Ortho News

Tuesday, August 9, 2011

Telemedicine to a moving ambulance improves outcome after trauma in simulated patients.

TM to a moving ambulance improved the care of simulated trauma patients. Furthermore, procedurally naïve EMTs were able to perform needle thoracostomy and pericardiocentesis with TM guidance. Charash WE, Caputo MP, Clark H, Callas PW, Rogers FB, Crookes BA, Alborg MS, Ricci MA. J Trauma. 2011 Jul;71(1):49-55. PMID: 21818014 PDF

Wayne State researcher discovers antibiotic useful for localized treatment of bone wear

Total joint replacement surgeries can help relieve joint pain common in people with conditions like osteoarthritis. But sometimes, the debris from prosthetic joints leads to aseptic loosening, or disintegration of surrounding bones. In 2009, a Wayne State University researcher determined that the anti-inflammatory antibiotic erythromycin can prevent and treat such disintegration. There was one caveat, however: there are side effects associated with long-term usage of erythromycin. Eurekalert!

The Plate-Joystick Technique to Reduce Proximal Humeral Fractures and Nonunions With a Varus Deformity Through the Extended Deltoid-Splitting Approach.

Fractures and nonunions in which there is a varus deformity of the humeral head producing posterinferior subluxation of the articular surface are increasingly recognized as an important subgroup of proximal humeral fractures. Operative open reduction and internal fixation of these injuries is often recommended when the varus deformity is severe. We describe a simple technique to assist in the open reduction and locking plate stabilization of this challenging and complex fracture subtype using tools and implants that are readily available in most modern orthopaedic trauma operating rooms. Robinson CM, Inman D, Phillips SA. J Orthop Trauma. 2011 Jul 28. [Epub ahead of print] PMID: 21804419 PDF

Arthroscopic Treatment of Rotator Cuff Disease (article in press)

The goal of this article is to summarize the current concepts on rotator cuff disease with an emphasis on arthroscopic treatment. Most rotator cuff tears are the result of an ongoing attritional process. Once present, a tear is likely to gradually increase in size. Partial thickness and subscapularis tears can both be successfully treated arthroscopically if conservative management fails. Partial tears involving greater than 50% of tendon thickness should be repaired. Articular sided partial tears involving less than 50% of the rotator cuff can reliably be treated with debridement. A more aggressive approach should be considered for low-grade tears (<50%) if they occur on the bursal side. Biomechanical and anatomic studies have shown clear superiority with dual-row fixation compared with single-row techniques. However, current studies have yet to show clear clinical advantage with dual-row over single-row repairs. Biceps tenotomy or tenodesis can reliably provide symptomatic improvement in patients with irreparable massive tears. True pseudoparalysis of the shoulder is a contraindication to this procedure alone and other alternatives should be considered. Jarrett CD, Schmidt CC. J Hand Surg Am. 2011 Aug 6. [Epub ahead of print] PMID: 21821368 PDF

See also:
Arthroscopic treatment of rotator cuff disease GM Gartsman - Journal of Shoulder and Elbow Surgery, 1995 - Elsevier Rotator cuff disease represents a spectrum of tendon lesions including inflammation of an intrinsically normal tendon, tendon fibrosis, partial-thickness tears, complete tears, and cuff tear arthropathy. An in-depth analysis of the entire subject is beyond the scope of this ...
Cited by 59 (drill up) - Related articles - All 3 versions - Import into EndNote

Visible Body is a complete, fully interactive 3D rendering of the human body and may one day replace traditional anatomy texts

Visible Body 3D Human Anatomy Atlas for iPad 2 is a huge breath of fresh air. While we at iMedicalApps have been reviewing anatomy apps that constantly improved on previous ones, Visible Body simply blew me away. After using Visible Body for mere minutes, it felt as if someone had read my previous review and made it a goal to silence my past quibbles. Not only does it take full advantage of the iPad’s touchscreen interface, it does so in such a gorgeous manner that there are not enough superlatives in my vocabulary to adequately describe it. But since a picture is worth a thousand words (especially when it comes to anatomy), I will include plenty of pictures to rectify my speechlessness and for you to judge for yourself. iMedicalApps

Have you tried the Google Translate App with your patients?

he Google Translate app for Android translates speech in real time. It works best if you don't have a heavy accent. Google Translate is a free mobile app (developed by Google) and you can instantly translate text between more than 50 languages. It includes:
Text-to-speech
and
Voice input
Soon, we won't need interpreters because we'll be using our technology, right? Maybe. MedicalSmartphones

Monday, August 8, 2011

New Ortho Books (via Amazon)

Knee Arthroscopy by Brian McKeon, James V. Bono and John C. Richmond (Aug 29, 2011)

New Advances in Wrist and Small Joint Arthroscopy, An Issue of Hand Clinics (The Clinics: Orthopedics) by David J. Slutsky (Aug 28, 2011)

The Poly-Traumatized Patient with Fractures: A Multi-Disciplinary Approach by Hans-Christoph Pape, Roy Sanders and Joseph Borrelli Jr. (Aug 28, 2011)

Tribology in Total Hip Arthroplasty by Karl Knahr (Aug 28, 2011)

Fundamentals of Revision Hip Arthroplasty: Diagnosis, Evaluation, and Treatment by David J. Jacofsky MD and Anthony K. Hedley MD (Aug 15, 2011)

Oxford Textbook of Trauma and Orthopaedics by Christopher Bulstrode, James Wilson-MacDonald,
Jeremy Fairbank and Tim Briggs (Aug 11, 2011)

Manual of INTERNAL FIXATION: Techniques Recommended by the AO-ASIF Group by Maurice E. Müller, Robert Schneider, Hans Willenegger and Martin Allgöwer (Jul 29, 2011)

FOOT AND ANKLE ARTHROSCOPY, An Issue of Clinics in Podiatric Medicine and Surgery (The Clinics: Orthopedics) by Lawrence G. Rubin DPM (Jul 28, 2011)

Concepts and Cases in Nonunion Treatment by Rene Marti and Peter Kloen (Jul 27, 2011)

Armed Conflict Injuries to the Extremities: A Treatment Manual by Alexander Lerner and Michael Soudry (Jul 18, 2011)

Sunday, August 7, 2011

Multidrug-resistant chronic osteomyelitis complicating war injury in iraqi civilians.

War-related orthopedic injury is frequently complicated by environmental contamination and delays in management, placing victims at increased risk for long-term infectious complications. We describe, among Iraqi civilians with war-related chronic osteomyelitis, the bacteriology of infection at the time of admission. Murphy RA, Ronat JB, Fakhri RM, Herard P, Blackwell N, Abgrall S, Anderson DJ.

