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Int Orthop 2018 Dec 1. Epub 2018 Dec 1.

Department of Orthopaedic Surgery, Northwestern University, Feinberg School of Medicine, 676 North St. Clair Street, NMH/Arkes Family Pavilion Suite 1350, Chicago, IL, 60611, USA.

Intervertebral disc herniations are a common cause of neck and back pain in athletes. It is thought to be more prevalent in athletes than in the general population due to the consistent pressure placed on the spine and concurrent microtraumas that are unable to heal. Prevention focuses on neck and trunk stability and flexibility, training on proper technique, and rule changes to minimize catastrophic injuries. Read More

Orthop J Sports Med 2018 Nov 26;6(11):2325967118810775. Epub 2018 Nov 26.

Biomechanics and Movement Science Program, University of Delaware, Newark, Delaware, USA.

Background: The risk for knee osteoarthritis (OA) is substantially increased after anterior cruciate ligament (ACL) injury. Tools are needed to identify characteristics of patients after ACL injury who are most at risk for posttraumatic OA.

Purpose: To determine whether clinical measures of knee function after ACL injury are associated with the development of radiographic knee OA 5 years after injury. Read More

Patient Saf Surg 2018 27;12:32. Epub 2018 Nov 27.

1Department of Trauma, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Background: Nonoperative management for blunt splenic injury is the preferred treatment. To improve the outcome of selective nonoperative therapy, the current challenge is to identify factors that predict failure. Little is known about the impact of concomitant injury on outcome. Read More

J Pediatr Surg 2018 Dec 2;53(12):2404-2408. Epub 2018 Sep 2.

Sunrise Children's Hospital, Las Vegas, NV.

Purpose: We describe our series of giant omphalocele patients treated with a serial taping method for gradual reduction of the abdominal contents and early fascial closure.

Methods: Between 2010 and 2017 we cared for ten newborns with giant omphaloceles. The average gestational age was 35. Read More

J Surg Res 2019 Jan 18;233:408-412. Epub 2018 Sep 18.

Division of Surgery, Trauma and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine and Ryder Trauma Center, Miami, Florida.

Background: Gastrografin (GG)-based nonoperative approach is both diagnostic and therapeutic for partial small bowel obstruction (SBO). Absence of X-ray evidence of GG in the colon after 8 h is predictive of the need for operation, and a recent trial used 48 h to prompt operation. We hypothesize that a significant number of patients receiving the GG challenge require >48 h before an effect is seen. Read More

J Surg Res 2019 Jan 26;233:1-7. Epub 2018 Jul 26.

Department of Surgery, Yale School of Medicine, New Haven, Connecticut. Electronic address:

Background: High-risk patients undergoing cholecystectomy may experience increased morbidity and mortality. Percutaneous cholecystostomy (PC) has been utilized as a treatment option for acute cholecystitis in this cohort. Little is known about risk factors for readmission following PC. Read More

J Shoulder Elbow Surg 2018 Nov 28. Epub 2018 Nov 28.

Department of Surgery, McMaster University, Hamilton, ON, Canada. Electronic address:

Background: Hyaluronic acid (HA) is an analgesic and chondroprotective agent often used for the nonoperative treatment of osteoarthritis (OA). The effects of HA injections are well studied in the treatment of knee OA, but the effects in glenohumeral OA remain unclear. This study evaluated the efficacy of HA to reduce pain in patients with glenohumeral OA. Read More

J Bone Joint Surg Am 2018 Dec;100(23):2066-2072

Department of Orthopedic Surgery, Gumi CHA University Hospital, Gumi, South Korea.

Background: Although simple posterolateral or posterior elbow dislocations are relatively common and usually stable after closed reduction, simple posteromedial dislocations are extremely rare and poorly characterized. We investigated the clinical characteristics, soft-tissue injury patterns, treatments, and outcomes of a series of posteromedial elbow dislocations without relevant osseous lesions.

Methods: We retrospectively reviewed 20 cases of simple posteromedial elbow dislocations without relevant osseous lesions that were treated at 7 fellowship training hospitals during a 10-year period. Read More

J Bone Joint Surg Am 2018 Dec;100(23):2015-2023

Movement Science Lab (K.A.J., A.L.E., and W.R.S.) and Department of Orthopaedics (L.A.K.), Texas Scottish Rite Hospital for Children, Dallas, Texas.

