The Boston technique for acute point-of-care single-practitioner fracture stabilization of the lower extremity.

In this report, we describe the novel single-practitioner technique utilized at our institution for acute point-of-care temporizing management of lower extremity fractures. The Boston technique: The patient is placed supine at the edge of the hospital bed. The injured extremity is suspended from an intravenous pole in 45° of hip abduction and 30° of hip flexion. Neutral rotation is adequately maintained due to suspension through the great and second toes, without the need for patient participation. A plaster cast is applied in the usual manner and allowed to dry. Once dry, the cast is bivalved per our standard protocol to mitigate the incidence of compartment syndrome and soft-tissue complications. Discussion: The Boston technique is recommended as a single practitioner method of lower extremity fracture casting in the emergency department, trauma bay or intensive care setting. However, future studies and inclusion of additional comparable novel casting methods are required to validate our empirical findings and to further characterize the benefits and risks of casting via the Boston technique. PMID: 31114632 [PubMed]
Source: Patient Safety in Surgery - Category: Surgery Authors: Tags: Patient Saf Surg Source Type: research

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This study aims to evaluate the use of functional bracing compared to plaster cast for the management of acute Achilles tendon rupture in adult patients treated non-operatively. The primary outcome is the Achilles Tendon Rupture Score measured at 9  months after injury and will be estimated based on a linear mixed effects regression model adjusted for the stratification factor (centre) and other key prognostic variables. Secondary outcomes include complications, quality of life and resource use evaluated at 8 weeks and at 3, 6 and 9 mont hs after the injury. Missing data will be summarised and reported...
Source: Trials - Category: Research Source Type: clinical trials
ConclusionsPatients who choose to continue long-term treatment with oral appliances for sleep apnea are unaware of various types of bite changes. Such changes will, however, progressively increase in magnitude and be more difficult to take care of, if needed. It is therefore important continuously to follow up patients in regard to bite changes.
Source: Sleep and Breathing - Category: Respiratory Medicine Source Type: research
We examined the effect of immobilization, low-intensity muscle contraction exercise, and transcutaneous electrical nerve stimulation (TENS) on tissue inflammation and acute pain following the onset of arthritis in a rat model. Sixty Wistar rats were divided into five groups: (1) Arthritis group, (2) arthritis and immobilization (Immobilization group), (3) arthritis and low intensity muscle contraction (Exercise group), (4) arthritis and TENS (TENS group), and (5) sham arthritis (Sham group). Arthritis was induced in the right knee joints by single injection of 3% kaolin and carrageenan. Immobilization of the right hindlimb...
Source: Neuroscience Letters - Category: Neuroscience Source Type: research
For many, healing fractures has meant submitting to a heavy and uncomfortable plaster cast. However, two Latvian entrepreneurs are on a mission to change that with 3-D printed casts.
Source: Healthcare News - Category: Pharmaceuticals Authors: Source Type: news
Superheated gases and rock fragments can reach speeds of up to 400mph by travelling on cushion of air, say scientistsCrouched figures, a child with its mother, a dog writhing on its back – the harrowing plaster casts of the dead of Pompeii reveal that when the end came in AD79, it was as swift as it was final.Caught in the eruption of Mount Vesuvius, many died when buildings collapsed under heavy ash and pumice. But for those still alive, another catastrophe was about to hit as deadly currents of superheated gases, ash and rock fragments raced through the streets.Continue reading...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Volcanoes Natural disasters and extreme weather Geology Science World news Source Type: news
Publication date: Available online 30 March 2019Source: Journal of Clinical Orthopaedics and TraumaAuthor(s): Paul Rai, Aziz Haque, Alwyn AbrahamAbstractDisplaced distal radius fractures involving the metaphysis are common childhood injuries requiring intervention. Patients frequently undergo operative treatment for these injuries. The aim of our study was to systematically review the literature comparing manipulation under anaesthesia (MUA) and Kirschner wire fixation(K wire). PRISMA guidelines were followed throughout. Medline and Cochrane databases were searched for comparative randomised controlled trials (RCTs) and co...
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
We describe the manufacturing process of the 3D device in place of the plaster cast usually applied to a child 48/72 h after the access to the Trauma Center Traumatology Hub. This procedure had already been performed at Level II, Trauma Center, Campania Region, Orthopaedic Division of Santobono Children’s Hospital, Naples, Italy. The operative phase was performed by two 3D printers and a scanner in the bioengineering laboratory of the hospital’s outpatient area. The phase of software elaboration requires close cooperation among physicians and engineers. We decided to use a model with a double-shell desig...
Source: Journal of Pediatric Orthopaedics B - Category: Orthopaedics Tags: PEDIATRIC ORTHOPAEDICS IN ITALY: SPECIAL ISSUE Source Type: research
Objectives: To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the level of the elbow, or cubital nerve block (CNB), and another an axillary nerve block (ANB). Design: Two prospective randomized controlled studies were performed to compare the difference in pain intensity during closed reduction of a distal radius fracture between FHB-, CNB-, and, ANB-treated patients. ...
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
ConclusionWe found that patients with boxer’s fractures who were randomized to buddy taping had functional outcomes similar to those of patients randomized to plaster cast at 12 weeks. We advocate a minimal intervention such as buddy taping for uncomplicated boxer’s fractures.
Source: Annals of Emergency Medicine - Category: Emergency Medicine Source Type: research
Wrist fractures are the most common bone injury in children, causing much pain, distress and life impact for them and their families. In a comprehensive Cochrane Review from December 2018, Joanne Elliott, Managing Editor of the Cochrane Bone, Joint and Muscle Trauma Group based at the University of Manchester in the UK and colleagues, also based in the UK, look at a variety of interventions that are used for these fractures and she outlines the findings in this podcast.Most wrist fractures in children are buckle fractures, also called torus fractures, where the bone surface bulges out. These minor fractures heal well, ofte...
Source: Cochrane News and Events - Category: Information Technology Authors: Source Type: news
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