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https://www.readbyqxmd.com/read/28428919/tibial-bone-grafting-for-wrist-reconstruction
#1
Schneider K Rancy, Stephanie D Malliaris, Scott W Wolfe
Background Iliac crest bone graft harvesting is routinely performed for upper extremity orthopedic procedures despite high complication rates associated with sensory nerve injury, hematoma, chronic pain, and fracture. Description of Technique Cancellous bone graft is harvested from the proximal tibia using a medial approach, minimizing donor site morbidity. Patients and Methods A retrospective review was undertaken of 14 patients who underwent cancellous proximal tibia bone graft harvesting to augment healing of wrist reconstruction, with 2 months minimum follow-up...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28425055/what-are-the-oncologic-and-functional-outcomes-after-joint-salvage-resections-for-juxtaarticular-osteosarcoma-about-the-knee
#2
Jing Li, Zhen Wang, Chuanlei Ji, Guojing Chen, Dong Liu, Haodong Zhu
BACKGROUND: Joint salvage surgery for patients with juxtaarticular osteosarcoma remains challenging, especially when the tumor invades the epiphysis. Because patients are surviving longer with current chemotherapy regimens, it is advantageous to retain native joints if possible, especially in young patients. However, the results using joint-preserving tumor resections in this context have not been well characterized. QUESTIONS/PURPOSES: (1) What are the functional outcomes after limb salvage surgery at a minimum of 3 years? (2) What are the oncologic outcomes? (3) Is joint salvage surgery for epiphyseal tumors associated with an increased risk of local recurrence compared with metaphyseal tumors not invading the epiphysis? (4) What are the complications associated with joint salvage surgery? METHODS: Between 2004 and 2013, we treated 117 patients with juxtaarticular osteosarcoma; of those, 43 (38%) were treated with joint salvage surgery, and 41 (95%) of the 43 patients are included in our study...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28421958/acute-limb-compartment-syndrome-in-the-lower-leg-following-trauma-assessment-in-the-intensive-care-unit
#3
Emma Limbert, Julie Santy-Tomlinson
Acute limb compartment syndrome (ALCS) is a serious complication of traumatic injury. Although ALCS can occur in any limb, it most commonly occurs following injury to the lower leg, particularly in fractures of the tibia. Practitioners should recognise and treat ALCS as early as possible to prevent the development of further, potentially serious, complications. Most of the literature recommends that patients at risk of ALCS should be carefully monitored, with a focus on pain as the main symptom. However, patients in the intensive care unit (ICU) who are unconscious or sedated may be unable to report pain or are unreliable in doing so, therefore it is necessary to consider alternative assessments for ALCS...
April 19, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28418276/thrombin-antithrombin-iii-complex-tests
#4
Sang Yang Lee, Takahiro Niikura, Takashi Iwakura, Yoshitada Sakai, Ryosuke Kuroda, Masahiro Kurosaka
PURPOSE: Patients with fractures of the pelvis and/or lower extremities are at a high risk of developing postoperative venous thromboembolism (VTE). The purpose of this study was to determine whether the thrombin-antithrombin III complex (TAT) tests could be used for postoperative screening of VTE in patients with lower limb or pelvic fractures. METHODS: We enrolled 133 patients who underwent surgical treatment for fracture of the pelvis or lower extremities. TAT and D-dimer levels were compared in patients with and without VTE...
