scholarly journals The treatment of intertrochanteric fracture: a survey on the preferred treatment used by orthopedic surgeons in Campania

2021 ◽  
Vol 35 (2) ◽  
pp. 106-111
Author(s):  
Raffaele Pezzella ◽  
Giuseppe Toro ◽  
Giacomo Errico ◽  
Achille Pellegrino ◽  
Antonio Medici ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
Orthopedic Surgeons

scholarly journals Radiological Assessment of Hip Fracture Union RUSH and Modified RUSH

2021 ◽  
Author(s):  
Xinlong Zhang ◽  
Wentao Ci ◽  
Kaiwen Luo ◽  
Ziyang Xing ◽  
shi yan ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Fracture Healing ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Intertrochanteric Fracture ◽  
Intertrochanteric Fractures ◽  
X Rays ◽  
Fracture Union ◽  
Lateral Plate ◽  
Orthopedic Surgeons

Abstract Objective：Intertrochanteric fracture is a common senile disease, which is mainly treated by surgery. The evaluation of postoperative healing of such fractures has always been based on qualitative evaluation of clinical and radiological indicators. Currently, there are no quantitative evaluations of hip fracture union other than the Radiographic Union Score or Hip (RUSH) score. The aim of this study was to evaluate fracture healing of intertrochanteric fractures treated with intramedullary nailing and plates using RUSH and the modified RUSH score we developed. Methods：We collected a total of 96 patients with surgically treated intertrochanteric fractures, including 46 with lateral plate fixation and 50 with intramedullary nailing. Six orthopedic surgeons assessed the overall impression of fracture union on more than 200 postoperative X-rays without knowing any information, followed by the use of RUSH and modified RUSH to evaluate the x-rays separately to see if the two methods improved the consistency of intertrochanteric fracture union. Results：the consistency of overall fracture healing impression was moderate（ICC=0.487）, RUSH and modified RUSH improved the consistency to substantial（ICC=0.80）and basically perfect（ICC=0.81）, respectively. In addition, for the evaluation of union of all intertrochanteric fractures, the overall score of plate was always higher than that of intramedullary nail. When the lateral plate and intramedullary nail were separately scored, the RUSH score of plate was basically the same as modified RUSH, while the modified RUSH of intramedullary nail was higher than modified RUSH. Ultimately,the medial (r=0.54 and R =0.53) and anterior (r=0.55 and R =0.54) and the global score (R =0.68 and R =0.68) in the single cortex showed a high correlation with the overall fracture healing impression in both RUSH and modified RUSH scores. Ultimately,medial (r=0.54 and r =0.53) and anterior (r=0.55 and r=0.54) in individual cortices and overall scores (r=0.68 and r =0.68) showed a high correlation with overall fracture healing impressions in both RUSH and modified RUSH scores. Conclusions：we developed a new hip fracture score comparable to the RUSH score that significantly improves the consistency of radiographic assessment of intertrochanteric fracture union. Most importantly, modified RUSH filled the callus formation gap in RUSH scores between cortical bridging and no cortical bridging. Therefore, we recommend the use of RUSH or a modified RUSH score to improve orthopedic surgeons' assessment of intertrochanteric fracture union.

Residency Training and Hand Surgery Practice Patterns: A National Surgical Quality Improvement Program Database Analysis

2020 ◽  
Author(s):  
James J. Drinane ◽  
Brian Drolet ◽  
Ashit Patel ◽  
Joseph A. Ricci
Keyword(s):  
Quality Improvement ◽  
Residency Training ◽  
Practice Patterns ◽  
Hand Surgery ◽  
Soft Tissue Coverage ◽  
Improvement Program ◽  
Surgical Quality ◽  
Orthopedic Surgeons ◽  
Procedural Volume ◽  
General Surgeons

Abstract Introduction Fellowship-trained hand surgeons may have residency training in either orthopedic, plastic, or general surgery, generating significant variability in education background. To study the effect of different training backgrounds on practice pattern variations, we utilized the NSQIP (National Surgical Quality Improvement Database) database to assess hand surgery volumes and case variety by specialty. Materials and Methods NSQIP years 2008 to 2017 was queried with hand surgery current procedural terminology codes defined by the American Board of Orthopedic Surgery. Procedures were grouped according to type and specialty, and relative rates calculated. Hand society membership data were used to determine if procedural volume for each specialty in each category and overall contribution to the volume of hand surgery performed nationally was distributed in accordance with membership data. Results A total of 145,015 hand surgeries were performed; 13,267 (9.1%) by general surgeons, 28,402 (19.6%) by plastic surgeons, and 103,346 (71.3%) by orthopedic surgeons. Orthopedic surgeons performed significantly more bone, fracture, joint, and tendon cases. General surgeons and plastic surgeons performed higher than expected numbers of soft tissue coverage and cases overall with respective excesses of 183 and 22%. Conclusion Hand surgery is an available fellowship pathway from multiple residencies. Fellowship training does not level the field of real-world practice patterns. Residency training experiences significantly impact practice.

