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Operative Techniques in Orthopaedics最新文献

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Editorial Board (pick up from previous issue w/updates) 编辑委员会（接续上期内容并进行更新）
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1053/S1048-6666(24)00048-X
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引用次数: 0
Hyperglycemia in Orthopaedic Trauma Patients: Implications, Management, and Future Directions 骨科创伤患者的高血糖症：影响、管理和未来方向
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101132
Anthony Belmonte, Logan Roebke, Humza S. Shaikh
Physiologic stress-induced hyperglycemia (SIH) significantly impacts patient outcomes in both nondiabetic and diabetic individuals following orthopaedic trauma. This review synthesizes current literature on SIH's effects, highlighting its association with increased surgical site infections (SSI), extended hospital stays, wound complications, nonunion, need for revision surgery, and mortality. Nondiabetic patients with SIH face worse outcomes compared to euglycemic patients, including a higher risk of deep infections and systemic complications. Diabetic patients experience exacerbated hyperglycemia during trauma, leading to poor wound healing and heightened infection risk. Effective glycemic control, through preoperative optimization, intraoperative monitoring, and postoperative management, is crucial for improving outcomes. Special considerations are discussed for the geriatric population, who are particularly vulnerable to SIH-induced morbidity and mortality. Future directions emphasize developing tailored glycemia management algorithms, utilizing continuous monitoring systems, and fostering multidisciplinary collaboration to optimize care for orthopaedic trauma patients.
生理应激诱导的高血糖（SIH）对骨科创伤后的非糖尿病和糖尿病患者的预后都有很大影响。这篇综述综述了目前有关 SIH 影响的文献，强调了 SIH 与手术部位感染（SSI）增加、住院时间延长、伤口并发症、不愈合、翻修手术需求和死亡率的关系。与优血糖患者相比，非糖尿病 SIH 患者的预后更差，包括深部感染和全身并发症的风险更高。糖尿病患者在创伤期间会出现加剧的高血糖，导致伤口愈合不良和感染风险增加。通过术前优化、术中监测和术后管理来有效控制血糖对改善预后至关重要。本文讨论了老年人群的特别注意事项，因为他们特别容易受到 SIH 引起的发病率和死亡率的影响。未来的发展方向强调开发量身定制的血糖管理算法、利用连续监测系统以及促进多学科合作，以优化创伤骨科患者的护理。
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引用次数: 0
Nutritional Prehabilitation in the Orthopaedic Trauma Patient 骨科创伤患者的营养预康复治疗
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101133
Katherine L. Shumate , Ivan S. Tarkin
Nutrition is a modifiable factor which should be optimized in the surgical patient. Peri-operative programs, such as “Strong for Surgery”, identify patients with protein malnutrition and provide resources for adequate feeding in the peri-operative period. The Orthopaedic Trauma patient benefits from this approach to encourage surgical wound healing, avoidance of septic complication, uneventful bone union, and successful rehabilitation. Acute Orthopaedic injuries requiring prompt intervention should be assessed for protein malnutrition and receive supplementation when necessary postoperatively. Patients with peri-articular fracture managed staged or for post-traumatic cases, nutrition should be assessed preoperatively and addressed prior to definitive surgical reconstruction.
营养是一个可调节的因素，应优化手术患者的营养状况。围手术期计划（如 "Strong for Surgery"）可识别蛋白质营养不良的患者，并提供资源，以便在围手术期提供充足的食物。创伤骨科患者可以从这种方法中获益，促进手术伤口愈合，避免化脓性并发症，使骨结合顺利进行并成功康复。需要及时干预的急性骨科创伤患者应进行蛋白质营养不良评估，必要时在术后补充蛋白质。对于分期治疗的关节周围骨折患者或创伤后病例，应在术前对营养进行评估，并在最终手术重建前解决营养问题。
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引用次数: 0
Special Considerations in the Orthopaedic Trauma Patient: Curbing Negative Social Behaviors 骨科创伤患者的特殊考虑因素：遏制负面社交行为
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101130
Kasey-Jean Bramlett, Andrew J. Marcantonio
Optimizing the orthopaedic trauma patient for surgical intervention presents unique challenges. Due to the acute nature of musculoskeletal injuries and time constraints for treatment, there is a limited window for overall patient comorbidity optimization prior to surgical fracture repair. Certain social behaviors including tobacco use, excessive alcohol consumption, and inappropriate opioid medication usage can have a negative impact on wound and fracture healing. Curbing such negative social behaviors can have a positive outcome on patients who are affected by musculoskeletal trauma. Addressing these challenging issues, via available resources, can have a significant impact on recovery after sustaining orthopaedic trauma. A tactical approach focused on relationship building with patients and their families as well as highlighting strategies to curb negative social behaviors is presented involving a patient with an infected tibial nonunion.
