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Difficult Diaphyseal Femur Fractures: Pearls and Pitfalls. 疑难股骨骨干骨折:珍珠和陷阱。
Instructional course lectures Pub Date : 2023-01-01
Utku Kandemir, Abhinav Janghala
{"title":"Difficult Diaphyseal Femur Fractures: Pearls and Pitfalls.","authors":"Utku Kandemir,&nbsp;Abhinav Janghala","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diaphyseal femur fractures are common injuries globally and range in complexity. The most common mechanism worldwide is motor vehicle accidents. Initial evaluation should include Advanced Trauma Life Support protocol and evaluation of the soft tissues, neurovascular examination, and associated injuries. The gold standard for treatment is a closed functional reduction (restoration of length, alignment, and rotation) and fixation with a reamed, statically locked, intramedullary nail. Fracture pattern, associated injuries, and patient factors can increase the difficulty of treatment. Malrotation and limb length discrepancy are not uncommon. Awareness of the problem and knowledge of the how to obtain and verify adequate reduction is critical. Diagnosis of malrotation and/or limb length discrepancy should prompt a detailed discussion of the deformity and treatment options with the patient. Most patients recover remarkably well from diaphyseal femur fractures. They should be followed until union and return to prior functional level with a watchful eye placed on any warning signs of complications such as nonunion and infection.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"405-427"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767683","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
Fractures of the Talus and Pantalar Dislocations. 距骨和掌骨脱位骨折。
Instructional course lectures Pub Date : 2023-01-01
Erika Roddy, Erik Magnuson, Reza Firoozabadi, Utku Kandemir
{"title":"Fractures of the Talus and Pantalar Dislocations.","authors":"Erika Roddy,&nbsp;Erik Magnuson,&nbsp;Reza Firoozabadi,&nbsp;Utku Kandemir","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Talar fractures and pantalar dislocations are usually the results of high-energy trauma. Dislocations and open injuries are managed urgently. Temporary stabilization with splinting, Kirschner wires, or external fixation may be performed until the soft tissues are ready for definitive fixation. A CT scan is critical to identify all injuries and is helpful in planning treatment including reduction of dislocations and definitive fixation. Lateral and posterior process fractures are often missed initially and require a high index of suspicion.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"517-541"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767685","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
Soft-Tissue Masses: A Visual Guide to the Good, the Bad, and the Ugly. 软组织肿块:好的、坏的和丑陋的视觉指南。
Instructional course lectures Pub Date : 2023-01-01
Ginger E Holt, Robert J Wilson, Nathan W Mesko, Cara A Cipriano
{"title":"Soft-Tissue Masses: A Visual Guide to the Good, the Bad, and the Ugly.","authors":"Ginger E Holt,&nbsp;Robert J Wilson,&nbsp;Nathan W Mesko,&nbsp;Cara A Cipriano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Benign soft-tissue masses drastically outnumber malignant tumors. Both benign and malignant soft-tissue masses can present in the same manner, as a painless growing soft-tissue lump or bump. The implications of misdiagnosing a soft-tissue sarcoma can be devastating. The most common mistake occurs when all masses are assumed to be lipomas. A careful history, physical examination, and appropriate imaging can determine the benign or malignant nature of a tumor. A mass that is large (>5 cm), deep (in relation to investing fascia), and firmer than the surrounding muscle should raise suspicion for a malignancy. Small, superficial masses are more likely to be benign, but up to 32% of soft-tissue sarcomas can present in this manner. The orthopaedic surgeon should be able to recognize common imaging findings for benign and malignant entities.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"125-138"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10400555","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
Rotational Instability and Complications Following Extracapsular Hip Fracture Fixation. 髋部骨折囊外固定后的旋转不稳定和并发症。
Instructional course lectures Pub Date : 2023-01-01
Matthew L Klima
