Abstract:
OBJECTIVE:To examine the cost and efficacy of methods of general and regional anesthetic for postoperative pain control after open repair of intra-articular calcaneal fractures. We compared single-injection popliteal fossa blocks and continuous infusion popliteal fossa blocks with drug delivered through a catheter from an infusion pump (CPNB) to general or spinal anesthetic alone in terms of hospital charges, length of hospital stay, and postoperative oral and intravenous narcotic use, antiemetic use, and safety. DESIGN:Retrospective review. SETTING:University Level I regional trauma center and associated orthopaedic surgery center. PATIENTS/PARTICIPANTS:Charts were reviewed for all patients undergoing open treatment of calcaneal fractures during a 9-year period. One hundred six of 203 met study inclusion criteria. INTERVENTION:All patients received either general or spinal anesthetic. Patients additionally received preoperative single-injection popliteal fossa blocks, CPNB, or no regional block. OUTCOME MEASUREMENTS:Data were compared from each group for total hospital cost, length of stay, operating room times, narcotic use, postoperative nausea, and hospital readmission. Eighteen patients from the CPNB group who were discharged within 24 hours of surgery were examined in a subgroup analysis of ambulatory treatment. RESULTS:There were no significant differences between the control group and the two regional anesthesia groups in total hospital cost, length of stay, narcotic use, or antiemetic use. However, subgroup analysis demonstrated that ambulatory CPNB patients had significantly lower total hospital costs and narcotic use compared with the remaining CPNB patients. There were no block-related complications. None of the short-stay patients required urgent medical attention or readmission after discharge. CONCLUSIONS:CPNB through an infusion pump may allow patients undergoing open treatment of calcaneal fractures to be safely discharged within 24 hours with a concomitant decrease in healthcare costs. These data suggest that this method of postoperative pain management might be applied to other patients with major foot and ankle trauma and/or reconstructive procedures and that wider use of continuous peripheral nerve blocks may lead to a reduction in healthcare costs.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Hunt KJ,Higgins TF,Carlston CV,Swenson JR,McEachern JE,Beals TCdoi
10.1097/BOT.0b013e3181bfc9f7subject
Has Abstractpub_date
2010-03-01 00:00:00pages
148-55issue
3eissn
0890-5339issn
1531-2291pii
00005131-201003000-00003journal_volume
24pub_type
杂志文章abstract:OBJECTIVES:(a) To develop a reliable and reproducible system for distraction osteogenesis in the rat to establish a model for future investigations of bone repair and regeneration. (b) To describe and characterize the histological events in distraction osteogenesis in the rat and to determine whether cartilage developm...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199802000-00008
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000015
更新日期:2014-06-01 00:00:00
abstract::The fracture classification systems currently used most frequently were not developed or validated by rigorous scientific evaluation methods. This paper discusses the classification of fractures from an epidemiological and clinical decision-making perspective and proposes a standardized methodological concept for thei...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/01.bot.0000155310.04886.37
更新日期:2005-07-01 00:00:00
abstract::Forty-three patients with 43 comminuted femoral shaft fractures treated with the Brooker-Wills interlocking nail were followed through bony union to determine the device's ability to maintain length and rotational control of these difficult injuries. Only severely comminuted fractures, types III and IV, were included....
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198702010-00002
更新日期:1987-01-01 00:00:00
abstract::The application of the pelvic clamp as a tool for emergency stabilization of unstable pelvic ring fractures has proved to be a life-saving procedure. Using correct technique, the pelvic clamp can be applied within a few minutes after the patient's admission. To avoid severe complications (eg, pin perforation into the ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200402000-00008
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVES:Retrospective evaluation of the long-term outcomes after surgical treatment of traumatic patellar dislocations in adolescents and identification of possible predictive factors of poor outcomes. DESIGN:Retrospective clinical study. SETTING:University Clinic, Level I Trauma Center. PATIENTS:All 33 adolescen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318299cb50
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To relate the incidence of implant failure after internal anterior fixation of the pelvic ring to functional outcome and the health-related quality of life in patients. DESIGN:Retrospective chart and radiographic review. SETTING:Level I Trauma center. METHODS:We retrospectively identified all patients who...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000501
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:Ankle fractures are one of the most common operatively treated lower extremity fractures. Several studies indicate that patients often have residual effects after this injury. The purpose of this study is to use the SF-36 questionnaire at two times to assess patients' functional recovery and residual effects ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200201000-00007
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVE:To determine humeral diaphyseal fractures at risk for nonunion with functional brace treatment. DESIGN:Retrospective case series. SETTING:A single surgeon's practice. PATIENTS:Forty-nine of 52 consecutive patients treated nonoperatively for an isolated diaphyseal fracture of the humerus during a 6-year per...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000249423.48074.82
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVES:To develop an accurate machine learning (ML) predictive model incorporating patient, fracture, and trauma characteristics to identify individual patients at risk of an (occult) PMF. METHODS:Databases of 2 studies including patients with TSFs from 2 Level 1 trauma centers were combined for analysis. Using te...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001663
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the loss of strength in the distal humerus that resulted from the creation of two different entry portals used for retrograde humeral nailing. DESIGN:Nine pairs, treated as blocks of size two, of fresh frozen humeri from individuals free of musculoskeletal disease w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200002000-00005
更新日期:2000-02-01 00:00:00
