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Sickle cell bone disease and response to intravenous bisphosphonates in children
ConclusionChildren with SCD have the potential for extensive and early-onset bone morbidity. In this series, IV bisphosphonates were effective for bone pain analgesia and did not trigger sickle cell complications.
Source: Osteoporosis International - July 29, 2022 Category: Orthopaedics Source Type: research

Factors associated with blunt internal carotid artery injury in petrous temporal bone fractures
The incidence of blunt cerebrovascular injury (BCVI), including internal carotid artery (ICA) injury, is approximately 1% of all blunt trauma patients (1-4). Although rare, these injuries can have devastating complications, including stroke, haemorrhage and death, the chance of which may be reduced with early intervention. In light of this, there have been a number of efforts to improve the screening criteria for detection of these injuries in asymptomatic patients (2, 5). It is currently recommended that patients with a petrous temporal bone (PTB) fracture should be considered for BCVI screening with a computed-tomography...
Source: Injury - March 19, 2022 Category: Orthopaedics Authors: Christine Li, Lorne Green, Jennifer Wang, Dylan Tully, Jonathan Woliansky, Kellie Gumm, Claire Iseli, Katherine Martin, David Read Source Type: research

Gait speed and spasticity are independently associated with estimated failure load in the distal tibia after stroke: an HR-pQCT study
ConclusionThe paretic distal tibia showed more compromised vBMD, cortical area, cortical thickness, and estimated failure load than the non-paretic tibia. Gait speed and spasticity were independently associated with estimated failure load. As treatment programs focusing on these potentially modifiable stroke-related impairments are feasible to administer, future studies are needed to determine the efficacy of such intervention strategies for improving bone strength in individuals with chronic stroke.
Source: Osteoporosis International - October 12, 2021 Category: Orthopaedics Source Type: research

Relationship between bone strength index of the hemiparetic tibial diaphysis and muscle strength in people with chronic stroke: influence of muscle contraction type and speed
ConclusionsConcentric muscle power was more predictive of %SSD in p-SSI at the tibial diaphysis than other contraction types and may be an important target for intervention to promote bone health in people with chronic stroke.
Source: Osteoporosis International - November 7, 2020 Category: Orthopaedics Source Type: research

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

Atypical calcific tendinitis involving the long biceps tendon: A rare cause of hemiplegic shoulder pain.
CONCLUSION: This is the first report on atypical calcific tendinitis involving the LBT causing hemiplegic shoulder pain after a stroke. PMID: 30507560 [PubMed - as supplied by publisher]
Source: Journal of Back and Musculoskeletal Rehabilitation - December 7, 2018 Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research

Resolution of traumatic bilateral vertebral artery injury
We described a case of traumatic bilateral vertebral artery injury (VAI) including unilateral vertebral arterial occlusion that resolved 3  months post-injury with antiplatelet and direct oral anticoagulant therapy. This resolution of traumatic bilateral VAI is very rare. Vertebral artery injury should be suspected in patients with displaced fracture dislocation of the cervical spine, particularly in the elder and those with ankylosi ng spondylitis, and therefore imaging of these patients should include a modality to look at the patency of the vertebral arteries.Case descriptionA 70-year-old man who was diagnosed with an...
Source: European Spine Journal - March 1, 2018 Category: Orthopaedics Source Type: research

Upright activity and higher motor function may preserve bone mineral density within 6  months of stroke: a longitudinal study
ConclusionBetter motor control and walking recovery were associated with reduced bone loss. Interventions targeting these impairments from early post-stroke are warranted.Clinical trial registrationURL:http://www.anzctr.org.au. Unique identifier: ACTRN12612000123842.
Source: Archives of Orthopaedic and Trauma Surgery - January 8, 2018 Category: Orthopaedics Source Type: research

Anatomical anomalies of the V3 segment of the vertebral artery in the Polish population
ConclusionsVery low incidence of V3 segment anomalies does not justify in our opinion routine vascular imaging in patients undergoing posterior cervical instrumented procedures.
Source: European Spine Journal - November 26, 2016 Category: Orthopaedics Source Type: research

Retroperitoneal haematoma in a postoperative ALIF patient taking rivaroxaban for atrial fibrillation
ConclusionThis is the first case of a rivaroxaban-induced retroperitoneal haematoma reported in the literature, secondary to elective spinal surgery. This report adds to the body of evidence on the risk of postoperative bleeding in patients taking NOACs. If patients on NOACs present with abdominal symptoms following anterior approach to the lumbar spine, treating clinicians should have a high index of suspicion for retroperitoneal haematoma.
Source: European Spine Journal - November 1, 2016 Category: Orthopaedics Source Type: research

Worsening Cervical Epidural Hematoma After Tissue Plasminogen Activator Administration for Stroke Like Symptoms
Conclusion. To our knowledge, only three cases of cervical SEH with hemiparesis erroneously treated with tPA resulting in neurological decline because of the enlargement of an existing hematoma, including the current case, have been reported in the English literature. It is important for physicians, especially those who administer tPA treatment, to include cervical SEH in the differential diagnosis of stroke in patients presenting with sudden back pain followed by the onset of neurological deficits including hemiparesis. Level of Evidence: 5
Source: Spine - March 26, 2016 Category: Orthopaedics Tags: Case Report Source Type: research

Spontaneous vertebral artery dissection: Posterior circulation stroke
Manoj Deshmukh, Anju Wadhwa, Ravi RajdeoJournal of Craniovertebral Junction and Spine 2015 6(4):206-208Spontaneous vertebral artery dissection (VAD) is relatively rare but an important cause of posterior circulation stroke. A 46-year-male complaining of sudden onset headache, neck pain with right-sided neuro deficit in the form of hemiparesis was evaluated by contrast magnetic resonance imaging and dual-energy computed tomography (CT) and brain neck angiography which revealed a short segment extracranial left-sided VAD, associated with acute infarct in the left occipital region. The patient was managed conservatively and f...
Source: Journal of Craniovertebral Junction and Spine - October 21, 2015 Category: Orthopaedics Authors: Manoj DeshmukhAnju WadhwaRavi Rajdeo Source Type: research

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