The optimal treatment of minimally displaced or nondisplaced fractures of the scaphoid is unclear. Traditionally, management of these fractures has been unpredictable with a significant risk of nonunion when treated conservatively. This study examined the results from 32 patients who underwent percutaneous screw fixation using a 3.
View Article and Find Full Text PDFWe describe 4 patients who were treated for symptomatic triggering of the index and small fingers with pain on the dorsum of the hand and were found to have impingement of an extensor tendon on the extensor retinaculum at the wrist. All cases were treated by release of the extensor retinaculum and excision of pathologic structures.
View Article and Find Full Text PDFWound healing is a complicated and dynamic process. The aim of this study was to determine whether systemic administration of common anticoagulants retards or delays wound healing in an animal model.
View Article and Find Full Text PDFAm J Orthop (Belle Mead NJ)
March 2007
Recent literature suggests that, in older children, acute cases of septic arthritis may be treated with aspiration and intravenous antibiotics. However, when surgical decompression is required, the technique described in this report has several advantages. It can be performed with an incision of approximately 1 to 2 inches and a posterior stab wound of <1 cm; it preserves anatomic planes and poses less risk to the circumflex femoral vessels (as with the anterior approach); and it allows fluid to drain when the patient is supine (as with the posterior approach).
View Article and Find Full Text PDFTreatment of infected orthopaedic hardware usually requires the removal of the appliance. When the device is removed and immediately replaced, persistent infection frequently complicates this exchange procedure. We modeled the exchange procedure in rats by passing a wire suture through a posterior spinous process and then contaminating the wound with Staphylococcus aureus.
View Article and Find Full Text PDFThe primary purpose of irrigation is to remove bacterial contaminants from the wound. Surfactants do that by disrupting the bonds of the organism to the surface. The use of this wound care strategy was studied in a series of investigations spanning several years.
View Article and Find Full Text PDFDeep wound infection involving an implanted biomaterial is a devastating complication in orthopaedic surgery. Two-thirds of such infections are monomicrobial and the most commonly isolated bacteria in human osteomyelitis and orthopaedic device infection are Staphylococcus aureus and Staphylococcus epidermidis. The purpose of the current study was to examine the effectiveness of the previously reported sequential surfactant irrigation protocol against human-isolated clinical strains of Staphylococcus aureus and Staphylococcus epidermidis in the rat model of orthopaedic implant contamination.
View Article and Find Full Text PDFHand surgeons have a rich heritage of stewardship to the community through volunteer medical work. There is a wide breadth of service opportunities that can be accomplished at home and overseas. The challenges of volunteerism are balanced by the personal and professional rewards.
View Article and Find Full Text PDFBackground: We observed an interaction in animals inoculated concomitantly with Staphylococcus aureus and Pseudomonas aeruginosa during a study of the efficacy of surfactants for disinfection of orthopaedic wounds. This led us to investigate whether synergy could be demonstrated between Staphylococcus aureus and Pseudomonas aeruginosa in a rat model of complex orthopaedic wounds.
Methods: A wire was implanted into the spinous process of a lumbar vertebra of Sprague-Dawley rats through a dorsal incision.
Am J Orthop (Belle Mead NJ)
October 2000
Complications with open reduction and internal fixation of distal radius fractures have led to the development of the AO/titanium Pi-plate. This was designed to be a low-profile plate to decrease its intrusion into surrounding soft tissues. Recent case reports are revealing an association of tendon ruptures with failures of this plate.
View Article and Find Full Text PDFObjective: The purpose of the present study was to determine the effects of cleaning a contaminated orthopaedic wound with different classes of wound irrigation solutions.
Study Design: Rats with a contaminated orthopaedic wound were randomized into treatment groups: normal saline (NS), castile soap (CS), benzalkonium chloride (BzC), bacitracin (Abx), or sequential irrigation with BzC, CS, and NS.
Intervention: Pseudomonas aeruginosa [P.
