Abstract:
OBJECTIVES:To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the level of the elbow, or cubital nerve block (CNB), and another an axillary nerve block (ANB). DESIGN:Two prospective randomized controlled studies were performed to compare the difference in pain intensity during closed reduction of a distal radius fracture between FHB-, CNB-, and, ANB-treated patients. SETTING:Level 2 trauma center. PATIENTS:One hundred ten patients with radiographic displaced distal radius fractures were randomized. Fifty patients were randomized between FHB and CNB, and 60 patients were randomized between CNB and ANB. INTERVENTION:FHB, CNB, or ANB. These were performed by 3 physicians new to ultrasound-guided peripheral nerve blocks and trained before onset of this study. MAIN OUTCOME MEASUREMENT:Pain was sequentially measured using an NRS during closed distal radius fracture reduction. RESULTS:CNB patients experienced less pain during block procedure (P = 0.002), finger trap traction (P = 0.007), fracture reduction (P = 0.00001), after plaster cast application (P = 0.01), and after control radiography (P = 0.01). In our second study, ANB-treated patients reported less pain during block procedure (P = 0.04), during finger trap traction (P < 0.0001), fracture reduction (P < 0.0001), after plaster cast application (P = 0.0001), and after control radiography (P = 0.0005). CONCLUSIONS:Although participating clinicians had minimal expertise using ultrasound-guided peripheral nerve blocks, nonoperative management of distal radius fracture using an ANB was less painful. These block types are expected to completely eradicate sensation the best. Future studies should address technical factors including adequate placement and time to let the block set up, as well as issues such as resource utilization including time and clinician availability to better determine the relative advantages and disadvantages to other analgesia techniques such as the FHB. LEVEL OF EVIDENCE:Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Siebelt M,Hartholt KA,van Winden DFM,Boot F,Papathanasiou D,Verdouw BC,de Vries MR,Mathijssen NM,Kraan GAdoi
10.1097/BOT.0000000000001388subject
Has Abstractpub_date
2019-04-01 00:00:00pages
e124-e130issue
4eissn
0890-5339issn
1531-2291pii
00005131-201904000-00011journal_volume
33pub_type
杂志文章,随机对照试验abstract::Tubular poly(L-lactide) membranes with a pore size of 5-15 microns and a molecular weight of 70,000 Daltons were implanted into 24 New Zealand skeletally mature rabbits to cover 10-mm mid-diaphyseal defects of the radius of the forelimb. An identical defect on the contralateral limb was not treated with the membrane a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199604000-00006
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200211000-00001
更新日期:2002-11-01 00:00:00
abstract::Autologous bone graft is usually necessary for reconstruction of nonunions with shortening or bone loss. We developed a new technique to reconstruct such nonunions or delayed unions without bone grafting by chipping and lengthening of bone at the original fracture site. Five in six nonunions with shortening or bone lo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318041f6d1
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVES:To compare the outcomes of two different surgical treatments for the management of isolated closed Mason Type 2 radial head fractures. DESIGN:Retrospective study. The Student t test and McPearson chi-square test were used to evaluate whether there was a significance difference between the groups. PATIENTS:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318220a227
更新日期:2012-04-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to analyze a large national trauma database to determine the incidence of, risk factors for, and outcomes after a fasciotomy of the lower leg or forearm after fracture. METHODS:Data from the National Trauma Data Bank for the years 2004-2016 were analyzed, and we identified 301,351...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001702
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Calcaneal fractures comprise 1 to 2 percent of all fractures. Approximately 75% of calcaneal fractures are intra-articular. The management of intra-articular calcaneal fractures remains controversial. Nonoperative treatment options include elevation, ice, early mobilization, and cyclic compression of the pla...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:
更新日期:2005-05-01 00:00:00
abstract::A case history of a trauma patient who developed a palsy of the marginal mandibular nerve from compression by a cervical spine hard collar is presented. After clinical and radiographic screening found no evidence of occult cervical spine pathology, the collar was removed; the palsy resolved uneventfully during the nex...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199504000-00015
更新日期:1995-04-01 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: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:To determine whether knee arthrodesis with simultaneous lengthening using the Ilizarov method for a nonreconstructable knee joint with bone loss and infection is a successful salvage procedure. DESIGN:Retrospective review of patients. SETTING:University hospital-based orthopaedic practice. PATIENTS:From 19...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200503000-00004
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia. METHODS:We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31827cd67d
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To determine if inpatient counseling with additional counseling could increase smoking cessation. DESIGN:Prospective study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Current smokers with an operative fracture randomly assigned to control (no counseling), brief counseling (inpatient counseling),...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002028
