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1.
Orthop Clin North Am ; 51(4): 499-509, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32950219

ABSTRACT

Overuse wrist injuries are a common problem in athletes and can be related to tendinopathies or osteoarticular pathology. Fortunately, athletes rarely miss time from their sport due to these conditions because many can be treated nonoperatively. For refractory cases, there often is a curative surgical procedure that can be done during the off-season.


Subject(s)
Athletic Injuries , Cumulative Trauma Disorders , Wrist Injuries , Humans , Tendinopathy
2.
Orthop Clin North Am ; 51(4): 511-516, 2020 Oct.
Article in English | MEDLINE | ID: mdl-32950220

ABSTRACT

Scaphoid fractures are common injuries in athletes. Most can be treated with cast immobilization, with an expected rate of union of 90% to 95%. Cast treatment, however, has the disadvantages of longer immobilization time, joint stiffness, reduced grip strength, and longer time to return to manual work or athletics. Closed reduction and percutaneous screw fixation generally are preferred in athletes to allow a quicker return to sport; if closed reduction cannot be obtained, open reduction and internal fixation may be required.


Subject(s)
Athletic Injuries/surgery , Scaphoid Bone/injuries , Arthroscopy , Athletic Injuries/diagnosis , Humans , Return to Sport
3.
JBJS Case Connect ; 9(4): e0458, 2019 Dec.
Article in English | MEDLINE | ID: mdl-31589174

ABSTRACT

CASE: Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue malignancy that very seldomly presents in the foot or ankle and as a result is not commonly in the differential of patients presenting with foot pain. We cite a case of EMC presenting in the atypical location of the midfoot. Because of its location and similarities, this tumor was initially misdiagnosed and mistreated by multiple medical providers as midfoot Charcot arthropathy. CONCLUSIONS: Neoplastic etiologies, including EMC, should remain in the differential for atypical, refractory foot pain that presents in a manner similar to Charcot foot.


Subject(s)
Chondrosarcoma/diagnostic imaging , Foot/diagnostic imaging , Neoplasms, Connective and Soft Tissue/diagnostic imaging , Chondrosarcoma/pathology , Chondrosarcoma/therapy , Foot/pathology , Humans , Joint Diseases/diagnosis , Magnetic Resonance Imaging , Male , Middle Aged , Neoplasms, Connective and Soft Tissue/pathology , Neoplasms, Connective and Soft Tissue/therapy
4.
Injury ; 49(11): 2036-2041, 2018 Nov.
Article in English | MEDLINE | ID: mdl-30236796

ABSTRACT

INTRODUCTION: Hip fractures and metabolic syndrome (MetS) are becoming major global healthcare burdens as populations age. This study sought to determine the impact of MetS in hip fracture patients on perioperative outcomes following operative fixation or arthroplasty. METHODS: Data from the 2004-2014 Nationwide Inpatient Sample was used to select 3,348,207 discharges with hip fracture. MetS patients were identified by having at least 3 of 4 component comorbidities: hypertension, dyslipidemia, obesity, and diabetes. Logistic regression was used to estimate odds ratios for the association between MetS and perioperative outcomes adjusted for age, gender, race, payer status, and comorbidities. RESULTS: Overall, 32% of hip fracture patients were treated with open reduction internal fixation (ORIF), 28% hemiarthroplasty (HA), 18% closed reduction with internal fixation (CRPP), and 3% primary total hip arthroplasty (THA). The remaining 19% of cases were either treated via unspecified procedure of hip repair (9%), managed non-operatively (2%), underwent multiple procedures during the hospital stay (6%), or the surgical procedure data was missing (2%) and were excluded from procedural analyses. The prevalence of MetS was 7.9% and increased among minorities, patients treated at urban hospitals, with comorbidities (heart failure, kidney disease, peripheral vascular disease), and with Medicare coverage. MetS was associated with increased odds of any adverse event (p < 0.0001), specifically: acute renal failure, myocardial infarction, acute posthemorrhagic anemia. MetS was also associated with increased LOS (p < 0.0001) and increased total charges (p < 0.0001). However, MetS was associated with reduced odds of postoperative pneumonia, deep vein thrombosis and pulmonary embolism, surgical site infection, septicemia, and in-hospital mortality (p < 0.0001). The above associations were maintained for MetS patients stratified according to their treatment groups: HA, CRPP, and ORIF. CONCLUSIONS: MetS is associated with increased odds of complications in hip fracture patients but decreased odds of in-hospital mortality. This may be related to patients' nutritional status and catabolic states in the perioperative period.


Subject(s)
Arthroplasty, Replacement, Hip , Hip Fractures/epidemiology , Length of Stay/statistics & numerical data , Metabolic Syndrome/epidemiology , Postoperative Complications/physiopathology , Aged , Arthroplasty, Replacement, Hip/mortality , Arthroplasty, Replacement, Hip/statistics & numerical data , Female , Hip Fractures/physiopathology , Hip Fractures/surgery , Hospital Mortality , Humans , Male , Metabolic Syndrome/complications , Metabolic Syndrome/physiopathology , Nutritional Status , Postoperative Complications/mortality , Prevalence , Treatment Outcome , United States/epidemiology
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