J Trauma. 2011 Jul;71(1):252-4. PMID: 21818032

Above- or below-elbow casts for distal third forearm fractures in children? A meta-analysis of the literature.

Fractures of the distal third forearm are common fractures in childhood. Most of these fractures can be treated non-operatively by means of closed reduction and immobilization. The purpose of this meta-analysis is to investigate whether above- or below-elbow cast should be considered the first-choice for conservative treatment. Hendrickx RP, Campo MM, van Lieshout AP, Struijs PA, van den Bekerom MP. Arch Orthop Trauma Surg. 2011 Aug 5. [Epub ahead of print] PMID: 21818587

Hallux valgus angle as a predictor of recurrence following proximal metatarsal osteotomy.

Our radiographic results indicated that a preoperative hallux valgus angle >40° can be a risk factor for hallux valgus recurrence. Decreased risk factors for recurrence included hallux valgus angle ≤15° and an intermetatarsal angle <10° at the early follow-up. These risk factors may be helpful for modifying surgical procedures, improving surgical outcome, and predicting hallux valgus recurrence. Okuda R, Kinoshita M, Yasuda T, Jotoku T, Shima H, Takamura M. J Orthop Sci. 2011 Aug 5. [Epub ahead of print] PMID: 21818604

Reconstructive osteotomy of fibular malunion: review of the literature.

The treatment of ankle fractures has a primary goal of restoring the full function of the injured extremity. Malunion of the fibula is the most common and most difficult ankle malunion to reconstruct. The most frequent malunions of the fibula are shortening and malrotation resulting in widening of the ankle mortise and talar instability, which may lead to posttraumatic osteoarthritis. The objective of this article is to review the literature concerning the results of osteotomies for correcting fibular malunions and to formulate recommendations for clinical practice. van Wensen RJ, van den Bekerom MP, Marti RK, van Heerwaarden RJ. Strategies Trauma Limb Reconstr. 2011 Aug;6(2):51-7. Epub 2011 Apr 6. PMID: 21818702 PDF

Saturday, August 6, 2011

Tornier Announces First Implant in U.S. Trial of Its Simpliciti Stemless Shoulder Joint Replacement System

Tornier N.V. (Amsterdam, The Netherlands), an orthopedic surgical solutions company, has announced the first implant of its Simpliciti stemless shoulder joint replacement system as part of an FDA -approved, investigational device exemption (IDE) study. The Simpliciti system is designed to allow surgeons to carry out total shoulder replacements without the complications, additional bone removal and time associated with conventional stemmed implants.

Functional reconstruction of ischemic contracture in the lower limb.

Ischemic contracture in the lower limb is a devastating complication after lower limb trauma. The prevention of contracture is much more important than the treatment of an established contracture. Split Achilles tendon transfer to flexor hallucis longus tendon and sural-tibial nerve anastomosis, which was initially implemented by us, could improve the functional recovery of ischemic contracture in lower limbs, and thus provides a new alternative for functional reconstruction of ischemic contracture in the lower limb. Tang H, Zhang SC, Tan ZY, Zhu HW, Zhang QL, Li M. Chin J Traumatol. 2011 Apr 1;14(2):96-9. PMID: 21453575

Management of Grade III Open Dislocated Ankle Fractures: Combined Internal Fixation with Bioabsorbable Screws/Rods and External Fixation.

Isolated dislocation of the ankle with grade III open fracture has been scarcely reported. These ankle injuries usually involved mortise fractures, complete dislocation of the tibial astragaloid joint, capsuloligamentous structure disruption, and severe soft-tissue damage. There is no well-recognized regimen that would result in desirable outcomes. Ye T, Chen A, Yuan W, Gou S. J Am Podiatr Med ssoc. 2011 Jul-Aug;101(4):307-15. PMID: 21816999

Friday, August 5, 2011

Mechanical Comparison of Two Types of Fixation for Ludloff Oblique First Metatarsal Osteotomy.

The use of a medially applied supplementary mini locking plate offers a simple and effective method to improve the mechanical stability of the Ludloff oblique osteotomy. Tsilikas SP, Stamatis ED, Kourkoulis SK, Mitousoudis AS, Chatzistergos PE, Papagelopoulos PJ. J Foot Ankle Surg. 2011 Aug 1. [Epub ahead of print] PMID: 21813302

American Journal of Sports Medicine [Epub ahead of print]

1. Platelet-Rich Plasma Versus Autologous Whole Blood for the Treatment of Chronic Lateral Elbow Epicondylitis: A Randomized Controlled Clinical Trial. Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813443 PDF

2. Patellar Tendon Ruptures in National Football League Players. Boublik M, Schlegel T, Koonce R, Genuario J, Lind C, Hamming D. Am J Sports Med. 2011 Aug 2. [Epub ahead of print] PMID: 21813442 PDF

3. Factors Affecting Rotator Cuff Healing After Arthroscopic Repair: Osteoporosis as One of the Independent Risk Factors. Chung SW, Oh JH, Gong HS, Kim JY, Kim SH. Am J Sports Med. 2011 Aug 3. [Epub ahead of print] PMID: 21813440 PDF

Stem cells in bone diseases: current clinical practice.

Introduction Bone is an obvious candidate tissue for stem cell therapy. This review provides an update of existing stem cell-based clinical treatments for bone pathologies. Sources of data A systematic computerized literature search was conducted. The following databases were accessed on 10 February 2011: NIH clinical trials database, PubMed, Ovid and Cochrane Reviews. Areas of agreement Stem cell therapy offers new options for bone conditions, both acquired and inherited. Areas of controversy There is still no agreement on the exact definition of 'mesenchymal stem cells'. Consequently, it is difficult to appreciate the effect of culture expansion and the feasibility of allogeneic transplantation. Growing points Based on the sound foundations of pre-clinical research, stem cell-based treatments and protocols have recently emerged. Areas timely for developing research Well-designed prospective clinical trials are needed in order to establish and develop stem cell therapy for bone diseases. Beyth S, Schroeder J, Liebergall M. Br Med Bull. 2011 Aug 3. [Epub ahead of print] PMID: 21813557

Efficacy of Treatment of Trochanteric Bursitis: A Systematic Review.

Efficacy among surgical techniques varied depending on the clinical outcome measure, but all were superior to corticosteroid therapy and physical therapy according to the VAS and HHS in both comparison studies and between studies. This systematic review found that traditional nonoperative treatment helped most patients, SWT was a good alternative, and surgery was effective in refractory cases. Lustenberger DP, Ng VY, Best TM, Ellis TJ. Clin J Sport Med. 2011 Aug 2. [Epub ahead of print] PMID: 21814140

Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant.

