56 results match your criteria General Principles of Fracture Care


What Factors Are Associated With Outcomes Scores After Surgical Treatment Of Ankle Fractures With a Posterior Malleolar Fragment?

Clin Orthop Relat Res 2019 Apr;477(4):863-869

D. T. Meijer, B. D. J. G. Deynoot, S. A. Stufkens, G. M. M. J. Kerkhoffs, J. N. Doornberg, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands D. T. Meijer, Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands I. N. Sierevelt, Slotervaart Center of Orthopedic Research and Education, Department of Orthopaedic Surgery, Medical Centre Slotervaart, Amsterdam, The Netherlands J. C. Goslings, Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands G. M. M. J. Kerkhoffs, Academic Center for Evidence-based Sports Medicine, Amsterdam Collaboration for Health and Safety in Sports, IOC Research Center, Amsterdam, The Netherlands J. N. Doornberg, Flinders University, Adelaide, Australia.

Background: Psychosocial factors, such as depression and catastrophic thinking, might account for more disability after various orthopaedic trauma pathologies than range of motion and other impairments. However, little is known about the influence of psychosocial aspects of illness on long-term symptoms and limitations of patients with rotational-type ankle fractures, including a posterior malleolar fragment. Knowledge of the psychosocial factors associated with long-term outcome after operative treatment of trimalleolar ankle fractures might improve recovery. Read More

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http://dx.doi.org/10.1097/CORR.0000000000000623DOI Listing
April 2019
11 Reads

Early management of severe pelvic injury (first 24 hours).

Anaesth Crit Care Pain Med 2019 Apr 21;38(2):199-207. Epub 2018 Dec 21.

CHRU de Lille, réanimation chirurgicale, pôle d'anesthésie-réanimation, 2 avenue Oscar-Lambret 59037 Lille, France.

Objective: Pelvic fractures represent 5% of all traumatic fractures and 30% are isolated pelvic fractures. Pelvic fractures are found in 10 to 20% of severe trauma patients and their presence is highly correlated to increasing trauma severity scores. The high mortality of pelvic trauma, about 8 to 15%, is related to actively bleeding pelvic injuries and/or associated injuries to the head, abdomen or chest. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S23525568183056
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http://dx.doi.org/10.1016/j.accpm.2018.12.003DOI Listing
April 2019
21 Reads

Perceptions and experiences of patients following treatment with single-implant mandibular overdentures: A qualitative study.

Clin Oral Implants Res 2019 Jan 26;30(1):79-89. Epub 2018 Dec 26.

School of Dentistry, Federal University of Goias, Goiania, Brazil.

Objective: This study aimed to explore the perceptions and long-term experiences of edentulous patients rehabilitated with single-implant mandibular overdentures (SIMO).

Methods: Thirteen participants, mean age 65.7 years, 69. Read More

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http://dx.doi.org/10.1111/clr.13394DOI Listing
January 2019
12 Reads

Chinese expert consensus on echelons treatment of pelvic fractures in modern war.

Mil Med Res 2018 06 30;5(1):21. Epub 2018 Jun 30.

Department of Trauma Surgery, Daping Hospital, Army Medical University, ChongQing, 400042, China.

The characteristics and treatment of pelvic fractures vary between general conditions and modern war. An expert consensus has been reached based on pelvic injury epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. According to this consensus, first aid, emergency treatment and early treatment of pelvic fractures are introduced in three separate levels. Read More

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http://dx.doi.org/10.1186/s40779-018-0168-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6029371PMC
June 2018
25 Reads

Anaesthetic aspects in the treatment of fragility fracture patients.

Injury 2018 Aug 22;49(8):1403-1408. Epub 2018 Jun 22.

North West Anglia Hospitals NHS FT, Bretton Gate, Peterborough, PE3 9GZ, United Kingdom.

As longevity increases globally, the number of older, frailer, comorbid patients requiring fragility fracture surgery will increase. Fundamentally, anaesthesia should aim to maintain these patients' pre-fracture cognitive and physiological trajectories and facilitate early (ie day 1) postoperative recovery. This review describes the 10 general principles of anaesthesia for fragility fracture surgery that best achieve these aims: multidisciplinary care, 'getting it right first time', timely surgery, standardisation, sympathetic anaesthesia, avoiding ischaemia, sympathetic analgesia, re-enablement, data collection and training. Read More

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http://dx.doi.org/10.1016/j.injury.2018.06.027DOI Listing
August 2018
9 Reads

Wartime Soft Tissue Coverage Techniques for the Deployed Surgeon.

