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elbow orthopedics

K Keely Boyle, Thomas R Duquin
Infection after orthopedic procedures is a devastating and serious complication associated with significant clinical and financial challenges to the health care system and unfortunate patient. The time and resource-intensive nature of treating infection after orthopedic procedures has turned attention toward enhancing prevention and establishing quality improvement measures. Prevention strategies throughout the perioperative period include host optimization, risk mitigation, reducing bacterial burden and proper wound management...
April 2018: Orthopedic Clinics of North America
Jeremy Kubik, Prism Schneider, Richard Buckley, Robert Korley, Paul Duffy, Ryan Martin
OBJECTIVES: The surgical reduction of intra-articular olecranon fractures is judged primarily on the lateral elbow radiograph, as orthogonal imaging of the articular surface is not obtainable. We sought to determine surgeon accuracy in identifying intra-articular olecranon malreductions on the lateral elbow radiograph. METHODS: Six human fresh-frozen cadaveric elbow specimens were sagittally sectioned in 5-mm increments after olecranon dissection, preservation of soft tissue envelope, and rigid fixation of the elbow in an external fixator...
March 2018: Journal of Orthopaedic Trauma
Joseph N Liu, Grant H Garcia, Alexandra C Wong, Alec Sinatro, Hao-Hua Wu, David M Dines, Russell F Warren, Lawrence V Gulotta
As the number of anatomic total shoulder arthroplasties performed on younger patients continues to grow, return to work after surgery becomes increasingly important. The purpose of this study was to evaluate the ability of anatomic total shoulder arthroplasty to return patients 55 years or younger to work postoperatively. A retrospective review was performed of consecutive anatomic total shoulder arthroplasty patients. Inclusion criteria were age 55 years or younger at surgery, greater than 2 years of follow-up, and employment within 3 years of surgery...
February 16, 2018: Orthopedics
Masahiro Takeyama, Keiji Nogami, Ryohei Kobayashi, Kenichi Ogiwara, Akira Taniguchi, Yasuaki Nakanishi, Yusuke Inagaki, Yasuhito Tanaka, Midori Shima
Continuous infusions (CI) of factor (F)VIII are preferable to the conventional bolus injections for the maintenance of consistent FVIII levels during surgery in patients with severe hemophilia A. A third generation, B domain-truncated recombinant FVIII (turoctocog alfa, Novo Nordisk, NovoEight®), was approved for clinical use in 2014. The hemostatic efficacy and safety of bolus injections of turoctocog alfa in patients undergoing surgery have been reported, but no reports on CI therapy have been published...
January 30, 2018: International Journal of Hematology
Man Hung, Maren W Voss, Jerry Bounsanga, Yushan Gu, Erin K Granger, Robert Z Tashjian
BACKGROUND: This study evaluated the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) instrument administered through computerized adaptive testing (CAT) compared with the traditional full-length Disabilities of the Arm, Shoulder and Hand (DASH). METHODS: The PROMIS PF CAT and the DASH were administered to 1759 patients seeking care for elbow conditions. This study used Rasch partial credit modeling to analyze the instruments with item fit, internal reliability, response category thresholds, dimensionality, local independence, gender differential item functioning, and floor and ceiling effects...
January 9, 2018: Journal of Shoulder and Elbow Surgery
Mohammad H Nabian, Shayan Abdollah Zadegan, Leila Oryadi Zanjani, Saeed R Mehrpour
Background: The epidemiology of traumatic dislocations and ligamentous/tendinous injuries is poorly understood. In this study, we aimed to evaluate the prevalence and distribution of various dislocations and ligamentous/tendinous injuries in a tertiary orthopedic hospital in Iran. Methods: Musculoskeletal injuries in an academic tertiary health care center in Tehran February 2005 to October 2010 were recorded. The demographic details of patients with pure dislocations and ligamentous/tendinous injuries were extracted and the type and site of injuries were classified according to their specific age/gender groups...
