Operative Techniques in Orthopaedics最新文献

英文中文

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。

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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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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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

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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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

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

引用次数: 0

Optimizing the Orthopaedic Trauma Patient- Staged Management 优化骨科创伤患者--分阶段管理

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2024-09-01 DOI: 10.1016/j.oto.2024.101127

Ashley E. Creager, Justin C. Siebler

Staged management of orthopedic trauma is employed to promote best outcomes and avoid known complications associated with acute definitive fracture reconstruction. Fracture in the setting of polytrauma is often initially managed with temporizing methods to allow for both optimization of the host and local soft tissue environment. Damage control orthopedics has promoted this strategy to delay definitive care of orthopaedic injuries based on the patient's level of resuscitation/inflammatory state. Further, staged care of peri-articular fracture respects the already traumatized soft tissue envelope in an effort to decrease the risk of infamous complications such as infection and fracture nonunion. Typically, external fixation is utilized in staged management and host optimization is performed in the “waiting period.”

骨科创伤采用分阶段管理，以促进最佳治疗效果，并避免与急性明确骨折重建相关的已知并发症。在多发性创伤的情况下，骨折最初通常采用暂时性方法进行处理，以优化宿主和局部软组织环境。损伤控制骨科提倡这一策略，即根据患者的复苏水平/炎症状态推迟骨科损伤的明确治疗。此外，对关节周围骨折的分期治疗尊重已受创伤的软组织包膜，以降低感染和骨折不愈合等恶性并发症的风险。通常情况下，在分期治疗中使用外固定，而在 "等待期 "进行宿主优化。

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Operative Treatment of Chronic Pediatric Patellar Instability 小儿慢性髌骨不稳的手术治疗

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101109

Peter Staunton , Alan Katz , Thierry Pauyo

Chronic patellar instability in the pediatric population presents early in life and can present as a permanent irreducible dislocation or a habitual dislocation with knee flexion. Congenital patellar dislocation tends to present at birth, with a knee flexion contracture, valgus malalignment of the lower limb and external tibial torsion. Habitual dislocation may present later. The pathoanatomy of congenital and habitual dislocation differentiate. Accurate diagnosis of the underlying pathology is important as the operative management of these conditions is based on addressing these underlying pathologies and so a thorough history and clinical exam is vital. Plain radiographs generally provide the information required to make a diagnosis and plan operatively. Nonoperative management tends to lead to poor long-term outcomes but there is poor consensus in the literature regarding the operative treatment of these conditions. The evaluation and operative treatment of these conditions is described in detail here, addressing the extensor mechanism rotation or attachment abnormalities, the lateral position of the patellar tendon insertion and the laxity of the medial soft tissues.

小儿慢性髌骨不稳在生命早期就会出现，可表现为永久性不可复位脱位或膝关节屈曲时的习惯性脱位。先天性髌骨脱位多在出生时出现，伴有膝关节屈曲挛缩、下肢外翻错位和胫骨外翻。习惯性脱位可能在以后出现。先天性脱位和习惯性脱位的病理解剖有所不同。对潜在病理的准确诊断非常重要，因为这些病症的手术治疗是以解决这些潜在病理为基础的，因此详尽的病史和临床检查至关重要。X光平片通常可提供诊断和手术计划所需的信息。非手术治疗往往会导致不良的长期疗效，但文献中对这些病症的手术治疗并没有达成共识。本文详细介绍了这些病症的评估和手术治疗方法，涉及伸肌机制旋转或附着异常、髌腱插入的外侧位置以及内侧软组织松弛。

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Transphyseal ACL Reconstruction: A Safe Option Even in Prepubescent Tanner I, II, and III Children 经前交叉韧带重建：即使是青春期前的坦纳一期、二期和三期儿童，也是一种安全的选择

IF 0.2 Q4 ORTHOPEDICS

Operative Techniques in Orthopaedics

Pub Date : 2024-06-01 DOI: 10.1016/j.oto.2024.101111

François Vézina , Lucy J. Salmon , Justin P. Roe

Prepubescent anterior cruciate ligament reconstruction presents a technical challenge to the surgeon due to the presence of the growth plates. Regaining knee stability and functionality are the main goals of treatment, while avoiding growth disturbances in this young population. Transphyseal reconstructions allows for an anatomic graft placement and is a safe option, even in the youngest patients, as long as specific technical points are taken into consideration. This present article describes in detail the operative technique of a transphyseal anterior cruciate ligament reconstruction with special attention to the pearls and pitfalls. The senior author has used this technique in 123 Tanner stage I, II, and III patients and his experience will also be presented.

由于生长板的存在，青春期前交叉韧带重建给外科医生带来了技术挑战。恢复膝关节的稳定性和功能性是治疗的主要目标，同时还要避免对这一年轻群体的生长造成干扰。只要考虑到特定的技术要点，经骨韧带重建可实现解剖性移植物置放，即使对最年轻的患者来说也是一种安全的选择。本文详细介绍了经骨骺前交叉韧带重建的手术技术，并特别关注了其中的要点和误区。资深作者曾在 123 例 Tanner I、II 和 III 期患者中使用过该技术，他的经验也将在本文中介绍。

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