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1.
Maninder Kaur Bedi Sujata Sarabahi Karoon Agrawal 《Burns : journal of the International Society for Burn Injuries》2019,45(2):335-340
Background
Ringer lactate is the main fluid for resuscitation of acute burns. However it is not a complete fluid alone, as it does not take care of sugar and electrolyte balance adequately. This study has been carried out to compare the use of Ringer lactate (RL) alone and combination of RL with Dextrose Normal Saline (DNS) as fluid replacement therapy in acute burn.Objective
To assess the biochemical parameters with the use of DNS as maintenance fluid in combination with Ringer lactate as resuscitation fluid in acute burns resuscitation.Method
A prospective randomized control study has been carried out by enrolling 200 patients into 2 groups, treated in ICU and resuscitated by using Modification of Brooke’s formula (2 mL/kg/% TBSA for resuscitation plus 2500 mL maintenance). Group A received RL for resuscitation and DNS as maintenance in 1st 72 h of burns. Group B received RL only for 1st 72 h. The effects of this on various blood parameters were studied.Results
Mean value of sodium at 24 h was 137.79 ± 3.89 in group A and was 133.2 ± 4.57 (p < .0001) in group B. The sodium levels remained in range of 137–138 (p < .0001) in group A with only 22% patients showing lower range of sodium levels, whereas, there was a falling trend (p < .0001) of sodium levels in group B on subsequent days with 54.00% (p < .0001) showing hyponatremia on 1st day which increased to 76% on 3rd day. Mean values of early morning random blood sugar (RBS) levels in group A remained between 165.5 ± 65.51 mg/dL–115.82 ± 32.52 mg/dL on all 3 days but in group B there was a falling trend from 127.49 ± 46.11 mg/dL to 102.84 ± 22.92 mg/dL by 3rd day. Thus, there was significant difference in levels of sodium and RBS in patients receiving DNS as maintenance fluid in addition to RL in acute phase.Conclusion
RL is not an ideal fluid for maintenance as it is low in sodium (130 mEq/L) as well as potassium (4 mEq/L) in view of daily electrolyte requirement. There is no glucose content in it to provide calories. Therefore, DNS should be added as daily maintenance fluid with RL as replacement for evaporative losses following burns. 相似文献2.
T. Carta J.P. Gawaziuk J. Diaz-Abele S. Liu M. Jeschke S. Logsetty 《Burns : journal of the International Society for Burn Injuries》2019,45(2):364-368
Objectives
The objective of this study is to identify what burn survivors and front-line staff indicate would improve satisfaction with burn dressings, and the ranking of importance of different burn dressing characteristics. These findings will guide the development of future dressings to meet these needs.Methods
Burn survivors (including the person injured and their family) and front-line burn healthcare providers completed a questionnaire on the importance given to different burn dressing characteristics (non-stick, absorbent, able to wear for a long time, flexible, easy to put on, easy to take off, antimicrobial, and non-bulky), and about the adequacy of pain management during dressing changes.Results
A total of 99 individuals filled out the questionnaire (31 caregivers/survivors and 68 front-line burn healthcare providers). The most important dressing characteristics by both groups were “non-stick” and “fights infection”. There was a significant difference between burn survivors and front-line burn healthcare providers pertaining to adequacy of pain management during dressing change. Adequate pain management was reported by 59% of burn survivors, which was significantly higher than that reported by the 25% front-line burn healthcare providers (p = 0.002).Conclusions
Our study suggests that burn survivors and front-line burn providers have similar views on what constitutes an ideal dressing. A significantly proportion of caregiver/survivors felt that pain associated with dressing changes is being adequately managed despite healthcare providers’ perception. 相似文献3.