Background: The purpose of this study was to assess function, at the age of 10 years, of children initially treated nonoperatively for clubfoot with either the Ponseti or French physiotherapy program and to compare outcomes in feet that had undergone only nonoperative treatment with those that required subsequent surgery.

Methods: Gait analysis, isokinetic ankle strength, parent-reported outcomes, and daily step activity data were collected when patients who had been treated for idiopathic clubfoot reached the age of 10 years. Patients who had undergone only nonoperative treatment were compared with those who subsequently underwent extra-articular surgery or intra-articular surgery (posterior release or posteromedial release). Read More

Ulus Travma Acil Cerrahi Derg 2018 Nov;24(6):569-574

Department of Pediatric Surgery, Marmara University Faculty of Medicine, İstanbul-Turkey.

Background: Although a nonoperative treatment approach is preferred for blunt liver and spleen trauma in childhood, there are significant differences between clinics in the algorithms used. The approach to high-grade liver and spleen injury is still controversial, particularly as grade V liver and spleen injuries are not included in the American Pediatric Surgical Association guideline. The aim of this study was to present experience with a non-operative treatment approach to children with high-grade liver and spleen injuries. Read More

Case Rep Surg 2018 28;2018:3829271. Epub 2018 Oct 28.

New York-Presbyterian/Queens, Weill Cornell Medical College, Flushing, NY 11355, USA.

Bezoars represent a rare cause of small bowel obstruction (SBO). Nonoperative management of bezoars includes use of endoscopy with mechanical or chemical dissolution methods. When obstruction persists, surgical intervention becomes necessary. Read More

Adv Orthop 2018 28;2018:6578097. Epub 2018 Oct 28.

UAB Faculty Office Tower #960, 510 20th Street South, Birmingham, AL 35233, USA.

Traumatic lumbosacral dislocation is a rare, high-energy mechanism injury characterized by displacement of the fifth lumbar vertebra in relation to the sacrum. Due to the violent trauma typically associated with this lesion, there are often severe, coexisting injuries. High-quality radiographic studies, in addition to appropriate utilization of CT scan and MRI, are essential for proper evaluation and diagnosis. Read More

J Orthop Sci 2018 Nov 30. Epub 2018 Nov 30.

Department of Orthopaedic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba 260-8670, Japan.

Background: The purpose of this study was to clarify the 2-year clinical and radiological outcomes of nonoperative treatment using foot orthosis for hallux valgus patients.

Methods: Patients who underwent nonoperative treatment using foot orthosis were surveyed prospectively. Foot orthoses were made by one certified orthotist using the standardized method. Read More

Arthroscopy 2018 Dec;34(12):3185-3186

Jackson, Mississippi.

The most efficacious treatment for patients with persistent lateral epicondylitis who have not adequately improved despite undergoing extended nonoperative measures may be arthroscopic. One advantage is the capability of the surgeon to fully assess the elbow intra-articularly. Second, the incision is often considered less appealing to both patients and surgeons than portal-site incisions. Read More

Arthroscopy 2018 Dec;34(12):3177-3184

Pan Am Clinic, Winnipeg, Canada.

Purpose: The purpose of this randomized clinical trial was to determine whether quality of life and function, as measured using subjective questionnaires and clinical assessment, are different after open versus arthroscopic debridement of the pathologic extensor carpi radialis brevis origin in the treatment of lateral epicondylitis at 1 year postoperatively.

Methods: Patients older than 16 years with a minimum of 6 months of nonoperative management for lateral epicondylitis were recruited into this prospective, single-blinded randomized clinical trial. Patients were randomized intraoperatively to undergo open or arthroscopic release. Read More

World J Emerg Surg 2018 27;13:55. Epub 2018 Nov 27.

Division of Vascular and Endovascular Surgery, Department of Surgery, University of Ottawa, The Ottawa Hospital, Civic Campus, Room A280, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9 Canada.

Background: Although mandatory laparotomy has been standard of care for patients with abdominal gunshot wounds (GSWs) for decades, this approach is associated with non-therapeutic operations, morbidity, and long hospital stays. This systematic review and meta-analysis sought to summarize outcomes of selective nonoperative management (SNOM) of civilian abdominal GSWs.