Mil Med 2018 Mar 26. Epub 2018 Mar 26.

Department of Surgery, University of Nevada School of Medicine, 1701 W Charleston Blvd, Suite 490, Las Vegas, NV 89102.

Background: Since the start of the conflict in the Middle East in 2001, military orthopedic surgeons have faced complex orthopedic injuries including high-energy soft tissue wounds, traumatic amputations, and open fractures. Although orthopedic surgeons are well trained in the management of osseous injuries, the treatment of soft tissue injuries can be technically challenging and unfamiliar. Early washout, debridement of devitalized tissue, external fixation of bony injuries, and antibiotic therapy remain the foundation of early wound management. Read More

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http://dx.doi.org/10.1093/milmed/usy022DOI Listing
March 2018
3 Reads

The principles and practice of open fracture care, 2018.

Chin J Traumatol 2018 Aug 21;21(4):187-192. Epub 2018 Feb 21.

Department of Orthopaedics, Harvard Medical School, Chief Orthopaedic Trauma Service, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. Read More

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http://dx.doi.org/10.1016/j.cjtee.2018.01.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6085196PMC
August 2018
1 Read

Perioperative management of external fixation in staged protocols: an international survey.

Eur J Orthop Surg Traumatol 2018 May 7;28(4):565-572. Epub 2018 Feb 7.

Department of Orthopaedic and Trauma Surgery, Luzerner Kantonsspital, 6000, Luzern 16, Switzerland.

Introduction: Despite the frequent use of external fixation, various regimes of antibiotic prophylaxis, surgical technique and postoperative pin care exist and underline the lack of current evidence. The aim of the study was to assess the variability or consensus in perioperative protocols to prevent implant-associated infections for temporary external fixation in closed fractures of the extremities.

Materials And Methods: A 26-question survey was sent to 170 members of the Traumaplatform. Read More

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http://dx.doi.org/10.1007/s00590-018-2135-9DOI Listing
May 2018
1 Read

Multidetector CT of Midfacial Fractures: Classification Systems, Principles of Reduction, and Common Complications.

Radiographics 2018 Jan-Feb;38(1):248-274

From the Section of Trauma and Emergency Radiology, Department of Diagnostic Radiology and Nuclear Medicine (D.D., U.K.B.), and the Division of Plastic Surgery (A.J.N., S.C.D.), R. Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 S Greene St, Baltimore, MD 21201; the Division of Trauma and Emergency Imaging, Department of Radiology, Bellevue Hospital/NYU Langone Medical Center, New York, NY (M.P.B.); and the Department of Diagnostic Radiology, University of Miami Leonard M. Miller School of Medicine, Ryder Trauma Center at Jackson Memorial Hospital, Miami, Fla (F.M.).

The advent of titanium hardware, which provides firm three-dimensional positional control, and the exquisite bone detail afforded by multidetector computed tomography (CT) have spurred the evolution of subunit-specific midfacial fracture management principles. The structural, diagnostic, and therapeutic complexity of the individual midfacial subunits, including the nose, the naso-orbito-ethmoidal region, the internal orbits, the zygomaticomaxillary complex, and the maxillary occlusion-bearing segment, are not adequately reflected in the Le Fort classification system, which provides only a general framework and has become less relevant in contemporary practice. The purpose of this article is to facilitate the involvement of radiologists in the delivery of individualized multidisciplinary care to adults who have sustained blunt trauma and have midfacial fractures by providing a clinically relevant review of the role of multidetector CT in the management of each midfacial subunit. Read More

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http://dx.doi.org/10.1148/rg.2018170074DOI Listing
August 2018
33 Reads

Effectiveness of sensor monitoring in an occupational therapy rehabilitation program for older individuals after hip fracture, the SO-HIP trial: study protocol of a three-arm stepped wedge cluster randomized trial.

BMC Health Serv Res 2017 01 3;17(1). Epub 2017 Jan 3.

Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

Background: The performance of activities of daily living (ADL) at home is important for the recovery of older individuals after hip fracture. However, 20-90% of these individuals lose ADL function and never fully recover. It is currently unknown to what extent occupational therapy (OT) with coaching based on cognitive behavioral treatment (CBT) improves recovery. Read More

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http://dx.doi.org/10.1186/s12913-016-1934-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209842PMC
January 2017
12 Reads

Delivering comprehensive geriatric assessment in new settings: advice for frontline clinicians.