R.Scott Eldredge Yan Zhai Amalia Cochran 《Burns : journal of the International Society for Burn Injuries》2019,45(2):317-321
Introduction
Acute respiratory distress syndrome (ARDS) is a complication that affects approximately 40% of burn patients and is associated with high mortality rates. Extracorporeal membrane oxygenation (ECMO) therapy is a management option for severe refractory hypoxemic respiratory failure; however, there is little literature reporting the effectiveness of this therapy in burns. Our study objective was to review patient outcomes in burns following severe ARDS treated with ECMO.Methods
We retrospectively reviewed all patients treated with ECMO for ARDS who received their burn care at a single regional burn center between 9/1/2006 and 8/31/2016. Primary patient outcome examined was discharge disposition.Results
We identified 8 patients who had ARDS secondary to burn who were placed onto ECMO during this 10-year period. The average APACHE score, SOFA score, and P/F ratio were 21 ± 3, 9 ± 2, and 59 ± 8, respectively, at the time of decision for ECMO. No ECMO-related complications were identified. Out of the 8 patients reviewed, 1 died, 4 were discharged to acute rehabilitation or a long-term acute care facility, and 3 were discharged to home.Conclusion
Mortality in burn patients with ARDS who are managed with ECMO is extremely low. Careful selection and timely intervention with ECMO contributed to good clinical outcomes. 相似文献4.
Colleen N. Bartley Kenisha Atwell Bruce Cairns Anthony Charles 《Burns : journal of the International Society for Burn Injuries》2019,45(2):322-327
Introduction
Discussions regarding withdrawal of life support after burn injury are challenging and complex. Often, providers may facilitate this discussion when the extent of injury makes survival highly unlikely or when the patient’s condition deteriorates during resuscitation. Few papers have evaluated withdrawal of life support in burn patients. We therefore sought to determine the predictor of withdrawal of life support (WLS) in a regional burn center.Methods
We conducted a retrospective analysis of all burn patients from 2002 to 2012. Patient characteristics included age, gender, burn mechanism, percentage total body surface area (%TBSA) burned, presence of inhalation injury, hospital length of stay, and pre-existing comorbidities. Patients <17 years of age and patients with unknown disposition were excluded. Patients were categorized into three cohorts: Alive till discharge (Alive), death by withdrawal of life support (WLS), or death despite ongoing life support (DLS). DLS patients were then excluded from the study population. Multivariate logistic regression was used to estimate predictors of WLS.Results
8,371 patients were included for analysis: 8134 Alive, 237 WLS. Females had an increased odd of WLS compared to males (OR 2.03, 95% CI 1.18–3.48; p = 0.010). Based on higher CCI, patients with pre-existing comorbidities had an increased odd of WLS (OR 1.28, 95% CI 1.08–1.52; p = 0.005). There was a significantly increased odds for WLS (OR 1.09, 95% CI 1.06–1.12; p < 0.001) with increasing age. Similarly, there was an increased odd for WLS (OR 1.08, 95% CI 1.07–1.51; p < 0.001) with increasing %TBSA. An increased odd of WLS (OR 2.47, 95% CI 1.05–5.78; p = 0.038) was also found in patients with inhalation injury.Conclusion
The decision to withdraw life support is a complex and difficult decision. Our current understanding of predictors of withdrawal of life support suggests that they mirror those factors which increase a patient’s risk of mortality. Further research is needed to fully explore end-of-life decision making in regards to burn patients. The role of patient’s sex, particularly women, in WLS decision making needs to be further explored. 相似文献5.
First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients
Varun Harish Neha Tiwari Oliver M. Fisher Zhe Li Peter K.M. Maitz 《Burns : journal of the International Society for Burn Injuries》2019,45(2):433-439
Background
Animal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes.Methods
Data was prospectively collected for patients with <10% total body surface area (TBSA) burns from 2007–2012. Multivariate regression analysis was used to determine the association of adequate first aid with four outcomes — wound depth, requirement for skin grafting, healing time (in non-grafted patients), and TBSA not grafted (in grafted patients). Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury.Findings
4918 patients were identified. Adequate first aid was received in 58.1% (2859) of patients. It was associated with a statistically significant reduction in burn wound depth (OR 1.39; 95% CI 1.24–1.55; P < 0.001) but was not associated with a reduction in TBSA (P = 0.86) or requirement for grafting (P = 0.47). In patients not requiring grafting, those who received adequate first aid were healed on average 10% (HR 1.10; 95% CI 1.03–1.18; P < 0.01) or 1.9 days faster (95% CI ?2.9 to ?0.9; P < 0.001). Adequate first aid in patients requiring grafting was associated with a 15% increase in TBSA that was not grafted (0.27%; 95% CI 0.01–0.52; P = 0.04).Interpretation
Adequate first aid with 20 min of running water is associated with improved outcomes. Benefits are seen in a reduction in wound depth, faster healing, and decreased grafting requirements. This has significant patient and health system benefits, and calls for promotion of 20 min of running water globally in burns care. 相似文献6.
