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Specialty: Orthopaedics
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Total 436 results found since Jan 2013.

Diagnostic accuracy of different clinical screening criteria for blunt cerebrovascular injuries compared with liberal state of the art computed tomography angiography in major trauma
BACKGROUND Blunt cerebrovascular injuries (BCVI) can significantly impact morbidity and mortality if undetected and, therefore, untreated. Two diagnostic concepts are standard practice in major trauma management: Application of clinical screening criteria (CSC) does or does not recommend consecutive computed tomography angiography (CTA) of head and neck. In contrast, liberal CTA usage integrates into diagnostic protocols for suspected major trauma. First, this study's objective is to assess diagnostic accuracy of different CSC for BCVI in a population of patients diagnosed with BCVI after the use of liberal CTA. Second, ...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

New ischemic lesions on brain magnetic resonance imaging in patients with blunt traumatic cerebrovascular injury
BACKGROUND Patients with blunt cerebrovascular injuries are at risk of thromboembolic stroke. Although primary prevention with antithrombotic therapy is widely used in this setting, its effectiveness is not well defined and requires further investigation. The aim of this study was to evaluate the utility of magnetic resonance imaging (MRI)–detected ischemic brain lesions as a possible future outcome for randomized clinical trials in this patient population. METHODS This prospective observational study included 20 adult blunt trauma patients admitted to a level I trauma center with a screening neck CTA showing extrac...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research

Evaluation and management of blunt cerebrovascular injury: A practice management guideline from the Eastern Association for the Surgery of Trauma
BACKGROUND Blunt cerebrovascular injuries (BCVIs) are associated with significant morbidity and mortality. This guideline evaluates several aspects of BCVI diagnosis and management including the role of screening protocols, criteria for screening cervical spine injuries, and the use of antithrombotic therapy (ATT) and endovascular stents. METHODS Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, a taskforce of the Practice Management Guidelines Committee of the Eastern Association for the Surgery of Trauma performed a systematic review and meta-analysis of currently avail...
Source: The Journal of Trauma: Injury, Infection, and Critical Care - May 29, 2020 Category: Orthopaedics Tags: GUIDELINES Source Type: research

Wheelchair backs that support the spinal curves: Assessing postural and functional changes.
Conclusions: This pilot study demonstrated that a wheelchair back, which supports the seated spinal curves improves upright posture, functional reach, and wheelchair propulsion skills. Further research is necessary to demonstrate statistical findings as well as to assess back height and lateral support. PMID: 32406808 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - May 16, 2020 Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research

The Effect of Anticoagulation on Outcomes After Liver and Spleen Injuries: A Research Consortium of New England Centers for Trauma (ReCONECT) Study.
Over the past several decades, following the initial description of non-operative management in the pediatric population, the management of liver and splenic injuries has transformed from a predominantly operative management to a more selective approach. Non-operative management, along with the adjunctive use of angioembolization, has been successfully utilized for the management of many adults with spleen and liver injuries. [1,2,3,4] During the same time, there has also been an increasing utilization of anticoagulation (AC) agents for a variety of cardiovascular conditions including stroke prevention in atrial fibrillation.
Source: Injury - May 13, 2020 Category: Orthopaedics Authors: Bishwajit Bhattacharya, Reza Askari, Kimberly A Davis, Jon Dorfman, Ahmed I Eid, Ahmed E Elsharkawy, George Kasotakis, Sandra Mackey, Stephen Odom, Barbara U Okafor, Michael Rosenblatt, Alexander Ruditsky, George Velmahos, Adrian A Maung Source Type: research

Weight loss since early adulthood, later life risk of fracture hospitalizations, and bone mineral density: a prospective cohort study of 0.5 million Chinese adults
ConclusionsWeight loss from early adulthood to midlife was associated with a higher risk of hip fracture and lower BMD in later life.
Source: Archives of Orthopaedic and Trauma Surgery - April 18, 2020 Category: Orthopaedics Source Type: research

Trunk biomechanics during walking after sub-acute stroke and its relation to lower limb impairments
This study suggests that lower limb impairments should not be considered as the sole contributor of trunk impairments during walking, as intrinsic trunk deficits are present after stroke.
Source: Clinical Biomechanics - April 18, 2020 Category: Orthopaedics Authors: Van Criekinge Tamaya, Saeys Wim, Nolan Herssens, Patricia Van de Walle, De Hertogh Willem, Truijen Steven, Hallemans Ann Source Type: research

