Prolonged cardiac arrest complicating a massive ST-segment elevation myocardial infarction associated with marijuana consumption.

Recreational substance use and misuse constitute a major public health issue. The annual rate of recreational drug overdose-related deaths is increasing exponentially, making unintentional overdose as the leading cause of injury-related deaths in the United States. Marijuana is the most widely used recreational illicit drug, with approximately 200 million users worldwide.

Assessing the utility of ICU admission for octogenarians.

Background: Advanced age is associated with increased severity of acute critical illnesses and admission to ICU. Despite advances in the support for older critically ill patients, the short- and long-term mortality rates remain substantial. The purpose of this study is to analyze the factors influencing the outcome of a geriatric population admitted to the ICU.

Novel Use of Synthetic Acellular Dermal Matrix for Coverage of a Tibial Defect Following Resection of an Osteochondroma: A Case Report.

The application of an artificial dermal matrix (Integra Life Sciences, Plainsboro, NJ) in the management of substantial burn injuries has been extensively documented. Use of an artificial dermal matrix has resulted in excellent outcomes and is free of the morbidity associated with harvesting free-tissue flaps. However, coverage of bony defects where the periosteum has been removed is often challenging.

Fracture pattern characteristics and associated injuries of high-energy, large fragment, partial articular radial head fractures: a preliminary imaging analysis.

Background: High-energy radial head injuries often present with a large partial articular displaced fragment with any number of surrounding injuries. The objective of the study was to determine the characteristics of large fragment, partial articular radial head fractures and determine any significant correlation with specific injury patterns.

Materials And Methods: Patients sustaining a radial head fracture from 2002-2010 were screened for participation.

Exposures of the humerus for fracture fixation.

The care of humeral shaft fractures is undergoing a transition to more aggressive treatment methods with more frequent operative fixation. The upper arm has an extensive network of nerves, arteries, and veins that must be protected during any operative exposure. The ultimate goal of fixation of a humerus fracture is rigid stabilization to allow early range of motion, protection of the neurovascular structures, and preservation of the triceps mechanism posteriorly and the anterior elbow flexor muscles.

Prognostic factors associated with adverse outcome among critically ill elderly patients admitted to the intensive care unit.

Introduction: Despite concerns over the appropriateness and quality of care provided in the intensive care unit (ICU) at the end of life, the number of elderly patients who receive critical care is increasing. Despite this, many physicians have doubts as to whether elderly patients are good candidates for ICU care because of the apparently poor outcome during and after critical care in this population. The objective of the present study was to describe the clinical characteristics and outcome of a geriatric population admitted to the ICU.

The use of skin substitutes in the treatment of the hand and upper extremity.

The introduction of skin substitutes in the last decade has dramatically changed how we think about the concept of "non-healing" wounds. Their use has improved prognosis and reduced morbidity in the treatment of open wounds. This article aims to summarize the development of tissue-engineered skin substitutes, discuss their use, and highlight some specific applications in different clinical settings.

Chronic scaphoid nonunion of 28-year duration treated with nonvascularized iliac crest bone graft.

Scaphoid nonunions present a challenging clinical problem, particularly if the diagnosis of nonunion is missed or delayed. The optimal management technique can vary from free vascularized bone grafts to scaphoid excision and limited wrist fusion. The classic method of open reduction, nonvascularized corticocancellous bone grafting and internal fixation is still an effective technique.

Treatment of dorsal perilunate dislocations and fracture-dislocations using a standardized protocol.

Background: The aims of this study were to evaluate the associated injuries occurring with acute perilunate instability and to assess the clinical and radiographic outcomes of perilunate dislocations and fracture-dislocations treated with a combined dorsal and volar approach.

Methods: A total of 45 patients (46 wrist injuries) with perilunate dislocations and fracture-dislocations were prospectively evaluated. The size of the mid-carpal ligament tear, the location of the scapholunate ligament tear, and the presence of osteochondral fragments and of the dorsal radiocarpal ligament avulsions were recorded at injury.

Extensor digitorum brevis manus muscle in association with a metacarpal boss.

Awareness of the existence of accessory muscles in the hand, such as the extensor digitorum brevis manus (EDBM) muscle, is important when making a differential diagnosis and considering the treatment of mass lesions with similar appearances. Cases of EDBM with associated dorsal wrist ganglion have been reported in earlier published reports. This report describes an unusual case of the EDBM muscle in association with carpometacarpal (CMC) boss.

Percutaneous screw fixation without bone grafting of scaphoid non-union.

Background: Delays in diagnosis and inadequate treatment of acute scaphoid fractures can lead to non-unions, presenting surgeons with unique challenges regarding optimal management.

Objectives: To evaluate the clinical and radiographic outcome of scaphoid non-unions treated with percutaneous screw fixation.

Methods: The study group comprised 12 patients with scaphoid non-unions of an average duration of 8.

The role for prophylaxis inferior vena cava filters in patients undergoing bariatric surgery: replacing anecdote with evidence.

The number of patients choosing surgical alternatives for weight reduction continues to increase. Despite common thromboembolic preventive methods, which include perioperative subcutaneous heparin injections, early mobilization, and sequential compression devices, postoperative deep vein thrombosis/pulmonary embolism remains a devastating complication after bariatric surgery. The role prophylactic inferior vena cava (IVC) filters may play in bariatric surgery remains controversial, and this article aims to address the risks and benefits of prophylactic IVC filters in high-risk bariatric patients and suggest an evidence-based algorithm for their use.

Isolated radial shaft fracture with unreducable posterior dislocation of the radial head and rupture of the lateral collateral ligament: A case report.

Combined injuries associated with forearm shaft fractures and elbow dislocations are well recognized. We describe an uncommon case of an isolated radial shaft fracture with an unreducable posterior dislocation of the radial head and associated rupture of the lateral collateral ligament of the elbow.

Corrective osteotomy and local bone grafting for extra-articular malunion of the proximal phalanx.

Corrective osteotomies are often utilised to treat finger deformities that may occur due to a phalangeal malunion. Rotational or angular malalignment, in addition to shortening of the digit may negatively affect hand function and be aesthetically displeasing. Thorough preoperative examination of the malunion and its associated deformities is crucial in determining the type of osteotomy technique to be used.

Closed sagittal band injury due to low energy trauma.

Sagittal band injury is a relatively common cause of extensor tendon subluxation caused by inflammatory disease or high-energy trauma. However, there are few reports in the literature describing sagittal band injury due to low energy trauma. In this report, we describe successful nonsurgical management of a closed sagittal band injury and extensor tendon subluxation associated with low-energy trauma.

Transplanted blood-derived endothelial progenitor cells (EPC) enhance bridging of sheep tibia critical size defects.

The angiogenic events that accompany bone regeneration function as a "limiting factor" and are the primary regulatory mechanisms that direct the healing process. The general aim of this study was to test whether blood-derived progenitor cells that have endothelial characteristics (EPC), when applied to a large segmental defect, would promote bone regeneration. We established a critical-sized gap platform in sheep tibiae.