Use of the anterolateral approach and endosteal augment of a lateral locking plate can minimize avascular necrosis following proximal humerus fracture Neviaser AS, Hettrich CM, Dines JS, Lorich DG. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814772

Intra-articular injection of hyaluronic acid (MW 1,500-2,000 kDa; HyalOne(®)) in symptomatic osteoarthritis of the hip: a prospective cohort study.

The study treatment reduced pain and improved mobility in osteoarthritis of the hip. These results in daily clinical practice demonstrate a beneficial effect and the safety of the study product and suggest adding intra-articular injections of HyalOne(®) to the armamentarium of conservative management of symptomatic hip osteoarthritis. Alberto M, Umberto M, Emanuele B, Bruno L, Valentina G, Prisco P, Mauro G, Sandro T. Arch Orthop Trauma Surg. 2011 Aug 4. [Epub ahead of print] PMID: 21814776

Wednesday, August 3, 2011

IT solution to improve hospital workflow and schedules (including the OR)

"The benefit of this system, over a human-run system, is that it is more accurate, efficient and quicker and is able to adapt to any changes in the availability of staff, equipment, or delays immediately.

"For example, surgical procedures can go overtime, staff can be off sick and equipment can fail, all of which can cause delays. This system is able to automatically revise the schedule of tasks in a way that maintains efficiency and assists in the decision making process." MedicalXpress

Orthopedic Reviews Vol 3, No 1 (2011) (open access)

1. Does improved instrumentation result in better component alignment in total knee arthroplasty?Hassaballa M, Budnar V, Gbejuade H, Learmonth I. Orthop Rev (Pavia). 2011 Mar 17;3(1):e3. PMID: 21808715 PDF

2. Enlarged transacromial superior approach with reverse shoulder arthroplasty for fractures. Poignard A, Bouhou M, Homma Y, Hernigou P. Orthop Rev (Pavia). 2011 Mar 17;3(1):e2. PMID: 21808714 PDF

3. Oxidative stress in secondary osteoarthritis: from cartilage destruction to clinical presentation? Ziskoven C, Jäger M, Zilkens C, Bloch W, Brixius K, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e23. PMID: 21808712 PDF

4. Additional external hinged fixator after open repositioning and internal fixation of acute elbow instability in non-compliant patients. Berendes S, Zilkens C, Anastasiadis A, Graf M, Muhr G, Kalicke T.

Orthop Rev (Pavia). 2010 Sep 23;2(2):e21. PMID: 21808711 PDF

5. Cell therapy in bone healing disorders. Jäger M, Hernigou P, Zilkens C, Herten M, Li X, Fischer J, Krauspe R. Orthop Rev (Pavia). 2010 Sep 23;2(2):e20. PMID: 21808710 PDF

6. Arthroplasty of a Charcot knee. Babazadeh S, Stoney JD, Lim K, Choong PF. Orthop Rev (Pavia). 2010 Sep 23;2(2):e17. PMID: 21808708 PDF

7. Surgical management of complex humerus head fractures. El-Sayed MM. Orthop Rev (Pavia). 2010 Sep 23;2(2):e14. PMID: 21808705 PDF

Proximal humeral fractures.

This article reviews the current literature on the classification and treatment options for proximal humeral fractures, while seeking to help the reader to define the most appropriate treatment plan for each individual patient with this type of fracture. Mauro CS. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print] PMID: 21808995

Anterior shoulder instability: a review of pathoanatomy, diagnosis and treatment.

The glenohumeral joint is inherently predisposed to instability by its bony architecture. The incidence of traumatic shoulder instability is 1.7% in the general population. Associated injuries to the capsulolabral structures of the glenohumeral joint have been described and may play a role in predicting recurrent instability. Advanced imaging, computed tomography or MRI may be necessary to adequately evaluate for associated glenohumeral pathology. Treatment algorithms have traditionally included a period of non-operative management in all patients, however young athletic patients may often benefit from early operative treatment. Various open and arthroscopic surgical options exist to address anterior glenohumeral instability. Bony injuries including bony Bankart lesions and Hills Sachs lesion have been implicated in failed surgical management using techniques that address only the soft tissues. An individualized treatment approach, based upon the patient's injury pattern and expectations, will likely lead to the most successful outcome. Dumont GD, Russell RD, Robertson WJ. Curr Rev Musculoskelet Med. 2011 Aug 2. [Epub ahead of print]PMID: 21808996

Operative Management of Flatfoot and Arthritis of the Ankle

OPERATIVE MANAGEMENT OF FLATFOOT AND ARTHRITIS OF THE ANKLE
Orthopaedics
Volume 34, Issue 16
August 21, 2011Lateral column lengthening and midfoot fusion – Alastair S.E. Younger, MD
Managing valgus angle pes planus – Timothy Daniels, MD
Ankle options: fusion and replacement – Dr. Daniels
Arthroscopic ankle fusion – Kevin J. Wing, MD

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Monday, August 1, 2011

Apps for surgeons and the operating room

The explosive growth of medical applications for smartphones, launched by the debut of the innovative Apple iTunes App store in 2008, promises to fundamentally change the physician’s tool set. While many specialties have always been heavily dependent on technology, such as radiology and cardiology, the ubiquity of these small, interconnected computers means that every physician will soon have access to a broad array of software and hardware to help them perform their daily work. iMedicalApps

New composite material may restore damaged soft tissue

Biomedical engineers at Johns Hopkins have developed a new liquid material that in early experiments in rats and humans shows promise in restoring damaged soft tissue relatively safely and durably. The material, a composite of biological and synthetic molecules, is injected under the skin, then "set" using light to form a more solid structure, like using cold to set gelatin in a mold. The researchers say the product one day could be used to reconstruct soldier's faces marred by blast injuries. Eurekalert!

Sunday, July 31, 2011

Accuracy of intra-articular injections of the glenohumeral joint through an anterior approach: arthroscopic correlation.

The results of this study show that an anterior injection into the glenohumeral joint can be accurately placed without radiographic assistance using standard landmarks. The technique used is similar to making a standard rotator interval portal during shoulder arthroscopy; therefore, it is most successful in the hands of experienced shoulder arthroscopists. Kraeutler MJ, Cohen SB, Ciccotti MG, Dodson CC. J Shoulder Elbow Surg. 2011 Jul 27. [Epub ahead of print] PMID: 21798769

Journal of Pediatric Orthopaedics. Part B [Epub ahead of print]

1. Reconstruction and anticipatory Langenskiöld procedure in traumatic defect of tibial medial malleolus with type 6 physeal fracture. Abbo O, Accadbled F, Laffosse JM, De Gauzy JS.