Authors:
J R Gladman

J R Coll Physicians Edinb 2016 Sep;46(3):174-179

JRF Gladman, Division of Rehabilitation and Ageing, B Floor Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK, E-mail

Over the decades, as the principles of comprehensive geriatric assessment have been established, there have been attempts to apply its principles to settings other than acute hospital medical wards or the general communitydwelling older population, for example, to other settings where older people with infirmity are found. The purpose of this paper is to describe and reflect upon the application of and evidence for comprehensive geriatric assessment in these new settings and give some advice to clinicians about how to optimise their contributions to these processes. I will state my advice having first discussed intermediate care, emergency surgery (hip fracture), elective surgery, dementia and delirium care, emergency care, cancer care, and the care of residents of care homes (mindful of the irony of calling the latter a new setting, given that geriatric medicine originated in long term care). Read More

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http://dx.doi.org/10.4997/JRCPE.2016.309DOI Listing
September 2016
3 Reads

Preperitoneal pelvic packing: Technique and outcomes.

Int J Surg 2016 Sep 1;33(Pt B):222-224. Epub 2016 Jul 1.

Rutgers University NJMS, Department of General Surgery, Division of Trauma Surgery and Critical Care, 140 Bergen Street, Suite E 1625, Newark, NJ 07101, USA. Electronic address:

Significant pelvic ring fractures are usually secondary to high-energy trauma, and when associated with other life-threatening injuries and hemodynamic instability, result in high mortality rates ranging from 40 to 60%. The major cause of death during the first 24 h after pelvic trauma is attributed to acute blood loss, with later mortality secondary to multisystem organ failure. In a majority of patients, the source of pelvic bleeding is from disruption of the presacral venous plexus and bony fracture sites, while arterial injury is present in only 10-15%. Read More

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http://dx.doi.org/10.1016/j.ijsu.2016.05.072DOI Listing
September 2016
13 Reads

Sticker Shock: The Experience of a Health Care Consumer.

Authors:
David Grande

Ann Fam Med 2016 05;14(3):270-2

Division of General Internal Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania

With implementation of the Patient Protection and Affordable Care Act, more Americans are gaining insurance coverage but often have high deductibles and significant out-of-pocket cost sharing. Deductibles routinely exceed $1,000 and often approach $5,000. In this essay, I share our family's experience attempting to navigate urgent medical decisions in a high-deductible health plan. Read More

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http://dx.doi.org/10.1370/afm.1921DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4868567PMC
May 2016
5 Reads

Bone fractures: assessment and management.

Authors:
L Lim P Sirichai

Aust Dent J 2016 Mar;61 Suppl 1:74-81

Department of Oral and Maxillofacial Surgery, Westmead Hospital, Westmead, New South Wales, Australia.

Severe dental traumatic injuries often involve the supporting bone and soft tissues. This article outlines the current concepts in the management of dentoalveolar fractures for the general dental practitioner with case reports to illustrate management principles and techniques. Read More

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http://dx.doi.org/10.1111/adj.12399DOI Listing
March 2016
4 Reads
1.482 Impact Factor

Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: a pragmatic, stepped-wedge, cluster-randomised controlled trial.

Lancet 2015 Jun 9;385(9987):2592-9. Epub 2015 Apr 9.

Physiotherapy Department, Monash University, Frankston, VIC, Australia; Allied Health Research Unit, Monash Health, Clayton, VIC, Australia.

Background: Falls are the most frequent adverse events that are reported in hospitals. We examined the effectiveness of individualised falls-prevention education for patients, supported by training and feedback for staff, delivered as a ward-level programme.

Methods: Eight rehabilitation units in general hospitals in Australia participated in this stepped-wedge, cluster-randomised study, undertaken during a 50 week period. Read More

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http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(
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http://linkinghub.elsevier.com/retrieve/pii/S014067361461945
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http://dx.doi.org/10.1016/S0140-6736(14)61945-0DOI Listing
June 2015
30 Reads

Applying evidence-based medicine principles to hip fracture management.

Front Surg 2014 20;1:40. Epub 2014 Oct 20.

Department of Orthopaedic Surgery, University of Pennsylvania , Philadelphia, PA , USA.

Bone has the capacity to regenerate and not scar after injury - sometimes leaving behind no evidence at all of a prior fracture. As surgeons capable of facilitating such healing, it becomes our responsibility to help choose a treatment that minimizes functional deficits and residual symptoms. And in the case of the geriatric hip fracture, we have seen the accumulation of a vast amount of evidence to help guide us. Read More

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http://dx.doi.org/10.3389/fsurg.2014.00040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286989PMC
January 2015
3 Reads

Common dental and orofacial trauma: evaluation and management.

