Instrumentation Failure in Adult Spinal Deformity Patients.

In recent years, advances in the surgical treatment of adult spinal deformity (ASD) have led to improved outcomes. Although these advances have helped drive the development of deformity surgery to meet the rising volume of patients seeking surgical treatment, many challenges have yet to be solved. Instrumentation failure remains one of the most common major complications following deformity surgery, associated with significant morbidity due to elevated re-operation rates among those experiencing mechanical complications.

Pelvic Fixation With a Quad-Rod Technique Using S2 Alar Iliac and Medialized Entry Iliac Screws for Long Fusion Constructs.

Purpose: Patients with adult spinal deformity (ASD) may have risk factors for nonunion and subsequent instrumentation failure. This study reviews a novel surgical technique for a quad-rod construct to the pelvis using both S2 alar iliac (S2AI) screw fixation and medialized entry iliac screw fixation as described through three separate cases and a review of the literature.

Methods: This technique facilitates alignment of the construct and rod insertion into the tulip heads.

A Novel Framework for Routine Versus Critical Communication in Surgical Education-Don't Take It Personally.

Despite their impressive academic track records and mastery of controlled classroom-based didactic learning, many orthopaedic surgery residents struggle to adjust from learning in the classroom environment in medical school to learning in the operating room as surgical residents. Instead of learning in lectures, surgical residents take on a more apprenticeship-based role with the goal of mastering technical skills in an experiential learning environment. Yet, no framework has been explicitly described in the literature to help learners make this transition.

Calcium sulfate in the management of osteomyelitis: A systematic review and meta-analysis of comparative studies.

Background: Calcium sulfate (CS) is used extensively as an antibiotic carrier in the treatment of chronic osteomyelitis, largely due to its biodegradable nature. The aim of this systematic review and meta-analysis is to analyze the comprehensive performance of CS in the literature when compared to other biomaterials or treatments for osteomyelitis. We assess the ability of CS to eradicate infection and achieve other key clinical outcomes.

Modified Wavelet Analyses Permit Quantification of Dynamic Interactions Between Ultradian and Circadian Rhythms.

Circadian rhythms provide daily temporal structure to cellular and organismal biological processes, ranging from gene expression to cognition. Higher-frequency (intradaily) ultradian rhythms are similarly ubiquitous but have garnered far less empirical study, in part because of the properties that define them-multimodal periods, non-stationarity, circadian harmonics, and diurnal modulation-pose challenges to their accurate and precise quantification. Wavelet analyses are ideally suited to address these challenges, but wavelet-based measurement of ultradian rhythms has remained largely idiographic.

Dynamic Thumb Circumduction Measured With a Wearable Motion Sensor: A Prospective Comparison of Patients With Basal Joint Arthritis to Controls.

Purpose: The purpose of this study was to compare the active range of motion in patients with thumb carpometacarpal (CMC) arthritis to healthy controls. A secondary objective of this study was to examine the feasibility of using wearable motion sensors in a clinical setting.

Methods: Asymptomatic controls and patients with radiographic and clinical evidence of thumb CMC joint arthritis were recruited.

Factors Influencing Why Children and Their Families Choose Surgery for Ganglion Cysts.

Purpose: Ganglion cysts of the hand/wrist are frequently managed without surgery but can be treated with surgical excision if there is pain or dysfunction. No studies have examined the specific factors predictive of surgical treatment for pediatric patients.

Methods: This was a study of pediatric patients (≤18 years) with ganglion cysts of the hand/wrist seen between 2017 and 2019 at 2 institutions.

Clinical Presentation and Characteristics of Hand and Wrist Ganglion Cysts in Children.

Purpose: Ganglion cysts are the most common mass of the hand or wrist. In adults, ganglions have a female predilection and are commonly located in the dorsal wrist. However, their presentation in children has not been well reported.

Motorized Internal Limb-Lengthening (MILL) Techniques Are Superior to Alternative Limb-Lengthening Techniques: A Systematic Review and Meta-Analysis of the Literature.

Background: The field of limb lengthening has undergone substantial advancement in recent years with respect to the subjective patient experience, the rate of surgical complications, and the time required to achieve regenerate consolidation. We aimed to assess the performance of motorized internal limb lengthening (MILL) devices when compared with alternative methods of limb lengthening through systematic review and meta-analysis.

Methods: Studies comparing MILL methods with alternative forms of limb lengthening were included for systematic review.

Increased Rates of Septic Shock, Cardiac Arrest, and Mortality Associated With Chronic Steroid Use Following Anterior Cervical Discectomy and Fusion for Cervical Stenosis.

Objective: Anterior cervical discectomy and fusion (ACDF) is an established treatment modality for cervical spondylosis. Many patients are on immunosuppressant therapy in the management of various inflammatory spinal pathologies and other comorbid conditions. The impact of chronic steroid use on postoperative complications has not been examined in cervical fusion procedures.

