Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Jan 2013
Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable.
The ulnar styloid is an important supportive structure for the triangular fibrocartilage complex. However, it remains inconclusive whether or not a fractured ulnar styloid should be fixed in an unstable distal radius fracture (DRF) with a stable distal radioulnar joint (DRUJ). The purpose of this study is to evaluate the effect of an untreated ulnar styloid fracture on the outcome of unstable DRF treated with transarticular external fixation when the DRUJ is stable. ⋯ When the DRUJ is stable, an untreated ulnar styloid fracture does not affect the wrist outcome of the patient with an unstable DRF treated with external fixation.
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Bmc Musculoskel Dis · Jan 2013
Myofascial trigger points and innervation zone locations in upper trapezius muscles.
Myofascial trigger points (MTrPs) are hyperirritable spots located in taut bands of muscle fibres. Electrophysiological studies indicate that abnormal electrical activity is detectable near MTrPs. This phenomenon has been described as endplate noise and it has been purported to be associated MTrP pathophysiology. Thus, it is suggested that MTrPs will be overlap the innervation zone (IZ). The purpose of this work was to describe the location of MTrPs and the IZ in the right upper trapezius. ⋯ According to the acquired results, we conclude that IZ and MTrPs are located in well-defined areas in upper trapezius muscle. Moreover, MTrPs in upper trapezius are proximally located to the IZ but not overlapped.
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Bmc Musculoskel Dis · Jan 2013
Frequent use of blood-saving measures in elective orthopaedic surgery: a 2012 Dutch blood management survey.
Blood loss in hip and knee arthroplasties may necessitate allogeneic blood transfusions. Different blood-saving measures (BSMs) were introduced to reduce these transfusions. Purpose of the present study was to assess the frequency of BSM use, stratified by type and hospital setting of orthopaedic departments in the Netherlands. ⋯ Compared with previous survey's there is a tremendous increase in use of BSMs. EPO and autologous blood salvage techniques are the most often used modalities. Costs might be saved if use of non-cost-effective BSMs is stopped.
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Bmc Musculoskel Dis · Jan 2013
Impact of age and comorbidity burden on mortality and major complications in older adults undergoing orthopaedic surgery: an analysis using the Japanese diagnosis procedure combination database.
The purpose of this study was to examine how complications in older adults undergoing orthopaedic surgery vary as a function of age, comorbidity, and type of surgical procedure. ⋯ Our data demonstrated that an increased comorbid burden as measured by Charlson comorbidity index has a greater impact on postoperative mortality and major complications than age in older adults undergoing orthopaedic surgery. After adjustment, mortality following lumbar arthrodesis or cervical laminoplasty was twice as high as that in TKA. Our findings suggest that an assessment of perioperative risks in elderly patients undergoing orthopaedic surgery should be stratified according to comorbidity burden and type of procedures, as well as by patient's age.
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Bmc Musculoskel Dis · Jan 2013
Randomized Controlled Trial Multicenter StudyThe effect of high dose antibiotic impregnated cement on rate of surgical site infection after hip hemiarthroplasty for fractured neck of femur: a protocol for a double-blind quasi randomised controlled trial.
Mortality following hip hemiarthroplasty is in the range of 10-40% in the first year, with much attributed to post-operative complications. One such complication is surgical site infection (SSI), which at the start of this trial affected 4.68% of patients in the UK having this operation. Compared to SSI rates of elective hip surgery, at less than 1%, this figure is elevated. The aim of this quasi randomised controlled trial (RCT) is to determine if high dose antibiotic impregnated cement can reduce the SSI in patients at 12-months after hemiarthroplasty for intracapsular fractured neck of femur. ⋯ Large randomised controlled trials assessing the effectiveness of a surgical intervention are uncommon, particularly in the speciality of orthopaedics. The results from this trial will inform evidence-based recommendations for antibiotic impregnated cement in the management of patients with a fractured neck of femur undergoing a hip hemiarthroplasty. If high dose antibiotic impregnated cement is found to be an effective intervention, implementation into clinical practice could improve long-term outcomes for patients undergoing hip hemiarthroplasty.