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  • 1
    Online Resource
    Online Resource
    Short Versus Long Cephalomedullary Nails for Pertrochanteric Hip Fracture
    SLACK, Inc. ; 2017
    In:  Orthopedics Vol. 40, No. 2 ( 2017-03), p. 83-88
    Details
    In: Orthopedics, SLACK, Inc., Vol. 40, No. 2 ( 2017-03), p. 83-88
    Abstract: This study compared patients who underwent treatment with short or long cephalomedullary nails with integrated cephalocervical screws and linear compression. Patients with AO/OTA 31-A2 or A3 pertrochanteric fractures treated with either short (n=72) or long (n=97) InterTAN (Smith & Nephew, Memphis, Tennessee) cephalomedullary nails were reviewed. Information on perioperative measures (estimated blood loss, surgical time, and fluoroscopy time) and postoperative orthopedic complications (infection, implant failure, screw cutout, and periprosthetic femur fracture) was included. Estimated blood loss (short nail, 161 mL; long nail, 208 mL; P =.002) and surgical time (short nail, 64 minutes; long nail, 83 minutes; P =.001) were lower in the short nail group. There were no differences in fluoroscopy time (short nail, 90 seconds; long nail, 142 seconds; P =.071) or rates of infection (short nail, 1.4%; long nail, 3.1%; P =.637) or overall orthopedic complications (short nail, 11.1%; long nail, 9.3%; P =.798) between the 2 groups. The long nail group had a trend toward more screw cutouts (long nail, 5.2%; short nail, 0.0%; P =.134) but fewer periprosthetic femur fractures (short nail, 8.3%; long nail, 0.0%; P =.013). This study found a similar overall rate of orthopedic complications between short and long nails with integrated cephalocervical screws and linear compression. These results confirm the suspected advantages of short nails, including faster surgery and less blood loss; however, the rate of periprosthetic femur fracture remains high, despite changes to implant design. [ Orthopedics. 2017; 40(2):83–88.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20161116-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2017
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  • 2
    Online Resource
    Online Resource
    Intraoperative Hypothermia During Surgical Fixation of Hip Fractures
    SLACK, Inc. ; 2016
    In:  Orthopedics Vol. 39, No. 6 ( 2016-11)
    Details
    In: Orthopedics, SLACK, Inc., Vol. 39, No. 6 ( 2016-11)
    Abstract: Hip fractures are common orthopedic injuries and are associated with significant morbidity/mortality. Intraoperative normothermia is recommended by national guidelines to minimize additional morbidity/mortality, but limited evidence exists regarding hypothermia's effect on orthopedic patients. The purpose of this study was to determine the incidence of intraoperative hypothermia in patients with operatively treated hip fractures and evaluate its effect on complications and outcomes. Retrospective chart review was performed on clinical records from 1541 consecutive patients who sustained a hip fracture and underwent operative fixation at the authors' institution between January 2005 and October 2013. A total of 1525 patients were included for analysis, excluding those with injuries requiring additional surgical intervention. Patient demographic data, surgery-specific data, postoperative complications, length of stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis with univariate and multivariate logistic regression modeling evaluated associations with hypothermia and effect on complications/outcomes. The incidence of intraoperative hypothermia in operatively treated hip fractures was 17.0%. Hypothermia was associated with an increase in the rate of deep surgical-site infection (odds ratio, 3.30; 95% confidence interval, 1.19–9.14; P =.022). Lower body mass index and increasing age demonstrated increased association with hypothermia ( P =.004 and P =.005, respectively). To the authors' knowledge, this is the first and largest study analyzing the effect of intraoperative hypothermia in orthopedic patients. In patients with hip fractures, the study's findings confirm evidence found in other surgical specialties that hypothermia may be associated with an increased risk of deep surgical-site infection and that lower body mass index and increasing age are risk factors for intraoperative hypothermia. [ Orthopedics. 2016; 39(6):e1170–e1177.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20160811-04
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2016
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  • 3
    Online Resource
    Online Resource
    Short-term Medical Complications Following Short Versus Long Cephalomedullary Nails
    SLACK, Inc. ; 2018
    In:  Orthopedics Vol. 41, No. 5 ( 2018-09)
    Details
    In: Orthopedics, SLACK, Inc., Vol. 41, No. 5 ( 2018-09)
    Abstract: The purpose of this retrospective cohort study was to evaluate whether there is an increased rate of short-term medical complications following short vs long cephalomedullary nails for the treatment of intertrochanteric hip fractures. A total of 899 patients treated surgically with cephalomedullary nails from January 1, 2005, to September 1, 2014, were included. Patients who received short nails (n=334) were older and had a higher incidence of coronary artery disease and diabetes mellitus compared with patients who received long nails (n=565). The incidences of 30-day medical complications, including myocardial infarction, stroke, deep venous thrombosis, pulmonary embolism, blood transfusion, non–surgical site infection, surgical site infection, and mortality, were recorded. The orthopedic complications of periprosthetic fracture of the ipsilateral hip and implant failure through the latest outpatient follow-up were recorded. No significant difference was found between nails for any studied medical complication (63.5% short vs 66.0% long, P =.4393) or mortality (6.9% short vs 5.3% long, P =.3322). There was also no significant difference in the incidence of orthopedic complications ( P =.70). Longer operating room time was associated with superficial surgical site infection. [ Orthopedics . 2018; 41(5):e636–e642.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20180711-03
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2018
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  • 4
    Online Resource
    Online Resource
    Three-Year Nursing PhD Model Recommendations from the RWJF Future of Nursing Scholars
    SLACK, Inc. ; 2022
    In:  Journal of Nursing Education Vol. 61, No. 1 ( 2022-01), p. 19-28
    Details
    In: Journal of Nursing Education, SLACK, Inc., Vol. 61, No. 1 ( 2022-01), p. 19-28
    Abstract: In response to the 2011 Future of Nursing report, the Robert Wood Johnson Foundation created the Future of Nursing Scholars (FNS) Program in partnership with select schools of nursing to increase the number of PhD-prepared nurses using a 3-year curriculum. Method: A group of scholars and FNS administrative leaders reflect on lessons learned for stakeholders planning to pursue a 3-year PhD model using personal experiences and extant literature. Results: Several factors should be considered prior to engaging in a 3-year PhD timeline, including mentorship, data collection approaches, methodological choices, and the need to balance multiple personal and professional loyalties. Considerations, strategies, and recommendations are provided for schools of nursing, faculty, mentors, and students. Conclusion: The recommendations provided add to a growing body of knowledge that will create a foundation for understanding what factors constitute “success” for both PhD programs and students. [ J Nurs Educ . 2022;61(1):19–28.]