Yaning Sun Huijuan Wang Yuchao Tang Haitao Zhao Shiji Qin Fengqi Zhang 《Foot and Ankle Surgery》2019,25(2):242-246
Background
This study aimed to report our institution’s experience in the treatment of chronic lateral ankle instability using the anterior half of the peroneus longus tendon (AHPLT) to reconstruct the lateral ligament.Methods
This retrospective study included 32 consecutive patients with chronic lateral ankle instability who underwent surgery from January 2013 to December 2014. All patients had failed to resolve with conservative treatment. A total of 32 ankles underwent AHPLT transfer. Patients returned for a clinical and radiologic follow-up evaluation at an average of 28 (range, 24–35) months postoperatively. Outcomes were assessed by comparison of pre- and postoperative American Orthopaedic Foot and Ankle Society (AOFAS) scores, visual analog scale pain scores, and Karlsson scores, and the radiographic assessment including talar tilt and anterior talar translation.Results
Thirty-two patients (32 ankles) (100%) returned for final evaluation. All patients had an excellent or good outcome on patient subjective self-assessment, pain scores, AOFAS scores, and Karlsson scores at final follow-up. Ankle range of motion was not affected by lateral ankle reconstruction. The talar tilt was significantly reduced from a preoperative mean of 14.1 ± 4.2° to 3.4 ± 1.3° postoperatively (P < .001), and the anterior drawer was significantly reduced from a preoperative mean of 13.8 ± 3.4 mm to 3.6 ± 1.5 mm after lateral ankle ligamentous reconstruction (P < .001).Conclusions
AHPLT transfer to reconstruct the lateral ligament resulted in a high percentage of successful results, with excellent ankle stability and not affected of ankle motion.Level of evidence
Level III-retrospective comparative study. 相似文献7.
Jacob A. Burns Adam B. Weiner William J. Catalona Eric V. Li Edward M. Schaeffer Stephen B. Hanauer Scott Strong James Burns Maha H.A. Hussain Shilajit D. Kundu 《European urology》2019,75(5):846-852
Background
There are limited data examining the risk of prostate cancer (PCa) in patients with inflammatory bowel disease (IBD).Objective
To compare the incidence of PCa between men with and those without IBD.Design, setting, and participants
This was a retrospective, matched-cohort study involving a single academic medical center and conducted from 1996 to 2017. Male patients with IBD (cases = 1033) were randomly matched 1:9 by age and race to men without IBD (controls = 9306). All patients had undergone at least one prostate-specific antigen (PSA) screening test.Outcome measurements and statistical analysis
Kaplan-Meier and multivariable Cox proportional hazard models, stratified by age and race, evaluated the relationship between IBD and the incidence of any PCa and clinically significant PCa (Gleason grade group ≥2). A mixed-effect regression model assessed the association of IBD with PSA level.Results and limitations
PCa incidence at 10 yr was 4.4% among men with IBD and 0.65% among controls (hazard ratio [HR] 4.84 [3.34–7.02] [3.19–6.69], p < 0.001). Clinically significant PCa incidence at 10 yr was 2.4% for men with IBD and 0.42% for controls (HR 4.04 [2.52–6.48], p < 0.001). After approximately age 60, PSA values were higher among patients with IBD (fixed-effect interaction of age and patient group: p = 0.004). Results are limited by the retrospective nature of the analysis and lack of external validity.Conclusions
Men with IBD had higher rates of clinically significant PCa when compared with age- and race-matched controls.Patient summary
This study of over 10 000 men treated at a large medical center suggests that men with inflammatory bowel disease may be at a higher risk of prostate cancer than the general population. 相似文献8.
