Bulletin of the Hospital for Joint Disease (2013)
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Bull Hosp Jt Dis (2013) · Dec 2018
National Trends in the Prevalence, Treatment, and Associated Spinal Diagnoses Among Pediatric Spondylolysis Patients.
Spondylolysis is an increasingly common diagnoses for young individuals and presents with a wide range of pathological and clinical findings. Most patients are treated conservatively, and surgery is reserved for severe cases. This is a populations study defining the incidence of spondylolysis in the Kids' Inpatient Database (KID) and assess trends in diagnoses, causes, and treatments. ⋯ The national incidence of spondylolysis has increased over time, and the surgical rate and treatment techniques have remained constant. The most common concurrent diagnoses were idiopathic scoliosis, cerebral palsy, and spina bifida. Further work is required to determine the significance of these trends and associations.
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Bull Hosp Jt Dis (2013) · Dec 2017
Risk Stratification, Triage, and Implementation of an Expedited Hip Fracture Treatment Protocol Is it Safe and Effective?
The population of patients in the USA over the age of 65 is expected to significantly increase over the next 40 years. These patients are at increased risk for hip fractures and will pose a burden to providers in the near future. In order to provide high value care, providers will need to maintain positive outcomes, mitigate complications, and reduce overall cost burdens. This study was designed to investigate the safety and efficacy of a patient transfer protocol between a large academic medical center and a single specialty orthopaedic institution. The protocol was, in turn, designed to provide high value care to the patients by safely redirecting a large volume of patients to the single specialty institution. ⋯ The transfer protocol was both safe and effective for patients with hip fractures. Transferring patients for treatment at single specialty institutions has the potential to significantly reduce hospital stays and is more likely to result in discharge to home than a rehabilitation facility, thus successfully providing high value care to patients.
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Bull Hosp Jt Dis (2013) · Apr 2017
Impact of Social Support and Pain Coping Abilityon Length of Stay and Discharge Disposition following Hip and Knee Arthroplasty A Prospective Study.
While there are many factors known to predict the outcomes of hip and knee arthroplasty procedures, there is a growing interest in predictors that take into consideration the social and psychological preparedness of patients prior to surgery. This study's aim was to determine whether patients' preoperative social support and pain catastrophizing characteristics are independently associated with the outcomes of postoperative length of stay or discharge disposition following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). ⋯ We did not find a significant association between pain catastrophizing behavior and level of social support with length of stay or discharge disposition.
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Bull Hosp Jt Dis (2013) · Sep 2016
Comparative StudySimilar Function and Improved Range of Shoulder Motion is Achieved Following Repair of Three- and Four-Part Proximal Humerus Fractures Compared with Hemiarthroplasty.
In order to compare open reduction and internal fixation (ORIF) with locked plating to hemiarthroplasty for the treatment of three- and four-part proximal humerus fractures, we compared two groups of patients treated during the same time period. ⋯ The results of this study suggest that ORIF using locked plates leads to similar postoperative function compared to hemiarthroplasty. Patients who underwent ORIF did achieve greater forward shoulder flexion. Neither strategy leads to a higher reoperation rate.
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Bull Hosp Jt Dis (2013) · Sep 2016
The Need for Clinical Hand Education in Emergency Medicine Residency Programs.
Complaints related to the hands, wrists, and fingers comprise approximately 3.7 million emergency department visits annually. The complexity of this subject can confound timely diagnosis and treatment, particularly if the treating physician has not received specialized training. We set out to determine whether emergency medicine training in the USA provides adequate preparation for dealing with the identification, management, and treatment of hand, wrist, and finger injuries. ⋯ Despite the preponderance of hand injuries seen by emergency physicians, the clinical and legal pitfalls that accompany these conditions, and the benefits to be gained from specialized training, very few programs emphasize clinical hand training in an equivalent fashion.