Injury
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Review Meta Analysis
Surgical outcome of chronic Lisfranc injury without secondary degenerative arthritis: A systematic literature review✰.
Chronic Lisfranc joint injuries (tarsometatarsal, TMT) can present as a variety of clinical symptoms and radiographic findings. If significant arthritis at the Lisfranc joint is present, salvage arthrodesis is an option. For patients who receive a delayed diagnosis and/or present with no signs of arthritic changes, selecting the most appropriate treatment can be challenging. This article provides a systematic review of current surgical treatment options and outcomes for patients with a chronic Lisfranc injury but no secondary degenerative changes. ⋯ Level IV; Systematic Review of Level IV Studies.
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Observational Study
A Comparison in Outcomes of Preoperative Single-shot versus Continuous Catheter Fascia Iliaca Regional Anesthesia in Geriatric Hip Fracture Patients.
Fascia iliaca nerve blocks relieve pain in geriatric hip fracture patients and can be administered via a single-shot or continuous catheter. We compared perioperative opioid consumption and pain scores between these two blocks. ⋯ We report no differences in opioid use and pain scores between single-shot and continuous catheter fascia iliaca nerve blocks. Both blocks similarly reduce preoperative opioid consumption.
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Multiple small relaxing skin incisions oriented parallel to the longitudinal axis (so-called "pie-crusting") near traumatic lacerations or surgical incisions in edematous tissue beds have been utilized to achieve primary closure when edema or skin loss would otherwise have made this difficult. Our study hopes to demonstrate (1) biomechanical evidence that pie-crusting decreases wound closure tension and (2) provide a case series with data showing clinical results. ⋯ Pie-crusting may allow for easier wound closure and decrease the need for skin-grafting in edematous extremity wounds, with minimal patient morbidity.
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Determining deltoid ligament incompetence in supination external rotation (SER) injuries commonly relies on stress radiography, given several studies demonstrating low predictive value of physical examination. Stress radiography can be difficult to obtain and may result in suboptimal radiographs with equivocal determination of stability. This study revisits the concept of medial ankle tenderness and its association with mortise instability. ⋯ Diagnostic study, Level II-1 (development of diagnostic criteria on basis of consecutive patients [with universally applied reference "gold" standard]).