Surgical technology international
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Fibular head avulsion fractures are rare injuries determined by traction of the fibular attachment of the lateral collateral ligament (LCL). Surgical treatment is often recommended with different techniques such as tension band fixation or lag screws stabilization. In this article, we describe a fixation technique of fibular head fractures obtained through the use of anchors. ⋯ He reported a complex injury of the posterolateral corner with an avulsion fracture of the left fibular head. We performed a clinical evaluation at the final follow-up visit (six months). We demonstrated that the use of suture anchors may be an effective technique of fixation in avulsion fracture of the fibular head associated with combined posterolateral corner injuries.
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Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients. ⋯ In the midst of the rapidly-increasing rates of TKA in the US, multimodal pain control has emerged as an extremely effective means of maximizing postoperative patient outcomes. To our knowledge, this is the first study to evaluate the postoperative outcomes of TKA patients treated with a regimen of IV diclofenac. We demonstrate shorter LOS, decreased 24-hour pain intensity, and significantly decreased 24-hour opioid consumption in patients treated with adjunctive IV diclofenac compared to patients managed with our institution's standard perioperative regimen.
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Observational Study
Social Media and Pediatric Scoliosis: An Analysis of Patient and Surgeon Use.
The purpose of this observational study was to investigate and analyze the social media presence of both patients and surgeons in relation to pediatric scoliosis. First, patient Instagram (Instagram, Inc., San Francisco, California) posts were evaluated for 1) media format; 2) timing in relation to surgery; 3) tone; 4) perspective; 5) content; and 6) subject reference. To analyze reciprocal engagement, the presence and activity of pediatric scoliosis surgeons at five major academic centers were subsequently analyzed on Instagram, Twitter (Twitter Inc., San Francisco, California), and LinkedIn (LinkedIn Corporation, Sunnyvale, California). ⋯ An analysis of Instagram posts related to scoliosis showed that the majority were shared by patients in the non-operative period and overwhelmingly had a positive tone. The content of the posts focused mainly on brace wear, activities of daily living, and post-operative appearance or x-rays. This information provides further insight into what patients deem important regarding pediatric scoliosis care. Analysis of the social media presence of scoliosis surgeons showed that they have an underwhelming presence on Instagram and Twitter, but are more active on LinkedIn, a site geared more toward professional development and networking than other social media options.
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Anastomotic leaks following colorectal anastomosis has substantial implications including increased morbidity, longer hospitalization, and reduced overall survival. The etiology of leaks includes patient factors, technical factors, and anastomotic perfusion. An intact anastomotic blood supply is especially crucial in the physiology of anastomotic healing. ⋯ Large, multi-center prospective trials, such as the Perfusion Assessment in Laparoscopic Left-Sided/Anterior Resection Study (PILLAR II), demonstrated ease of use with remarkably low anastomotic leak rates after ICG-FA-guided intraoperative revision. Current randomized control trials featuring utilization in ICG-FA in low anterior resection are currently underway and will further clarify the role of ICG-FA in leak identification and prevention. Apart from colorectal surgery, FA has also been successfully employed in other surgical disciplines such as plastic surgery, vascular surgery, foregut surgery, urology, and gynecology.
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Postoperative dislocation occurs in approximately 2% of primary total hip arthroplasties (THAs). Risk factors associated with dislocation include: age of 70 years or older, body mass index (BMI) of 30 kg/m2 or greater, alcohol abuse, and neuro-degenerative diseases such as multiple sclerosis or Parkinson's disease. As a result, dual-mobility articulations, which have been typically used for revision procedures, have become an increasingly popular option for these "at risk" primary THAs. Few studies have assessed their use in this complex patient population. Therefore, the purpose of this study was to assess: 1) survivorship; 2) radiographic outcomes (cup migration, progressive radiolucencies, and changes in component position); 3) Harris Hip Scores; and 4) complications of the dual-mobility articulation in the setting of primary THA for patients at high risk for dislocation. ⋯ At short-term follow-up, dual-mobility articulations in primary THA offer survivorship, outcomes, and complications comparable to conventional THA designs in patients who are at increased risk for postoperative dislocation. Serious complications, such as polyethylene wear and intraprosthetic dislocations, have occasionally been reported with the use of these components. Therefore, future studies should be prospective, multi-center, and have longer-term follow-up to determine the true benefit of modular dual-mobility articulations in patients who are at high risk for dislocation.