Surgical strategies for spinal infections: A narrative review.

The successful operative management of spinal infections necessitates a thoughtful approach. Ideal treatment combines the universal goals of any spine operation, which are decompression of the neural elements and stabilization of instability, with source control and eradication of infection. Techniques to treat infection have evolved independently and alongside advances in implant technology and surgical techniques.

Treatment of Chronic Femoral Neck Fracture With Cemented Bipolar Hemiarthroplasty and Management of Intraoperative Fracture With Cerclage Cabling.

We cover the operative treatment of a neglected chronic femoral neck fracture nonunion treated at 6 months. We begin with a description of the case and concomitant injuries. The operative portion includes the direct lateral approach with the patient in lateral decubitus position, exposure of the fracture site, osteotomy of the neck, debridement of the nonunion site, broaching, trialing, recognition and treatment of an intraoperative proximal femur fracture using cerclage cabling above and below the lesser trochanter, cementation of final components, and reduction.

Decreasing Trend in Complications for Patients With Obesity and Metabolic Syndrome Undergoing Total Knee Arthroplasty From 2006 to 2017.

Background: To describe longitudinal trends in patients with obesity and Metabolic Syndrome (MetS) undergoing total knee arthroplasty (TKA) and the impact on complications.

Methods: We identified primary TKA patients between 2006 and 2017 within the National Surgical Quality Improvement Program database. We recorded patient demographics and 30-day complications.

The Clinical Impact of Image Guidance and Robotics in Spinal Surgery: A Review of Safety, Accuracy, Efficiency, and Complication Reduction.

Image guidance (IG) and robotic-assisted (RA) surgery are modern technological advancements that have provided novel ways to perform precise and accurate spinal surgery. These innovations supply real-time, three-dimensional imaging information to aid in instrumentation, decompression, and implant placement. Although nothing can replace the knowledge and expertise of an experienced spine surgeon, these platforms do have the potential to supplement the individual surgeon's capabilities.

Threaded Intramedullary Nails Are Biomechanically Superior to Crossed K-wires for Metacarpal Neck Fractures.

Background: Intramedullary nail (IMN) fixation of metacarpal fractures is an alternative to Kirschner wire (K-wire) fixation. The goal of this study was to compare the biomechanical properties of K-wire fixation with a threaded IMN (InNate; ExsoMed, Aliso Viejo, California).

Methods: The study design was based on previously described biomechanical models for evaluating metacarpal fractures.

Inferior tilt of the glenoid leads to medialization and increases impingement on the scapular neck in reverse shoulder arthroplasty.

Background: In reverse shoulder arthroplasty, Inferior tilt was originally promoted to decrease rates of baseplate failure. However, the literature is conflicting regarding the effect of tilt on scapular neck impingement, which has been associated with an increased risk of notching, increased risk of impingement-related instability, and decreased range of motion. We hypothesized that inferior tilt of -10° would lead to increased medialization and increased scapular neck impingement compared with 0° of tilt.

Inpatient Outcomes in Dialysis Dependent Patients Undergoing Elective Cervical Spine Surgery for Degenerative Cervical Conditions.

Study Design: Retrospective cohort study.

Objective: To evaluate inpatient outcomes in dialysis dependent patients undergoing elective cervical spine surgery.

Methods: A total of 1605 dialysis dependent patients undergoing elective primary or revision cervical spine surgery for degenerative conditions were identified from the National Inpatient sample from 2002 to 2012 and compared to 1 450 642 nondialysis-dependent patients undergoing the same procedures.

Operative Fixation of a Displaced Midshaft Clavicle Fracture.

Midshaft clavicle fractures are frequently encountered orthopaedic injuries. Significant displacement portends a higher likelihood of nonunion and symptomatic malunion after nonoperative treatment. Surgical fixation has been shown to reduce the rate of these adverse outcomes.

Inpatient Outcomes in Dialysis-dependent Patients Undergoing Elective Lumbar Surgery for Degenerative Lumbar Disease.

Study Design: Retrospective cohort study.

Objective: To evaluate hospital outcomes in dialysis-dependent patients undergoing elective lumbar surgeries.

Summary Of Background Data: Because of their overall poor health status and concomitant comorbidity burden, spinal surgery in dialysis-dependent patients represents a significant challenge to spine surgeons.

Noninvasive image texture analysis differentiates K-ras mutation from pan-wildtype NSCLC and is prognostic.

Background: Non-invasive characterization of a tumor's molecular features could enhance treatment management. Quantitative computed tomography (CT) based texture analysis (QTA) has been used to derive tumor heterogeneity information, and the appearance of the tumors has been shown to relate to patient outcome in non-small cell lung cancer (NSCLC) and other cancers. In this study, we examined the potential of tumoral QTA to differentiate K-ras mutant from pan-wildtype tumors and its prognostic potential using baseline pre-treatment non-contrast CT imaging in NSCLC.

Mechanical strain applied to human fibroblasts differentially regulates skeletal myoblast differentiation.

Cyclic short-duration stretches (CSDS) such as those resulting from repetitive motion strain increase the risk of musculoskeletal injury. Myofascial release is a common technique used by clinicians that applies an acyclic long-duration stretch (ALDS) to muscle fascia to repair injury. When subjected to mechanical strain, fibroblasts within muscle fascia secrete IL-6, which has been shown to induce myoblast differentiation, essential for muscle repair.