JBJS Case Connect
January 2025
Case: A 41-year old man fell from height sustaining displaced radial shaft and ulnar styloid fractures underwent open reduction internal fixation of the radius with early recognition of a radiocapitellar dislocation and longitudinal forearm instability in the early postoperative period. Revision surgery was performed 13 days postoperatively involving annular ligament reconstruction, elbow spanning external fixation, and distal radioulnar joint stabilization. Favorable functional and radiographic outcomes are shown at 1-year follow-up.
View Article and Find Full Text PDFBackground: Value is defined as the ratio of patient outcomes to the cost of care. One method to assess value is through patient-level value analysis (PLVA). To our knowledge, this tool has not previously been implemented in the setting of total hip arthroplasty (THA).
View Article and Find Full Text PDFObjectives: To determine sources of frustration for surgeons and how they might affect job satisfaction within the orthopaedic trauma community.
Methods: A 25-question survey regarding potential common causes of frustration, operating room (OR) utilization, and career satisfaction was electronically distributed to the Orthopaedic Trauma Association (OTA) membership.
Results: Four hundred seventy-one surgeons participated in the survey (response rate 27.
Introduction Sarcopaenia has been examined as a predictor of frailty in surgical patients and may predict mortality. The hypothesis of this study is that sarcopaenia is associated with an increased risk of death following an episode of acute lower gastrointestinal bleeding (ALGB). Methods This study included patients admitted with ALGB between January 2017 and June 2022, who underwent cross-sectional imaging (CSI).
View Article and Find Full Text PDFDNA has shown great biocompatibility, programmable mechanical properties, and precise structural addressability at the nanometer scale, rendering it a material for constructing versatile nanorobots for biomedical applications. Here, we present the design principle, synthesis, and characterization of a DNA nanorobotic hand, called DNA NanoGripper, that contains a palm and four bendable fingers as inspired by naturally evolved human hands, bird claws, and bacteriophages. Each NanoGripper finger consists of three phalanges connected by three rotatable joints that are bendable in response to the binding of other entities.
View Article and Find Full Text PDFBackground: The purpose of this study is to analyze the relationship between discharge opioids after operative treatment of carpometacarpal (CMC) arthritis and patient-reported outcomes (PROs) over a 6-month episode of care.
Methods: A total of 172 patients met inclusion criteria for this study. Patient-reported outcomes including patient-reported wrist/hand evaluation (PRWHE), single assessment numeric evaluation, and PRO measurement information system (PROMIS) global-10 questionnaires were collected prospectively and stored in an electronic data capture system until review for the purpose of this study.
Background: Microcystins are an emergent public health problem. These toxins are secondary metabolites of harmful cyanobacterial blooms, with blooms becoming more prevalent with eutrophication of water. Exposure to microcystins can result in sickness, liver damage, and even death.
View Article and Find Full Text PDFBackground: The purpose of this study was to evaluate differences in 90-day clinical outcomes between patients treated with generic volar locking plates (VLPs) and conventional VLPs in distal radius fractures. Secondary aims included assessing for differences in surgical characteristics and cost between the groups.
Methods: From November 2022 to April 2023, a prospective block-randomized study was undertaken in which surgeons alternated between using a generic VLP and a conventional VLP each month.
Purpose: Previous literature has proposed barriers to speech-language pathologists (SLPs) using standard clinical labels; however, the perspectives of SLPs have been studied to a lesser extent. This quality improvement project reports on SLPs' perceived barriers and facilitators to using currently recommended clinical labels for preschool communication disorders and identifies next steps to support implementation in one preschool communicative health system.
Method: This project aimed to establish the consistent use of clinical labels in one large Canadian preschool speech and language program.
Background: The purpose of this retrospective analysis of a prospective quality control project was to determine whether the use of intrawound vancomycin powder (IVP) decreases the rate prosthetic joint infection (PJI) within 90-days following primary total knee arthroplasty (TKA).
Methods: From October 2021-September 2022, a prospective quality control project was undertaken in which 10 high-volume arthroplasty surgeons alternated between using IVP and not using IVP each month. Patients who received IVP were compared to those who did not.
We report the design, development, and characterization of a miniaturized version of the photonic resonator absorption microscope (PRAM Mini), whose cost, size, and functionality are compatible with point-of-care (POC) diagnostic assay applications. Compared to previously reported versions of the PRAM instrument, the PRAM Mini components are integrated within an optical framework comprised of an acrylic breadboard and plastic alignment fixtures. The instrument incorporates a Raspberry Pi microprocessor and Bluetooth communication circuit board for wireless control and data connection to a linked smartphone.