Possibility of simultaneous transposition of segments of the pectoralis major muscle to restore flexion in the shoulder and elbow joints (clinical observation)

MedAlliance ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 61-68
Keyword(s):  
Anterior Part ◽  
Pectoralis Major Muscle ◽  
Elbow Flexion ◽  
Functional Results ◽  
Proximal Part ◽  
Deltoid Muscle ◽  
Pectoralis Major ◽  
Orthopedic Surgeons ◽  
Active Function ◽  
Head Neck

The pectoralis major is a widely used muscle in reconstruction surgery for replacement soft tissue defects of a head, neck, thorax, upper limbs and restoration of muscle active function. The peculiarities of anatomy of the pectoralis major makes it possible to divide the muscle into several segments with their own innervations and supply and use them independently from each other. This article describes the anatomy of the pectoralis major and the opportunity for clinical applications of different segments of this muscle. The authors demonstrate the result of the restoration of shoulder and elbow flexion in a patient with arthrogryposis due to simultaneous transfer of the proximal part of pectoralis major to the anterior part of the deltoid muscle and the distal part of pectoralis major to the biceps with good functional results. The article will be useful for plastic surgeons, orthopedic surgeons and physiotherapists.

scholarly journals A Pharmacological Analysis of the Activity and Failure of the Medical Treatment of High-Grade Osteosarcoma

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 141
Author(s):  
Alessandro Comandone ◽  
Antonella Boglione ◽  
Tiziana Comandone ◽  
Fausto Petrelli
Keyword(s):  
Bone Cells ◽  
Age Groups ◽  
The Elderly ◽  
New Drugs ◽  
High Grade ◽  
Secondary Resistance ◽  
Orthopedic Surgeons ◽  
Close Cooperation ◽  
High Grade Osteosarcoma ◽  
Effective Drugs

Osteosarcomas (OSs) are a group of neoplasms originating from bone cells, usually presenting in three specific age groups: children, young adults, and the elderly. High-grade OS is an extremely malignant tumor mainly due to evolution into metastatic disease, usually in the lungs. Survival of these patients has improved since the 1980s thanks to close cooperation between oncologists, oncological surgeons and orthopedic surgeons. Unfortunately, no progress has been made in the last 30 years and new, more effective drugs are needed. This article reviews the biological and pharmacological basis of the treatment of OS. Models of clinical pharmacology of the active drugs, toxic effects and reasons for primary and secondary resistance to old and new drugs are discussed.

scholarly journals Social Media Use Among Foot and Ankle Orthopedic Surgeons

2021 ◽  
Vol 6 (1) ◽  
pp. 247301142098192
Author(s):  
Garret Garofolo-Gonzalez ◽  
Cesar R. Iturriaga ◽  
Jordan B. Pasternack ◽  
Adam Bitterman ◽  
Gregory P. Guyton
Keyword(s):  
Social Media ◽  
Clinical Practice ◽  
Media Use ◽  
The United States ◽  
Foot And Ankle ◽  
Social Media Use ◽  
Social Media Platform ◽  
Orthopedic Surgeons ◽  
Media Platform ◽  
Social Media Presence

Background: Digital media is an effective tool to enhance brand recognition and is currently referenced by more than 40% of orthopedic patients when selecting a physician. The purpose of this study was to evaluate the use of social media among foot and ankle (F&A) orthopedic surgeons, and the impact of that social media presence on scores of a physician-rated website (PRW). Methods: Randomly selected F&A orthopedic surgeons from all major geographical locations across the United States were identified using the AAOS.org website. Internet searches were then performed using the physician’s name and the respective social media platform. A comprehensive social media use index (SMI) was created for each surgeon using a scoring system based on social media platform use. The use of individual platforms and SMI was compared to the F&A surgeon’s Healthgrades scores. Descriptive statistics, unpaired Student t tests, and linear regression were used to assess the effect of social media on the PRW scores. Results: A total of 123 board-certified F&A orthopedic surgeons were included in our study demonstrating varying social media use: Facebook (48.8%), Twitter (15.4%), YouTube (23.6%), LinkedIn (47.9%), personal website (24.4%), group website (52.9%), and Instagram (0%). The mean SMI was 2.4 ± 1.6 (range 0-7). Surgeons who used a Facebook page were older, whereas those using a group website were younger ( P < .05). F&A orthopedic surgeons with a YouTube page had statistically higher Healthgrades scores compared to those without ( P < .05). Conclusion: F&A orthopedic surgeons underused social media platforms in their clinical practice. Among all the platforms studied, a YouTube page was the most impactful social media platform on Healthgrades scores for F&A orthopedic surgeons. Given these findings, we recommend that physicians closely monitor their digital identity and maintain a diverse social media presence including a YouTube page to promote their clinical practice. Level of Evidence: Level IV.