Methods: We searched electronic databases (March 1966-April 1, 2017) and reference lists of articles included in the systematic review for studies reporting outcomes of SNOM of civilian abdominal GSWs. Read More

J Shoulder Elbow Surg 2018 Nov 26. Epub 2018 Nov 26.

Department of Orthopaedic Surgery, Mount Sinai Health System, New York, NY, USA.

Background: Reverse total shoulder arthroplasty (RSA) accounts for nearly one-third of shoulder arthroplasty utilization nationally. The complication rate has increased concurrently. Consensus is lacking regarding the incidence, etiology, and treatment of acromial or scapular spine fractures after RSA. Read More

J Vasc Surg 2018 Nov 26. Epub 2018 Nov 26.

Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md.

Background: Six hours has long been considered the threshold of ischemia after peripheral artery injury. However, there is a paucity of evidence regarding the impact of operative delays on morbidity and mortality in patients with lower extremity arterial injuries.

Methods: We analyzed the records of 3,441,259 injured patients entered into the National Trauma Data Bank Research Dataset from 2012 to 2015. Read More

J Neurosurg 2018 Oct 1:1-8. Epub 2018 Oct 1.

OBJECTIVEAlthough numerous arteriovenous malformation (AVM) grading scales consider eloquence in risk assessment, none differentiate the types of eloquence. The purpose of this study was to determine if eloquence subtype affects clinical outcome.METHODSThis is a retrospective review of a prospectively collected clinical database of brain AVMs treated with microsurgery in the period from 1997 to 2017. Read More

J Neurosurg Spine 2018 Nov 1:1-6. Epub 2018 Nov 1.

OBJECTIVEDiagnostic workup for lumbar degenerative disc disease (DDD) includes imaging such as radiography, MRI, and/or CT myelography. If a patient has unsuccessful nonoperative treatment, the surgeon must then decide if obtaining updated images prior to surgery is warranted. The purpose of this study was to investigate whether the timing of preoperative neuroimaging altered clinical outcome, as reflected by the subsequent rate of revision surgery, in patients with degenerative lumbar spinal pathology. Read More

Microsurgery 2018 Nov 29. Epub 2018 Nov 29.

Division of Plastic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.

Background: The success of salvage procedures for failing digital replants (FR) is poorly documented. We sought to evaluate the success of salvage procedures for FR and factors contributing to successes and failures of replants.

Methods: Adult patients who presented to our center between January 1, 2000 and December 31, 2015, suffered ≥1 digital amputation(s), and underwent digital replantation were included. Read More

J Surg Orthop Adv 2018 ;27(3):219-225

Department of Shoulder & Elbow Surgery, Holy Cross Orthopedic Institute, Fort Lauderdale, Florida.

The purpose of this study was to examine alterations in national trends managing midshaft clavicle fractures (MCF) and intra-articular distal humerus fractures (DHF) surrounding recent level 1 publications. A retrospective review of the PearlDiver supercomputer for DHF and MCF was performed. Using age limits defined in the original level 1 studies, total use and annual use rates were examined. Read More

Surg Neurol Int 2018 23;9:211. Epub 2018 Oct 23.

Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, Illinois, USA.

Background: Ependymomas represent 50-60% of all brain and central nervous system tumors. Previous lumbar spine surgery for resection of an ependymoma should not be considered a relative contraindication for the administration of epidural/subarachnoid anesthesia to patients in labor.

Case Description: A 34-year-old G1P0, who underwent resection of an L1-L3 intramedullary ependymoma 8 years previously, presented in active labor with residual left leg numbness and tingling. Read More

JAMA Surg 2018 Nov 28. Epub 2018 Nov 28.

Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.

Importance: The step after conservative treatment of periappendicular abscess arouses controversy, ranging from recommendations to abandon interval appendectomy based on low recurrence rates of the precipitating diagnosis to performing routine interval appendectomy owing to novel findings of increased neoplasm risk at interval appendectomy. To our knowledge, there are no randomized clinical trials with sufficient patient numbers comparing these treatments.

Objective: To compare interval appendectomy and follow-up with magnetic resonance imaging after initial successful nonoperative treatment of periappendicular abscess. Read More

J Anesth 2018 Nov 27. Epub 2018 Nov 27.

Department of Anesthesiology and Intensive Care Medicine, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.

