Orthopedic Reviews最新文献

Background and objectives: Titanium Elastic Nails (TENs) in the surgical management of pediatric long bone fractures (LBF) have emerged as a pivotal technique. This study aimed to report experience with this technique for managing pediatric LBF at the Orthopaedic Department of Samtah General Hospital.

Material and methods: A retrospective analysis was conducted using the pediatric LBF patients treated with TENs at the hospital from January 2021 to December 2023. Data regarding demographics, mechanism of injury, fracture patterns, time to achieve union, and functional outcome was extracted from their medical charts. Functional outcome was evaluated using the Flynn et al. criteria.

Results: A total of 26 patients, four females and 22 males, were included in the study, and the mean age was 9.6 years (6-16 years). Fractures analyzed were radius and ulna (n=12), femur (n=8), tibia (n=5), and isolated ulna (n=1). The most frequent cause was self-fall (n=17). The average time to achieve fracture consolidation (grade 3 callus) was 11.5±2.9 (6-16 weeks) for all fractures. The outcomes were excellent in 19 patients (73.1%) and satisfactory in 7 (26.9%). There were no poor results; only minor complications, such as skin irritation, were recorded in the study.

Conclusion: TENs fixation for Pediatrics LBF is an efficient and safe method with satisfactory outcomes.

Objective: This study aims to provide beneficial information, from a clinical perspective, on how healthcare providers and sports educators can navigate treatment and safety for TAF athletes. This was done by identifying trends seen in lower-extremity TAF injuries and providing potential treatments to counter specific injuries, closing gaps in current literature.

Methods: The National Electronic Injury Surveillance System (NEISS) database was queried during a ten-year time span (2014-2023) to analyze lower-extremity track and field-related musculoskeletal injuries.

Results: There were 128,761 cases reported in the Emergency Department from 2014-2023. Fifty eight percent occurred in females compared to only 42% in males, making females 1.4 times more likely to experience injury. Most injuries took place in 2017. Most cases in adolescents were aged 15 and 14 years old. The 10-19 age group had disproportionately more cases. 1,067 reported cases of strain/sprains were associated with female patients with 733 cases present in males. Strain/sprains ranked the highest, followed by fractures, excluding other/not stated cases. The ankle was the body part with the most cases, followed by injury to the knee.

Conclusions: As a widely popular sport, future studies should look at providing a more comprehensive characterization into how a patient's specific demographics may play into injury detection and prevention.

Penicillin is a frequently reported medication allergy. The beta-lactam ring shared between cephalosporins and penicillin often leads to the use of alternative antibiotics for surgical prophylaxis due to concern for cross-reactivity, despite a true IgE-mediated hypersensitivity being very rare. This misconception leads to the use of less effective second line antibiotics, such as clindamycin or vancomycin, for penicillin-allergic patients which has been shown to increase odds of postoperative infection in elective knee arthroplasty, shoulder arthroplasty and spine surgery. Preoperative penicillin allergy testing has been demonstrated to be a cost-effective measure in the prevention of prosthetic joint infection and is suggested for all penicillin-allergic patients in the peri-operative setting. This review highlights and summaries the outcomes of orthopaedic procedures in patients with reported penicillin allergies and discusses potential solutions to the perioperative challenges of patients with reported penicillin allergies.

Background: Certain demographics and/or risk factors contribute to complications following cervical spinal surgery including pseudarthrosis, prolonged pain, and reduced quality of life (QoL). Pulsed electromagnetic field (PEMF) stimulation is a non-invasive therapy that may enhance fusion success in at-risk patients.

Objective: To evaluate the safety and efficacy of post-operative adjunctive PEMF therapy following cervical spinal surgery in subjects at risk for pseudarthrosis.

Methods: This prospective, multicenter study investigated PEMF as an adjunctive therapy to cervical spinal fusion procedures in subjects at risk for pseudarthrosis based on having at least one of the following: prior failed fusion, multi-level fusion, nicotine use, osteoporosis, or diabetes. Radiographic fusion status and patient-reported outcomes (SF-36, EQ5D, NDI, and VAS-arm pain and VAS-neck pain) were assessed.