{"title":"Rotational Instability and Complications Following Extracapsular Hip Fracture Fixation.","authors":"Matthew L Klima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Successful management of extracapsular hip fractures requires a comprehensive understanding of fracture stability to optimize outcomes and help prevent mechanical failures. Currently, the definition of stability is imperfect, as demonstrated by continued failure and moderate-to-severe collapse observed in stable fractures. Adopting a more three-dimensional approach has led to a greater understanding of the role of rotational instability in mechanical failures, and torsion control devices are now becoming more readily available as part of the most recent generation of cephalomedullary nails. Although new technology can be useful when used appropriately, new products alone are neither able to completely eliminate failures nor do they obviate the need for a good reduction or good surgical technique. The management of complications following extracapsular hip fracture fixation now involves a more inclusive definition of failure to address the loss of independence reflected in the functional outcomes associated with these injuries. In the presence of combined radiographic and clinical failure, early revision surgery can immediately improve mobility and outcome.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"319-339"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402023","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
When the Physician Becomes the Patient: Considerations for Work, Life, and Leadership. 当医生变成病人:对工作、生活和领导的思考。
Instructional course lectures Pub Date : 2023-01-01
Miho J Tanaka, Milton L Routt, Mary Lloyd Ireland, Christopher M Bono
{"title":"When the Physician Becomes the Patient: Considerations for Work, Life, and Leadership.","authors":"Miho J Tanaka,&nbsp;Milton L Routt,&nbsp;Mary Lloyd Ireland,&nbsp;Christopher M Bono","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Most orthopaedic surgeons are unprepared for serious medical illnesses. In such cases, the unique work-related and personal considerations for orthopaedic surgeons affect their career, their practice partners, and their patients. Planning together as an orthopaedic business organization for such issues can provide a framework to better navigate these difficult situations. Understanding the considerations and stressors from the individual's perspective can help provide the appropriate level of support while maintaining privacy. Throughout these considerations, open communication regarding expectations and concerns and expressions of empathy are the cornerstones of dealing with physician illness. Being a physician-patient adds complexity to an already difficult and stressful profession. Further dialogue regarding the physician-patient experience can help increase awareness of this issue and allow organizations to create a structure to best manage this almost inevitable occurrence.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"11-15"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10406516","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
What to Do When It Is Anterior Cruciate Ligament Reconstruction Number Two. 当它是前交叉韧带重建2号时该怎么办。
Instructional course lectures Pub Date : 2023-01-01
Ian D Engler, Emre Anıl Özbek, Mikalyn T DeFoor, Andrew J Sheean, Asheesh Bedi, Volker Musahl, Bryson P Lesniak
{"title":"What to Do When It Is Anterior Cruciate Ligament Reconstruction Number Two.","authors":"Ian D Engler,&nbsp;Emre Anıl Özbek,&nbsp;Mikalyn T DeFoor,&nbsp;Andrew J Sheean,&nbsp;Asheesh Bedi,&nbsp;Volker Musahl,&nbsp;Bryson P Lesniak","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Several factors contribute to the greater complexity of revision anterior cruciate ligament reconstruction compared with primary anterior cruciate ligament reconstructive surgery. Prior tunnels and hardware may compromise revision tunnel placement and secure fixation. This may necessitate two-stage revision or specific techniques to achieve anatomic revision tunnels. Prior autograft use may limit graft options. Individuals with a failed anterior cruciate ligament reconstruction are more likely to have risk factors for further failure. These may include malalignment, occult instability, knee hyperextension, or increased tibial slope. There are also higher rates of meniscus and cartilage injuries in revision anterior cruciate ligament reconstruction that may require intervention. Successful revision anterior cruciate ligament reconstruction requires thoughtful preoperative planning along with multiple potential intraoperative plans depending on the pathology encountered. It is important to provide the orthopaedic surgeon with an up-to-date, evidence-based overview of how to approach and execute a successful revision anterior cruciate ligament reconstruction.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"461-476"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767682","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
Ultrasonography for the Busy Orthopaedic Surgeon: The Upper Extremity. 忙碌的骨科医生的超声检查:上肢。
Instructional course lectures Pub Date : 2023-01-01
Abdul Kareem Zalikha, Mouhanad M El-Othmani, Zachary Crespi, Kassem-Ali J Abbas, Georges Haidamous, Zaid Altawil, J Antonio Bouffard, Henry T Goitz