Med Clin North Am 2014 Nov 23;98(6):1261-79. Epub 2014 Sep 23.

Department of Oral and Maxillofacial Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, 5th Floor White Building, Philadelphia, PA 19104, USA. Electronic address:

This article reviews common dental and orofacial traumatic injuries, and provides a broad overview and general principles of the diagnosis and management of common dental and orofacial injuries. Such knowledge will aid the physician in recognition and assessment of injury, proper treatment, and appropriate referral to the specialist. Although many of these injuries warrant appropriate consultation, a sound understanding of assessment and treatment protocol is important. Read More

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http://dx.doi.org/10.1016/j.mcna.2014.08.003DOI Listing
November 2014
3 Reads

Spontaneous Resorption of a Penetrating Orbital Bone Fracture Fragment.

Ophthalmic Plast Reconstr Surg 2015 Sep-Oct;31(5):e123-5

*Ophthalmic Plastic Surgery, Massachusetts Eye and Ear Infirmary; †Department of Ophthalmology, Harvard Medical School; ‡Massachusetts Eye and Ear Infirmary; §Department of Radiology/Neuroradiology, Harvard Medical School; ‖Department of Neurosurgery, Massachusetts General Hospital; ¶Department of Neurosurgery, Harvard Medical School; #Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary; and **Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A.

The authors describe a 20-year-old man who sustained multiple facial fractures in a high-speed motor vehicle crash, including a bone fragment from a skull base fracture that penetrated the orbital soft tissues superomedially. Serial CT scans documented spontaneous resorption over a 6-month period. While it is known that autologous bone grafts used in craniofacial reconstruction exhibit variable amounts of bone resorption, the complete resorption of an intraorbital fracture fragment has not been documented in the literature. Read More

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http://pdfs.journals.lww.com/op-rs/2015/09000/Spontaneous_Re
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http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:land
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http://dx.doi.org/10.1097/IOP.0000000000000146DOI Listing
May 2016
4 Reads

The treatment of maxillofacial trauma in austere conditions.

Authors:
J Michael Ray

Atlas Oral Maxillofac Surg Clin North Am 2013 Mar;21(1):9-14

Baylor College of Dentistry, Department of Oral and Maxillofacial Surgery, 3302 Gaston Avenue, Dallas, TX 75246, USA.

Caring for severely injured patients, whether they be in the theater of combat or after natural disasters, can be a rewarding and even life-changing experience for all involved. Sound surgical principles and an attempt to achieve a high standard of care should still guide the treating surgeon. The surgical team undoubtedly face numerous obstacles, but with careful and considerate planning, many of these can be minimized. Read More

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http://dx.doi.org/10.1016/j.cxom.2012.12.009DOI Listing
March 2013
3 Reads

Damage control and austere environment external fixation: techniques for the civilian provider.

J Surg Orthop Adv 2012 ;21(1):22-31

Walter Reed National Military Medical Center, Bethesda, MD, USA.

Extremity injuries associated with natural disasters and combat are typically high-energy, often open injuries, and routinely represent only part of the scope of injury to a poly-traumatized patient. The early management of these injuries is normally performed in austere environments, and relies heavily on the principles of damage control orthopaedics, with external fixation of associated long bone and peri-articular fractures. While the general principles of ATLS, wound management, and external fixation do not differ from that performed in the setting of civilian trauma, there are special considerations and alterations in standard practice that become necessary when providing this care in an austere environment. Read More

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August 2012
4 Reads

Techniques of anterior pelvic fixation.

Authors:
Brian H Mullis

Instr Course Lect 2012 ;61:19-25

Department of Orthopaedics, Indiana University School of Medicine, Indianapolis, IN, USA.

Although definitive fixation of anterior pelvic ring injuries is usually referred to an orthopaedic trauma surgeon or a surgeon proficient in pelvic surgery, all orthopaedic surgeons should be familiar with the initial management and resuscitation of patients with high-energy pelvic ring injuries. The initial treatment may be limited to sheet or binder application in the emergency department to allow transfer of the patient to a trauma center or the application of an external fixator by an on-call surgeon, even though that surgeon may not be responsible for definitive fixation. It is important to understand the general principles and approaches used at the time of definitive surgery because decisions made by the initial treating physician may affect (or limit) the ability of the orthopaedic traumatologist to provide definitive care. Read More

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June 2013
5 Reads

Prevention of falls and fractures in old people by administration of calcium and vitamin D, randomized clinical trial.

BMC Public Health 2011 Dec 9;11:910. Epub 2011 Dec 9.

