Primary Arthrodesis for Tibial Pilon Fractures

Staged primary ankle arthrodesis is a viable option for high-energy pilon fractures that are nonreconstructible, in patients with delay in treatment or multiple medical comorbidities, or in patients with peripheral neuropathy. Small retrospective series demonstrate high union and low wound complication rates, although further studies are needed to determine the long-term results. Ankle arthrodesis offers decreased complication rates while eliminating the potential of posttraumatic ankle arthritis pain.
Source: Foot and Ankle Clinics - Category: Orthopaedics Authors: Source Type: research

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by Drew Rosielle (@drosielle)A Series of Observations on Opioids By a Palliative Doc Who Prescribes A Lot of Opioids But Also Has Questions.This is the 5th post in a series about opioids, with a focus on how my thinking about opioids has changed over the years. See also:Part 1 – Introduction, General Disclaimers, Hand-Wringing, and a Hand-Crafted Graph.Part 2 – We Were Wrong 20 years Ago, Our Current Response to the Opioid Crisis is Wrong, But We Should Still Be Helping Most of our Long-Term Patients Reduce Their Opioid DosesPart 3 – Opioids Have Ceiling Effects, High-Doses are Rarely Therapeutic, and Ano...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: cancer opioids pain rosielle The profession Source Type: blogs
Discussion Restless legs syndrome (RLS) is also known as Willis-Ekbom disease. RLS is a clinical diagnosis with criteria being: 1. An urge to move the legs usually accompanied by uncomfortable and unpleasant sensations in the lower extremities (Note: sometimes other body parts can be affected) 2. The urge to move begins or worsens when sitting or lying down 3. The urge to move is partially or totally relieved by movement (Note: relief by activity may not be noticable if severely affected but must have been previously present) 4. The urge to move the legs and any accompanying unpleasant sensations during rest or in activ...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
Conclusion: These exploratory findings indicate that patients with NeP across different etiologies are medically complex and experience impaired function across multiple domains. PMID: 30662281 [PubMed]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: J Pain Res Source Type: research
Conclusions: DCM symptoms are poorly identified by Web-based symptom checkers, which leads to a large differential of many other common conditions. While a diagnosis becomes more likely as the number of symptoms increases, this represents more advanced disease and will not support much-needed earlier diagnosis. Symptom checkers remain an attractive concept with potential. Further research is required to support their optimization.
Source: Journal of Medical Internet Research - Category: General Medicine Authors: Source Type: research
With all our talk of opiate withdrawal syndromes accompanied by nausea, headache, fatigue, and depression, it can be daunting, even terrifying, to people who face the prospect of tossing all wheat and grains into the trash bin, vowing to never let a Danish, donut, or dish of pasta cross your lips again. So it may help to lay out a timeline of what and when various changes can develop in the Wheat Belly wheat- and grain-free lifestyle. You can expect different symptoms and health conditions to recede at different rates, since they are caused by a variety of different mechanisms. For instance, the direct gastrointestinal tox...
Source: Wheat Belly Blog - Category: Cardiology Authors: Tags: Wheat Belly Lifestyle acid reflux detoxification grains IBS Inflammation joint pain opiates withdrawal Source Type: blogs
We report a case of a 57-year-old woman diagnosed with Hansen disease 10 years ago, who suffered from joints swelling, pain and joints deformities of both hands for 19 years. The skin on the hands showed rashes, thickening, desquamation and chapping, with both thenar muscles atrophy. She also had severe hypoalgesia of the whole body, and morning stiffness for one hour. Diagnoses: The final diagnosis was joint damage and peripheral neuropathy due to Hansen disease. Interventions: The patient received neurotrophic treatment instead of anti-rheumatic treatment. Outcomes: At 1-year follow up, no further aggravation of...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Neurostimulation has the capacity to stop pain signals from traveling up to the brain, but to mask the pain effectively and for long periods of time clinicians have turned to implants. That is because conventional TENS (Transcutaneous Electrical Nerv...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Medicine Orthopedic Surgery Pain Management Source Type: blogs
We report an unusual case of SFN initially developing in a patient with UA, who ultimately develops RA.
Source: Neurology Clinical Practice - Category: Neurology Authors: Tags: Autoimmune diseases, Peripheral neuropathy, Neuropathic pain Case Source Type: research
CONCLUSION: The use of IFN-free regimens is safe and effective in the treatment of most HCV-related rheumatologic EHM. PMID: 28795238 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Rheumatologie - Category: Rheumatology Authors: Tags: Z Rheumatol Source Type: research
The endocannabinoid system has been shown to reduce inflammatory flares and pain in rodent models of arthritis. A limitation of endocannabinoids is that they are rapidly denatured by hydrolysing enzymes such a...
Source: Arthritis Research and Therapy - Category: Rheumatology Authors: Source Type: research
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