Results: A total of 160 subjects were assessed for fusion 12-months postoperative, and 144 subjects were successfully fused (90.0%). Fusion success for subjects with 1, 2+, or 3+ risk factors was 91.7%, 89.0%%, and 90.9%, respectively. Significant improvements in NDI, VAS-arm and VAS-neck were observed compared to baseline scores (p < 0.001) along with improvements in SF-36 and EQ5D (p < 0.001).

Conclusions: Adjunctive treatment with PEMF provides a high rate of successful fusion and significant improvements in pain, function, and quality of life despite having risk factors for pseudarthrosis.

Foot drop due to peroneal nerve palsy is a complex condition stemming from multiple etiologies. It can result from central or peripheral injuries, leading to a variable spectrum of deformities and weakness in the ankle and a "foot drop," which can be either flexible or fixed. As a result, there is no universal approach with which to treat patients. This article presents and reviews the most common surgical procedures used to address foot drop, with emphasis on peripheral etiology.

Anterior cervical spine surgery (ACSS) is a frequently performed procedure that enhances life quality by reducing pain and improving functionality. A rare but serious complication after ACCS is cervical hematoma, which can lead to acute airway obstruction and subsequent rapid deterioration. Effective management of cervical hematomas requires an astute awareness of the developing signs and proficiency in the techniques involved when issues arise. Here, we present the challenges and considerations encountered in managing the airway of a patient with an enlarging hematoma in the retropharyngeal space after ACSS.

Given the rise of swimming as a casual, competitive, artistic, and health-related activity in the past few years, it has become increasingly important to look at injuries that can be caused by swimming. Through studying swimming-related injuries to the upper extremities, swimmers can understand how to prevent major, long-lasting injuries and how to treat these injuries if they occur. The National Electronic Injury Surveillance System (NEISS) Database was used to analyze data on swimming-related injuries to the upper extremities in the last five years. In these past five years, 82,834 injuries to the upper extremities of swimmers have been reported to the Emergency Department (ED). The study highlights the most common upper-extremity-related injury in swimming and how to prevent it, as well as how to treat it. In addition, it is vital to note that future research could delve into possible equipment that would help prevent the injury altogether.

The authors present a case of a traumatic hallux (big toe) fracture in a 77-year-old male who was walking near a construction site when a brick fell and hit his big toe on his right foot. This case report highlights the usage of different treatment types in a toe fracture and different techniques used to diagnose the fracture. Treatment options are evaluated based on the location and severity of the fracture.

The authors report on the case of a 34-year-old male intravenous heroin user who experienced severe complications including deep vein thrombosis (DVT), and compartment syndrome (CS), in his left leg as a result of drug abuse. An immediate surgical intervention and subsequent physical therapy led to the patient's successful recovery. The diagnosis, clinical presentation and emergency department management are discussed.

Objectives: Playing sports is crucial to adolescents as a source of entertainment, a factor in improving mental health, and a way to promote physical development. However, sports, including volleyball, have an inherent risk of causing injuries to its players. The objective of this study is to determine the most common locations, types, and outcomes of volleyball injuries in adolescent athletes so that more people are aware of how these injuries occur. This would encourage volleyball athletes to be more mindful of these injuries when playing.

Methods: The National Electronic Injury Surveillance System (NEISS) was used to analyze injuries in adolescents (ages 10-19) that occurred due to volleyball between the years 2013 and 2022.

Results: Approximately 347,395 volleyball injuries occurred in adolescents between 2013 and 2022, with the median age of patients being 15 years old. 274,003 patients were female (78.9%) while 73,392 patients were male (21.1%). 59,530 had injuries in the head or neck (17.1%), 141,660 in the lower extremities (40.8%), and 119,230 in the upper extremities (34.3%). 151,364 patients had sprains or strains (43.6%), 35,760 had fractures (10.3%), 36,804 had contusions or abrasions (10.6%), and the rest of the patients had other injuries. 342,567 patients were treated and released (98.6%), 2049 patients were left without being seen (0.6%), and 1648 patients were hospitalized (0.5%).

Conclusions: This study shows that volleyball players are most vulnerable to getting sprains, strains, fractures, or bruises in the upper or lower extremities. While there are more injuries in adolescent females, this is likely because a majority of volleyball players between the ages of 10 and 19 are female. Further study may be done to identify how volleyball causes these injuries in an effort to prevent them.