Bulletin of the Hospital for Joint Disease (2013)
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Bull Hosp Jt Dis (2013) · Dec 2020
Ethical Implications of Resuming Elective Orthopedic Surgery During the COVID-19 Pandemic.
The COVID-19 pandemic has had unprecedented impact on the United States health care system. One of the consider-ations was the decision to halt elective orthopedic surgery to preserve consumption of scarce resources. ⋯ Ethical considerations will come to the forefront in terms of determining the best course of action, patient selection, resource rationing, and financial implications. These factors will be examined through the lens of the four tenets of bioethics, beneficence, maleficence, autonomy, and justice, to elucidate the best approach in ethically manag-ing elective orthopedic surgery during a global pandemic.
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Bull Hosp Jt Dis (2013) · Dec 2020
Patient and Surgeon Satisfaction with Telehealth During the COVID-19 Pandemic.
Until recently, telehealth represented a small fraction of orthopedic surgery patient interactions. The COVID-19 pandemic necessitated a swift adoption of telehealth to avoid patient and provider exposure. This study analyzed patient and surgeon satisfaction with telehealth within the department of orthopedic surgery during the height of the COVID-19 pandemic. ⋯ Telehealth emerged as a valuable tool for the delivery of health care during the COVID-19 pandemic. While both patients and surgeons were satisfied with its use, this study identifies areas that can improve the patient and surgeon experience. The effectiveness and satisfaction with telehealth should inform regulatory and reimbursement policy.
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Bull Hosp Jt Dis (2013) · Dec 2020
Early Experience with Virtual Pediatric Orthopedics in New York CityPearls for Incorporating Telemedicine into Your Practice.
The purpose of this study was to identify and characterize challenges and benefits to the use of tele-medicine for the treatment of pediatric orthopedic patients during and after the COVID-19 pandemic. ⋯ The ability to provide pediatric orthopedic care through telemedicine has allowed us to safely evaluate and treat pediatric patients with musculoskeletal problems in New York City and its environs despite the COVID-19 pandemic. The efficient evaluation of both new and exist-ing pediatric orthopedic patients via telehealth is viable. Physical examination is the most challenging aspect of the physician-patient encounter to replicate virtually. Targeted educational efforts for patients and their families before the visit about what to expect and how to prepare improves efficiency with virtual pediatric orthopedic visits. Efforts to limit disparities in access to telemedicine will be needed to allow all pediatric orthopedic patients to participate in telemedicine equitably.
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Bull Hosp Jt Dis (2013) · Dec 2019
Open Surgical Management of Chronic Exertional Compartment Syndrome of the Leg.
The purpose of this study is to present one institution's experience managing chronic exertional compartment syndrome (CECS) and to identify patient and surgical characteristics associated with better outcomes following open surgical management of CECS with specific emphasis on return to sports. ⋯ Although open surgical fasciotomy for treatment of chronic exertional compartment syndrome leads to high rates of symptom improvement or resolution, fewer patients are able to return to their prior level of sports. Presence of symptoms at rest, presence of bilateral symptoms, and history of prior lower extremity surgery all portend worse outcomes.
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Legg-Calve-Perthes disease is a multifactorial process that can lead to debilitating femoral head deformity in children. Management can range from conservative (such as nonweightbearing protocols), bracing (such as A frames), to more invasive measures involving surgical interventions. First described by Axer in 1965, the varus derotational osteotomy (VDRO) has been a staple in the surgical management of Perthes disease. ⋯ Through varusization of the neck shaft angle of the proximal femur, the VDRO has been shown to be a powerful tool in the management of those afflicted. As with any operative procedure, the VDRO can be associated with complications such as premature epiphyseal closure leading to shortened extremity, albeit very rare in occurrence. The VDRO is a mainstay in the treatment algorithm for Legg-Calve-Perthes disease and will continue to remain so in the future.