    Type of Medium: Online Resource
    ISSN: 0148-4834 , 1938-2421
    URL: Article
    DOI: 10.3928/01484834-20211202-01
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2022
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  • 5
    Online Resource
    Online Resource
    Treatment of Medial Collateral Ligament Injury During Total Knee Arthroplasty With Internal Suture Brace Augmentation: A Cadaveric and Biomechanical Study
    SLACK, Inc. ; 2022
    In:  Orthopedics Vol. 45, No. 5 ( 2022-09)
    Details
    In: Orthopedics, SLACK, Inc., Vol. 45, No. 5 ( 2022-09)
    Abstract: Intraoperative medial collateral ligament (MCL) injury during total knee arthroplasty (TKA) is a serious complication. External bracing and/or conversion to a constrained implant has previously been studied. The technique of using an internal high-strength suture brace to augment an MCL repair has been evaluated in the nonarthroplasty patient and could provide an alternate solution. The goal of this study was to determine whether MCL repair with internal suture bracing restores stability of the implanted knee joint. A robotic simulator completed laxity testing on 5 cadaveric knee specimens in 4 sequential phases: (1) intact knee, (2) after implantation with TKA, (3) after sectioning of the MCL, and (4) after MCL repair with suture brace augmentation. Laxity was compared between the different test phases throughout range of motion. Subsequently, the internal brace was tested to failure under valgus load. The MCL repair with internal bracing was effective at restoring laxity in varus-valgus, internal-external, and medial-lateral degrees of freedom through midflexion, with limited support at deeper flexion angles and in anterior-posterior laxity. Rotational laxity was not significantly different than intact knee laxity. Generally, medial-lateral translations were less and anterior-posterior translations were greater and were significantly different at 30° to 45° and 90°, respectively. The mean failure moment was 46.4±9.1 Nm, with the primary mode of failure being MCL repair. Primary MCL repair with internal bracing using a high-strength suture augment showed the potential to provide adequate stability and strength to correct MCL incompetence in TKA without the use of an external knee brace or constrained implants. [ Orthopedics . 2022;45(5):e269–e275.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20220425-05
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2022
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  • 6
    Online Resource
    Online Resource
    Intraoperative Hypothermia in Total Hip and Knee Arthroplasty
    SLACK, Inc. ; 2017
    In:  Orthopedics Vol. 40, No. 1 ( 2017-01), p. 56-63
    Details
    In: Orthopedics, SLACK, Inc., Vol. 40, No. 1 ( 2017-01), p. 56-63
    Abstract: Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes. The clinical records of 2580 consecutive patients who underwent TKA or THA at a single institution between January 1, 2011, and December 31, 2013 were reviewed. After excluding patients with complex or revision procedures, a total of 2397 patients comprised the study population. Patient demographic data, surgery-specific data, postoperative complications, length of hospital stay, and 30-day readmission were recorded. Patients with a mean intraoperative temperature less than 36°C were identified as hypothermic. Statistical analysis evaluated associations with hypothermia and the effect on complications and outcomes. The incidence of mean intraoperative hypothermia was 37%, 43.9%, and 32.6% for arthroplasty, THA, and TKA, respectively. General anesthesia was significantly associated with hypothermia ( P 〈 .001). Women and THA patients were at higher risk for hypothermia. In the arthroplasty and THA cohorts, longer operating room time and re-warmer use were associated with hypothermia ( P =.010). Overall, hypothermia was associated with increased estimated blood loss, but no increase in associated transfusion was demonstrated ( P =.006). Hypothermia was not associated with postoperative complications. [ Orthopedics. 2017; 40(1):56–63.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20161017-04
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2017
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  • 7
    Online Resource
    Online Resource
    Innovation and Entrepreneurship: Perspectives From Orthopedic Surgery
    SLACK, Inc. ; 2018
    In:  Orthopedics Vol. 41, No. 3 ( 2018-05), p. 135-140
    Details
    In: Orthopedics, SLACK, Inc., Vol. 41, No. 3 ( 2018-05), p. 135-140
    Abstract: Orthopedic surgeons are tasked with treating complex patients while employing critical surgical skills, clinical knowledge, and new technologies. The constant inundation of information, coupled with hours in the hospital setting, provides unique perspectives on various aspects of how health care is delivered, thereby creating a milieu ripe for innovation. The rigors of an orthopedic career make it challenging for physicians to translate an idea into a great product. Through the authors' experiences at a tertiary orthopedic practice, they review the process of taking an idea from concept to fruition. [ Orthopedics . 2018; 41(3):135–140.]
    Type of Medium: Online Resource
    ISSN: 0147-7447 , 1938-2367
    URL: Article
    DOI: 10.3928/01477447-20180409-08
    Language: English
    Publisher: SLACK, Inc.
    Publication Date: 2018
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