J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799451 Related citations

Hemivertebra resection and scoliosis correction by a unilateral posterior approach using single rod and pedicle screw instrumentation in children under 5 years of age. Peng X, Chen L, Zou X.

J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799450 Related citations

3. Risk of redisplacement after first successful reduction in paediatric distal radius fractures: sensitivity assessment of casting indices. Devalia KL, Asaad SS, Kakkar R. J Pediatr Orthop B. 2011 Jul 27. [Epub ahead of print] PMID: 21799449 Related citations

Extensor pollicis longus rupture after distal radius fracture: Results of reconstruction by transposition of the extensor indicis tendon and postoperative dynamic splinting.

Injury of the extensor pollicis longus tendon is one of the commonest extensor tendon injuries after distal radius fracture. In 2003-2005 we performed extensor indicis transfer in 31 patients with loss of function of the EPL tendon and postoperative dynamic splinting. In 25 patients, a distal radius fracture managed surgically led to the EPL rupture (wire internal fixation in 23 patients, plate internal fixation in 2 patients). In 6 patients, the cause was a distal radius fracture treated conservatively. Out of our 25 followed-up patients, 9 (36%) had a very good and 15 (60%) a good result in the Geldmacher score. We did not identify any re-rupture. In injuries of the extensor pollicis tendon, transposition of the extensor indicis tendon is a simple and uncomplicated procedure. Considerable improvement of thumb extension can be achieved through this substitution repair. Figl M, Mayer M, Lederer S, Bogner R, Leixnering M. Wien Klin Wochenschr. 2011 Aug 3. [Epub ahead of print] PMID: 21800046

Knee Surgery, Sports Traumatology, Arthroscopy [Epub ahead of print]

1. Navigated opening wedge high tibial osteotomy improves intraoperative correction angle compared with conventional method. Akamatsu Y, Mitsugi N, Mochida Y, Taki N, Kobayashi H, Takeuchi R, Saito T. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800168

Predisposing factors which are relevant for the clinical outcome after revision total knee arthroplasty.

Hardeman F, Londers J, Favril A, Witvrouw E, Bellemans J, Victor J. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800167

3. The painful knee after total knee arthroplasty. Becker R, Bonnin M, Hofmann S. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] No abstract available. PMID: 21800166

4. Medium to long-term follow-up after ACL revision. Lind M, Lund B, Faunø P, Said S, Miller LL, Christiansen SE. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 29. [Epub ahead of print] PMID: 21800165

Insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures.

Insufficiency fractures are often overlooked, particularly when associated with greater trochanteric avulsion fractures. Here, we report magnetic resonance imaging (MRI) findings of insufficiency femoral intertrochanteric fractures associated with greater trochanteric avulsion fractures treated by internal fixation. Suzuki K, Kawachi S, Nanke H. Arch Orthop Trauma Surg. 2011 Jul 29. [Epub ahead of print] PMID: 21800198

Friday, July 29, 2011

Stress fractures, active component, U.S. Armed Forces, 2004-2010.

No abstract. Lee D; Armed Forces Health Surveillance Center (AFHSC). MSMR. 2011 May;18(5):8-11. No abstract available. PMID: 21793616 PDF

Effects of different initial bundle tensioning strategies on the outcome of double-bundle ACL reconstruction: a cohort study.

The current clinical study does not recommend manual maximum of initial tension applied to the anteromedial or posterolateral bundles with graft tension imbalance at 30 degrees of flexion in double-bundle ACL reconstruction to achieve a better clinical outcome. Muneta T, Koga H, Ju YJ, Yagishita K, Sekiya I. Sports Med Arthrosc Rehabil Ther Technol. 2011 Jul 8;3(1):15. [Epub ahead of print] PMID: 21794179

Tendon phenotype should dictate tissue engineering modality in tendon repair: a review.

Advancements in the technical aspects of tendon repair have significantly improved the treatment of tendon injuries. Arthroscopic techniques, suture material, and improved rehabilitation have all been contributing factors. Biological augmentation and tissue engineering appear to have the potential to improve clinical outcomes as well. After review of the physiology of tendon repair, three critical components of tissue engineering can be discerned: the cellular component, the carrier vehicle (matrix or scaffold), and the bioactive component (growth factors, platelet rich plasma). These three components are discussed with regard to each of three tendon types: Intra-synovial (flexor tendon), extra-synovial (Achilles tendon), and extra-synovial tendon under compression (rotator cuff). Scaffolds, biologically enhanced scaffolds, growth factors, platelet rich plasma, gene therapy, mesenchymal stem cells, and local environment factors in combination or alone may contribute to tendon healing. In the future it may be beneficial to differentiate these modes of healing augmentation with regard to tendon subtype. Gott M, Ast M, Lane LB, Schwartz JA, Catanzano A, Razzano P, Grande DA. Discov Med. 2011 Jul;12(62):75-84. PMID: 21794211

Isolated scaphoid fracture with anterosuperior dislocation of the proximal fragment.

Isolated fracture of the scaphoid with an associated anterosuperior dislocation of the proximal fragment is an extremely rare injury. We present two cases where open reduction and internal fixation through a palmar and dorsal approach was performed. No instances of non-union, necrosis of the proximal fragment of the scaphoid or scapholunate dissociation were noted during a mean follow-up period of 18months. Clinical results (active motion, power grip, DASH) following such injury and intervention are presented. The aetiology of this rare injury is discussed. Durand S, Macquillan A, Delpit X. Chir Main. 2011 Jul 5. [Epub ahead of print] PMID: 21795095

Fractures during Childhood and Adolescence in Healthy Boys: Relation with Bone Mass, Microstructure, and Strength.

In a homogeneous cohort of healthy boys, fractures recorded until 15.2±05 yr of age were associated with lower femoral neck aBMD and with lower distal tibia trabecular vBMD and number, stiffness and failure load. These deficits in bone mineral mass, microstructure and strength could contribute to the occurrence of fractures during growth. Chevalley T, Bonjour JP, van Rietbergen B, Ferrari S, Rizzoli R. J Clin Endocrinol Metab. 2011 Jul 27. [pub ahead of print] PMID: 21795454

Contrast-enhanced sonographic characterization of the vascularity of the repaired rotator cuff: utility of maximum intensity projection imaging.