Am J Orthop (Belle Mead NJ)
March 1999
This investigation sought to determine the capacity of irrigation solutions in decontaminating orthopedic wounds challenged with a polymicrobial inoculum. Rats were divided into two groups, a control group and a treatment group. After creation of a dorsolumbar incision and placement of a wire through the spinous process, rats were inoculated with Staphylococcus aureus and Pseudomonas aeruginosa.
View Article and Find Full Text PDFClin Orthop Relat Res
January 1998
The efficacy of benzalkonium chloride was evaluated as an irrigating solution for the eradication of Staphylococcus aureus from a contaminated orthopaedic wound. Thirty Sprague Dawley rats were randomized into two groups. A stainless steel wire was placed in a lumbar spinous process, and the wound was inoculated with 10(7) or 10(6) colony forming units of Staphylococcus aureus.
View Article and Find Full Text PDFPlast Reconstr Surg
November 1997
In recent years, electrodiagnostic studies have become an expected component in the work up and evaluation of carpal tunnel syndrome. We conducted a retrospective review of 460 carpal tunnel decompressions to determine whether the accuracy of diagnosis and the prediction of therapeutic outcome could be related to the positivity and severity of findings on preoperative electrical studies. The 349 patients (460 hands) were divided into two groups: group 1 consisted of hands with the clinical diagnosis of carpal tunnel syndrome but with normal electrodiagnostic studies (n = 62); in group 2 the hands had a clinical diagnosis of carpal tunnel syndrome with confirmatory electrodiagnostic studies (n = 398).
View Article and Find Full Text PDFObjective: To determine the disinfecting properties of benzalkonium chloride as an irrigation agent.
Design: Comparison was made between irrigation of contaminated muscle strips with benzalkonium chloride and normal saline (control).
Summary Of Background Data: Benzalkonium chloride is a cationic disinfectant, which has questionable efficacy in an organic environment.
Clin Orthop Relat Res
August 1996
This investigation seeks to determine whether surfactants or detergents can be used to clean and disinfect orthopaedic wounds with implanted hardware. Thus, a stepwise investigation of biocompatible surfactants and detergents was performed to identify an irrigation agent for disinfecting orthopaedic wounds. Bacterial adhesions assays, irrigation studies, and bactericidal assays determined that benzalkonium chloride showed the greatest efficacy.
View Article and Find Full Text PDFWe examined the efficacy of various irrigation solutions delivered through a power irrigator to remove bacteria from three different surfaces. Titanium, stainless-steel, and cortical bone surfaces were coated with three different bacterial species: Staphylococcus aureus, Pseudomonas aeruginosa, and Staphylococcus epidermidis. They were then irrigated with 1 L of fluid delivered by jet lavage.
View Article and Find Full Text PDFJ Hand Surg Am
March 1995
Two patients with complicated giant cell tumors of the distal ulna were treated by resection of 7.5 and 5.5 cm of the ulna, respectively.
View Article and Find Full Text PDFJ South Orthop Assoc
October 1996
To determine the rate of healing of the osteotomy, we studied the cases of 10 patients who had transverse osteotomy of the olecranon for surgical exposure of a complex distal humerus fracture. The average age of the patients was 48 years, and the average follow-up was 24 months. Nine of the fractures were complex supracondylar/intercondylar fractures.
View Article and Find Full Text PDFTo determine which type of irrigation solution and which method of irrigation most effectively removes slime-producing Staphylococcus from implant surfaces, we performed experimental washings of bacteria-coated stainless steel screws with various solutions delivered by bulb syringe or by jet lavage. The quantity of bacteria remaining on the screw surface was determined after irrigation with 1 L of saline, 1 L of antibiotic solutions, or 1 L of saline containing a liquid soap. Antibiotic solutions tested included bacitracin, neomycin, and polymyxin/neomycin.
View Article and Find Full Text PDFJ South Orthop Assoc
November 1996
We did a retrospective analysis of 28 patients who were treated with the Orthofix external fixation system for complex fractures of the distal radius to study complications associated with screw size. The 14 patients in group 1 had a 4.5/3.
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