Recommendations for evaluation of neurogenic bladder and bowel dysfunction after spinal cord injury and/or disease.
Conclusion: There is no one single measure that can be used to assess NBB dysfunction across all clinical research studies. Clinical and diagnostic tools are here recommended based on specific medical needs of the person with SCI/D. Following the CDE for SCI studies guidelines, we recommend both the SF-Qualiveen for bladder and the NBDS for bowel as relatively short measures with strong psychometrics. Other measures are also recommended. A combination of assessment tools (objective and subjective) to be used jointly across the spectrum of care seems critical to best capture changes related to NBB and develop better treatme...
Source: Journal of Spinal Cord Medicine - February 29, 2020 Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research

Impact of Patent Foramen Ovale on Total Knee Arthroplasty Cerebrovascular Accident Perioperative Management.
This study was undertaken to determine whether patients with a PFO would have a significantly increased risk of cerebrovascular accident (CVA) following TKA. The Humana national database was used to identify TKA patients who were stratified by the presence of a PFO from 2007 to 2016. Ninety-day follow-up was used for the primary outcome of CVA. Potential confounding comorbidities also were investigated, including age, sex, anticoagulation, insurance type, arrhythmia, valvular disease, peripheral vascular disease, chronic kidney disease, and diabetes mellitus. Of 153,245 TKAs, a total of 2272 patients had strokes; 479 of th...
Source: Orthopedics - February 19, 2020 Category: Orthopaedics Authors: Hong CS, Politzer C, Ryan SP, Wellman SS, Jiranek WA, Bolognesi MP, Seyler TM Tags: Orthopedics Source Type: research

Dynamic imaging of the craniovertebral junction is mandatory in patients with posterior circulation strokes
ConclusionEarly diagnosis and surgical treatment of CVJ instability prevent recurrent strokes and improve outcomes in patients with PCS. Physicians and spine surgeons need to be sensitized regarding CVJ anomalies as a cause of PCS enabling early diagnosis with dynamic imaging particularly in the younger age group.Graphic abstractThese slides can be retrieved under Electronic Supplementary Material.
Source: European Spine Journal - February 18, 2020 Category: Orthopaedics Source Type: research

Does aerobic exercise benefit persons with tetraplegia from spinal cord injury? A systematic review.
Conclusion: Evidence gathered from this systematic review of literature is inconclusive due to the lack of research focusing on those with tetraplegia. Higher power studies (level 1-3) are needed with the focus on those with tetraplegia. PMID: 32043944 [PubMed - as supplied by publisher]
Source: Journal of Spinal Cord Medicine - February 12, 2020 Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research

Blood and fluid management during scoliosis surgery: a single-center retrospective analysis
ConclusionThe application of a protocol for blood and fluid management, based on goal-directed fluid therapy, cell salvage and tranexamic acid, was associated with less crystalloid fluid administration, less perioperative RBC transfusions and significantly better diuresis than patients in the no-protocol group in scoliosis surgery.Registration numberClinicalTrials.gov Identifier: NCT03814239.
Source: European Journal of Orthopaedic Surgery and Traumatology - February 2, 2020 Category: Orthopaedics Source Type: research

Effect of Heart Failure With Preserved Ejection Fraction on Perioperative Outcomes in Patients Undergoing Hip Fracture Surgery.
CONCLUSION: HFpEF confers a significant perioperative risk of MACCE in patients undergoing hip fracture surgery. PMID: 31977615 [PubMed - in process]
Source: The Journal of the American Academy of Orthopaedic Surgeons - January 26, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research

Predictors of fatal and non-fatal cardiovascular events in ANCA-associated vasculitis: data from the Toronto CanVasc cohort
Conclusions: In this cohort of patients with granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis, both traditional and disease related risk factors were predictive of cardiovascular events. Further prospective studies should elucidate the impact of these and other modifiable risk factors on cardiovascular risk in ANCA-associated vasculitis.
Source: Joint Bone Spine - January 18, 2020 Category: Orthopaedics Source Type: research

Effects of Diabetes Mellitus on Functional Outcomes and Complications After Torsional Ankle Fracture.
CONCLUSIONS: Diabetes was associated with more complications and secondary operations. However, functional outcomes including pain and dysfunction were not markedly affected by these clinical outcomes, potentially due to diminished sensory function and less baseline physical activity among diabetic patients. LEVEL OF EVIDENCE: Prognostic level III. PMID: 31922995 [PubMed - as supplied by publisher]
Source: The Journal of the American Academy of Orthopaedic Surgeons - January 12, 2020 Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research