January 1, 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28413557/c2-primary-leiomyoma-in-an-immunocompetent-woman-a-case-report-and-review-of-literature
#5
Mohana Rao Patibandla, Madhukar T Nayak, A K Purohit, Megha Uppin, Sundaram Challa, Gokul Chowdary Addagada, Manisha Nukavarapu
Clinical case report and review of the literature. This is the first case of primary leiomyoma in an immunocompetent woman without previous history of uterine leiomyoma being reported in the literature to the best of our knowledge. Leiomyoma, a type of smooth muscle cell tumor, involving the vertebra is extremely rare. There were very few primary leiomyoma in patients with AIDS or in the immune-suppressed patients. This 48-year-old female came with H/o neck pain, weakness and bladder retention. On examination, tone increased in all four limbs, power on the right side of the limbs 4/5, power on the left upper limb 0/5, lower limb 3/5, left plantar was up going, decreased sensation over the left second cervical vertebra (C2) dermatome and all modalities decreased below C2...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28409214/-fractures-of-the-upper-limbs-in-childhood-and-adolescence
#6
P P Schmittenbecher
Fractures of the upper limbs are frequent and often need operative treatment in addition to a well-indicated conservative management. This depends on the maturity of the nearest growth plate and the local remodeling potential, which is dependent on age. Following conventional x‑ray imaging an individual prognostic growth analysis leads to the therapeutic decision. Around the elbow and the shaft of the forearm, criteria are stricter than near the shoulder or wrist. Gilchrist or Desault bandages as well as braces are adequate for most subcapital and humeral shaft fractures...
April 13, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28409141/intrathoracic-fracture-dislocation-of-the-humerus-case-report-and-literature-review
#7
Wilson Carlos Sola Junior, Paulo Sérgio Dos Santos
Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away...
March 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#8
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28400667/epidemiology-of-lower-limb-musculoskeletal-trauma-with-associated-vascular-injuries-in-a-tertiary-care-institute-in-india
#9
Nirmal Raj Gopinathan, Siva Swaminathan Santhanam, Balaji Saibaba, Mandeep Singh Dhillon
BACKGROUND: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma. The aim of this study is to describe the epidemiology and outcome of lower extremity musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#10
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28398398/-new-technologies-and-applications-for-drug-coated-balloons
#11
Bernardo Cortese, Gaetano Di Palma, Roberto Nerla, Antonio Micari
Drug-eluting stents (DES) represent nowadays the gold standard treatment for coronary artery disease. Despite the safety and efficacy, and favorable long-term clinical outcomes of new generation DES, their use is still associated with a not negligible risk of long-term events, related to the presence of a definitive prosthesis in the vessel wall. In addition, DES implantation is not always desirable in particular anatomic settings (small vessels, bifurcations) or in patients with higher bleeding risk. In recent years, drug-coated balloons (DCB) have been developed to overcome some of these limitations, offering a combined mechanical (balloon dilation) and biological therapy (drug-release)...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28391518/discovery-elbow-system-clinical-and-radiological-results-after-2-to-10-year-follow-up
#12
Patrik Hänninen, Tuukka Niinimäki, Tapio Flinkkilä, Jaakko Niinimäki, Pasi Ohtonen, Susanna Yli-Luukko, Juhana Leppilahti
BACKGROUND: Discovery Elbow System (DES) is a semi-constrained prosthesis, mainly used for patients with rheumatoid arthritis (RA). METHODS: Records from 79 patients with RA (90 DES arthroplasties) were reviewed; 47 patients with 55 DES elbows were re-examined. Range of motion (ROM) of both elbows, upper limb function, and quality of life (Disabilities of the Arm, Shoulder, and Hand [DASH] score, Mayo Elbow Performance Score [MEPS], and the RAND 36-Item Health Survey [RAND-36]) were assessed...
April 8, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28389120/reference-equations-for-handgrip-strength-normative-values-in-young-adult-and-middle-aged-subjects
#13
Jordão Lopes, Samantha Torres Grams, Edy Floriano da Silva, Luana Adriano de Medeiros, Christina May Moran de Brito, Wellington Pereira Yamaguti
BACKGROUND & AIMS: Handgrip strength (HS) has been widely used as a functionality parameter of the upper limbs (UL) and general health. The measurement of HS by dynamometry is a low cost, non-invasive method of simple applicability, widely used in pulmonary rehabilitation and in critical care units. However, there are no reports in the literature of reference equations for the Brazilian population involving young and middle-aged adults. The aim of this study was to establish reference equations to predict normal HS for young and middle-aged adults through demographic and anthropometric data...
