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Saturday, December 10, 2011

Brief psychosocial education, not core stabilization, reduced incidence of low back pain: results from the Prevention of Low Back Pain in the Military (POLM) cluster randomized trial

Core stabilization has been advocated as preventative, but offered no such benefit when compared to traditional lumbar exercise in this trial. Instead, a brief psychosocial education program that reduced fear and threat of low back pain decreased incidence of low back pain resulting in seeking of health care. Since this trial was conducted in a military setting future studies are necessary to determine if these findings can be translated into civilian populations. George SZ, Childs JD, Teyhen DS, Wu SS, Wright AC, Dugan JL, Robinson ME. BMC Med. 2011 Nov 29;9(1):128. [Epub ahead of print] PMID: 22126534 PDF

Friday, December 9, 2011

Ultrasound surgery -- healing without cuts - Yoav Medan (2011)

Imagine having a surgery with no knives involved. At TEDMED, Yoav Medan shares a technique that uses MRI to find trouble spots and focused ultrasound to treat such issues as brain lesions, uterine fibroids and several kinds of cancerous growths. TED Talks

Thursday, December 8, 2011

Journal of Orthopaedic Research - early view

Recent Ortho Related Ultrasound Articles via PubMed

External Fixation versus Internal Fixation for Unstable Distal Radius Fractures: A Systematic Review and Meta-Analysis of Comparative Clinical Trials

There is no consensus on the surgical management of unstable distal radius fractures. In this systematic review and meta-analysis, we pool data from trials comparing external fixation and open reduction and internal fixation (ORIF) for this injury.  Data Sources: We searched electronic databases (including MEDLINE, EMBASE, and SCOPUS) and conference proceedings from 1950 to 2009 in the English literature. Wei, David H; Poolman, Rudolf W; Bhandari, Mohit; Wolfe, Valerie; Rosenwasser, Melvin. Journal of Orthopaedic Trauma: POST AUTHOR CORRECTIONS, 21 November 2011 view this article in OvidSP (via Athens).

Surgical treatment and management of hip fracture patients

Osteoporosis-related hip fractures are associated with high mortality and costs. The optimum type of treatment for such fractures is controversial. To shed some light on this issue, the surgical treatment and management of osteoporotic hip fractures were discussed during a hip fracture surgical working group at the 2009 International Society For Fracture Repair Annual Meeting comprising leading experts in the field. Antonio Moroni, Martha Hoque, James P. Waddell, Thomas A. Russell, Burkhard Wippermann and Gary DiGiovanni. Archives of Orthopaedic and Trauma Surgery. {Epub ahead of print] Dec 2011. PDF

Recent Navy Ortho Publications via PubMed

1. Joint chondrolysis. Provencher MT, Navaie M, Solomon DJ, Smith JC, Romeo AA, Cole BJ.
J Bone Joint Surg Am. 2011 Nov 2;93(21):2033-44. PMID: 22048100
2. Low Complication Rate Associated With Raising Mature Flap for Tibial Nonunion Reconstruction. Will RE, Fleming ME, Lafferty PM, Fletcher JW, Cole PA. J Trauma. 2011 Oct 13. [Epub ahead of print] PMID: 22002619
3. Low lumbar burst fractures: a unique fracture mechanism sustained in our current overseas conflicts. Lehman RA Jr, Paik H, Eckel TT, Helgeson MD, Cooper PB, Bellabarba C. Spine J. 2011 Oct 7. [Epub ahead of print] PMID: 21982760
4. Two-Year Outcomes of Open Shoulder Anterior Capsular Reconstruction for Instability From Severe Capsular Deficiency. Dewing CB, Horan MP, Millett PJ. Arthroscopy. 2011 Oct 5. [Epub ahead of print] PMID: 21978433
5. Identification of the Radial Nerve During the Posterior Approach to the Humerus: A Cadaveric Study. Seigerman DA, Choung EW, Yoon RS, Lu M, Frank MA, Gaines RJ, Liporace FA. J Orthop Trauma. 2011 Sep 10. [Epub ahead of print] PMID: 21918485

From the mHealth Conference Dec 2011

Researchers discover that changes in bioelectric signals cause tadpoles to grow eyes in back, tail

For the first time, scientists have altered natural bioelectrical communication among cells to directly specify the type of new organ to be created at a particular location within a vertebrate organism. Using genetic manipulation of membrane voltage in Xenopus (frog) embryos, biologists at Tufts University's School of Arts and Sciences were able to cause tadpoles to grow eyes outside of the head area.

These findings break new ground in the field of biomedicine because they identify an entirely new control mechanism that can be capitalized upon to induce the formation of complex organs for transplantation or regenerative medicine applications, according to Michael Levin, Ph.D., professor of biology and director of the Center for Regenerative and Developmental Biology at Tufts University's School of Arts and Sciences. Levin is senior and corresponding author on the work published in the journal Development online December 7 2011, in advance of print.