November 2017: Archives of Bone and Joint Surgery
Amir R Kachooei, David Ring
Background: To study if patients that have a second radiograph 2 or more years after nonoperative treatment of an isolated radial head fracture have radiocapitellar osteoarthritis (RC OA). Methods: We used the database of 3 academic hospitals in one health system from 1988 to 2013 to find patients with isolated radial head fractures (no associated ligament injury or fracture) that had a second elbow radiograph after more than 2 years from the initial injury. Of 887 patients with isolated radial head fractures, 54 (6%) had an accessible second radiograph for reasons of a second injury (57%), pain (30%), or follow-up visit (13%)...
November 2017: Archives of Bone and Joint Surgery
M M Elzohairy
BACKGROUND: Pyomyositis PM is defined as a primary pyogenic infection of the striated skeletal muscle; although it has many dystrophic musculoskeletal complications, it is always misdiagnosed by many orthopedic surgeons. HYPOTHESIS: PM is rare in temperate climates and usually considered to be a tropical disease, until recent times, after globalization, it is possible to occur in the subtropical climate as in our country. MATERIAL AND METHODS: In the present series, the results of 15 children patients with primary pyomyositis have been reviewed...
December 21, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
K Linnea Welton, Matthew J Kraeutler, Eric C McCarty, Armando F Vidal, Jonathan T Bravman
BACKGROUND: Orthopedic surgeons are among the highest prescribers of narcotic pills, and no guidelines currently exist for appropriate management of postoperative pain within this field. The purpose of this study was to gain understanding of the current pain management strategies used perioperatively and postoperatively among orthopedic shoulder surgeons. METHODS: Members of the American Shoulder and Elbow Surgeons were e-mailed an online survey regarding methods for managing pain in the perioperative and postoperative setting for total shoulder arthroplasty, labral and capsular stabilization procedures, and rotator cuff repair...
December 14, 2017: Journal of Shoulder and Elbow Surgery
Richard J Hawkins, Charles A Thigpen
The movement toward a value-based health care market requires comparison of physicians, hospitals, and health systems. Traditionally, process-based measures such as infection and readmission rates have been used. However, these events are uncommon in shoulder and elbow surgery, thus limiting their utility. Patient-reported outcomes (PROs) are a promising measure of quality and have been proposed as a potential metric to compare surgeon performance. However, there are over 25 different PROs for shoulder and elbow conditions...
December 13, 2017: Journal of Shoulder and Elbow Surgery
Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
R Papalia, A Tecame, G Vadalà, F Russo, M Perna, G Papalia, F Bressi, S Sterzi, V Denaro
Adhesive capsulitis (AC) is a common pathological condition of the shoulder characterized by painful restriction of range of motion (ROM) of the glenohumeral joint. Currently, no consensus has been reached regarding the best treatment. Hyaluronic acid (HA) injection is a safe procedure that can result in significant improvement in active and passive ROM, alleviating pain and improving shoulder function. We systematically reviewed current literature in order to evaluate the best evidence about the effectiveness of intra-articular HA injection for the treatment of primary AC...
December 27, 2017: Journal of Biological Regulators and Homeostatic Agents
Eli S Kupperman, Asher I Kupperman, Scott A Mitchell
PURPOSE: Optimal treatment strategies for radial head fractures remain a subject of debate. We examined national practice patterns in the management of radial head fractures to determine rates of surgical treatment, type of surgery employed, and the incidence of reoperation. METHODS: Between 2007 and 2011, we identified patients with radial head fractures along with their associated injuries by International Classification of Diseases, Ninth Revision codes in a national database of orthopedic insurance records...
November 21, 2017: Journal of Hand Surgery
Nata Parnes, Nicole R Bartoszewski, Michael J Defranco
This study characterized injury patterns and reported clinical outcomes of all-arthroscopic management of full-thickness rotator cuff tears among military patients younger than 40 years. A retrospective review was performed of prospective data for 42 patients younger than 40 years who underwent arthroscopic rotator cuff repair and, in some cases, concomitant labral repair. Preoperative and postoperative evaluations (minimum follow-up, 2 years; mean, 41 months; range, 24-66 months) included range of motion, visual analog scale (VAS) score, Subjective Shoulder Value (SSV), and American Shoulder and Elbow Surgeons (ASES) Shoulder Score...
