Orthopaedics and Trauma最新文献_第6页

Acute Achilles tendon rupture: modern management 急性跟腱断裂：现代治疗方法

Orthopaedics and Trauma Pub Date : 2024-02-01 DOI: 10.1016/j.mporth.2023.11.002

Mona Theodoraki, Victoria Sinclair

{"title":"Acute Achilles tendon rupture: modern management","authors":"Mona Theodoraki, Victoria Sinclair","doi":"10.1016/j.mporth.2023.11.002","DOIUrl":"10.1016/j.mporth.2023.11.002","url":null,"abstract":"<div><p>Achilles tendon rupture is a common injury and its incidence is increasing. There is a large body of literature on the subject and much of it debates the influence of management on re-rupture rates. Operative treatment was thought to be superior in reducing the risk of re-rupture. However, it must be balanced against the risks, in particularly wound infection and breakdown, and sural nerve injury. Minimally invasive surgery aimed to reduce wound complications but has frequently been associated with a higher risk of sural nerve damage and irritation. The introduction of functional rehabilitation, which includes early weight bearing and range of motion within an orthosis, has been pivotal in improving outcomes particularly in non-operatively managed patients. More recent evidence suggests that re-rupture rates are now similar between operatively and non-operatively managed patients when incorporating a functional rehabilitation protocol. The publication of the Achilles Tendon Rupture Score, which has been validated specifically for this injury, has been helpful in providing a more detailed picture of post-injury symptoms and function. The studies which have included this as an outcome measure have also shown comparable results between operatively and non-operatively treated patients.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 1","pages":"Pages 7-10"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877132723001215/pdfft?md5=99f6b8a6507a5a2ffc8d6b287cab8b30&pid=1-s2.0-S1877132723001215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138993283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Turf toe: a review of mechanism, pathoanatomy and management 草坪趾：机制、病理解剖和管理综述

Orthopaedics and Trauma Pub Date : 2024-02-01 DOI: 10.1016/j.mporth.2023.11.006

Juliet M. Clutton, Daniel MG. Winson, Aureola Tong

引用次数: 0

Acute and stress fractures of the metatarsals in athletes 运动员跖骨的急性骨折和应力性骨折

Orthopaedics and Trauma Pub Date : 2024-02-01 DOI: 10.1016/j.mporth.2023.11.008

Laura Beddard, Charline Roslee, Nikki Kelsall

{"title":"Acute and stress fractures of the metatarsals in athletes","authors":"Laura Beddard, Charline Roslee, Nikki Kelsall","doi":"10.1016/j.mporth.2023.11.008","DOIUrl":"10.1016/j.mporth.2023.11.008","url":null,"abstract":"<div><p>Metatarsal fractures sustained in sport can either be acute, or stress fractures. The aim of treatment of any fracture of the metatarsals in an athlete should be to achieve bony union, allow return to play quickly and at the same level as prior to the injury with few complications. In addition, further injuries should be prevented. Up to 9% of metatarsal fractures occur in sport. The majority of these involve the fifth metatarsal, particularly the proximal aspect of it. This location has a problematic blood supply and has a high rate of non-union. There is a wealth of information published about proximal fifth metatarsal fractures in the sporting population, with a consensus that surgical management provides the best outcomes. The second to fourth metatarsals are most likely to sustain stress fractures. These are likely to heal with non-operative treatment with good outcomes. Stress fractures of the fifth metatarsal are at high risk for fracture propagation, displacement and non-union so are best managed surgically. These injuries can be effectively prevented by improving bone health and biomechanics.</p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"38 1","pages":"Pages 46-50"},"PeriodicalIF":0.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877132723001276/pdfft?md5=43481f656ddd9aa5fcb49f997b77652e&pid=1-s2.0-S1877132723001276-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139014095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An overview of exertional leg pain in the athlete 运动员劳累性腿部疼痛概述

Orthopaedics and Trauma Pub Date : 2024-02-01 DOI: 10.1016/j.mporth.2023.11.010

Sophie A. Crooks, Thumri Paavana, Catriona Heaver

引用次数: 0

Editorial: best practice in bone and joint infection 社论:骨和关节感染的最佳实践

Orthopaedics and Trauma Pub Date : 2023-11-23 DOI: 10.1016/j.mporth.2023.09.011

Martin McNally

引用次数: 0

Paediatric bone and joint infections: a guide from diagnosis to management 儿童骨关节感染:从诊断到治疗指南

Orthopaedics and Trauma Pub Date : 2023-10-19 DOI: 10.1016/j.mporth.2023.09.004

Maximillian Mifsud, Martin.A. McNally

{"title":"Paediatric bone and joint infections: a guide from diagnosis to management","authors":"Maximillian Mifsud, Martin.A. McNally","doi":"10.1016/j.mporth.2023.09.004","DOIUrl":"10.1016/j.mporth.2023.09.004","url":null,"abstract":"<div><p><span><span>Paediatric </span>bone and joint infections (PBJI) can be challenging to diagnose due to their non-specific symptoms including fever, pain, swelling, and limited range of motion of the limb. The diagnosis involves a combination of </span>clinical evaluation<span>, laboratory tests, and imaging studies. Plain radiographs, ultrasound, and MRI can aid in the diagnosis of these infections. The approach to treating PBJI is multidisciplinary, involving paediatricians, infectious disease specialists, orthopaedic surgeons, and radiologists. Family-centred care and close follow-up are crucial to ensure optimal outcomes for children with bone infections. Management involves a combination of medical treatment<span><span> with intravenous and oral antibiotics, and, if required, surgical interventions centred around debriding all dead bone and soft tissue, draining intra- or extra-osseus abscesses, stabilizing pathological fractures and delivering high doses of local antibiotics. Early diagnosis and prompt initiation of appropriate treatment are crucial to prevent long-term complications such as </span>chronic osteomyelitis<span>, septic arthritis, growth disturbances and limb length discrepancies.</span></span></span></p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"37 6","pages":"Pages 344-352"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135851784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Definition of periprosthetic joint infection and fracture-related infection 假体周围关节感染和骨折相关感染的定义

