Multiple myeloma: diagnosis and orthopaedic implications.

Multiple myeloma is a hematologic malignancy that commonly affects the skeletal system. The disease is primarily managed medically with chemotherapeutic agents. Pathologic fractures are common in patients with diagnosed and undiagnosed disease.

Femoral malrotation following intramedullary nail fixation.

Intramedullary nailing of femoral shaft fracture can result in inadvertent malalignment. Malrotation is the most common cause of deformity, but it is underrecognized, in part because of the difficulty in accurately assessing rotation as well as the variation that exists in normal anatomy. The consequences of femoral malrotation are not completely understood.

Pedicle screw-based posterior dynamic stabilization in the lumbar spine.

Traditionally, management of spinal pathology has centered on decompression, correction of deformity, and stabilization. Deformity correction and stabilization have been accomplished largely by spinal fusion at the pathologic levels. In addition to the risks and potential complications, there are sequelae to a successful fusion.

Combined heart-kidney transplantation: the University of Wisconsin experience.

Background: Combined heart-kidney transplantation (HKTx) is increasing in frequency, but long-term outcomes are unknown and appropriately comparative analysis is lacking.

Methods: This study was a retrospective review of prospectively collected data for 19 HKTx patients. Patient and graft survival, graft rejection and coronary allograft vasculopathy (CAV) were compared for HKTx vs recipients of a heart (n = 515) or kidney alone (n = 3,188) or both organs at separate time-points (n = 8).

Early institution of extracorporeal membrane oxygenation for primary graft dysfunction after lung transplantation improves outcome.

Background: Primary graft dysfunction (PGD) after lung transplantation (LTx) carries a significant mortality and clinical management is controversial. Extracorporeal membrane oxygenation (ECMO) has been used infrequently for recovery from acute lung injury (ALI) in this setting. We reviewed our experience with ECMO after primary LTx.

Is extreme obesity a risk factor for cardiac surgery? An analysis of patients with a BMI > or = 40.

Background: The increasing prevalence of obesity is a public health concern and perceived as a potential risk factor in open heart surgery. We critically appraised the literature available regarding postoperative complications in obese patients.

Methods: A single-center retrospective evaluation of complication rates (1999-2004) in cardiac surgical patients categorized by body mass index (BMI) was conducted.