abstract:PURPOSE:There are an estimated 1.2 million deaths from road traffic injuries annually, disproportionately affecting patients in low-resource settings. The purpose of this scoping review is to identify knowledge gaps in global orthopaedic trauma in an effort to help prioritize future research. METHODS:Using the 6-stage...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001293
更新日期:2018-10-01 00:00:00
abstract::With the increase in demand for total hip and knee arthroplasty, the orthopaedic community has seen a dramatic increase in periprosthetic fractures. Given the high morbidity and mortality associated with these fractures, the orthopaedic surgeon needs to be prepared to deal with this difficult problem. The purpose of t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821b8c3b
更新日期:2011-06-01 00:00:00
abstract::Monteggia fractures represent approximately 1 to 2 percent of forearm fractures, whereas Galeazzi fractures represent 3 to 6 percent. The combination of these injuries in the same extremity is an exceedingly rare occurrence. We report a case of ipsilateral combination Monteggia and Galeazzi fractures in an adult patie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00011
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To determine the effect of retrograde femoral reaming on the blood flow of the distal femur and the cruciate ligaments. DESIGN:Canine experimental study. SETTING:Tertiary referral and teaching hospital in Toronto, Canada. PARTICIPANTS:Thirteen skeletally mature, cross-bred dogs. MAIN OUTCOME MEASURE:Red c...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199805000-00007
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVES:We evaluated the economic aspects of an orthopaedic trauma section at a regional Level I, semi-academic community hospital. This study analyzes the economics of a dedicated hospital-based orthopaedic trauma program. METHODS:Institutional financial reports were analyzed for 2 time periods. In the pre-program...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31816bae67
更新日期:2008-04-01 00:00:00
abstract::The extraosseous tissue contribution to diaphyseal fracture callus has been investigated using a rabbit tibial fracture model and osteocalcin immunocytochemistry. The extraosseous tissues were isolated for study by reaming and nailing an osteotomy and excising 2 cm of periosteum on either side of the osteotomy. Specim...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199206000-00010
更新日期:1992-01-01 00:00:00
abstract:INTRODUCTION:External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000817
更新日期:2017-05-01 00:00:00
abstract::After completing an orthopaedic trauma fellowship, what challenges will you have as regard to maintaining balance and perspective in your new position in society? How will you view yourself, family, and your profession? These are simple suggestions on maintaining passion for your profession. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000431
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVE:To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. DESIGN:Standardized proximal tibial fractures (AO classificati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200409000-00010
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVE:To evaluate the results after closed reduction and percutaneous fixation of displaced fractures of the proximal humerus with the Humerusblock system. DESIGN:Prospective case series. SETTING:Level 1 trauma center. PATIENTS AND METHODS:Fifty-eight consecutive patients with displaced proximal humerus fracture...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c81b1c
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the difference in quality of fracture reduction between the sinus tarsi approach (STA) and extensile lateral approach (ELA) using postoperative CT scans in displaced intra-articular calcaneal fractures (DIACFs). DESIGN:Retrospective SETTING:: Level 1 and Level 2 academic centers. PATIENTS:Consec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001971
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. The purpose of this review is to provide an evidence-based analysis of the literature and clinical outcomes associated with the surgical and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000952
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVE:The optimal exposure interval for anteromedial coronoid fractures is unknown. The purpose of this study was to quantitatively compare the osseous and ligamentous exposure of the medial elbow using the flexor carpi ulnaris (FCU)-Splitting and Hotchkiss Over-the-Top approaches. METHODS:Forty surgical approache...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828ba91c
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Lateral cortical stress reactions have been documented to precede femoral insufficiency fractures after long-term bisphosphonate therapy. We studied the natural history of femoral stress lesions associated with long-term bisphosphonate therapy. DESIGN AND SETTING:A retrospective clinical and radiologic revie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181b6499b
更新日期:2010-02-01 00:00:00
abstract::Bone healing after fracture occurs in a well-organized manner and involves a multitude of cell types, inflammatory cytokines, growth factors, prostaglandins, and certain vitamins. Some of the means by which alterations in these essential components affect bone repair are understood, whereas others still need to be del...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e318274da8b
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:The aim of this article is to provide a concise review of the basic science of extracorporeal shock wave therapy (ESWT) and to perform a systematic review of the literature for the use of ESWT in the treatment of fractures and delayed unions/nonunions. DATA SOURCES:Articles in the English or German language...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0b013e3181cad510
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVE:Screw fixation of the injured syndesmosis restores stability but may reduce motion. The purpose of this study is to determine whether functional outcomes and radiographic results after ankle fracture are affected by the status of the syndesmosis screw. DESIGN:Retrospective review of a consecutive clinical se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a9f7a5
更新日期:2010-01-01 00:00:00
abstract::Road traffic accidents are a leading cause of global mortality. In March 2010, the United Nations General Assembly and the World Health Organization (WHO) officially proclaimed 2011-2020 as the "Decade of Action for Road Safety." Researchers must focus on vulnerable road users and low- and middle-income countries (LMI...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000103
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVES:Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical servi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182a59d6b
更新日期:2014-05-01 00:00:00