Levin and his colleagues are pursuing further research, additionally targeting the brain, spinal cord, and limbs. The findings, he said "will allow us to have much better control of tissue and organ pattern formation in general. We are developing new applications of molecular bioelectricity in limb regeneration, brain repair, and synthetic biology." Additional authors include post-doctoral fellow Sherry Aw, Tufts Postdoctoral Associate Tal Shomrat, and Research Associate Joan M. Lemire. Funding for this research came from the National Institutes of Health. Eurekalert!

Wednesday, December 7, 2011

ASHP: Post-Surgery Opioids Add Dollars, Days to Hospital Stay (CME/CE)

The mHealth Summit 2011 is in full swing and there are many exciting booths and demonstrations available to see. We recently reported that ResolutionMD has received FDA clearance for its mobile radiology viewing system. The platform is available as a free downloadable demo “lite” version via iTunes. iMedicalApps

Common bone drug may extend life of replacement joints

People who take bisphosphonates after joint replacement surgery are less likely to need a repeat operation, finds a new study published in the British Medical Journal today. MedicalXpress

Monday, December 5, 2011

Recent Military Related Ortho Articles via PubMed

1.  Prevalence of heterotopic ossification after cervical total disc arthroplasty: a meta-analysis. Chen J, Wang X, Bai W, Shen X, Yuan W. Eur Spine J. 2011 Dec 2. [Epub ahead of print] PMID: 22134486
2. Bony avulsion of the supraspinatus origin from the scapular spine.  Vochteloo AJ, Henket M, Vincken PW, Nagels J.  Orthop Traumatol. 2011 Dec 2. [Epub ahead of print] PMID: 22134393
3. Mandibular fractures in British military personnel secondary to blast trauma sustained in Iraq and Afghanistan.  Breeze J, Gibbons AJ, Hunt NC, Monaghan AM, Gibb I, Hepper A, Midwinter M. Br J Oral Maxillofac Surg. 2011 Dec;49(8):607-11. Epub 2010 Nov 11. PMID: 21074305
4. Face, neck, and eye protection: adapting body armour to counter the changing patterns of injuries on the battlefield.  Breeze J, Horsfall I, Hepper A, Clasper J. Br J Oral Maxillofac Surg. 2011 Dec;49(8):602-6. Epub 2010 Oct 30. PMID: 21036436
5. Military sports medicine clinics should continue to organise MRI prior to listing for "fast track" meniscectomy.  Howes J, Wood AM, Bell DJ, Wrigley S, Angus C. Br J Sports Med. 2011 Dec;45(15):A17. PMID: 22077019
6. Fast track surgery for anterior cruciate ligament reconstruction in military patients in Scotland. Howes J, Wood AM, Bell DJ, Wrigley S, Angus C. Br J Sports Med. 2011 Dec;45(15):A15. PMID: 22077012
7. Utilization profile of the trauma intensive care unit at the Role 3 Multinational Medical Init at Kandahar Airfield between May 1 and Oct. 15, 2009. Shah K, Pirie S, Compton L, McAlister V, Church B, Kao R. Can J Surg. 2011 Dec;54(6):S130-4. PMID: 22099326 Free Article
8. Dual delivery of an antibiotic and a growth factor addresses both the microbiological and biological challenges of contaminated bone fractures.  Wenke JC, Guelcher SA. Expert Opin Drug Deliv. 2011 Dec;8(12):1555-69. Epub 2011 Oct 22. PMID: 22017669
9. Injuries and injury risk factors among British army infantry soldiers during predeployment training. Wilkinson DM, Blacker SD, Richmond VL, Horner FE, Rayson MP, Spiess A, Knapik JJ. Inj Prev. 2011 Dec;17(6):381-7. Epub 2011 Apr 19. PMID: 21507884
10. Outcomes in lower limb amputation following trauma: A systematic review and meta-analysis. Penn-Barwell JG. Injury. 2011 Dec;42(12):1474-9. Epub 2011 Aug 9. PMID: 21831371
11. A systematic review of job-specific workers' health surveillance activities for fire-fighting, ambulance, police and military personnel.  Plat MJ, Frings-Dresen MH, Sluiter JK. Int Arch Occup Environ Health. 2011 Dec;84(8):839-57. Epub 2011 Feb 12. PMID: 21318608
12. Use of vacuum-assisted closure (VAC™) in high-energy complicated perineal injuries: analysis of nine cases.  Ozer MT, Coskun AK, Ozerhan IH, Ersoz N, Yildiz R, Sinan H, Demirbas S, Kozak O, Uzar AI, Cetiner S. Int Wound J. 2011 Dec;8(6):599-607. doi: 10.1111/j.1742-481X.2011.00835.x. Epub 2011 Aug 19. PMID: 21854547
13. Randomized, Prospective Comparison of Plate versus Intramedullary Nail Fixation for Distal Tibia Shaft Fractures.  Vallier HA, Cureton BA, Patterson BM. J Orthop Trauma. 2011 Dec;25(12):736-41. PMID: 21904230
14. Anemia, Iron Deficiency, and Stress Fractures in Female Combatants During 16 Months. Yanovich R, Merkel D, Israeli E, Evans RK, Erlich T, Moran DS. J Strength Cond Res. 2011 Dec;25(12):3412-3421. PMID: 22080308
15. Practice of ultrasound-guided arthrocentesis and joint injection, including training and implementation in Europe: results of a survey of experts and scientific societies.  Mandl P, Naredo E, Conaghan PG, D'Agostino MA, Wakefield RJ, Bachta A, Backhaus M, Hammer HB, Bruyn GA, Damjanov N, Filippucci E, Grassi W, Iagnocco A, Jousse-Joulin S, Kane D, Koski JM, Möller I, De Miguel E, Schmidt WA, Swen WA, Szkudlarek M, Terslev L, Ziswiler HR, Ostergaard M, Balint PV. Rheumatology (Oxford). 2011 Dec 1. [Epub ahead of print] PMID: 22120466
16. Changes in muscle strength and morphology after muscle unloading in Special Forces missions. Thorlund JB, Jakobsen O, Madsen T, Christensen PA, Nedergaard A, Andersen JL, Suetta C, Aagaard P. Scand J Med Sci Sports. 2011 Dec;21(6):e56-63. doi: 10.1111/j.1600-0838.2010.01149.x. Epub 2010 Jun 18. PMID: 20561275
17. Can orthotic insoles prevent lower limb overuse injuries? A randomized-controlled trial of 228 subjects.  Mattila VM, Sillanpää PJ, Salo T, Laine HJ, Mäenpää H, Pihlajamäki H. Scand J Med Sci Sports. 2011 Dec;21(6):804-8. doi: 10.1111/j.1600-0838.2010.01116.x. Epub 2010 May 12. PMID: 20492587
18. Blood Serum Antibody Analysis and Long-Term Follow-up of Patients Treated With Recombinant Human Bone Morphogenetic Protein-2 in the Lumbar Spine.  Burkus JK, Gornet MF, Glassman SD, Slosar PJ, Rosner MK, Deckey JE, Nowak J, Hatcher BM. Spine (Phila Pa 1976). 2011 Dec 1;36(25):2158-67. PMID: 21325990 