Orthopaedics and Trauma Pub Date : 2023-10-19 DOI: 10.1016/j.mporth.2023.09.001

Irene K Sigmund, Martin A McNally

引用次数: 1

Prosthetic joint infection in the hip and knee 髋关节和膝关节假体关节感染

Orthopaedics and Trauma Pub Date : 2023-10-19 DOI: 10.1016/j.mporth.2023.09.005

Thomas Hamilton, Antony Palmer, Ben Kendrick, Abtin Alvand

{"title":"Prosthetic joint infection in the hip and knee","authors":"Thomas Hamilton, Antony Palmer, Ben Kendrick, Abtin Alvand","doi":"10.1016/j.mporth.2023.09.005","DOIUrl":"10.1016/j.mporth.2023.09.005","url":null,"abstract":"<div><p>Prosthetic joint infection (PJI) is one of the worst complications of joint arthroplasty<span><span><span> with an incidence of around 1% following primary arthroplasty, 3% following aseptic revision, and 20% following septic revision. It can occur following direct inoculation, haematogenous or contiguous spread. The majority of PJIs are secondary to bacterial infection although fungal PJI may be seen in multiply operated or immune compromised patients<span>. Risk factors for PJI include patient, pathology and procedure-related factors which, where possible, should be optimized prior to surgery. The diagnosis of PJI remains a challenge and is based on patient history, clinical examination, laboratory tests, and imaging studies. No diagnostic assessment is 100% accurate with various diagnostic criteria used clinically. Investigation and treatment of PJI should be guided by a multi-disciplinary team. Surgical treatment remains the gold standard with the aim of eradicating infection. During surgery the causative organism is sought through a rigorous standardized tissue sampling technique. Surgical approaches including </span></span>debridement<span>, antibiotics and implant retention (DAIR), single-stage revision, two-stage revision, excision arthroplasty, </span></span>arthrodesis and amputation. The approach used is tailored to the individual patient with the optimum surgical strategy being one that successfully eradicates the infection, but at the same time minimizes morbidity to the patient.</span></p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"37 6","pages":"Pages 353-358"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135848985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Controversies in the microbiological diagnosis and treatment of bone and joint infections 骨关节感染微生物诊断与治疗的争议

Orthopaedics and Trauma Pub Date : 2023-10-13 DOI: 10.1016/j.mporth.2023.09.003

Ruth Alexandra Corrigan, Bridget L Atkins

{"title":"Controversies in the microbiological diagnosis and treatment of bone and joint infections","authors":"Ruth Alexandra Corrigan, Bridget L Atkins","doi":"10.1016/j.mporth.2023.09.003","DOIUrl":"10.1016/j.mporth.2023.09.003","url":null,"abstract":"<div><p><span><span>Recently, bone and joint infections such as fracture-related infection (FRI) and prosthetic joint infections (PJI) have been defined for clinical and research purposes. National and international guidelines are being produced to guide clinicians towards what is considered best practice. However, much of what we do regarding the microbiological diagnosis and management of </span>orthopaedic infection is based on expert opinion, rather than evidence-based medicine. This is largely because, prior to the publication of the clinical definitions of orthopaedic infection, studies included a heterogeneous population making comparisons between them difficult. More recently the publication of large </span>clinical trials<span> in the antimicrobial management of orthopaedic infection has demonstrated that such clinical research is possible, and can both challenge the existing dogma in this field and lead to universal changes in clinical practice. There is robust evidence for microbiological sampling techniques and their interpretation in diagnosis of orthopaedic infection, as well as the choice of empiric broad-spectrum antibiotics and the non-inferiority of oral versus intravenous systemic antibiotics. For other elements of the diagnosis and management of orthopaedic infection this is not the case. For example, there are limited or no data to support recommendations regarding time off antibiotics prior to microbiological sampling, systemic antibiotic duration, when to do a joint aspirate in PJI revisions or the timing of definitive joint implantation in the two-stage management of PJI. In summary, this review highlights what is currently considered best practice within the field of orthopaedic infection and discusses both the evidence behind it and where there is controversy or where further research is warranted.</span></p></div>","PeriodicalId":39547,"journal":{"name":"Orthopaedics and Trauma","volume":"37 6","pages":"Pages 336-343"},"PeriodicalIF":0.0,"publicationDate":"2023-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135761241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Classification of prosthetic joint infection and fracture-related infection 假体关节感染与骨折相关感染的分类

Orthopaedics and Trauma Pub Date : 2023-10-12 DOI: 10.1016/j.mporth.2023.09.002

Andrew J. Hotchen, Martin A McNally

引用次数: 1