication and local ice compression was recommended. She revisited her physician twice and at the last visit she had a large purulent effusion in her knee. The gram stain of the joint fluid aspirate demonstrated gram-positive cocci and the cultures grew methicilline-sensitive Staphylococcus aureus...
May 16, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28524620/clinical-performance-and-survivorship-of-navigated-floating-platform-mobile-bearing-total-knee-arthroplasty-a-minimum-10-year-follow-up
#18
Sang-Min Kim, Jai-Gon Seo, Seung-Jae Lim, Hyung-Tae Lim, Chang-Ho Cho, Young-Wan Moon
BACKGROUND: The purpose of this study is to report the outcome of navigation-assisted cruciate-retaining total knee arthroplasty (TKA) using one type of cemented, second-generation, floating-platform (FP), mobile-bearing system. METHODS: Forty-two patients who underwent cruciate retaining TKAs using e.motion-FP prostheses under navigational guidance were retrospectively reviewed. The preoperative diagnosis was osteoarthritis in all knees except one rheumatoid arthritis...
May 19, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28523894/primary-cutaneous-mucormycosis-in-an-extremely-preterm-infant-successfully-treated-with-liposomal-amphotericin-b
#19
Christopher D Lowe, Rebecca J Sainato, David R Stagliano, Maribel M Morgan, Brian P Green
Cutaneous mucormycosis is a rare but often fatal invasive fungal infection that occurs most commonly in patients with diabetes, malignancy, and other immunocompromising conditions. We report an extremely preterm (<28 weeks) baby boy who developed polymicrobial sepsis and primary cutaneous mucormycosis within his first 10 days of life. He was successfully treated with medical management alone since he was not a candidate for surgery. Successful treatment of cutaneous mucormycosis without surgical debridement has been reported on only two other occasions...
May 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28523889/collagenase-for-wound-debridement-in-the-neonatal-intensive-care-unit-a-retrospective-case-series
#20
Elizabeth Huett, Whitney Bartley, Darla Morris, Della Reasbeck, Beth McKitrick-Bandy, Charlotte Yates
BACKGROUND/OBJECTIVES: The use of collagenase for enzymatic wound debridement has been studied extensively and has been established as the standard of care for nonhealing and necrotic wounds in individuals for whom surgical intervention is not an option. Collagenase has been shown to be effective in adults but has been studied in a limited capacity in infants and neonates. The purpose of this study was to investigate the use of collagenase in the neonatal intensive care unit (NICU). METHODS: Retrospective chart review of infants and neonates admitted to the NICU at Arkansas Children's Hospital with nonhealing wounds for which collagenase was used for wound healing over a 1-year time period...
May 2017: Pediatric Dermatology
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