Jesús Vilá-Rico Josep María Cabestany-Castellà Bernat Cabestany-Perich César Núñez-Samper Cristina Ojeda-Thies 《Foot and Ankle Surgery》2019,25(1):24-30
Background
Anatomic graft reconstruction of the anterior talo-fibular ligament is an alternative for patients who are bad candidates for standard procedures such as a Broström–Gould reconstruction (high-demand athletes, obesity, hyperlaxity or collagen disorders, capsular insufficiency or talar avulsions). The purpose of this study is to describe an all-inside arthroscopic technique for ATFL reconstruction, and the results in a series of patients with chronic ankle instability.Methods
We reviewed patients with chronic ATFL ruptures treated with an all-inside arthroscopic allograft reconstruction of the ATFL, with a minimum 2-year follow-up. Twenty-two patients with lateral ankle instability were included. Mean follow-up was 34 ± 2.5 months.Results
The mean AOFAS score improved from 62.3 ± 6.7 points preoperatively to 97.2 ± 3.2 points at final follow-up. Three patients suffered complications: one case each of ankle rigidity, superficial peroneal nerve injury and fibular fracture.Conclusions
Chronic ATFL injuries are amenable to all-inside arthroscopic allograft reconstruction fixed with tenodesis screws. This procedure simplifies other reported techniques in that it facilitates identification and bone tunnel placement of the talar ATFL insertion. 相似文献9.
Chloe Xiaoyun Chan Jonathan Zhi-Wei Gan Hwei Chi Chong Inderjeet Rikhraj Singh Sean Yung Chuan Ng Kevin Koo 《Foot and Ankle Surgery》2019,25(2):119-126
Background
We report our experience with the Minimally Invasive Chevron Akin (MICA) technique for correcting hallux valgus, and evaluate its effectiveness and associated complications.Methods
Case series of 13 feet with mild to moderate symptomatic hallux valgus treated surgically from July 2013 to December 2014, with at least 48-months follow-up. Patients were assessed pre-operatively and post-operatively with radiographical measurements (Hallux Valgus Angle (HVA) and Intermetatarsal Angle (IMA)) and clinical scores (American Orthopaedic Foot and Ankle Society (AOFAS), 36-Item Short Form Health Survery (SF-36), Visual Analog Scale (VAS)).Results
Mean HVA and IMA decreased from 30.4° and 13.9°–10.9° and 10.2° respectively (p < 0.05). The mean AOFAS score improved from an average of 59.0–93.7 (p < 0.05). All patients reported a VAS score of 0 post-operatively, and the 4 SF-36 domains improved significantly (p < 0.05).Conclusions
The MICA technique is a safe and effective method in the surgical correction of mild to moderate hallux valgus deformity, and continued use is justified. 相似文献10.
Rodrigo Díaz Fernández 《Foot and Ankle Surgery》2019,25(2):106-112
Background
With hundreds of operative methods described for correction of hallux valgus we can state that the ideal surgical treatment is still controversial. The Bösch technique has been used as a percutaneous way of correcting hallux valgus deformities with the use of a pin fixation. The aim of this study is to evaluate a new method of fixation by using a percutaneous locking plate.Methods
Between June 2013 and January 2015, 24 consecutive percutaneous subcapital osteotomies of the first metatarsal bone were performed for the treatment of painful hallux valgus deformities in 24 patients. Additional surgical procedures included DMMO’s (Distal Metatarsal Minimally-Invasive Osteotomies) in 12 of the operated feet (44.44%); minor digits were corrected in 7 cases (25.9%). An Akin procedure was performed in 81% of cases and all cases underwent an adductor hallucis tenotomy. All patients were clinically assessed using the AOFAS score. Radiographic measures included the preoperative and postoperative values of the Hallux Valgus Angle (HVA), Intermetatarsal Angle (IMA), and the Distal Metatarsal Articular Angle (DMAA).Results
The mean correction achieved improved for AHV from 36.57 ± 7.1 to 12.22 ± 8.69°, for IMA from 13.8 ± 1.59 to 7.08 ± 2.72 and for DMAA from 13.98 ± 7.38 to 6.07 ± 4.99. Clinically, scores on the AOFAS scale improved from a 45.8 ± 9.6 to 91.29 ± 9.8.Although healing of the osteotomies was observed radiographically within 6 to 12 weeks, two cases (8.3%) exhibited delayed healing. There were no cases of nonunion. There were no superficial or deep infections or wound healing problems. Plate had to be removed in 3 cases (12.5%).Conclusion
This technique modification is an acceptable procedure to correct hallux valgus in patients with a moderate level of deformity.Level of evidence
Level IV. Case series. 相似文献11.