Unidad de Investigación de la Gerencia de Atención Primaria de Albacete (Servicio de Salud de Castilla-La Mancha), Marqués de Villores 6-8, 02001 Albacete, Spain.

Background: There are many studies that associate vitamin D serum levels in older persons with muscle strength, physical performance and risk of fractures and falls. However, current evidence is insufficient to make a general recommendation for administrating calcium and vitamin D to older persons. The objective of this study is to determine the effectiveness of calcium and vitamin D supplementation in improving musculoskeletal function and decreasing the number of falls in person aged over 65 years. Read More

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http://bmcpublichealth.biomedcentral.com/articles/10.1186/14
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http://dx.doi.org/10.1186/1471-2458-11-910DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267804PMC
December 2011
8 Reads

Economic evaluations in shoulder pathologies: a systematic review of the literature.

J Shoulder Elbow Surg 2012 Mar 23;21(3):367-75. Epub 2011 Aug 23.

Harvard Shoulder Service, Department of Orthopedics, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, USA.

Background: Economic evaluations provide decision makers with a tool for reducing health care costs because they assess both the costs and consequences of health care interventions. This study reviewed the quality of published economic evaluations for shoulder pathologies.

Materials And Method: A MEDLINE search was conducted to identify articles published from 1980 to 2010 that contained "cost" or "economic" combined with terms for several shoulder disorders and treatments. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10582746110025
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http://dx.doi.org/10.1016/j.jse.2011.05.019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783003PMC
March 2012
3 Reads

Preventing postsurgical venous thromboembolism: pharmacological approaches.

Semin Thromb Hemost 2011 Apr 31;37(3):252-66. Epub 2011 Mar 31.

Regional Reference Centre for Coagulation Disorders, Department of Clinical and Experimental Medicine, Federico II University Hospital, Naples, Italy.

The use of antithrombotic drugs for the prevention of venous thromboembolism (VTE) in patients undergoing surgery is presently based on solid principles and high-level scientific evidence. This article reviews current strategies of pharmacological thromboprophylaxis. The level of VTE risk following surgery depends on a variety of factors that the surgeon should take into account, including the type of surgery and the presence of additional risk factors, such as elderly age and cancer. Read More

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http://dx.doi.org/10.1055/s-0031-1273089DOI Listing
April 2011
4 Reads

Management of cervical esophageal injury after spinal surgery.

Ann Thorac Surg 2010 Oct;90(4):1128-33

Department of Surgery, Division of General Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minnesota, USA.

Background: Esophageal injury is a rare but catastrophic complication of anterior cervical spine surgery. Cases of esophageal perforation may be discovered intraoperatively, or as late as 10 years after surgery. In the current study we aim to review the principles of care and provide an algorithm that can be employed for successful management of this complex problem. Read More

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http://dx.doi.org/10.1016/j.athoracsur.2010.06.045DOI Listing
October 2010
8 Reads

Stress fractures: diagnosis and management in the primary care setting.

Authors:
Dilip R Patel

Pediatr Clin North Am 2010 Jun;57(3):819-27

Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Kalamazoo, MI 49008, USA.

Stress fracture represents an overuse injury of the bone resulting from excessive repetitive stress. Diagnosis in most cases is based on clinical evaluation. Plain radiographs may show characteristic changes 2 to 4 weeks from onset of symptoms. Read More

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http://dx.doi.org/10.1016/j.pcl.2010.03.004DOI Listing
June 2010
9 Reads

Temporizing external fixation of the lower extremity: a survey of the orthopaedic trauma association membership.

Orthopedics 2010 Apr 16;33(4). Epub 2010 Apr 16.

Department of Orthopedic Trauma, Harris Methodist Fort Worth Hospital, and Fort Worth Affiliated Hospitals Orthopedic Training Program, John Peter Smith Hospital, Fort Worth, Texas 76104, USA.

This study examined the opinions of practicing traumatologists to aid in the initial treatment of complicated lower extremity fractures in accordance with current staged protocols. A 40-question online survey of the Orthopaedic Trauma Association (OTA) membership was administered from November 2008 to February 2009. The survey investigated surgeons' preferences regarding general principles and routine management of joint-spanning lower extremity external fixators, as well as favored knee- and ankle-spanning constructs and conditions of definitive surgical reconstruction. Read More

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http://dx.doi.org/10.3928/01477447-20100225-04DOI Listing
April 2010
5 Reads

Surgeons' beliefs and perceptions about removal of orthopaedic implants.

BMC Musculoskelet Disord 2008 May 24;9:73. Epub 2008 May 24.