The maximum intensity projection technique after contrast-enhanced sonography provides a topographic map of rotator cuff vascularity; the latter has been implicated as an important factor in promoting bone-tendon healing. Approximately 3 months after rotator cuff repair, the suture anchor and peribursal regions showed the most robust vascularity. Maximum intensity projection imaging further establishes that there is a global increase in vascular response at the repair site after exercise. Adler RS, Johnson KM, Fealy S, Maderazo A, Gallo RA, Gamradt SC, Warren RF. J Ultrasound Med. 2011 Aug;30(8):1103-9. PMID: 21795486

Operative treatment of avascular necrosis of the femoral head after proximal femur fractures in adolescents.

Patients treated for ANFH had good medium-term outcomes after THR for total necrosis and also after VITO for partial necrosis. Bartoníček J, Vávra J, Bartoška R, Havránek P. Int Orthop. 2011 Jul 28. [Epub ahead of print] PMID: 21796335

Development and Validation of a Computational Model for Investigation of Wrist Biomechanics.

The computational model was able to accurately predict flexion, extension, radial deviation, and ulnar deviation motions in four states: normal (intact), RSL fusion, RSL fusion with the scaphoid distal pole excised, and RSL fusion with both the scaphoid distal pole and triquetrum excised. The model was also able to calculate other parameters of interest that are not easily obtainable experimentally, such as midcarpal forces. This model and modeling approach are anticipated to have value as a predictive clinical tool including effect of injuries or anatomical variations and initial outcome of surgical procedures for patient specific planning and custom implant design. Majors BJ, Wayne JS. Ann Biomed Eng. 2011 Jul 28. [Epub ahead of print] PMID: 21796501]

Learning of musculoskeletal ligament stress testing in a gross anatomy laboratory.

Human anatomy in physical therapy programs is a basic science course serving as a foundation for subsequent clinical courses. Integration of anatomy with a clinical emphasis throughout a curriculum provides opportunities for reinforcement of previously learned material. Considering the human cadaver laboratory as a fixed cost to our program, we sought opportunities to add value to the resource via vertical integration into a clinical skills course taught later in the curriculum. Krause DA, Youdas JW, Hollman JH. Anat Sci Educ. 2011 Jul 27. doi: 10.1002/ase.248. [Epub ahead of print] PMID: 21796799

Heterotopic ossification in complex orthopaedic combat wounds: quantification and characterization of osteogenic precursor cell activity in traumatized muscle.

Heterotopic ossification frequently develops following high-energy blast injuries sustained in modern warfare. We hypothesized that differences in the population of progenitor cells present in a wound would correlate with the subsequent formation of heterotopic ossification. Davis TA, O'Brien FP, Anam K, Grijalva S, Potter BK, Elster EA. J Bone Joint Surg Am. 2011 Jun 15;93(12):1122-31. PMID: 21776549

Thursday, July 28, 2011

Risk factors for fractured clavicle in the newborn.

We could not identify significant risk factors that could be dealt with in order to avoid a fractured clavicle being sustained during birth. Most fractured clavicles occur in normal newborns following normal labor and delivery. Lurie S, Wand S, Golan A, Sadan O. J Obstet Gynaecol Res. 2011 Jul 25. doi: 10.1111/j.1447-0756.2011.01576.x. [Epub ahead of print] PMID: 21790882

A brachialis muscle rupture diagnosed by ultrasound; case report.

Trauma to the elbow caused by lifting heavy objects frequently involves rupture of the tendon of the biceps brachii muscle. Less frequently a rupture of the brachialis muscle occurs. To our knowledge, only five cases involving traumatic rupture of the brachialis muscle were described in the past 20 years. We will briefly report these cases. To demonstrate and evaluate muscle injuries, magnetic resonance imaging (MRI) is considered the most sensitive and specific method of choice. We report an isolated brachialis muscle rupture caused by resisted flexion and pronation of the lower arm. Physical examination combined with ultrasound evaluation confirmed the diagnosis of ruptured brachialis muscle. Treatment was non-operative with full restoration of function. Schonberger TJ, Ernst MF. Int J Emerg Med. 2011 Jul 26;4(1):46. [Epub ahead of print] PMID: 21791098

Effectiveness of intra-articular hyaluronan (Synvisc, hylan G-F 20) for the treatment of first metatarsophalangeal joint osteoarthritis: a randomised placebo-controlled trial.

An intra-articular injection of hylan G-F 20 is no more effective than a placebo in reducing symptoms in people with symptomatic first MTPJ OA Munteanu SE, Zammit GV, Menz HB, Landorf KB, Handley CJ, Elzarka A, Deluca J. Ann Rheum Dis. 2011 Jul 25. [Epub ahead of print] PMID: 21791454

Comparison of Clinical Results of Anatomic Posterolateral Corner Reconstruction for Posterolateral Rotatory Instability of the Knee With or Without Popliteal Tendon Reconstruction.

It is unknown whether popliteal tendon reconstruction is necessary in anatomic posterolateral corner reconstruction, although the tendon has function in the varus and rotatory stability of the knee joint. Hypothesis: Anatomic reconstructions of the posterolateral corner with the popliteal tendon reconstructed will present better clinical and radiographic results than cases with the popliteal tendon not reconstructed. Yoon KH, Lee JH, Bae DK, Song SJ, Chung KY, Park YW. Am J Sports Med. 2011 Jul 26. [Epub ahead of print] PMID: 21791626 PDF

Retention treatment after periprosthetic total hip arthroplasty infection.

Retention treatment can be considered an initial treatment option in selected cases of primary THA, with a single organism, non-S. aureus infection with 50% chance of infection control and no disadvantages in terms of additional procedure, hospital stay, and treatment duration. Choi HR, von Knoch F, Kandil AO, Zurakowski D, Moore S, Malchau H. Int Orthop. 2011 Jul 27. [Epub ahead of print] PMID: 21792609

Wednesday, July 27, 2011

A practical guide to research: design, execution, and publication

No abstract available. Karlsson J, Marx RG, Nakamura N, Bhandari M. Arthroscopy. 2011 Apr;27(4 Suppl):S1-S112. PMID: 21749939 PDF

Inflammatory phase of bone healing initiates the regenerative healing cascade.

Results from this study suggest that there are unfavorable immune cells and factors participating in the initial healing phase. In conclusion, identifying beneficial aspects may lead to promising therapeutical approaches that might benefit further by eliminating the unfavorable factors. Schmidt-Bleek K, Schell H, Schulz N, Hoff P, Perka C, Buttgereit F, Volk HD, Lienau J, Duda GN. Cell Tissue Res. 2011 Jul 26. [Epub ahead of print] PMID: 21789579

Sensate composite calcaneal flap in leg amputation: a full terminal weight-bearing surface-experience in eight adult patients.