Background
A recent case series suggested that surgery with wide-awake local anesthesia is tolerated well by most foot and ankle patients. However, patients were assessed retrospectively and there was no comparison group to show the relative efficacy of this approach. The present study was conducted to address these concerns.Methods
Perioperative pain and anxiety were assessed in 40 patients receiving forefoot surgery using either wide-awake local anesthesia or general anesthesia. Ratings were collected on the day of surgery using 11-point (0–10) numerical rating scales.Results
Patients in the two anesthesia groups reported no differences in preoperative pain (p = 0.500) or anxiety (p = 0.820). Patients who received wide-awake local anesthesia reported lower levels of postoperative pain (p < 0.001) and anxiety (p < 0.001) than patients who received general anesthesia. They also reported little pain (M = 0.17, SD = 0.32) or anxiety (M = 1.33, SD = 1.74) during the operation.Conclusions
Results indicate that surgery with wide-awake local anesthesia is tolerated well by most patients, and that it may have some benefit compared to surgery with general anesthesia. 相似文献12.
Ibukunoluwa B. Araoye Yvonne E. Chodaba Kenneth S. Smith Ryan W. Hadden Ashish B. Shah 《Foot and Ankle Surgery》2019,25(1):2-7
Background
Current literature on carbon fiber implant use in foot and ankle surgery is scant. The purpose of this paper is to report medium-term outcomes of hindfoot fusion using a carbon fiber intramedullary nail.Methods
We retrospectively reviewed 30 cases of hindfoot fusion using carbon fiber intramedullary nail fixation between 2014 and 2017. We excluded revisions and cases with bulk allograft or ankle infection prior to surgery. We reviewed charts for length of followup, radiographic union, and complications.Results
Eleven patients were included (6 females, 5 males; mean age = 52 ± 15 years; mean BMI = 29.0 ± 6.4 kg/m2). Mean followup was 20 (range, 1.5–107) months. Nine of eleven cases achieved radiographic union while one case developed a complication requiring surgery. The mean time to union was 3 (range, 1.5–6) months.Conclusions
Carbon fiber implants offer several theoretical advantages over traditional metallic implants. They can be used safely in foot and ankle surgery without concern for high failure or complication rate. Larger scale studies with longer followup are needed on this topic. 相似文献13.
Panagiotis Touzopoulos Athanasios Ververidis Giannis Giakas Georgios I. Drosos 《Foot and Ankle Surgery》2019,25(1):8-12
Background
The purpose of this study was the translation, cross-cultural adaptation and validation of the Achilles Tendon Total Rupture Score (ATRS) in Greek population.Methods
The translation and cross-cultural adaptation of the original version of ATRS in Greek language was performed according to the methodology described by Beaton et al. Validation and test–retest reliability were evaluated in forty-six patients, treated surgically for acute Achilles tendon rupture. Validity was evaluated by correlation of total and all subscale scores of Greek version of Manchester Foot Pain and Disability Index (MFPDI). Test–retest reliability evaluated with interclass correlation coefficient and Crombach’s α coefficient was used for internal consistency.Results
The internal consistency (α = 0.96) and test–retest reliability (ICC = 0.97) were excellent. There were no ceiling and floor effects during test–retest assessment. The Greek version of ATRS showed strong correlation with all subscales and overall score of MFPDI (pain subscale: R = ?0.954, p < 0.01, function subscale: R = ?0.811, p < 0.01, appearance subscale: R = ?0.763, p < 0.01, overall: R = ?0.914, p < 0.01).Conclusions
Greek version of ATRS was successfully adapted in Greek population and it appears to be a valid and reliable instrument to evaluate outcomes in Greek speaking patients after Achilles tendon rupture.Level of evidence
Level III. 相似文献14.