March 24, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#14
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28384948/clinico-radiological-outcome-analysis-of-parallel-plating-with-perpendicular-plating-in-distal-humeral-intra-articular-fractures-prospective-randomised-study
#15
Ramachandran Govindasamy, Vishal Shekhawat, Ramesh Chandra Banshiwal, Rajender Kumar Verma
INTRODUCTION: The distal humeral fractures are common fractures of upper limb and are difficult to treat. These fractures, if left untreated or inadequately treated, leads to poor outcomes. Management of distal humeral fractures are pertained to many controversies and one among them is position of plates. AIM: To compare the clinical and radiological outcomes in patients with intra-articular distal humerus fractures, treated using parallel and perpendicular double plating methods...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383440/cementless-total-hip-arthroplasty-with-extended-sliding-trochanteric-osteotomy-for-high-congenital-hip-dislocation-a-retrospective-study
#16
Zhengliang Luo, Min Chen, Fei Hu, Zhe Ni, Xiaofeng Ji, Xiaoqi Zhang, Peng Cheng, Xifu Shang
Total hip arthroplasty (THA) for high congenital hip dislocation (CHD) is technically demanding. The purpose of this retrospective study was to evaluate the results of cementless THA combined with extended sliding trochanteric osteotomy. We also assessed whether chronic low back pain was relieved after surgery.The study included 19 patients (23 hips) with high CHD treated with cementless THA using extended sliding trochanteric osteotomy technique. Clinical and radiographic outcomes were evaluated.Harris Hip Score, WOMAC score, visual analog scale for low back pain and Trendelenburg sign were significantly improved (P < 0...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28381356/blocking-screws-for-alignment-control-in-intramedullary-limb-lengthening
#17
Julian Fürmetz, Stefan Bösl, James Schilling, Florian Wolf, Nikolaus Degen, Peter H Thaller
Simultaneous deformity correction in the frontal and sagittal plane becomes more and more an important part of intramedullary lengthening to avoid further operative procedures. Such as in fracture treatment blocking screws can be used for alignment control if osteotomy is performed in the metaphyseal bone. 31 intramedullary lengthening procedures between 2009 and 2011 were retrospectively analysed for precision of simultaneous deformity correction. The average planned correction to the HKA was 2.4° (0.1°-8...
March 31, 2017: Injury
https://www.readbyqxmd.com/read/28379937/treatment-of-post-traumatic-femoral-discrepancy-with-precice-magnetic-powered-intramedullary-lengthening-nails
#18
Ahmed I Hammouda, Julio J Jauregui, Martin G Gesheff, Shawn C Standard, Janet D Conway, John E Herzenberg
OBJECTIVE: Post traumatic limb length discrepancy (LLD) may present secondary to fracture shortening, malunion, or epiphyseal growth arrest. The purpose of this study was to evaluate the outcomes of lengthening post-traumatic femoral segments utilizing a recently available magnetic intramedullary (IM) lengthening system. DESIGN: Retrospective cohort study SETTING:: Urban Level II Trauma CenterPatients/Participants: This study was performed to review post-traumatic patients treated for femoral shortening at our institution between 2011 and 2015...
April 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28377260/infection-after-fracture-fixation-of-the-tibia-analysis-of-healthcare-utilization-and-related-costs
#19
Willem-Jan Metsemakers, Bart Smeets, Stefaan Nijs, Harm Hoekstra
INTRODUCTION: One of the most challenging complications in musculoskeletal trauma surgery is the development of infection after fracture fixation (IAFF). It can delay healing, lead to permanent functional loss, or even amputation of the affected limb. The main goal of this study was to investigate the total healthcare costs and length-of-stay (LOS) related to the surgical treatment of tibia fractures and furthermore identify the subset of clinical variables driving these costs within the Belgian healthcare system...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28374715/-clinical-experience-with-various-techniques-integrated-treat-the-wounded-with-gunshot-fractures-of-limbs
#20
V K Kozlov, B G Akhmedov, A M Chililov
AIM: To increase an efficiency of complex treatment of patients with diaphyseal gunshot fractures of long bones by introduction of modern minimally invasive surgical techniques of internal osteosynthesis into clinical practice of civil health care and to improve the outcomes in victims. MATERIAL AND METHODS: Prospective comparative clinical trial included 104 victims from the Republic of Yemen with gunshot wounds of limbs of various severity for the period 2009-2011...
2017: Khirurgiia
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