The challenges and advances of polytrauma care in 2012 (Editorial)

Trauma centers are designated to provide systematized multidisciplinary care to injured patients. Effective trauma systems reduce patient mortality by facilitating the treatment of injured patients at appropriately resourced hospitals. Several U.S. studies report reduced mortality among patients admitted directly to a level I trauma center compared with those admitted to hospitals with less resources. It has yet to be shown whether there is an outcome benefit associated with the “level of hospital” initially treating severely injured trauma patients in Australia. This study was designed to determine whether the level of trauma center providing treatment impacts mortality and/or hospital length of stay. Z. J. Balogh and H.-C. Pape. European Journal of Trauma and Emergency Surgery. [Epub ahead of print] Dec 2011 PDF

Engineering cartilage replacements

A lab discovery is a step toward implantable replacement cartilage, holding promise for knees, shoulders, ears and noses damaged by osteoarthritis, sports injuries and accidents.

Self-assembling sheets of mesenchymal stem cells permeated with tiny beads filled with growth factor formed thicker, stiffer cartilage than previous tissue engineering methods, researchers at Case Western Reserve University have found. A description of the research is published in the Journal of Controlled Release. Eurekalert!

Engineered cartilage via self-assembled hMSC sheets with incorporated biodegradable gelatin microspheres releasing transforming growth factor-β1

US baby boomers feed need for joint replacements

With 76 million baby boomers still kicking, many are rejecting the sedentary lifestyle of their parents' generation, and are using advances in technology and surgical techniques to keep on running, cycling, skiing and engaging in other sports.

The 45-64 age group accounted for more than 40 percent of the more than 906,000 total knee or total hip replacement surgeries in 2009, the last year for which figures were available from the American Academy of Orthopedic Surgeons. MedicalXPress

Sunday, December 4, 2011

Department of Defense embracing alternative medicine

Would you be surprised to know that the Department of Defense has designated several billion dollars for research into these healing techniques. The Pentagon has also dedicated five million dollars as grant money to research into some of these methods such as acupuncture and meditation in order to treat PTSD in veterans. Let us not forget the U.S. Army who gave four million dollars in grant money for research into alternative methods to treat and heal conditions such as PTSD, anxiety, substance abuse and depression. These unconventional healing methods have been showing promise among veterans and military personnel.