AO Foundation, Clinical Investigation and Documentation, Dübendorf, Switzerland.

Background: The routine removal of orthopaedic fixation devices after fracture healing remains an issue of debate. There are no evidence-based guidelines on this matter, and little is known on surgeons' practice and perceived effectiveness of implant removal in different clinical settings.

Methods: A 41-item questionnaire was distributed to 730 attendees of the AO Principles and Masters Courses of Operative Fracture Treatment in Davos, Switzerland, to assess their attitudes towards removal of different types of implants, and perceived benefits and risks with this common procedure. Read More

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http://dx.doi.org/10.1186/1471-2474-9-73DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430567PMC
May 2008
4 Reads

Brachial plexus palsy following proximal humerus fracture in patients who are skeletally immature.

J Orthop Trauma 2008 Apr;22(4):286-90

Massachusetts General Hospital, Department of Orthopaedic Surgery, Boston, Massachusetts, USA.

From 1998 to 2006, 578 patients who were skeletally immature with proximal humerus fractures were treated at our institution. During that time period, 4 patients (0.7%) had associated brachial plexus and major peripheral nerve palsies. Read More

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http://dx.doi.org/10.1097/BOT.0b013e31816b7898DOI Listing
April 2008
6 Reads

Irrigation of the wounds in open fractures.

J Bone Joint Surg Br 2007 May;89(5):580-5

Academic Department of Trauma & Orthopaedics, Leeds General Infirmary, Clarendon Wing, Great George Street, Leeds, LS1 3EX, UK.

Modern principles for the treatment of open fractures include stabilisation of the bone and management of the soft tissues. Wound debridement and irrigation is thought to be the mainstay in reducing the incidence of infection. Although numerous studies on animals and humans have focused on the type of irrigation performed, little is known of the factors which influence irrigation. Read More

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http://dx.doi.org/10.1302/0301-620X.89B5.19286DOI Listing
May 2007
5 Reads

Fracture treatment by bonesetters in central Ghana: patients explain their choices and experiences.

Trop Med Int Health 2007 Apr;12(4):564-74

Department of General Surgery, Holy Family Municipal Hospital, Techiman, Ghana.

Objective: To understand factors influencing patients' decisions to choose either fracture treatment by a bonesetter or in the hospital and to explore patients' experiences with bonesetter treatment.

Method: In-depth interviews with 46 patients with a radiological proven fracture in a district hospital in central Ghana.

Results: Traditional healers, such as bonesetters, play a substantial role in the Ghanaian healthcare system. Read More

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http://dx.doi.org/10.1111/j.1365-3156.2007.01822.xDOI Listing
April 2007
30 Reads

Towards Regionalized Care of Severe Orthopedic Injuries: A Survey on Non-university Hospitals in Finland.

Eur J Trauma Emerg Surg 2007 Apr 4;33(2):183-7. Epub 2007 Apr 4.

Department of Surgery, Meilahti Hospital, University of Helsinki, Helsinki, Finland.

Introduction: The principles of a designated trauma system and regionalization of trauma care exist in very limited areas in Finland. In this study, we obtained information on the current personal opinions of orthopedicsin-chief (OICs) and surgeons-in-chief (SICs) towards regionalization of severe orthopedic trauma care in Finland.

Materials And Methods: A questionnaire was sent to OICs and SICs working in 36 primary and secondary hospitals providing acute surgical care asking to give their personal opinions whether certain severe orthopedic injuries should be managed in their hospitals or be referred. Read More

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http://dx.doi.org/10.1007/s00068-007-6099-4DOI Listing
April 2007
4 Reads

Broken bones: common pediatric lower extremity fractures--Part III.

Orthop Nurs 2006 Nov-Dec;25(6):390-407; quiz 408-9

Massachusetts General Hospital for Children, Department of Orthopaedic Surgery, Yawkey Center for Outpatient Care, Boston, MA, USA.

Lower extremity injuries and fractures occur frequently in young children and adolescents. Nurses are often one of the first healthcare providers to assess a child with an injury or fracture. Although basic fracture care and principles can be applied, nurses caring for these young patients must have a good understanding of normal bone growth and development as well as common mechanisms of injury and fracture patterns seen in children. Read More

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February 2007
10 Reads

The Jehovah's Witness and dementia: who or what defines 'best interests'?

Authors:
R Hegde D Bell P Cole

Anaesthesia 2006 Aug;61(8):802-6

Specialist Registrar in Anaesthesia, The General Infirmary at Leeds, Great George Street, Leeds, LS1 3EX, UK.

