Abstract:
:In the current health care environment, cost containment is more important than ever. Most physicians currently are unaware of the cost of operating room supplies. A large amount of waste occurs secondary to lack of knowledge and absence of physician incentives for cost saving. Many of the decisions for supply use can be based on good scientific evidence, which supports specific cost saving measures. Careful attention to blood utilization and use of tranexamic acid has the potential to save millions in the hip fracture treatment and arthroplasty treatments. Standardization of surgical preparation and draping can decrease costs and prevent costly surgical site infections. Following protocols and guidelines for bone graft and orthobiologics is critical. The clinical and legal repercussions of retained instruments and costs associated with dropped implants is a huge source of wasted health care dollars. Reprocessing programs for external fixators and tourniquets have been extremely successful. A myriad of opportunities for intraoperative cost savings exist that could be applied to nearly every orthopaedic surgery performed in the United States. It is incumbent on all surgeons to put aside the choices made out of habit and take part in reducing operating room waste for the benefit of hospitals, patients, and the health care system. When applied to the 5.3 million orthopaedic surgeries performed annually in the United States, billions of dollars could easily be saved with no adverse effect on patient care.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Gurnea TP,Frye WP,Althausen PLdoi
10.1097/BOT.0000000000000718subject
Has Abstractpub_date
2016-12-01 00:00:00pages
S21-S26eissn
0890-5339issn
1531-2291pii
00005131-201612001-00005journal_volume
30 Suppl 5pub_type
杂志文章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::To evaluate the use of a two-prong splint for displaced, proximal, humerus, epiphyseal fractures, seven children with Neer-Horwitz Classification Type 3-4 fractures of the proximal humerus were retrospectively investigated. After closed reduction, fracture stabilization was accomplished with the use of a two-prong spl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200309000-00007
更新日期:2003-09-01 00:00:00
abstract:BACKGROUND:Although there is general agreement as to the pathophysiology and treatment of compartment syndrome and the importance of intramuscular pressure measurements, there are many methods described to obtain these measurements. Variations in experimental measurements using current electronic monitoring, needle, an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31822908cf
更新日期:2012-01-01 00:00:00
abstract::Compression screws, Ender rods, and Zickel nails were evaluated mechanically to determine their resulting stability in the fixation of experimental subtrochanteric femur osteotomies. Twenty-five pairs of human cadaver femurs were used. Experimental osteotomies were created and a random member of each pair was fixed wi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199003000-00010
更新日期:1990-01-01 00:00:00
abstract::We reviewed 21 cases of humeral nonunion following the failure of "locking" humeral nails. The nails had been inserted as the primary operative procedure following humeral fracture in fifteen cases or after the failure of closed treatment in six cases. Reconstruction after the failure of these implants was complicated...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199610000-00008
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:The pathomorphology of posttraumatic acetabular dysplasia differs fundamentally from the classic developmental dysplasia of the adolescent. The aim of this report is to qualify and quantify the pathomorphologic characteristics of the posttraumatic acetabular dysplasia and to define the requirements for adequ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200009000-00004
更新日期:2000-09-01 00:00:00
abstract:OBJECTIVES:To report the complications and pitfalls in the treatment of complex injuries of the proximal tibia when locking plates are used. DESIGN, SETTING, AND PATIENTS:This was a retrospective case series conducted at a university Level I trauma center. Thirty-seven patients with complex proximal tibia fractures (4...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318030df96
更新日期:2007-02-01 00:00:00
abstract::Rupture of the medial head of the gastrocnemius muscle ("tennis leg") is an affliction generally associated with athletic activity. The diagnosis is made by careful history and physical examination. Although its findings are characteristic, previous reports have documented misdiagnosis of this lesion as thrombophlebit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00016
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVES:To compare the hospital costs, charges, and reimbursement for treatment of pediatric femur fractures by two treatment methods: external fixation and 90-90 traction with spica casting. DESIGN:Retrospective clinical review. SETTING:Department of Orthopaedic Surgery, Children's Hospital Oakland, regional pedi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199811000-00006
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:Improved patient outcomes after plating of displaced clavicle fractures have been demonstrated by recent clinical studies. Many of these patients, however, complain of anterior chest wall numbness after this procedure; we hypothesize that numbness likely persists long term for many patients, but without effe...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000095
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the outcomes of a single-stage surgical protocol to treat a presumed aseptic long-bone nonunion with positive intraoperative cultures obtained at the time of surgery. DESIGN:Retrospective comparative series. SETTING:Orthopaedic specialty hospital. PATIENTS AND METHODS:We retrospectively identif...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001084
更新日期:2018-02-01 00:00:00
abstract::The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 ye...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00002
