Bulletin of the Hospital for Joint Disease (2013)
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Bull Hosp Jt Dis (2013) · Jan 2014
Intramedullary nailing of subtrochanteric fractures--does malreduction matter?
Subtrochanteric femur fractures remain challenging injuries to treat. Historically, varus malreduction has been linked to the development of nonunion; however, there is a paucity of literature evaluating the impact of sagittal plane malreduction. The purpose of this study was to evaluate the influence of coronal and sagittal plane malreductions on time to union of subtrochanteric femur fractures treated with an intramedullary device. ⋯ For patients with subtrochanteric fractures treated with an intramedullary device, malreduction in any plane of greater than 10° resulted in a significantly increased rate of delayed or nonunion or both.
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Bull Hosp Jt Dis (2013) · Jan 2014
ReviewOpen knee joint injuries--an evidence-based approach to management.
Open knee joint injuries are potentially devastating injuries if not properly diagnosed and treated. Current diagnostic techniques, such as the saline load test (SLT), are based on outdated literature. Diagnosis of traumatic arthrotomies via the presence of intra-articular air on computed tomography (CT) scan has recently been shown to be 100% sensitive and specific to detect these injuries. ⋯ Antibiotic therapy following I&D of an open knee joint injury includes 24 to 48 hours of intravenous antibiotics. Oral antibiotic therapy can be administered afterwards for 3 to 5 days if the original injury was grossly contaminated. Ultimately, a unified management algorithm for open knee joint injuries based on current literature should be followed to ensure appropriate diagnosis and treatment of this potentially devastating injury.
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Bull Hosp Jt Dis (2013) · Jan 2014
Postoperative spinal fusion care in pediatric patients: Co-management decreases length of stay.
Standardized pediatric hospitalist and orthopaedic co-management of spinal fusion patients may improve quality processes and outcomes. This approach has not been studied in a general academic center. ⋯ Interdisciplinary, clinical guideline development and postoperative co-management significantly decreased hospital LOS in pediatric PSF patients. In a general academic medical center, this change may be attributed to a pediatric hospitalist academic team, a universal co-management process with well-communicated roles, and a pediatric hospital-based physician development of and adherence to standardized practice.
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Bull Hosp Jt Dis (2013) · Jan 2014
The impact of orthopaedic injuries sustained at an urban public ice skating rink: is it really free?
Previous reports in the literature from Europe and Asia cite an increased burden on the local emergency departments and orthopaedic services during the operational period of the ice skating rinks. This retrospective observational study was undertaken in order to report the incidence, characteristic, and severity of injuries during a full season at a large urban ice skating rink, as well as to quantify the added burden the ice skating rink places on the local emergency department and the orthopaedic service. ⋯ An ice-rink may be "free" but adds significant burden to the healthcare system, and these costs should be factored in by both the sponsoring body and the healthcare system for treatment of these additional patients.
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Bull Hosp Jt Dis (2013) · Jan 2014
Case ReportsThe arthroscopic-assisted removal of a distal femoral condylar locking plate--a case report.
We describe a minimally invasive procedure for removal of a distal femur locking plate using arthroscopic assistance. Using lateral accessory portals, we performed arthroscopically-assisted removal of distal locking screws. ⋯ Through this arthrotomy, the plate was elevated from the distal femur and removed without difficulty. With this method we were able to concomitantly visualize the intra-articular regions while accomplishing the hardware removal.