Despite modern reconstruction techniques and replantation, the preservation of a severely traumatised limb, or even a limb affected by a congenital malformation, usually gives poorer functional results compared with amputation and prosthetisation. The aim of this study was to describe a hind foot (including the calcaneum and fat pad) sensate flap with a surface that allows full terminal weight bearing in transtibial amputations in adults. Livani B, Castro G, Filho JR, Morgatho TR, Mongon ML, Belangero WD, Davitt M, Carvalho JA. Strategies Trauma Limb Reconstr. 2011 Jul 26. [Epub ahead of print] PMID: 21789589

Do Patients With Traumatic Recurrent Anterior Shoulder Instability Have Generalized Joint Laxity?

A number of studies suggest a relationship between generalized joint laxity (GJL) and increased risk of some musculoskeletal injuries. However, there are conflicting data on the association between GJL and traumatic recurrent shoulder instability (RSI). Ranalletta M, Bongiovanni S, Suarez F, Ovenza JM, Maignon G. Clin Orthop Relat Res. 2011 Jul 26. [Epub ahead of print] PMID: 21789709

Tuesday, July 26, 2011

Clinical experience with a reverse-flow anterolateral thigh perforator flap for the reconstruction of soft-tissue defects of the knee and proximal lower leg.

Despite a variable vascular anatomy that can be challenging for the surgeon, reverse-flow anterolateral thigh perforator flap is a safe and reliable method for reconstruction of the defects around the knee and even the upper third of the leg. Demirseren ME, Efendioglu K, Demiralp CO, Kilicarslan K, Akkaya H. J Plast Reconstr Aesthet Surg. 2011 Jul 22. [Epub ahead of print] PMID: 21784720 PDF

Is the Anterior Tibial Artery Safe During Ankle Arthroscopy? Anatomic Analysis of the Anterior Tibial Artery at the Ankle Joint by Magnetic Resonance Imaging.

In 22 (6.2%) of the 358 cases, the ATA and its branches were located near the anterolateral ankle portal, which introduces the risk of vascular damage during arthroscopic surgery. Furthermore, the mean distance between the ATA and the joint capsule was only 2.3 ± 1.1 mm, and thus the ATA is very close to the anterior working space of the ankle joint. Careful preoperative evaluation and an intra-articular procedure may reduce the risk of vascular complications attributable to ankle arthroscopy. Son KH, Cho JH, Lee JW, Kwack KS, Han SH. Am J Sports Med. 2011 Jul 22. [Epub ahead of print] PMID: 21785000 PDF

Incidence of Patients with Lower Extremity Injuries Presenting to US Emergency Departments by Anatomic Region, Disease Category, and Age.

The incidence of patients with lower extremity injuries presenting to emergency departments in the United States with respect to specific anatomic regions and disease categories is unknown. Such information might be used for injury prevention, resource allocation, and training priorities. Lambers K, Ootes D, Ring D. Clin Orthop Relat Res. 2011 Jul 22. [Epub ahead of print] PMID: 21785896 PDF

Orthopedic resident anatomy review course: A collaboration between anatomists and orthopedic surgeons

A challenge for new residents and senior residents preparing for board examinations is refreshing their knowledge of basic science disciplines, such as human gross anatomy. The Department of Orthopaedics at the University of Utah School of Medicine has for many years held an annual Orthopedic Resident Anatomy Review Course during the summer months for all of its residents. The primary purpose of the course is to renew competencies in basic science disciplines so that incoming residents more quickly reach a level of functional proficiency and to afford senior residents a platform to teach their junior colleagues. Before 2005, this course was conducted with minimal participation from anyone outside of the Department of Orthopaedics. Many of the residents voiced concerns that the educational benefits were not proportionate to the time invested. To improve the teaching of orthopedic-related anatomy, an educational collaboration between the Departments of Neurobiology and Anatomy and Orthopaedics was established in 2004 and continues to the present time. The major objectives of refining the course pedagogy, developing a Course Manual and Dissection Guide, and evaluating the results by administering a course survey questionnaire are described in this article. Implementation of all facets of the revised course has resulted in better participation by orthopedic faculty and more favorable reviews by the participating residents. Based on current levels of interest and positive comments from course participants, the Anatomy and Orthopedic faculty course directors plan to continue to develop course materials and pedagogy. Defriez CB, Morton DA, Horwitz DS, Eckel CM, Foreman KB, Albertine KH. Anat Sci Educ. 2011 Jul 22. [Epub ahead of print] PMID: 21786430

BBC Documentary: Blood and Guts: A History of Surgery (May need to view offsite)

Documentary series looking at the brutal, bloody and dangerous history of surgery. Michael Mosley recounts the history of surgery through its catastrophes and successes.
1. Into the Brain. Just over 100 years ago, cutting into the brain was a terrifying prospect for both patient and surgeon. They could expect the result to be the surgeon bloodied and defeated, and the patient dead. From freak accidents involving crowbars through the skull to notorious lobotomies with icepicks, this programme reveals how, through mishap and misadventure, brain surgery has become the life-saving discipline it is today.
2. Bleeding Hearts. With a family history of heart problems, presenter Michael Mosley takes a personal interest in these pioneers, who teetered on the scalpel-edge between saviour and executioner. Michael has a go at heart surgery, meets a man with no heartbeat and witnesses an operation where the patient is cooled until their brain stops and has all of their blood sucked out.
3. Spare Parts. These days, transplant surgery saves thousands of lives every year and almost everything, from heart to eyes, can be replaced. But in the beginning, transplants killed rather than cured, because surgeons didn’t understand that they were taking on one of the most efficient killing systems we know of – the human immune system.
4. Fixing Faces. Thought of as a modern phenomenon, it actually started over 400 years ago with a spate of botched nose jobs. Since then, surgeons have been entranced with the idea that not only could they fix the body, but could even fix our sense of self-esteem. Presenter Michael Mosley undergoes both 16th-century bondage and 21st-century botox in his journey of discovery.
5. Bloody Beginnings. Presenter Michael Mosley finds out how the early days of surgery were dark and barbaric, when the surgeon’s knife was more likely to kill you than save you, and invasive medicine generally meant being bloodlet by leeches to within an inch of your life.

Incidence of physician diagnosed osteoarthritis among active duty united states military service members.