An elderly woman with dementia presented for repeat surgical management of fractured neck of femur. Although no advance directive had ever been generated, the patient was declared to be a strict Jehovah's Witness by her daughter, who vetoed the transfusion of any blood products. The fracture was managed conservatively but the patient suffered repeated chest infections, from which she died 4 months after admission. Read More

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http://dx.doi.org/10.1111/j.1365-2044.2006.04716.xDOI Listing
August 2006
4 Reads

The use of computer navigation in performing minimally invasive surgery for intertrochanteric hip fractures--The experience in Singapore.

Injury 2006 Aug;37(8):755-62

Department of Orthopaedic Surgery, Trauma Service, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.

Objective: Intertrochanteric hip fractures are very common and early mobilisation correlates with a better outcome. The ideal surgical procedure should protect the soft tissue envelope, thereby preserving blood supply and reducing blood loss. Furthermore, occupational exposure to fluoroscopy that is used in hip fracture fixation remains a concern amongst orthopaedic surgeons. Read More

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http://dx.doi.org/10.1016/j.injury.2006.03.002DOI Listing
August 2006
4 Reads

Does McKenzie therapy improve outcomes for back pain?

J Athl Train 2006 Jan-Mar;41(1):117-9

University of Oregon, Department of Human Physiology, Eugene, OR 97403, USA.

Clinical Question: What is the clinical evidence base for McKenzie therapy in management of back pain?

Data Sources: Studies were identified using a computer-based literature search of 7 databases: MEDLINE, EMBASE, DARE, CINAHL, PEDro, the Cochrane Register of Clinical Trials (CENTRAL), and the Cochrane Database of Systematic Reviews. Search terms included McKenzie therapy, McKenzie treatment, and McKenzie method. Studies published before September 2003 were eligible. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421491PMC
May 2006
4 Reads

Pediatric orthopedic trauma: principles in management.

Crit Care Med 2002 Nov;30(11 Suppl):S431-43

Department of Orthopaedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Optimal management of pediatric orthopedic trauma requires understanding the unique characteristics of the immature musculoskeletal system. The principles of pediatric orthopedic trauma management include anticipating future growth and bone remodeling potential, minimizing physeal injury, and aggressive treatment of open fractures and compartment syndromes. This article discusses the fundamentals of the pediatric musculoskeletal system and pediatric orthopedic trauma management in general and as they apply to specific injuries. Read More

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November 2002
5 Reads

Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions.

J Craniofac Surg 2002 Nov;13(6):726-37; discussion 738

Bobby R. Alford Department of Otolaryngology-Head & Neck Surgery and Communicative Sciences, Baylor College of Medicine, Houston, Texas, U.S.A.

Orbital skeletal injuries are frequently associated with other significant injuries and require a substantial surgical effort to correct. The use of a unified classification of orbital injury may better predict the surgical effort required to correct such injuries and help with future comparisons of results. In an attempt to summarize the principles of reconstruction of the orbital skeleton following trauma and introduce a unified classification system for orbital injuries, a retrospective review of all consecutive orbital reconstructions in a tertiary care teaching hospital was conducted. Read More

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November 2002
4 Reads

Fracture-dislocation of the elbow.

Hand Clin 2002 Feb;18(1):55-63

Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusets General Hospital, Harvard Medical School, ACC 525, 15 Parkman Street, Boston, MA 02114, USA.

Recognition of the pattern of an elbow fracture-dislocation allows immediate knowledge of the treatment principles, pitfalls, and prognosis of the injury. Specific techniques for each injury component increase the surgeon's ability to restore stability to the elbow. When complications are anticipated and avoided or addressed expediently, it is possible to restore elbow function in spite of the complexity of these injuries. Read More

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February 2002
45 Reads

Key legal principles for hospitalists.

Authors:
Ann Alpers

Dis Mon 2002 Apr;48(4):197-206

In a hospitalist system, when a patient leaves the hospital, he or she will return to a primary care provider (PCP) for follow-up and continuing care. The hand-off after discharge can compromise communication with the PCP. Physicians have a legal duty to provide follow-up care to patients with whom they have a relationship. Read More

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http://hospitalmedicine.ucsf.edu/improve/literature/discharg
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April 2002
6 Reads

Fracture of the tibial diaphysis treated by external fixation and the axial alignment grid: a single surgeon's experience.

Injury 1997 Sep;28(7):437-43

University Department of Surgical Sciences, Northern General Hospital Trust, Sheffield, UK.