Risk Factors for Postoperative Urinary Tract Infections Following Anterior Lumbar Interbody Fusion.

Background: Although risk factors contributing to UTI have been studied in posterior approaches to lumbar fusion, there is a lack of literature on factors contributing to UTI in anterior lumbar interbody fusion (ALIF). Our purpose was to identify preoperative independent risk factors for postoperative urinary tract infection (UTI) following anterior lumbar interbody fusion (ALIF) so that surgeons may be able to initiate preventative measures and minimize the risk of UTI-related morbidity following ALIF.

Methods: The American College of Surgeons-National Surgical Quality Improvement Program database was queried to identify 10 232 patients who had undergone ALIF from 2005 to 2016; 144 patients (1.

Loss of Elbow Flexion in Congenital Arthrogryposis Treated with a Bipolar Latissimus Transfer: A Case Report.

Case: A 20-year-old man with congenital arthrogryposis presented for evaluation of biceps dysfunction. Although his left elbow was supple with 0° to 110° passive range of motion (ROM), he had no active ROM and was unable to perform basic activities of daily living such as bringing his hand to his mouth to feed himself. A bipolar latissimus transfer was performed to achieve functional active ROM.

Community organization factors affecting veteran participation in adaptive sports.

This study aims to describe United States military veteran participation in adaptive sports and to assess the demographic make-up and organizational characteristics of existing adaptive sports programs. Prospective, cross-sectional survey. Community organizations with adaptive sports programs.

Zone- and layer-specific differences in proteoglycan content in patellofemoral pain syndrome are detectable on T1ρ MRI.

Objective: Determine if differences in T1ρ would be detected in specific regions or layers of patellofemoral cartilage between patients with symptomatic patellofemoral pain syndrome and asymptomatic control subjects.

Materials And Methods: Ten subjects diagnosed with patellofemoral pain syndrome were compared with ten age-, gender-, and BMI-matched control subjects with no knee pain or prior trauma. Conventional turbo (fast) spin echo sequences and T1ρ-weighted imaging were performed on the symptomatic knee in each of the ten subjects.

Late Presentation of a Retained Stingray Spine in the Plantar Medial Hindfoot.

Unlabelled: In the United States, approximately 2000 stingray injuries occur annually. The majority of reports on stingray injuries to the foot and ankle reflect acute injuries. Delayed presentation after stingray injury to the foot and ankle has not been reported.

Surgical complications associated with congestive heart failure in elderly patients following primary hip hemiarthroplasty for femoral neck fractures.

Introduction: Although there are reports of the impact of congestive heart failure (CHF) on total knee arthroplasty and total hip arthroplasty, there is a lack of literature analyzing CHF in hip hemiarthroplasty (HHA) procedures. The main objective of this study was to evaluate the effect of CHF on risks for complications following HHA for the treatment of FNF.

Methods: The ACS-NSQIP database was queried for all patients who had undergone HHA from 2005 to 2016.

A comparison of narcotic usage and length of post-operative hospital stay in open versus minimally invasive lumbar interbody fusion with percutaneous pedicle screws.

Background: Instrumented lumbar fusion can be accomplished through open or minimally invasive techniques. The focus of this study was to compare perioperative narcotic usage and length of hospital stay between patients undergoing open versus minimally invasive spinal surgery (MISS).

Methods: A retrospective chart review was performed on 110 patients who underwent instrumented lumbar fusion over 2 years at our institution.

Pathologic Tuft Fracture in a Thumb: A Rare Presentation of Metastatic Endometrioid Ovarian Carcinoma: A Case Report and Review of the Literature.

Case: A 51-year-old woman with a medical history noteworthy for endometrioid ovarian carcinoma presented with progressive left thumb swelling in the absence of trauma or injury. Radiographs revealed a lytic lesion in the distal phalanx. Inflammatory markers and white blood-cell count were mildly elevated.

Cocoa flavanol intake improves endothelial function and Framingham Risk Score in healthy men and women: a randomised, controlled, double-masked trial: the Flaviola Health Study.

Cocoa flavanol (CF) intake improves endothelial function in patients with cardiovascular risk factors and disease. We investigated the effects of CF on surrogate markers of cardiovascular health in low risk, healthy, middle-aged individuals without history, signs or symptoms of CVD. In a 1-month, open-label, one-armed pilot study, bi-daily ingestion of 450 mg of CF led to a time-dependent increase in endothelial function (measured as flow-mediated vasodilation (FMD)) that plateaued after 2 weeks.

Shared, unique and redundant functions of three members of the class I myosins (MyoA, MyoB and MyoF) in motility and chemotaxis in Dictyostelium.

Most cell types express two distinct forms of myosin I, amoeboid and short, distinguished by differences in their tail domains. Both types of myosin I have been implicated in the regulation of pseudopod formation in Dictyostelium discoideum. We examined three members of the myosin I family, one amoeboid, MyoB, and two short, MyoA and MyoB, for shared, unique and redundant functions in motility and chemotaxis.