The overall unadjusted incidence rate among all active duty US service members during the study period was 7.86 per 1,000 person-years. Significant demographic and occupational risk factors for OA included sex, age, race, service, and rank (p<0.001). Women experienced an adjusted incidence rate for OA that was nearly 20% higher than men (IRR=1.19, 95% CI=1.17, 1.21). Service members in the ≥40 age group experienced an adjusted incidence rate for OA that was approximately 19 times higher when compared to those in the <20 age category (IRR=18.61, 95% CI=17.57, 19.57). Black service members experienced significantly higher incidence rates of OA when compared to those in the white and other categories for race. Conclusion: Rates for OA were significantly higher in military populations when compared to comparable age groups in the general population. Cameron KL, Hsiao MS, Owens BD, Burks R, Svoboda SJ. Arthritis Rheum. 2011 Jun 29. [Epub ahead of print] PMID: 21717422

An Evaluation of Two Tourniquet Systems for the Control of Prehospital Lower Limb Hemorrhage.

Hemorrhage remains the main cause of preventable death on the modern battlefield. As Improvised Explosive Devices in Afghanistan become increasingly powerful, more proximal limb injuries occur. Significant concerns now exist about the ability of the windlass tourniquet to control distal hemorrhage after mid-thigh application. To evaluate the efficacy of the Combat Application Tourniquet (CAT) windlass tourniquet in comparison to the newer Emergency and Military Tourniquet (EMT) pneumatic tourniquet. Taylor DM, Vater GM, Parker PJ. J Trauma. 2011 Jul 15. [Epub ahead of print] PMID: 21768905

Sunday, July 24, 2011

Proximal humerus fractures in the pediatric population: a systematic review.

The currently available literature supports a non-operative treatment approach, particularly in younger children with more growth remaining. Older patients (>13 years) with more widely displaced fractures may benefit from anatomic reduction with stabilization, though the data in the literature at this point is too weak to strongly recommend this approach. Further analysis with a more rigorous scientific method is necessary to evaluate the optimum treatment modality in this subgroup. Pahlavan S, Baldwin KD, Pandya NK, Namdari S, Hosalkar H. J Child Orthop. 2011 Jun;5(3):187-94. Epub 2011 Mar 11. PMID: 21779308

Symptomatic heterotopic ossification: seven years after patella fracture.

We describe a case of heterotopic ossification (HO) of the lateral patella becoming symptomatic after 7 years following horizontal patella fracture. The patient presented peripatellar pain in full knee flexion and kneeling position. We resected the ossification, and the patient was immediately relieved from pain and was mobilised under full weight bearing with no limitation of knee flexion. The patient was able to return to his previous level of daily activities with no further episodes of pain. To our knowledge, this is the first case of heterotopic peripatellar ossification becoming symptomatic 7 years after a patellar fracture to be reported in the literature. Daniilidis K, Vogt B, Raschke MJ. Musculoskelet Surg. 2011 Jul 21. [Epub ahead of print] PMID: 21779765

Reconstruction nailing for ipsilateral femoral neck and shaft fractures.

The current study suggests that reconstruction nailing produces satisfactory clinical and functional results in the mid-term. The complications involved only the femoral shaft fracture and were successfully treated with a single operative procedure. Tsarouhas A, Hantes ME, Karachalios T, Bargiotas K, Malizos KN. Strategies Trauma Limb Reconstr. 2011 Jul 21. [Epub ahead of print] PMID: 21779894

Friday, July 22, 2011

Why do I like Google+ even in Medicine?

This is a real professional networking site, while Facebook is just a playground for friends. ScienceRoll

Bone Feed allows the busy orthopedist to quickly browse abstracts, but can be improved

Being able to scan and read journal articles is integral to clinical practice and teaching. However, with so much information and new research available, sorting through the publications can be a daunting task. Even Orthopedics, considered to be a specialized field, has over 50 American publications and journals.

Dr. Jeffrey Wint, an orthopedic hand specialist in cooperation with Hand Fed developers created Bone Feed as a way for orthopedic surgeons at all levels of training to have access to abstracts from popular orthopedic journals using an iPhone. It is a good concept, but does the app perform?

Thursday, July 21, 2011

Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print]

1. Primary total knee arthroplasty using rotating-hinge prosthesis in severely affected knees.

Yang JH, Yoon JR, Oh CH, Kim TS. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773833

2. Development of femoral trochlear groove in growing rabbit after patellar instability.

Huri G, Atay OA, Ergen B, Atesok K, Johnson DL, Doral MN. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773832

3. Conventional rotator cuff repair complemented by the aid of mononuclear autologous stem cells.

Ellera Gomes JL, da Silva RC, Silla LM, Abreu MR, Pellanda R. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773831

4. Validity and reliability of the SPORTS score.

Blonna D, Castoldi F, Delicio D, Bruzzone M, Dettoni F, Bonasia DE, Rossi R. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773830

5. Increase in posterior tibial slope would result in correction loss in frontal plane after medial open-wedge high tibial osteotomy. Asada S, Akagi M, Mori S, Matsushita T, Hashimoto K, Hamanishi C.

Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773829

6. Anterior cruciate ligament tears: conservative or surgical treatment? A critical review of the literature. Delincé P, Ghafil D. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773828

7. Partial tear of the anterior cruciate ligament of the knee: injury patterns on MR imaging.

Van Dyck P, De Smet E, Veryser J, Lambrecht V, Gielen JL, Vanhoenacker FM, Dossche L, Parizel PM. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773827

8. Cryopreservation increases apoptosis in human menisci. Villalba R, Peña J, Navarro P, Luque E, Jimena I, Romero A, Gómez Villagrán JL. Knee Surg Sports Traumatol Arthrosc. 2011 Jul 20. [Epub ahead of print] PMID: 21773826

The Effect of Long-term Alendronate Treatment on Cortical Thickness of the Proximal Femur.

Long-term alendronate treatment did not appear to cause thickened femoral cortices within the detection limits of our method. This finding contrasts with the notion that long-term alendronate treatment leads to generalized cortical thickening. Unnanuntana A, Ashfaq K, Ton QV, Kleimeyer JP, Lane JM. Clin Orthop Relat Res. 2011 Jul 20. [Epub ahead of print] PMID: 21773861

Trying to save troops' lives with flying hospital

The critical care flights are part of a big evolution in getting wounded troops back to the U.S., which took about three weeks on average during the Vietnam War. That process can now take as little as three days, depending on the patient's needs. The Associated Press rode along on one of these special flights when Castagna and two other patients were flown from Germany home to the U.S. AP

Coagulate is a useful reference when dealing with the anticoagulated patient in the OR

“Is it safe for me to perform a regional or neuraxial procedure on this patient taking anticoagulants?”
This is a question we are often faced with in the operating room when dealing with patients taking anticoagulants. Answering this question has become increasingly difficult as both the number of anticoagulant drugs and the indications for these drugs have increased recently. iMedicalApps

New Audio-Digest Orthopaedics

Now available online! Contact Library for User Name and Password

ETHICS
Audio-Digest Orthopaedics
Volume 34, Issue 15
August 7, 2011
Death and dying – Steven Z. Pantilat, MD
"Do not resuscitate" in the perioperative period – Carl W. Peters, MD