November 20, 2017: Orthopedics
Nadir Yalçın, Enes Uluyardımcı, İbrahim Bozkurt
OBJECTIVES: This study aims to investigate the durations of scientific presentations and factors affecting the rates of exceeding the time limit in presentations at 26th Turkish National Congress of Orthopedics and Traumatology, which is one of Turkey's largest nationally organized orthopedics and traumatology meetings in terms of the numbers of speakers and participators. MATERIALS AND METHODS: Speech durations of Turkish orthopedists and the rates of these durations against the durations specified in the schedule were calculated...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Nipun Sodhi, Anton Khlopas, Michael D Vaughn, Jaiben George, George Yakubek, Assem A Sultan, Steven F Harwin, Michael A Mont
Multiple surgical and nonsurgical treatment options exist for patients with elbow stiffness. Many nonsurgical mobilization bracing options have been implemented to increase elbow range of motion. Three of the main bracing options for these patients are turnbuckle, static progressive stretch, and dynamic bracing. The purpose of this study was to review the current literature on turnbuckle, static progressive stretch, and dynamic bracing to provide information for practitioners and patients regarding which brace is more appropriate to use for elbow stiffness...
January 1, 2018: Orthopedics
Julianne M Kowalski, James T Monica
Indications for elbow arthroscopy are expanding; however, it is uncommon compared with shoulder arthroscopy. Elbow arthroscopy can be complicated by positioning, including the need to obtain specific arm holders required by most operating rooms. Surgery can be performed in the supine, prone, or lateral position. Arm traction allows for distraction of the joint space, full insufflation, and therefore visualization of intra-articular anatomy. This article outlines a new technique using previously available shoulder arthroscopy equipment to avoid increased cost incurred by procuring new, elbow-specific equipment...
November 8, 2017: Orthopedics
Adilson Sanches de Oliveira, Bruno Braga Roberto, Mario Lenza, Guilherme Figueiredo Pintan, Benno Ejnisman, Breno Schor, Eduardo da Frota Carrera, Joel Murachovsky
OBJECTIVE: To determine the current clinical practice in Latin America for treating midshaft clavicle fractures, including surgical and non-surgical approaches. METHODS: A cross-sectional study using a descriptive questionnaire. Shoulder and elbow surgeons from the Brazilian Society of Shoulder and Elbow Surgery and from the Latin American Society of Shoulder and Elbow were contacted and asked to complete a short questionnaire (SurveyMonkey®) on the management of midshaft fractures of the clavicle...
July 2017: Einstein
Russell R Russo, Matthew B Burn, Sabir K Ismaily, Brayden J Gerrie, Shuyang Han, Jerry Alexander, Christopher Lenherr, Philip C Noble, Joshua D Harris, Patrick C McCulloch
OBJECTIVES: Comparison of range of motion measurements by 3 types of investigators with different levels and types of training using three different measurement techniques. The study hypothesis was that the accuracy and precision of range of motion measurements would vary based on (1) the level and type of experience of the investigator and (2) the measurement technique used. DESIGN/SETTING: Descriptive laboratory study. PARTICIPANTS: Ten fresh frozen cadavers (20 upper and 20 lower extremities)...
October 13, 2017: Journal of Surgical Education
Eyal Ginesin, Yaniv Keren, Ofer Zachs, Doron Norman
BACKGROUND: Intra-articular elbow fractures are considered to be one of the most complex injuries in orthopedic trauma. Some are too comminuted for open reduction and internal fixation. Recently, total elbow replacement (TER) has gained popularity for the treatment of comminuted elbow trauma when other treatment options are not possible. METHODS: Since 2007-2013 we treated 18 patients with TER due to comminuted distal humeral fractures. We used the Disabilities of the Arm, Shoulder and Hand scoring system (DASH) to evaluate the patient's satisfaction...
September 2017: Harefuah
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