Purpose: In contrast to that in a nonoperative setting, it has been shown that perioperative administration of aspirin did not decrease the rate of death or myocardial infarction but increased major bleeding risk. Since these conflicting results might be due to concurrent use of anticoagulants and a lower thrombotic risk of patients, this cohort study was carried out for patients at a high thrombotic risk without concurrent use of anticoagulants.

Methods: Medical records for patients who underwent major abdominal malignancy surgery and who were on a preoperative antiplatelet regimen were reviewed. Read More

J Bone Joint Surg Am 2018 Nov;100(22):1912-1918

The University of Edinburgh, Edinburgh, United Kingdom.

Background: Nonoperative management of complete acromioclavicular (AC) joint dislocation has yielded reasonable results, although patients may report dissatisfaction with the outcome. The purpose of this prospective, randomized, controlled trial was to compare patient outcome following nonoperative care versus operative treatment with open reduction and tunneled suspension device (ORTSD) fixation for acute, type-III or IV disruptions of the AC joint.

Methods: Sixty patients aged 16 to 35 years with an acute type-III or IV disruption of the AC joint were randomized to receive ORTSD fixation or nonoperative treatment, following a power analysis to determine sample size. Read More

Orthop J Sports Med 2018 Nov 7;6(11):2325967118805385. Epub 2018 Nov 7.

Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado, USA.

Massive, irreparable rotator cuff tears (MIRCTs) provide a significant dilemma for orthopaedic surgeons. One treatment option for MIRCTs is reverse total shoulder arthroplasty. However, other methods of treating these massive tears have been developed. Read More

JBJS Essent Surg Tech 2015 Feb 25;5(1):e4. Epub 2015 Feb 25.

Division of Orthopedic Surgery, Hand and Upper Limb Center, St. Joseph's Health Care, University of Western Ontario, 268 Grosvenor Street, London, ON N6A 4L6, Canada.

Introduction: Open reduction and internal fixation of crista supinatoris fractures is required when the elbow is unstable despite appropriate nonoperative management and when a patient is undergoing surgical treatment of a periarticular elbow fracture-dislocation.

Step 1 Skin Incision And Surgical Approach: Use a posterior or lateral skin incision according to your preference and then utilize the Kocher interval to access the joint, lateral collateral ligament, and crista supinatoris or, in the setting of a proximal ulnar fracture, use the Boyd interval.

Step 2 Management Of Associated Injuries: Crista supinatoris fractures have not been identified in isolation; address associated injuries such as radial head/neck fractures, capitellar fractures, and coronoid fractures first. Read More

Spine (Phila Pa 1976) 2018 Nov 20. Epub 2018 Nov 20.

Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, MD.

Study Design: Cost utility analysis OBJECTIVE.: To compare the cost utility of operative vs. nonoperative treatment of adolescent idiopathic scoliosis (AIS) and identity factors that influence cost-utility estimates. Read More

Surg Technol Int 2018 Nov 23;34. Epub 2018 Nov 23.

Strategic Initiatives, Department of Orthopaedic Surgery, Lenox Hill Hospital, Northwell Health, New York, New York, Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio.

Introduction: Placental and amniotic membrane-based tissues have gained widespread popularity for their ability to promote healing and tissue regeneration and have manifested multiple applications in wound care, burn treatment, and management of various ocular conditions. Recently, there have been multiple studies that investigated the nonoperative uses of placental tissue-based products in orthopaedic sports injuries. However, there is a relative paucity of studies that have attempted to evaluate their adjuvant operative uses. Read More

J Pediatr Surg 2018 Oct 31. Epub 2018 Oct 31.

Division of Pediatric Surgery, Department of Surgery, University of Utah School of Medicine, 100 North Mario Capecchi Drive, Suite 3800, Salt Lake City, UT 84113. Electronic address:

Background/purpose: Nonoperative management of blunt solid organ injuries continues to progress and improve cost-effective utilization of resources while maximizing patient safety. The purpose of this study is to compare resource utilization and patient outcomes after changing admission criteria from a grade-based protocol to one based on hemodynamic stability.

Methods: A retrospective review of isolated liver and spleen injuries was done using prospectively collected trauma registry data from 2013 to 2017. Read More

Bone Joint Res 2018 Oct 3;7(10):561-569. Epub 2018 Nov 3.