优化骨科创伤患者的手术治疗是一项独特的挑战。由于肌肉骨骼损伤的急性特点和治疗时间的限制，在骨折手术修复前对患者合并症进行整体优化的窗口期非常有限。某些社会行为，包括吸烟、过度饮酒和不当使用阿片类药物，会对伤口和骨折愈合产生负面影响。遏制这些负面的社会行为会对受肌肉骨骼创伤影响的患者产生积极的影响。通过现有资源解决这些具有挑战性的问题，可对骨科创伤后的康复产生重大影响。本文介绍了一种战术方法，该方法侧重于与患者及其家属建立关系，并强调了遏制负面社交行为的策略，涉及一名感染性胫骨不连接患者。
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引用次数: 0
Perioperative Blood Glucose Optimization in Orthopaedic Trauma Patients 骨科创伤患者围手术期血糖优化
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101128
Segal K , Okewunmi J , Mujahid N , Tong I , Fernandes A , Evans AR
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引用次数: 0
Endocrine Abnormalities and Optimization in Patients with a Fracture Nonunion 骨折未愈合患者的内分泌异常与优化治疗
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101131
Tyler L. McGee, Peter N. Mittwede
Significant advancements have been made in the management and understanding of fracture nonunions. Recently, there has been an interest in identifying modifiable risk factors in patients with nonunions. Endocrine and metabolic abnormalities have been studied for their association with the development of nonunion. Identifying these abnormalities and correcting them requires a multidisciplinary approach involving the orthopaedic surgeon, primary care provider, and endocrinologist. This article discusses the various endocrine abnormalities and their association with fracture nonunion, and highlights studies that have focused on methods of endocrine optimization of patients with a nonunion.
在管理和了解骨折非不连方面取得了重大进展。最近，人们开始关注确定骨折不愈合患者的可改变风险因素。研究发现，内分泌和代谢异常与骨折不愈合的发生有关。要识别这些异常并加以纠正，需要矫形外科医生、初级保健提供者和内分泌科医生共同参与的多学科方法。本文讨论了各种内分泌异常及其与骨折不愈合的关系，并重点介绍了针对骨折不愈合患者内分泌优化方法的研究。
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引用次数: 0
Introduction- Optimizing the Orthopaedic Trauma Patient 导言--优化创伤骨科患者
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101129
Ivan S. Tarkin
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引用次数: 0
Optimizing the Geriatric Host for Fracture Surgery 优化骨折手术中的老年病人宿主
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101134
Naoko Onizuka MD, PhD , Rebekah Kleinsmith MD , Julie Switzer MD
Fractures represent a significant health concern among the elderly population, leading to functional decline, loss of independence, and increased morbidity and mortality. The management of geriatric patients undergoing fracture surgery requires a comprehensive approach that addresses their specific physiological, psychological, and social needs. This article aims to elucidate the various strategies for optimizing the geriatric host for fracture surgery by addressing preoperative assessment, intraoperative management, and postoperative care.
骨折是老年人群的一个重大健康问题，会导致功能衰退、丧失独立性、发病率和死亡率上升。对接受骨折手术的老年患者进行管理需要采取综合方法，以满足其特殊的生理、心理和社会需求。本文旨在通过术前评估、术中管理和术后护理，阐明优化老年患者骨折手术的各种策略。
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引用次数: 0
Contributors (pick up from previous issue w/updates) 投稿人（接上期内容/更新）
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1053/S1048-6666(24)00050-8
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引用次数: 0
Table of Contents (pick up from previous issue w/updates) 目录（接上一期/更新内容）
IF 0.2 Q4 ORTHOPEDICS
Operative Techniques in Orthopaedics
Pub Date : 2024-09-01 DOI: 10.1053/S1048-6666(24)00049-1
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引用次数: 0
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