The results of tibial fracture fixation for 50 unstable closed and open fractures, using the dynamic axial fixator (DAF) and the limb axial alignment grid have been assessed both clinically and radiologically. Each patient has been carefully followed up in a dedicated clinic and each procedure was conducted or directly supervised by the senior author. All patients achieved union, although 16 per cent required a further procedure such as bone grafting or fibula osteotomy to secure this and a further 6 per cent were revised to intramedullary nails. Read More

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September 1997
2 Reads

Damage control for devastating pelvic and extremity injuries.

Surg Clin North Am 1997 Aug;77(4):879-95

Department of Emergency Medicine, SUNY, Health Science Center at Brooklyn, USA.

This article focuses on some general principles of care and then discusses devastating pelvic injury secondary to both blunt and penetrating trauma. The authors describe the current approach to the mangled extremity and discuss indications for primary amputation. Read More

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August 1997
3 Reads

Guidelines for treatment of head injury in adults. Opinions of a group of neurosurgeons.

Zentralbl Neurochir 1997 ;58(2):72-4

Klinik f. Neurochirurgie, Med. Fakultat Otto-von-Guericke-Universität Magdeburg.

There are a number of parallel activities world wide to devise guidelines for the treatment of head injuries. A Group of neurosurgeons from various European countries worked on guidelines during three informal meetings, which may serve as a base for discussion of national or local protocols. Three levels of certainty were distinguished: Measures that must be taken which such a high degree of certainty, that they have not seriously been challenged-principles. Read More

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October 1997
4 Reads

Quality development based on informatics in health care: steps in the Danish national strategy illustrated by four cases.

Medinfo 1995 ;8 Pt 2:1632

Department of Pulmonary Medicine, Bisbebjerg Hospital, Copenhagen, Denmark.

The first step for quality development is identification of the quality problem. This should be followed by a set up of criteria and standards and relevant data should be collected to perform quality assessment. The quality-level is evaluated and in cases with non-satisfying results, the problem(s) should be identified and the process repeated [1]. Read More

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April 1996
3 Reads

Rehabilitation of fractures in the elderly.

Clin Geriatr Med 1993 Nov;9(4):717-30

Veterans Administration Medical Center, Sepulveda, California.

Rehabilitation is the most important aspect of care after a fracture in an older person. Epidemiology, contributing factors, general principles of management are discussed in this article. Proper management requires knowledge of various mechanisms of injury, different forms of orthopedic treatments, interpretation of radiographs, and familiarity with available therapeutic modalities. Read More

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November 1993
4 Reads

[Use in the cat of the "small external fixator for hand and forearm" of the Association for Osteosynthesis Inquiry. I. Introduction].

Schweiz Arch Tierheilkd 1993 ;135(10):291-7

Veterinär-Chirurgische Klinik, Universität Zürich.

In the first part general principles and indications for external fixator use in cats for treatment of fractures and luxations are described. This study considers only one of many external fixator systems. The results of the clinical use of this system in cats are described in the second part of this investigation. Read More

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December 1993
5 Reads

The management of dento-alveolar trauma--a review.

Authors:
R G Stapleford

J Can Dent Assoc 1990 Jan;56(1):39-41

Hotel Dieu Hospital, Windsor, Ontario.

The clinician faced with the management of an insult to the masticatory system involving the dentition, its alveolar housing and the investing tissues often faces a formidable task. The restitution of traumatic derangement of oral-facial structures mandates a systematic approach to hard and soft tissue management with particular reference to the unique biological characteristics of this environment. A decidedly improved prognosis may be offered to the patient when basic principles are followed and the indicators for successful long term stabilization are realized. Read More

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January 1990
3 Reads

[Admission and organization of emergency care for multiple injured patients. The experience of the Strasbourg Center of traumatology and orthopedics].

Authors:
I Kempf

Chirurgie 1990 ;116(8-9):633-8

Orthopédique et traumatologique, chirurgien des hôpitaux de Strasbourg.

The admission of patients with severe multiple trauma and the organization of treatment must follow a few basic principles: 1) continuous, uninterrupted management by the various links of the medical chain, 2) single location: the various persons ensuring the treatment must go to the patient's side, and not the opposite, 3) pluridisciplinary, polyvalent care, and lastly, 4) single command: for us, the orthopedist-traumatologist must direct and coordinate care to the severely injured persons, and the so-called general surgeons is in charge of the others. Three structures of admission currently coexist in France: the department of admission, the emergency department and, rarely, the center of traumatology. Carefully planned routes, adapted facilities, plenty of material and staff are essential. Read More

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October 1991
5 Reads