{"title":"Ultrasonography for the Busy Orthopaedic Surgeon: The Upper Extremity.","authors":"Abdul Kareem Zalikha,&nbsp;Mouhanad M El-Othmani,&nbsp;Zachary Crespi,&nbsp;Kassem-Ali J Abbas,&nbsp;Georges Haidamous,&nbsp;Zaid Altawil,&nbsp;J Antonio Bouffard,&nbsp;Henry T Goitz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ultrasonography is increasingly used in the diagnosis and treatment of musculoskeletal conditions and injuries. Ultrasonography possesses multiple advantages compared with other methods of imaging, including low cost, lack of radiation exposure, speed, and means for dynamic examination. Because of these advantages, many orthopaedic surgeons are routinely using ultrasonography to diagnose musculoskeletal conditions of the upper extremity. Musculoskeletal ultrasonography is technically challenging, but with proper guidance and practice, every orthopaedic surgeon can confidently integrate ultrasonography into their clinical practice.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"139-148"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10400105","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
Developmental Dysplasia of the Hip From Birth to Adolescence: Clear Indications and New Controversies. 从出生到青春期的髋关节发育不良:明确的适应症和新的争议。
Instructional course lectures Pub Date : 2023-01-01
Stuart L Weinstein, Pablo G Casteñada, Wudbhav N Sankar, Hilary T Campbell, Raghav Badrinath
{"title":"Developmental Dysplasia of the Hip From Birth to Adolescence: Clear Indications and New Controversies.","authors":"Stuart L Weinstein,&nbsp;Pablo G Casteñada,&nbsp;Wudbhav N Sankar,&nbsp;Hilary T Campbell,&nbsp;Raghav Badrinath","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It is important to be knowledgeable about the latest information on the diagnosis and the evidence-based management of developmental hip dysplasia and dislocation from birth through adolescence. The focus should be on the effect of the problem; normal growth and development of the hip joint; and the pathoanatomy, natural history, and long-term outcomes of developmental dysplasia of the hip, hip subluxation, and dysplasia. Many controversies exist in the management of this complex spectrum of disorders.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"659-672"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767688","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
Do You Really Need a Hand Surgeon? Distal Radius Fractures. 你真的需要手外科医生吗?桡骨远端骨折。
Instructional course lectures Pub Date : 2023-01-01
Bhavik H Patel, Dmitriy Peresada, Alfonso Mejia
{"title":"Do You Really Need a Hand Surgeon? Distal Radius Fractures.","authors":"Bhavik H Patel,&nbsp;Dmitriy Peresada,&nbsp;Alfonso Mejia","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Distal radius fractures are one of the most common injuries treated by orthopaedic surgeons. As the number of distal radius fractures grows and practice patterns demonstrate more of these fractures are treated surgically, it is incumbent for orthopaedic surgeons to understand the fundamentals of evaluation, treatment, and rehabilitation.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"577-594"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10767690","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
Caliper-Verified Kinematically Aligned Total Knee Arthroplasty: Rationale, Targets, Accuracy, Balancing, Implant Survival, and Outcomes. 卡钳验证的运动学对齐全膝关节置换术:基本原理，目标，准确性，平衡，植入物存活和结果。
Instructional course lectures Pub Date : 2023-01-01
Stephen M Howell, Maury L Hull, Alexander J Nedopil, Charles Rivière
{"title":"Caliper-Verified Kinematically Aligned Total Knee Arthroplasty: Rationale, Targets, Accuracy, Balancing, Implant Survival, and Outcomes.","authors":"Stephen M Howell,&nbsp;Maury L Hull,&nbsp;Alexander J Nedopil,&nbsp;Charles Rivière","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Peer-reviewed studies published up to May 2022 are used to provide a comprehensive understanding of unrestricted kinematically aligned total knee arthroplasty. The intent is to cultivate the curiosity of those interested in this method of personalized alignment. The rationale of unrestricted kinematic alignment is to set the femoral and tibial components coincident with the patient's prearthritic joint lines, restore the femoral and tibial phenotypes, and coalign the three kinematic axes of the components with those of the knee. The surgical technique, learning curve, and accuracy of performing kinematically aligned total knee arthroplasty with a caliper and company manufactured manual instrumentation should be explored and compared with robotic instrumentation. Kinematic alignment restores the native knee's medial and lateral tibial compartment forces, which mechanically aligned total knee arthroplasty cannot do even after ligament release. In addition, insert conformity plays a role in restoring native tibiofemoral kinematics. A literature review of clinical outcomes, long-term durability, and the risk of varus tibial component failure and patellofemoral instability shows unrestricted kinematic alignment has comparable if not superior results when compared with mechanical alignment.</p>","PeriodicalId":73392,"journal":{"name":"Instructional course lectures","volume":"72 ","pages":"241-259"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10393605","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
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