scholarly journals Do Orthopedic Surgeons or Neurosurgeons Detect More Hip Disorders in Patients with Hip-Spine Syndrome? A Nationwide Database Study

2021 ◽  
Vol 11 (4) ◽  
pp. 485
Author(s):  
Tsung-Cheng Yin ◽  
Adam M. Wegner ◽  
Meng-Ling Lu ◽  
Yao-Hsu Yang ◽  
Yao-Chin Wang ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spine Surgery ◽  
Hip Surgery ◽  
Lumbar Spine Surgery ◽  
Research Database ◽  
X Rays ◽  
Replacement Surgery ◽  
Orthopedic Surgeons ◽  
Spine Pathology ◽  
Sh Group

Background: Disorders of the hip and lumbar spine can create similar patterns of pain and dysfunction. It is unknown whether all surgeons, regardless of orthopedic or neurosurgery training, investigate and diagnose concurrent hip and spine pathology at the same rate. Methods: Data were retrieved from Taiwan’s National Health Insurance Research Database (NHIRD). Enrolled patients were stratified into hip and spine surgery at the same admission (Both), hip surgery before spine surgery (HS), or spine surgery before hip surgery (SH). The SH group was further subdivided based on whether spine surgery was performed by an orthopedic surgeon (OS) or neurosurgeon (NS), and differences in preoperative radiographic examinations and diagnoses were collected and analyzed. Results: In total, 1824 patients received lumbar spine surgery within 1 year before or after hip replacement surgery. Of these, 103 patients had spine and hip surgery in the same admission (Both), 1290 patients had spine surgery before hip surgery (SH), and 431 patients had hip surgery before spine surgery (HS). In the SH group, patients were categorized into spine surgery by orthopedic surgeons (OS) (n = 679) or neurosurgeons (NS) (n = 522). In the SH group, orthopedic surgeons investigated hip pathology with X-rays more often (52.6% vs. 38.1%, p < 0.001) and diagnosed more cases of hip disease (43.6% vs. 28.9%, p < 0.001) than neurosurgeons. Conclusions: Of patients in Taiwan’s NHIRD who had concurrent surgical degenerative hip and lumbar spine disorders who had spine surgery before hip surgery, orthopedic surgeons obtained hip images and made hip-related diagnoses more frequently than did neurosurgeons.

scholarly journals The Correlation Between Timing of Surgery and the Need for RBC Transfusions in the Geriatric Intertrochanteric Fracture Population

2021 ◽  
Vol 12 ◽  
pp. 215145932199861
Author(s):  
Yun-fa Yang ◽  
Jian-wen Huang ◽  
Xiao-sheng Gao ◽  
Zai-li Liu ◽  
Jian-wei Wang ◽  
...  
Keyword(s):  
Intertrochanteric Fracture ◽  
The Elderly ◽  
Timing Of Surgery ◽  
Intertrochanteric Fractures ◽  
The Third ◽  
Transfusion Requirements ◽  
Surgical Fixation ◽  
Fracture Population ◽  
The Relationship ◽  
Rbc Transfusion

Objective: To identify whether the timing of surgery affects red blood cell (RBC) transfusion requirements in the elderly with intertrochanteric fractures. Methods: We retrospectively studied all patients undergoing surgical fixation of their intertrochanteric fractures in our hospital between January 2009 and December 2018 and analyzed the relationship between the timing of surgery and RBC transfusion. Results: A total of 679 patients were included in this study. The need for RBC transfusion was lower in the patients who underwent surgery within 12 h after admission (timing of surgery <12 h, <12 h group) than those who underwent surgery over 12 h after admission (timing of surgery >12 h, >12 h group) (P = 0.046); lower in the the patients who underwent surgery within 24 h after admission (timing of surgery <24 h, <24 h group) than in those who underwent surgery over 24 h after admission (timing of surgery >24 h, >24 h group) (P = 0.008), and lower in the <24 h group compared to the patients who underwent surgery within 48 h after admission (timing of surgery <48 h, <48 h group) (P = 0.035). Moreover, the need for RBC transfusion was lower in the <24 h group (in the first 24 h from admission to surgery) than in the 24-48 h group (in the second 24 h from admission to surgery) (P = 0.016), and also lower in the <24 h group compared to the 48-72 h group (in the third 24 h from admission to surgery) (P = 0.047). However, there were no differences between the <12 h group and 12-24 h group, between the <12 h group and <24 h group, and between the 12-24 h group and <24 h group, respectively. Conclusion: Timing of surgery within 24 h contributes to the reduction of RBC transfusion in the elderly with intertrochanteric fractures.

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