Department of Orthopedic Surgery, Key Laboratory of Musculoskeletal Trauma & War Injuries PLA, Beijing Key Lab of Regenerative Medicine in Orthopedics, Chinese PLA General Hospital, Beijing, China.

Objectives: The incidence of acute Achilles tendon rupture appears to be increasing. The aim of this study was to summarize various therapies for acute Achilles tendon rupture and discuss their relative merits.

Methods: A PubMed search about the management of acute Achilles tendon rupture was performed. Read More

Onco Targets Ther 2018 31;11:7655-7668. Epub 2018 Oct 31.

Department of General Surgery, Second Xiangya Hospital, Central South University, Changsha 410011, China,

The risk of gastrointestinal (GI) events induced by nonoperative therapies in patients with neuroendocrine tumors (NETs) is unclear. Nonoperative therapies include somatostatin analogs, molecular targeted agents, cytotoxic chemotherapy, interferon-α, and peptide receptor radionuclide therapy. We undertook an up-to-date meta-analysis to determine the incidence and relative risks (RRs) of GI events in NET patients treated with these therapies. Read More

J Surg Res 2018 Dec 3;232:82-87. Epub 2018 Jul 3.

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona. Electronic address:

Background: Thromboprophylaxis with oral Xa inhibitors (Xa-Inh) are recommended after major orthopedic operation; however, its role in spine trauma is not well-defined. The aim of our study was to assess the impact of Xa-Inh in spinal trauma patients managed nonoperatively.

Methods: A 4-y (2013-2016) review of the Trauma Quality Improvement Program database. Read More

Tech Hand Up Extrem Surg 2018 Nov 19. Epub 2018 Nov 19.

Leni & Peter W. May Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY.

Hypothesis And/or Background: The failure rate of extensor carpi radialis brevis debridement for refractory lateral epicondylitis is reported around 15%. Our novel arthroscopic treatment is predicated on the hypothesis that lateral epicondylitis is an intra-articular problem related to a variation of the capsule-meniscal anatomy that impinges on the radiocapitellar joint. We report long-term outcomes of 35 patients treated with a novel arthroscopic resection of their capsulosynovial fringe. Read More

Curr Opin Pediatr 2018 Nov 15. Epub 2018 Nov 15.

Pediatric Orthopaedic Surgery Service, Hospital for Special Surgery, Weill Cornell Medical College, New York, New York, USA.

Purpose Of Review: To describe surgical treatment options for pediatric tibial shaft fractures which are the third most common pediatric long bone fracture. Management of these injuries is dictated by fracture location, fracture pattern, associated injuries, skeletal maturity, and other patient-specific factors. Although most pediatric tibial shaft fractures can be treated nonoperatively, this review provides an update on surgical treatment options when operative intervention is indicated. Read More

Acta Orthop Belg 2018 Mar;84(1):62-67

Medial clavicle fractures represent less than 5% of all clavicle injuries. The purpose of this study was to evaluate reliability of a new anatomically based (AB) classification system compared to other classification systems and to evaluate the clinical outcome of nonoperative treated fractures. 55 acute medial clavicle fractures (55 patients) were 3D reconstructed and evaluated using the Edinburgh (ED), Throckmorton (TR) and new AB classification. Read More

Am Surg 2018 Apr;84(4):e117-e119

Department of Surgery, Medical College of Georgia at Augusta University, Augusta, Georgia, USA.

Am Surg 2018 Jul;84(7):e234-e236

J Int Med Res 2018 Nov 19:300060518810889. Epub 2018 Nov 19.

Center for Joint Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, P. R. China.

Tarsal coalition refers to an abnormal fibrous, cartilaginous, or bony connection that develops between two or more tarsal bones. Talocalcaneal coalition and calcaneonavicular coalition account for more than 90% of all cases of tarsal coalition. Coalition exists early at birth, but bony connection usually develops during the patient's late growth period. Read More

Clin Spine Surg 2018 Nov 16. Epub 2018 Nov 16.

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

Study Design: This was a retrospective case-control study.

Objective: We aim to describe a novel 5-point grading system to determine the degree and severity of spinal cord compression secondary to a spinal epidural abscess (SEA). Secondarily, we aim to correlate the degree of compression with clinical presentation and outcomes. Read More

Clin Med Insights Arthritis Musculoskelet Disord 2018 1;11:1179544118809050. Epub 2018 Nov 1.