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:This review aims to summarize current knowledge regarding the underlying patho-mechanisms of delayed fracture healing in polytraumatized patients. DATA SOURCES AND STUDY SELECTION:The following search terms were used: "fracture", "hemorrhage," "chest trauma," "inflammation," "inflammatory response," "fractur...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0000000000000489
更新日期:2016-03-01 00:00:00
abstract::Two unusual cases of symptomatic partial rupture of the extensor carpi ulnaris tendon associated with ulnar-styloid nonunion are described. Intraoperative findings suggested that the jagged surface of the distal ulna was the cause of flaying. In one case, debridement of the frayed extensor carpi ulnaris tendon and fix...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200210000-00011
更新日期:2002-10-01 00:00:00
abstract::One major advancement in the treatment of femoral neck fractures has been the development of cannulated screws. This study investigates the integrity of five commercially available cannulated screw systems. Transcervical fractures were created in 25 adult femora and repaired by three cannulated hip screws of a randoml...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199408000-00004
更新日期:1994-08-01 00:00:00
abstract::Posterior wall (PW) fractures are the most common fractures requiring surgical fixation in acetabular surgery. Extra-articular screw placement must be confirmed intraoperatively. Herein we describe the use of the inlet and obturator oblique view (the Leeds view) for screw placement in elementary PW and in associated b...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000724
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:The purpose of this prospective cohort study was to determine if a new patella fracture fixation construct resulted in improved outcomes compared with traditional tension band techniques. DESIGN:Comparative cohort study. SETTING:Academic level I trauma center. PATIENTS/PARTICIPANTS:Patients with isolated, ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000787
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To evaluate and compare the mechanical stability of two different fixation techniques on experimentally induced calcaneus fractures. METHODS:Thirteen fresh frozen cadaver lower limbs had intraarticular calcaneal fractures produced with an impact loading device. Internal fixation was then performed through la...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199708000-00010
更新日期:1997-08-01 00:00:00
abstract::Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outco...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000415
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:To determine if distal femoral traction pins result in knee dysfunction in patients with femoral or pelvic fracture, and to determine if skeletal traction relieves pain more effectively than splinting for femoral shaft fractures. DESIGN:Prospective cohort trial. SETTING:Level I urban trauma center. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000202
更新日期:2015-02-01 00:00:00
abstract::A prospective randomized study was set up, comparing a compression hip screw with the Vandeputte (VDP) endoprosthesis treatment for fresh, unstable peritrochanteric fractures, according to the Evans-Jensen and AO systems. Ninety patients, ages > or = 70 years, 47 of whom were treated with a compression hip screw and 4...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199509040-00004
更新日期:1995-01-01 00:00:00
abstract::This biomechanical study compares two methods of internal fixation of the tibiofibular syndesmosis used in Weber type C malleolar fractures of the ankle. The transverse syndesmotic 3.5-mm screw was compared with two 1.5-mm Kirschner wires introduced obliquely across the distal tibiofibular syndesmosis. The influence o...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00006
更新日期:1994-01-01 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:To evaluate the relationship between mechanism of injury and mortality in geriatric trauma patients and the ability of existing injury severity indices (ISIs) to assess mortality. DESIGN:Retrospective review. SETTING:Urban level 1 trauma center. PARTICIPANTS:Four thousand five hundred forty-five trauma pa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000281
更新日期:2015-07-01 00:00:00
abstract::The proximal femur nail antirotation represents a new generation of intramedullary nailing devices for fixation of stable and unstable trochanteric fractures of the proximal femur. We report 3 cases of postoperative perforation of the helical blade through the femoral head into the hip joint without any signs of rotat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181893b1b
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVES:This study compared the acute treatment effects of systemic analgesics with (celecoxib) and without anti-inflammatory activity (acetaminophen) on bone fracture healing. STUDY DESIGN:Longitudinal time study of fracture healing in rats. METHODS:Closed, mid diaphyseal femur fractures were produced in female S...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000184144.98071.5d
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:Performing an examination under general anesthesia (EUA) using dynamic stress fluoroscopy of patients with posterior wall acetabular fractures has been used as a tool to determine hip stability and the need for surgical intervention. The purpose of this study was to further evaluate the effectiveness of this...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000308
更新日期:2015-08-01 00:00:00
abstract::An 80-year-old man sustained a T-shaped supracondylar fracture of the femur associated with distal one-third shaft comminution. Initial failure of a 95 degrees angle blade plate was followed by insertion of an intraarticular intramedullary nail stabilized with static locking-screw fixation. A second failure of the imp...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199308000-00004
更新日期:1993-01-01 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::The induced membrane technique for reconstruction of bone defects has proved its effectiveness and is now widely accepted. The 2 stages procedure, implying a cement spacer in the first stage and a huge bone graft in the second stage, responds to rigorous technical details involving each phase of the procedure. Prerequ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000979
更新日期:2017-10-01 00:00:00