Appearing in the Journal of the American College of Cardiology, 2010, research had been conducted on the effects reiki on Acute Coronary Syndrome. The results of the study had demonstrated it was a benefit to patients however, the long term effects are still unclear.

This month the US Department of Veteran Affairs has announced the launch of the Congressionally mandated chiropractic services program. The following has been released by the DAV:

Veterans can receive chiropractic care at 26 selected Department of Veterans Affairs (VA) facilities beginning this fall, Secretary of Veterans Affairs Anthony J. Principi announced today. AllVoices

Journal of Orthopaedics and Traumatology (Open Access)

Outcome of closed ipsilateral metacarpal fractures treated with mini fragment plates and screws: a prospective study PDF

Foot & Ankle Specialist [Epub ahead of print] Dec 2011

1. Closed Total Talar Extrusion After Ankle Sprain. Turhan Y, Cift H, Ozkan K, Ozkut A, Eren A. Foot Ankle Spec. 2011 Dec 1. [Epub ahead of print] PMID: 22134439
2. The Relationship Between Knee Arthroplasty and Foot Loading. Voronov ML, Pinzur MS, Havey R, Carandang G, Gil J, Hopkinson WJ. Foot Ankle Spec. 2011 Dec 1. [Epub ahead of print] PMID: 22134436
3. Long-Term Results of Neurectomy in the Treatment of Morton's Neuroma: More Than 10 Years' Follow-up. Lee KT, Kim JB, Young KW, Park YU, Kim JS, Jegal H. Foot Ankle Spec. 2011 Dec 1. [Epub ahead of print] PMID: 22134434

The evaluation of the effects of hyperbaric oxygen therapy on new bone formation obtained by distraction osteogenesis in terms of consolidation periods.

The effect of hyperbaric oxygen therapy on vertical distraction osteogenesis procedure according to consolidation periods has been determined. Hyperbaric oxygen therapy may increase the quality and the quantity of bone and shorten the consolidation period. Mutlu I, Aydintug YS, Kaya A, Bayar GR, Suer BT, Gulses A. Clin Oral Investig. 2011 Dec 3. [Epub ahead of print] PMID: 22134666

Effects of seasonal Vitamin D deficiency and respiratory acidosis on bone metabolism markers in submarine crewmembers during prolonged patrols

The aim of the study was to determine the seasonal influence of vitamin D status on bone metabolism in French submariners over a 2-month patrol. Blood samples were collected as follows: pre-patrol, patrol days 20, 41 and 58 on crewmembers from both a winter (WP; n = 20) and a summer patrol (SP; n = 20), respectively. Vitamin D status was evaluated for WP and SP. Moreover, extended parameters for acid-base balance (pCO(2), pH and bicarbonate), bone metabolism (bone alkaline phosphatase or BAP and C-terminal telopeptide of type I collagen or ICTP) and mineral homeostasis (parathyroid hormone, ionized calcium and phosphorus) were scrutinized. Holy X, Collombet JM, Labarthe F, Granger-Veyron N, Begot L. J Appl Physiol. 2011 Dec 1. [Epub ahead of print] PMID: 22134698

Lumbar Spine Fractures Within a Complete American Cohort: Epidemiology and Risk Factors Among Military Service Members.

This investigation is the first to document the incidence and postulate risk factors for lumbar spine fracture in an American population. In this study, males, whites, enlisted personnel, those serving in the Army and Marines, and individuals aged 20-24 or greater than 40 were found to be at an increased risk of lumbar fractureSchoenfeld AJ, Romano D, Bader JO, Walker JJ. J Spinal Disord Tech. 2011 Nov 29. [Epub ahead of print] PMID: 22134730

Effect of diclofenac with B vitamins on the treatment of acute pain originated by lower-limb fracture and surgery.

Diclofenac plus B vitamins combination was more effective to reduce the pain than diclofenac alone. The results showed that the addition of B vitamins to diclofenac increased its analgesic effect. The novelty of this paper consists in that diclofenac and diclofenac plus B vitamins were useful for treatment of acute pain originated by lower-limb fracture and surgery. Ponce-Monter HA, Ortiz MI, Garza-Hernández AF, Monroy-Maya R, Soto-Ríos M, Carrillo-Alarcón L, Reyes-García G, Fernández-Martínez E. Pain Res Treat. 2012;2012:104782. Epub 2011 Oct 31. PMID: 22135737 PDF