Don Koh Jeremy Lim Jerry Y. Chen Inderjeet R. Singh Kevin Koo 《Foot and Ankle Surgery》2019,25(2):221-225
Background
Repairs of chronic Achilles tendon ruptures are technically challenging due to large defects after scar excision. Multiple techniques for repair have been proposed but little consensus on best practice established. This study aims to compare flexor hallucis longus (FHL) transfers versus turndown flaps augmented by FHL transfers.Methods
Between 2005 and 2015, 49 unilateral repairs of chronic Achilles tendon ruptures were performed. We retrospectively compared the outcomes of 20 patients who underwent FHL transfer with 19 patients who underwent turndown flaps augmented with FHL transfer before surgery and at three time points after surgery (three, six and twelve months). Visual Analogue Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and the 36-Item Short Form Health Survey (SF-36) were used to evaluate outcome.Results
Both techniques demonstrated significant improvement in their outcome scores and were comparable to one another. At one year, the mean VAS score was 0 for both groups. The mean AOFAS Ankle-Hindfoot score was 90 ± 11 (FHL) and 95 ± 10 (FHL with turndown flaps); and SF-36 scores showed significant improvements in physical, role and social function scores. Turndown flaps augmented with FHL transfer however required significantly longer operative time (100 ± 21 min) compared to FHL transfer alone (73 ± 23 min).Conclusions
FHL transfer required significantly less operative time compared to turndown flaps augmented with FHL transfer, with comparable outcomes. FHL transfer is a reliable and effective technique in the repair of chronic Achilles tendon ruptures. 相似文献15.
Zhengxun Li Ning Zhang Yang Wang Songhua Cao Zheng Huang Yong Hu 《Foot and Ankle Surgery》2019,25(2):165-168
Background
Equinus of the ankle is a common deformity in spastic cerebral palsy. Achilles tendon lengthening is one of the effective options for the treatment of equinus deformity.Methods
In the study, a new stair-shaped Achilles tendon lengthening (ATL) procedure that preserves of the tendon continuity was performed in 28 tendons with equinus deformity (20 patients, mean age = 10.5 ± 2.6 years). The results were compared with a group of patients treated with the Z-lengthening procedure. During the latest follow-up visit, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scale score was much higher in the stair-shaped ATL group than in the Z-lengthening group (p < 0.05).Results
The two groups showed similar surgical correction angle after ATL(37.2 ± 3.5° for stair-shaped ATL and 36.1 ± 4.5° for Z-lengthening). During the latest follow-up visit, the correction angle in the Z-lengthening group decreased to 21.6 ± 4.3°, which was lower than in the stair-shaped ATL group (29.0 ± 3.1°; p < 0.05). In addition, the data regarding the time required by each patient before being able to start rehabilitation and walking as well as gaining better stability for running indicated that the stair-shaped ATL group recovered significantly quicker than the Z-lengthening group.Conclusions
The stair-shaped ATL procedure resulted in a successful correction of the equinus deformity in spastic cerebral palsy, with the advantage of preserving a degree of continuity without a complete section of the tendon. This confers greater antigravity stability and quicker recovery in patients. 相似文献16.
Fabrício Tavares Mendonça Marcelo Cabral de Lucena Raul Silva Quirino Catia Sousa Govêia Gabriel Magalhaes Nunes Guimarães 《Brazilian Journal of Anesthesiology》2019,69(2):122-130
Background
Hypothermia occurs in up to 20% of perioperative patients. Systematic postoperative temperature monitoring is not a standard of care in Brazil and there are few publications about temperature recovery in the postoperative care unit.Design and setting
Multicenter, observational, cross‐sectional study, at Hospital de Base do Distrito Federal and Hospital Materno Infantil de Brasília.Methods
At admission and discharge from postoperative care unit, patients undergoing elective or urgent surgical procedures were evaluated according to tympanic temperature, vital signs, perioperative adverse events, and length of stay in postoperative care unit and length of hospital stay.Results
78 patients, from 18 to 85 years old, were assessed. The incidence of temperatures <36 °C at postoperative care unit admission was 69.2%. Spinal anesthesia (p < 0.0001), cesarean section (p = 0.03), and patients who received morphine (p = 0.005) and sufentanil (p = 0.003) had significantly lower temperatures through time. During postoperative care unit stay, the elderly presented a greater tendency to hypothermia and lower recovery ability from this condition when compared to young patients (p < 0.001). Combined anesthesia was also associated to higher rates of hypothermia, followed by regional and general anesthesia alone (p < 0.001).Conclusion
In conclusion, this pilot study showed that perioperative hypothermia is still a prevalent problem in our anesthetic practice. More than half of the analyzed patients presented hypothermia through postoperative care unit admission. We have demonstrated the feasibility of a large, multicenter, cross‐sectional study of postoperative hypothermia in the post‐anesthetic care unit. 相似文献17.
