Methods to Manage Edema and Reduce Flap Compression in Postoperative Nursing Care Following Trauma to the Lower Extremity.

Lower extremity edema and compression are potential causes of poor soft tissue healing and flap failure for patients who suffer lower extremity trauma. This review summarizes techniques aimed at reducing edema and mechanical pressure in these patients as well as those undergoing soft tissue coverage techniques. We conducted a literature review for postoperative nursing management to reduce edema in the lower extremity, following traumatic injury.

Stability Reliability and External Validity of Myrick THIRD Test for Hip Labral Tears.

The purpose of the study is to examine whether the physical examination technique, Myrick The Hip Internal Rotation with Distraction (THIRD), is reliable and valid. The Myrick THIRD test has previously established and documented sensitivity, specificity, positive predictive value, and internal and external validity. The goal of this original research was to demonstrate stability reliability of the Myrick THIRD test when the study is conducted in a clinical setting where the test has not previously been performed, as well as to demonstrate that the Myrick THIRD test has external validity when conducted across multiple examiners in a new setting.

Resident Involvement in Shoulder-Stabilization Procedures Is Not Associated With an Increased Risk of 30-Day Postoperative Complications.

Purpose: To examine the 30-day postoperative outcomes of resident involvement in shoulder-stabilization surgical procedures using the American College of Surgeons National Surgical Quality Improvement database.

Methods: We conducted a retrospective review of the National Surgical Quality Improvement database for all shoulder-stabilization procedures from 2010 to 2018. Procedures included arthroscopic Bankart, arthroscopic Bankart with SLAP repair, arthroscopic Bankart with Remplissage, open Bankart, anterior bone block, posterior bone block, Latarjet coracoid process transfer, and capsular shift/capsulorrhaphy for multidirectional instability.

Abdominal aortic aneurysm presenting to the orthopedic clinic as posterior hip and low back pain.

Abdominal aortic aneurysms (AAAs) are typically asymptomatic. When symptomatic, AAA may present as a chief concern of musculoskeletal hip and low back pain. Assessment in the orthopedic clinic should focus on a holistic examination of the patient.

Obesity and total joint arthroplasty: Does weight loss in the preoperative period improve perioperative outcomes?

Background: The obese population is more likely to develop degenerative joint disease requiring total joint arthroplasty (TJA) and also experience increased rates of adverse post-surgical outcomes. This study assessed whether a quantifiable weight loss prior to TJA had any impact on perioperative and 30-day outcomes in obese patients.

Method: Using the American College of Surgeons-National Surgical Quality Improvement Program database, obese patients who underwent total hip or total knee arthroplasty and lost at least 10% of their total body weight prior to surgery were identified and matched to other obese individuals undergoing the same procedures without weight loss.

Outpatient Total Joint Arthroplasty: Are We Closing the Racial Disparities Gap?

Introduction: As ne arly half of all total joint arthroplasty (TJA) procedures are projected to be performed in the outpatient setting by 2026, the impact of this trend on health disparities remains to be explored. This study investigated the racial/ethnic differences in the proportion of TJA performed as outpatient as well as the impact of outpatient surgery on 30-day complication and readmission rates.

Methods: The ACS National Surgical Quality Improvement Program was retrospectively reviewed for all patients who underwent primary, elective total hip and knee arthroplasty (THA, TKA) between 2011 and 2018.

Total Versus Unicondylar Knee Arthroplasty: Does Race Play a Role in the Treatment Selection?

Introduction: Racial disparities have been well reported in the utilization and outcomes of knee arthroplasty, but it is unclear whether disparities also extend to the choice of surgical treatment. The primary objective of this study is to identify if race plays a role in the selection of unicondylar versus total knee arthroplasty (UKA, TKA) for isolated tibiofemoral osteoarthritis (OA). A secondary objective is to identify the differences in the complication rates for each procedure by racial identity.

Complementary and integrative medicine: An observational study on pediatric clinicians' knowledge, beliefs and practices.

Objective: Complementary and Integrative Medicine (CIM) is a group of diverse health care therapies that often serve as adjuncts to conventional medical treatments. Our aim for this study was to evaluate the current knowledge, beliefs and practices of pediatric clinicians regarding CIM.

Methods: Clinicians from the pediatric unit of a large US based teaching hospital in Connecticut were surveyed, through self-administered questionnaires.

Ulnar stress fracture in a softball player.

Clinicians need to have a high index of suspicion in overhead athlete with persistent pain. MRI and bone scans are more sensitive than X-rays in detecting ulnar stress fractures. Increased awareness will improve diagnosis and patient outcomes.

