Although pelvic fractures constitute a small percentage of total orthopedic injuries, they are associated with highest mortality rate. Pelvic fractures, along with long bone fractures, frequently are the result of significant blunt trauma often encountered in high-speed motor vehicle accidents. However, other types of trauma can cause these devastating injuries. Early recognition and a high index of suspicion are necessary to ensure that effective and aggressive resuscitation is instituted immediately. Expeditious assessment in the emergency department and care of the patient with pelvic and long bone fractures will greatly enhance the ongoing resuscitation in the operating room. Potentially life-threatening associated injuries in these patients make resuscitation even more challenging. Therefore, a basic knowledge of the mechanisms of injury, early treatment in the emergency department, and the factors that affect intraoperative management will help optimize the outcome for patients with these injuries. This course describes the perioperative concerns and the evaluation and treatment of a patient with a pelvic or a long bone fracture.
Download full-text PDF |
Source |
---|
Otol Neurotol
February 2025
Department of Otorhinolaryngology-Head and Neck Surgery, Donders Center for Neuroscience, Radboud University Medical Center, Radboud University, Nijmegen, the Netherlands.
Objective: To compare the 3-year outcomes of the modified minimally invasive Ponto surgery (m-MIPS) to both the original MIPS (o-MIPS) and linear incision technique with soft tissue preservation (LIT-TP) for inserting bone-anchored hearing implants (BAHIs).
Study Design: Prospective study with three patient groups: m-MIPS, o-MIPS, and LIT-TP.
Setting: Tertiary referral center.
Transplantation
January 2025
Department of Surgery, Center for Transplantation Sciences, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Background: Long-term renal allograft acceptance has been achieved in macaques using a transient mixed hematopoetic chimerism protocol, but similar regimens have proven unsuccessful in heart allograft recipients unless a kidney transplant was performed simultaneously. Here, we test whether a modified protocol based on targeting CD154, CD2, and CD28 is sufficient to prolong heart allograft acceptance or promote the expansion of regulatory T cells.
Methods: Eight macaques underwent heterotopic allo-heart transplantation from major histocompatibility complex-mismatched donors.
Adv Skin Wound Care
January 2025
At Baylor College of Medicine, Houston, Texas, United States, Livia Frost, BS, is Medical Student, School of Medicine; Ya Xu, MD, PhD, is Assistant Professor, Department of Pathology & Immunology; and Yuriko Fukuta, MD, PhD, CWSP, is Assistant Professor, Department of Medicine, Section of Infectious Diseases.
Diabetic foot bacterial osteomyelitis is a serious infection that can lead to major amputations. However, fungal osteomyelitis in a diabetic foot ulcer is uncommon and has been underrecognized. It typically occurs in patients with underlying immunocompromised status and is associated with poor outcomes.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Division of Endocrinology, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Importance: Data characterizing the severity and changing prevalence of bone mineral density (BMD) deficits and associated nonfracture consequences among childhood cancer survivors decades after treatment are lacking.
Objective: To evaluate risk for moderate and severe BMD deficits in survivors and to identify long-term consequences of BMD deficits.
Design, Setting, And Participants: This cohort study used cross-sectional and longitudinal data from the St Jude Lifetime (SJLIFE) cohort, a retrospectively constructed cohort with prospective follow-up.
The therapeutic potential of extracellular vesicles (EVs) in bone regeneration is noteworthy; however, their clinical application is impeded by low yield and limited efficacy. This study investigated the effect of low-intensity pulsed ultrasound (LIPUS) on the therapeutic efficacy of EVs derived from periodontal ligament stem cells (PDLSCs) and preliminarily explored its mechanism. PDLSCs were cultured with osteogenic media and stimulated with or without LIPUS, and then EVs and LIPUS-stimulated EVs (L-EVs) were isolated separately.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!