Andrzej Boszczyk Sławomir Kwapisz Martin Krümmel Rene Grass Stefan Rammelt 《Foot and Ankle Surgery》2019,25(1):51-58
Background
The study aims at comparing the bony anatomy of the syndesmosis in patients who sustained a high fibular fracture with syndesmosis disruption and that of the non-injured population. We hypothesised that there are certain anatomical features making the syndesmosis susceptible to injury.Methods
The CT examinations of 75 patients who sustained a high fibular fracture with syndesmosis disruption and control group of 75 patients with unrelated foot problems were compared. The depth, fibular engagement and rotational orientation of the tibial incisura were analyzed.Results
With the median values of the control group as cutoff there were 71% shallow, 71% disengaged and 77% retroverted syndesmoses in the injury group. The differences between the groups were statistically significant for every measure (P < .002 to P > .0001).Conclusions
Patients with a shallow, disengaged and retroverted bony configuration of the syndesmosis are overrepresented among patients with syndesmosis disruption. 相似文献18.
Joana Arcângelo Francisco Guerra-Pinto André Pinto André Grenho Alfons Navarro Xavier Martin Oliva 《Foot and Ankle Surgery》2019,25(2):96-105
Background
Periprosthetic cystic osteolysis is a well-known complication of total ankle replacement. Several theories have been proposed for its aetiology, based on individual biomechanical, radiological, histopathology and outcome studies.Methods
Studies that met predefined inclusion/exclusion criteria were analysed to identify literature describing the presence of peri-prosthetic ankle cystic osteolysis. Quantitative data from the selected articles were combined and statistically tested in order to analyse possible relations between ankle peri-prosthetic bone cysts and specific implant characteristics.Results
Twenty-one articles were elected, totalizing 2430 total ankle replacements, where 430 developed peri-prosthetic cystic osteolysis.A statistically significant association (P < .001) was found between the presence of bone cysts and non-anatomic implant configuration, hydroxyapatite-coating, mobile-bearing and non tibial-stemmed implants. No significant association existed between the type of constraining and the presence of cysts (P > .05).Conclusions
Non-anatomic, mobile-bearing, hydroxyapatite-coated and non tibial-stemmed total ankle replacements are positively associated with more periprosthetic bone cysts. 相似文献19.
Bahman SahraNavard Parke W. Hudson Cesar de Cesar Netto Bradley W. Wills Ibukunoluwa B. Araoye Shelby Bergstresser Brent M. Cone Ashish Shah 《Foot and Ankle Surgery》2019,25(1):84-89
Background
The number of screws used for sliding calcaneal osteotomy fixation has not been examined in the literature. The purpose of this paper is to examine this topic.Methods
Retrospective chart review was performed on 190 patients who met selection criteria. We compared complication risk for single versus double screw, headed versus headless screw, and short versus longitudinal incision cases.Results
The mean age was 48.4 (18–83) years and average follow up was 28 (12–150) weeks. All cases achieved radiographic union. Overall complication rate was 19.5% (37/190). Risk of complication did not differ significantly between single and double screw (RR: 1.170; 95% CI: 0.66–2.09; p = 0.594) or short and extended incision groups (RR: 0.868; 95% CI: 0.42–1.80; p = 0.704). Risk of complication differed significantly between headed and headless screw fixation (RR: 5.558; 95% CI: 2.69–11.50; p < 0.0001).Conclusions
Single screw fixation of sliding calcaneal osteotomy achieves similar outcomes as double screw fixation. Headless screws are advantageous for minimizing hardware pain and subsequent hardware removal. 相似文献20.
Luigi Manzi Jorge Hugo Villafañe Cristian Indino Jacopo Tamini Pedro Berjano Federico Giuseppe Usuelli 《Foot and Ankle Surgery》2019,25(2):169-173