Department of Surgery, McMaster University, Hamilton, ON, Canada.

Avulsion fractures compromise function and movement at the affected joint. If left untreated, it can lead to deformity, nonunion, malunion, pain, and disability. The purpose of this review was to identify and describe the epidemiology and available treatment options for common avulsion fractures of the upper and lower extremities. Read More

Injury 2018 Nov 12. Epub 2018 Nov 12.

Ahi Evran University Faculty of Medicine, Department of Orthopaedics and Traumatology, Kirsehir, Turkey. Electronic address:

Background: Standard radiographs are limited in the evaluation of fracture characteristics and preoperative planning of OTA/AO 43C3 fractures. Therefore, CT imaging is an accepted as a useful method. CT is however expensive and has high radiation, and traction radiographs could be an alternative. Read More

Global Spine J 2018 Oct 8;8(7):661. Epub 2018 Oct 8.

Swedish Medical Center, Seattle, WA, USA.

JAMA Surg 2018 Nov 14. Epub 2018 Nov 14.

Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Stanford University, Stanford, California.

Importance: Health care professionals have shown significant interest in nonoperative management for uncomplicated appendicitis, but long-term population-level data are lacking.

Objective: To compare the outcomes of nonoperatively managed appendicitis against appendectomy.

Design, Setting, And Participants: This national retrospective cohort study used claims data from a private insurance database to compare patients admitted with uncomplicated appendicitis from January 1, 2008, through December 31, 2014, undergoing appendectomy vs nonoperative management. Read More

BMC Cancer 2018 Nov 12;18(1):1094. Epub 2018 Nov 12.

Colorectal Surgery Unit, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.

Background: In patients with locally advanced rectal cancer treated by neoadjuvant chemoradiation, pathological complete response in the surgical specimen is associated with favourable long-term oncologic outcome. Based on this observation, nonoperative management is being explored in the subset of patients with clinical complete response. Whereas, patients with poor response have a high risk of local and distant recurrence, and appear to receive no benefit from standard neoadjuvant chemoradiation. Read More

Am J Sports Med 2018 Dec 12;46(14):3480-3485. Epub 2018 Nov 12.

South Carolina Center for Effectiveness Research in Orthopedics, Greenville, South Carolina, USA.

Background:: There is an ever-increasing demand for widespread implementation of patient-reported outcomes. However, adoption is slow owing to limitations in clinical infrastructure and resources within busy orthopaedic practices. Prior studies showed the single alpha-numeric evaluation (SANE) score to correlate at a single point in time with the American Shoulder and Elbow Surgeons (ASES) score. Read More

J Pediatr Orthop 2018 Nov 9. Epub 2018 Nov 9.

Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE.

Background: Modern treatment of early onset scoliosis (EOS) includes implantation of traditional growing rods (TGR) or magnetically controlled growing rods (MCGR) for posterior-based distraction if nonoperative treatment plans failed. The recent MCGR innovation has largely been expected to improve patient and family burden by avoiding frequent return to the operating room. At least one study has shown no HRQoL difference between TGR and MCGR, but none have specifically investigated a cohort of conversion patients whose families have experienced both. Read More

Hand (N Y) 2018 Nov 12:1558944718810855. Epub 2018 Nov 12.

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

Background: Carpal tunnel syndrome (CTS) is one of the most common compressive neuropathies and affects a large amount of individuals. We investigated the direct and indirect cost to society of operative versus nonoperative management of CTS.

Methods: A Monte Carlo simulation model was used to estimate the lifetime direct and indirect costs associated with nonoperative and operative treatment of CTS, and its utility to patients. Read More

J Pediatr Surg 2018 Oct 5. Epub 2018 Oct 5.

University of Chicago Medicine Comer Children's Hospital, 5841 S. Maryland Ave, MC 4062, Chicago, IL, USA 60637. Electronic address:

Background/purpose: We examined outcomes before and after implementing an enteral water-soluble contrast protocol for management of pediatric adhesive small bowel obstruction (ASBO).

Methods: Medical records were reviewed retrospectively for all children admitted with ASBO between November 2010 and June 2017. Those admitted between November 2010 and October 2013 received nasogastric decompression with decision for surgery determined by surgeon judgment (preprotocol). Read More