更新日期:2020-11-25 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:OBJECTIVE:To evaluate whether scientific abstracts selected for podium presentation at the Orthopaedic Trauma Association (OTA) Annual Meeting differ based on the program committee size and/or the proportion of abstracts each committee member evaluates. METHODS:Abstract scores from the Orthopaedic Trauma Association p...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001108
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the cost-effectiveness of screw fixation versus hemiarthroplasty for nondisplaced femoral neck fractures in low-demand elderly patients. METHODS:We constructed a Markov decision model using a low-demand, 80-year-old patient as the base case. Costs, health-state utilities, mortality rates, and tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001747
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:To compare reports of implant fatigue failure submitted to the FDA of 2 commonly used cephalomedullary nails. METHODS:In total, 2724 medical device reports from the FDA's MAUDE database from Jan 2015 to Oct 2019 were reviewed for the Trochanteric Femoral Nail-Advanced (TFNa) and Gamma 3 implants. RESULTS:D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001864
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Accurate prediction of likelihood of reoperation in patients with tibial shaft fractures would facilitate optimal management. Previous studies were limited by small sample sizes and noncomprehensive examination of possible risk factors. OBJECTIVE:We conducted an observational study to determine which progno...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200305000-00006
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. DESIGN:Retrospective review. SETTING:Urban level 1 academic trauma center. PATIENTS:A total of 307 (226 men/8...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000346
更新日期:2015-11-01 00:00:00
abstract::Opening an abdominal window in a hip spica type of cast can be a troubling maneuver for both orthopaedic surgeon and patient. We present a simple device to create an abdominal window more easily. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200307000-00009
更新日期:2003-07-01 00:00:00
abstract::Over a 15-month period, 41 open grade I-IIIA tibia fractures were treated with unreamed interlocking nails. A protocol previously established by the authors to enhance fracture union was followed. The purpose of the study was to determine if union rate for the comminuted statically locked fracture could be reduced thr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199504000-00005
更新日期:1995-04-01 00:00:00
abstract::Displaced intra-articular fractures of the glenoid are rare and frequently result from high-energy injuries. Types IV, V, and VI fractures have in common a fracture line which extends medially into the scapular body. These fracture patterns present unique challenges for surgical approaches and reduction and fixation s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31817d5356
更新日期:2008-08-01 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::The technique of lengthening over an antegrade nail is used widely for distraction osteogenesis of the femur. Most reported complications of this technique are related to Schanz pins. We hypothesized that reducing the number of Schanz pins would enable successful distraction with fewer complications. To this purpose, ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31824a3e66
更新日期:2013-01-01 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:OBJECTIVES:To determine whether severe open tibial fractures in children behave like similar fractures in adults. DESIGN AND SETTING:A combined retrospective and prospective review evaluated treatment protocol for type II and type III open tibial fractures in children over a ten-year period from 1984 to 1993. PATIENT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199707000-00010
更新日期:1997-07-01 00:00:00
abstract::A previously developed experimental model for producing nonunions in rats was used to study the biochemical changes of connective tissue parameters in impaired fracture repair. The model is based on rotational instability between the fracture fragments. A mid-diaphyseal femoral osteotomy was performed on 30 male rats ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199602000-00007
更新日期:1996-01-01 00:00:00
abstract::This report describes the use of articulating external fixation in patients with lower extremity trauma with segmental nerve defects. Four patients who would otherwise require nerve grafting underwent application of an articulated external fixator, allowing optimal positioning for end-to-end, tension-free nerve repair...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200304000-00008
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the outcomes of treatment with a percutaneous compression plate (PCCP) in stable and unstable intertrochanteric hip fractures. DESIGN:Clinical prospective nonrandomized cohort study. SETTING:San Cecilio University Hospital, Granada (Spain). A tertiary-care hospital. PATIENTS:Patients older tha...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000509
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To determine the most commonly associated injuries, complications, and healing rates of patients sustaining segmental tibial shaft fractures. DESIGN:Retrospective review. SETTING:Two Level I trauma centers. PATIENTS:A total of 108 patients with segmental tibial shaft fractures were identified between 2005...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001132
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVES:Report the technical aspects, radiographic results, and complications after minimum 1-year follow up of the anterior intra-pelvic (AIP or modified Rives-Stoppa) approach as an alternative to the ilioinguinal approach for the treatment of acetabular fractures. DESIGN:Retrospective review. SETTING:Level I tr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181dd0b84
更新日期:2010-05-01 00:00:00