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Following fracture fixation, fracture-related infection (FRI) is a common complication and requires systematic evaluation to allow for an optimal treatment strategy. A high index of suspicion is necessary for early and timely diagnosis, to diagnose occult infection, and to prevent untreated infections from worsening. Diagnosis of FRI includes evaluation based on history and clinical examination, surgical exploration, serum inflammatory markers, imaging modalities, microbiology, histopathology, and, when needed, molecular biology.
View Article and Find Full Text PDFGun-related violence is becoming increasingly more common in the United States, and ballistic injuries pose a challenge to the orthopaedic surgeon on trauma call. The guiding principles of trauma care are almost exclusively based on blunt trauma, and the management principles do not always translate. Ballistic long bone fractures, particularly of the lower extremity, can often be managed with similar principles, although the injury pattern can make restoration of anatomic alignment a challenge.
View Article and Find Full Text PDFThe medial ulnar collateral ligament (MUCL) complex is integral for valgus elbow stability, especially in individuals engaged in repetitive overhead activities such as throwing. MUCL injuries often necessitate surgical intervention to restore elbow stability. Early studies reporting outcomes after MUCL repair demonstrated suboptimal return to play compared with ulnar collateral ligament reconstruction, prompting a shift toward reconstruction techniques.
View Article and Find Full Text PDFA framework for sequential monitoring of individual N-of-1 trials and combining results across a series of sequentially monitored N-of-1 trials.
Clin Trials
January 2025
Department of Biostatistics, University of Washington, Seattle, WA, USA.
Background: N-of-1 trials compare two or more treatment options for a single participant. These trials have been used to study options for chronic conditions such as arthritis and attention deficit hyperactivity disorder. In addition, they have been suggested as a means to study interventions in rare populations that may not be tractable to include in standard clinical trials, such as treatment options for HIV-positive patients in need of organ transplant.
View Article and Find Full Text PDFPhysiological monitoring to prevent diving disorders.
Front Physiol
December 2024
The Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States.
Insight into human physiology is key to maintaining diver safety in underwater operational environments. Numerous hazardous physiological phenomena can occur during the descent, the time at depth, the ascent, and the hours after a dive that can have enduring consequences. While safety measures and strict adherence to dive protocols make these events uncommon, diving disorders still occur, often with insufficient understanding of the factors that triggered the event.
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