The Missing Link: Defining the Functional Parameters of Pelvic and Acetabular Alignment.

Background: This study aimed to define the three-dimensional functional alignment of the pelvis, proximal femur, and acetabulum during postural and physical activities.

Methods: Thirty volunteers aged 40 years or greater were recruited. Reflective markers placed on bony prominences on the pelvis and lower extremities were tracked using a 12-camera motion analysis system.

Kinematics and EMG activity in Reverse Total Shoulder Arthroplasty.

Introduction: Patients undergoing a Reverse Total Shoulder Arthroplasty (RTSA) often have functional limitations that affect the range of motion of the shoulder. These limitations are not mechanical in nature, but instead linked to a reduced ability to generate muscle force. The specific aims of this study was to offer a comparison between the muscle activity generated by a post-operative RTSA shoulder in a patient to that of their contralateral shoulder during a series of functional activities.

The Role of Volume Regulation and Thermoregulation in AKI during Marathon Running.

Background And Objectives: Marathon runners develop transient AKI with urine sediments and injury biomarkers suggesting nephron damage.

Design, Setting, Participants, & Measurements: To investigate the etiology, we examined volume and thermoregulatory responses as possible mechanisms in runners' AKI using a prospective cohort of runners in the 2017 Hartford Marathon. Vitals, blood, and urine samples were collected in 23 runners 1 day premarathon and immediately and 1 day postmarathon.

Trunk Muscle Endurance, Flexibility, Stride Foot Balance, and Contralateral Trunk Lean in Collegiate Baseball Pitchers.

Myrick, KM, Pallone, AS, Feinn, RS, Ford, KM, and Garbalosa, JC. Trunk muscle endurance, flexibility, stride foot balance, and contralateral trunk lean in collegiate baseball pitchers. J Strength Cond Res 33(10): 2641-2647, 2019-The incidence of shoulder and elbow injuries in baseball is increasing.

Effects of season long participation on ACL volume in female intercollegiate soccer athletes.

Background: The aim of this study was to characterize the volumetric changes of the anterior cruciate ligament over the course of a competitive soccer season in female athletes.

Methods: Seventeen Division-I collegiate soccer players were recruited. Two data collection sessions were conducted.

The influence of non-modifiable and modifiable factors on cardiac biomarkers after marathon running.

Background: This study investigated the influence of modifiable (training) and non-modifiable factors (age and gender) on cardiac troponin I (cTnI) and B-type natriuretic peptide (BNP) levels post-marathon.

Methods: Thirteen female and nine male recreational runners participated in the 2015 Hartford Marathon. A venous blood draw was taken from each subject at 24 hours pre-race, immediately post-race and 24 hours post-race.

Morel-Lavallee injury a case study.

Morel-Lavallee lesions are post-traumatic, soft-tissue degloving injuries commonly misdiagnosed as hematomas or ruptured bursa. The clinician needs to be aware of this injury, in order to provide appropriate patient care and treatment. If not treated early, risks include superinfection, continued expansion, overlying tissue necrosis, and suboptimal patient outcomes.

Appropriate Use Criteria for Hyaluronic Acid in the Treatment of Knee Osteoarthritis in the United States.

Objective: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria.

Methods: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy.

Common electrocardiogram variations pre- and post-marathon.

Electrocardiographic changes can be present in marathon runners. These findings may be misinterpreted as malignant by healthcare providers. For example, incomplete right bundle branch block, early ventricular repolarization, and left ventricular hypertrophy by voltage criteria alone are quite common in athletes, yet considered benign.

Head Injuries in Soccer.

Unlabelled: Soccer is currently the most popular and fastest growing sport worldwide, with approximately 265 million registered soccer players existing around the world. The popularity of the sport, coupled with the high incidence of 18.8-21.

Clinical assessment and management of ankle sprains.

Ankle sprains are a common occurrence and are frequently either undertreated or overtreated. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the United States alone, this is an orthopaedic injury that providers should be acutely aware of and successfully able to evaluate and treat.

Improving follow-up after fragility fractures: an evidence-based initiative.

Background: Patients with fragility fractures are at risk for recurrent fractures and are at risk for inadequate follow up. Prevention of future fractures through appropriate follow-up can decrease annual healthcare expenditures and patient morbidity and mortality.

Purpose: The purpose of this quality improvement project was to delineate an evidence-based practice initiative at a university health center to improve patient follow-up care after fragility fractures.