View Article and Find Full Text PDFGeriatr Orthop Surg Rehabil
October 2024
Introduction: The purpose of this study was to describe how hip fractures differentially affect male and female patients regarding fracture pattern, hospital course, and postoperative course.
Materials And Methods: This retrospective case series was performed in a metropolitan healthcare system involving 2996 hip fracture patients >59 years old who underwent surgical management (eg, intramedullary nail, hemiarthroplasty, percutaneous pinning, etc.).
Purpose: To evaluate short-term patient-reported outcomes (PROs) in patients aged 40 years and older after primary anterior cruciate ligament reconstruction (ACLR) between patients who received allograft or autograft. Secondary aims included assessing the effect of preexisting osteoarthritis on short-term PROs.
Methods: A retrospective review of an ambulatory surgery center's electronic medical record was conducted for patients who underwent primary ACLR between 2009 and 2022.
Knee Surg Sports Traumatol Arthrosc
September 2024
Purpose: This study aims to evaluate clinical and patient-reported outcome measures (PROMs) of patients 40 years and older that underwent anterior cruciate ligament reconstruction (ACLR) and determine the influence of preexisting arthritis and chondral wear on ACLR outcomes. We hypothesized that patients aged 40+ with ACLR would have excellent clinical outcomes and PROMs regardless of preexisting arthritic changes.
Methods: A total of 118 patients were included.
Situs inversus totalis (SIT) is a rare congenital condition in which there is complete transposition of both the thoracic and abdominal viscera. Given how infrequently this abnormality is encountered, operating on patients with SIT can be technically difficult and challenging for the surgeon. This case report outlines the steps used to successfully carry out a laparoscopic cholecystectomy on a patient with SIT.
View Article and Find Full Text PDFThe ability of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) to infect a wide-range of species raises significant concerns regarding both human-to-animal and animal-to-human transmission. There is an increasing demand for highly sensitive, rapid, and simple diagnostic assays that can detect viral infection across various species. In this study, we developed a biosensor assay that adapted a monoclonal-antibody (mAb)-based blocking ELISA format into an Activate Capture + Digital Counting (AC + DC)-based immunoassay.
View Article and Find Full Text PDFEighty consecutive complex spinal robotic cases utilizing intraoperative 3D CT imaging (E3D, Group 2) were compared to 80 age-matched controls using the Excelsius robot alone with C-arm Fluoroscopic registration (Robot Only, Group 1). The demographics between the two groups were similar-severity of deformity, ASA Score for general anesthesia, patient age, gender, number of spinal levels instrumented, number of patients with prior spinal surgery, and amount of neurologic compression. The intraoperative CT scanning added several objective factors improving patient safety.
View Article and Find Full Text PDFBackground: The impact of non-steroidal anti-inflammatory drugs (NSAIDs) on rotator cuff repair is an ongoing area of study within orthopedics, with conflicting results in current literature. Despite concerns over the deleterious effects of NSAIDs on rotator cuff healing, they are becoming an integral part of a multimodal post-operative pain control regiment. The purpose of this study was to compare post-operative patient-reported outcomes (PROs), complications rates, and retear rates of arthroscopic rotator cuff repairs in patients using ibuprofen post-operatively to those who abstained from NSAIDs for six weeks after surgery.
View Article and Find Full Text PDFBackground: Overcompression of the distal tibiofibular syndesmosis during open reduction and internal fixation of ankle fracture may affect multidirectional flexibility of the ankle bones.
Methods: Ten cadaveric lower limbs (78.3±13.
Arch Orthop Trauma Surg
June 2024
Introduction: The treatment of closed humeral shaft fractures tends to be successful with functional bracing. Treatment failure due to iatrogenic conversion to an open fracture has not been described in the literature. We present a case series of patients that experienced open humeral shaft fractures after initially being treated with functional bracing for closed humeral shaft fractures and describe what factors are associated with this complication.
View Article and Find Full Text PDFBackground And Aims: Caregiver-delivered programs are a recommended best practice to support young autistic children. While research has extensively explored children's outcomes quantitatively, minimal qualitative research has been conducted to understand caregivers' perspectives of program outcomes for themselves and their children. Hearing directly from caregivers is an important step in ensuring these programs are meeting the needs of those who use them.
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