PEDIATRIC FOOT PROBLEMS
Audio-Digest Orthopaedics
Volume 34, Issue 14
July 21, 2011
Painful flatfoot in adolescents – Vincent Mosca, MD,
Adults with a history of club foot – Richard Miller, MD
Tarsal coalition: it’s not just about size – Dr. Mosca

FOOT AND ANKLE ORTHOPAEDICS
Audio-Digest Orthopaedics
Volume 34, Issue 13
July 7, 2011
Maximizing nonoperative treatment – Jeffrey L. Nacht, MD
Optimizing the patient for surgery – Alastair S.E. Younger, MD
Nonoperative management of the ankle – Kevin J. Wing, MD
Osteochondritis dissecans lesions of the talus – Gregory C. Berlet, MD

Wednesday, July 20, 2011

When injured muscles mistakenly grow bones

For hundreds of thousands of people, injuring a muscle through an accident like falling off a bike or having surgery can result in a strange and serious complication. Their muscles start growing bones. New research shows a neuropeptide called Substance P appears to trigger the formation of the extraskeletal bone. Eliminating Substance P prevents the bone growth, offering a new drug target to prevent and treat the bone growth. Journal of Cellular Biochemistry via Eurekalert!

Tuesday, July 19, 2011

Patient participation in surgical site marking: can this be an additional tool to help avoid wrong-site surgery?

Wrong-site surgery is defined as an operation conducted at the wrong site, on the wrong person, or resulting in the wrong procedure. Since 1993, more than 2200 wrong-site surgeries have been reported by the National Practitioner Data Base. A 2005 survey reported, 5.6% of replying academy fellows encountered a wrong-site surgery incident. Multiple interventions have been since suggested for prevention of these occurrences by the American Academy of Orthopaedic Surgeons and Joint Commission on Accreditation of Healthcare Organizations. Bergal LM, Schwarzkopf R, Walsh M, Tejwani NC. J Patient Saf. 2010 Dec;6(4):221-5. PMID: 21500609

Painful legacy of teen sports

Vigorous sports activities, like basketball, during childhood and adolescence can cause abnormal development of the femur in young athletes, resulting in a deformed hip with reduced rotation and pain during movement. This may explain why athletes are more likely to develop osteoarthritis than more sedentary individuals, according to Dr. Klaus Siebenrock, from the University of Bern in Switzerland, and colleagues, whose work is published online in Springer's journal Clinical Orthopaedics and Related Research. Eurekalert!

Monday, July 18, 2011

Army Develops Home-Made Leg Prostheses

The DIY spirit is so strong these days that even the U.S. Army is now building home made leg prostheses and planning on teaching Afghans how to make more from readily available parts. A team of soldiers developed a custom prototype for an eight year old boy who lost both legs, with the idea that locals should be able to make their own prostheses so that people injured by mines and bombs can get on their feet quickly, without having to wait for a distant charity to help. medGadget.com

CPT® E/M Quick Reference App

CPT® E/M Quick Reference—now available for the Apple iPhone®, iPad® and iPod Touch®. Fast. Easy. Reliable. This on-the-go reference guide helps you easily determine the appropriate CPT Evaluation and Management (E/M) billing codes. Featuring both decision-tree logic and quick search options, this critical app allows you to digitally track the codes you select and then email them anywhere. MedicalSmartphones.com

A meta-analysis of the Gamma nail and dynamic hip screw in treating peritrochanteric fractures

The review found there was a higher rate of postoperative femoral shaft fracture with Gamma nail compared with dynamic hip screw fixation in treating peritrochanteric fractures, but no differences for other outcomes; further research is needed. The authors' conclusions reflect the data presented, but should be interpreted considering the substantial methodological flaws in included trials and potential review process bias.

PubMedID

19401825

Original Paper URL

http://www.springerlink.com/content/23822747152j47l3/

Saturday, July 16, 2011

Surgical Technique: A Minimally Invasive Approach to Scapula Neck and Body Fractures.

The approach of choice for open reduction internal fixation of displaced fractures involving the scapula neck or body is from posterior. We describe a new approach that minimizes the surgical insult to the soft tissues but preserves the ability to restore alignment and stability to the fracture.

Gauger EM, Cole PA. Clin Orthop Relat Res. 2011 Jul 15. [Epub ahead of print] PMID: 21761253

Augmented Reality for surgeons comes via mobile medical technology – Hallux Angles app

“Hallux Angles is a radiographic measurement aid to assist in the pre-op radiographic planning process. It is intended to supplement – not replace – conventional techniques. The target audience includes all those practicing forefoot surgery” iMedicalApps

Thursday, July 14, 2011

Study Identifies Patients at Increased Risk of Morbidity and Mortality after Bilateral Knee Replacement Surgery

Study Identifies Patients at Increased Risk of Morbidity and Mortality after Bilateral Knee Replacement Surgery - A new study by researchers at Hospital for Special Surgery has identified patients who are at a higher risk of morbidity and mortality when undergoing knee replacement surgery in both legs at the same time. Newswise

Monday, July 11, 2011

Spanish surgeons claim first double leg transplant

Spanish surgeons Monday performed the world's first double-leg transplant on a man whose legs were amputated above the knee after an accident, officials said. PhysOrg.com

Sunday, July 10, 2011

Journal of Orthopaedic Trauma [Epub ahead of print]

1. Managing Bone Defects. Nauth A, McKee MD, Einhorn TA, Watson JT, Li R, Schemitsch EH.

J Orthop Trauma. 2011 Jul 6. [Epub ahead of print] PMID: 21738065

2. Preclinical Animal Models in Trauma Research. Harvey EJ, Giannoudis PV, Martineau PA, Lansdowne JL, Dimitriou R, Moriarty TF, Richards RG. J Orthop Trauma. 2011 Jul 6. [Epub ahead of print] PMID: 21738062

Archives of Orthopaedic and Trauma Surgery [Epub ahead of print]

1. Relationship between human femorotibial joint configuration and the morphometry of the anterior cruciate ligament. Dargel J, Schmidt-Wiethoff R, Feiser J, Koebke J, Schlüter-Brust K, Eysel P, Michael JW. Arch Orthop Trauma Surg. 2011 Jul 8. [Epub ahead of print] PMID: 21739115

2. Hip abductor muscle strength after total hip arthroplasty with short stems. Kamada S, Naito M, Nakamura Y, Kiyama T. Arch Orthop Trauma Surg. 2011 Jul 8. [Epub ahead of print] PMID: 21739114

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