Иркутская область получит 491,5 млн руб. на оказание медпомощи при ДТП

Как сообщили в пресс-службе правительства Иркутской области на оказание медицинской помощи пострадавшим при дорожно-транспортных происшествиях из федерального бюджета в Приангарье поступит 491,5 млн. рублей.
Как пояснил министр здравоохранения области Дмитрий Пивень, в медучреждениях, расположенных вдоль федеральных трасс М-53 и М-55, будут созданы травмоцентры пяти уровней.

Экстренную помощь планируется оказывать в опорных травмпунктах пятого уровня, созданных на базе фельдшерско-акушерских пунктов и врачебных амбулаторий. Здесь же предполагается проводить иммобилизацию и обезболивание.

Research shows good mid-term results with clavicle hook plate fixation of acute displaced lateral clavicle fractures

Tiren D. J Orthop Surg Res. 2012. doi:10.1186/1749-799X-7-2.

The clavicle hook plate produced good results at midterm follow-up as primary treatment for acute displaced lateral clavicle fractures, according to a retrospective study published in the Journal of Orthopaedic Surgery and Research.

Of 28 consecutive patients with acute displaced lateral clavicle fractures treated with the plate, 24 patients were followed up at 5.4 years mean (65 months). All patients had good to excellent short-term functional results, according to the abstract.

At mid-term follow-up patients scored 97 points with the Constant-Murley scale and 3.5 points with the DASH score, however 4 patients developed acromioclavicular joint arthrosis (14%) and 3 patients developed extra articular ossification (11%). One patient each with those complications was symptomatic, researchers noted.

Tennessee Hip Replacement Patient Files Suit Against DePuy For Alleged Debilitating Injuries

Lawsuit Charges Pinnacle Metal on Metal Hip Implant Manufactured by DePuy is Defective

Kathryn E. Barnett of the national plaintiffs’ law firm Lieff Cabraser Heimann & Bernstein, LLP, announced that Paul McCurley of Chattanooga, Tennessee, has filed a lawsuit against DePuy Orthopaedics, Inc., and its parent company, Johnson & Johnson, Inc., for the injuries he suffered after his DePuy Pinnacle metal on metal hip implant failed.

“In one study, hip replacement patients who have undergone a revision surgery were almost four times more likely to suffer from hip dislocation than those who have not.”


The lawsuit charges that DePuy knew that the Pinnacle metal on metal hip generated unusual and dangerous levels of metal debris accumulation in many patients and presented abnormally high risks of early failure. Despite notice of these alleged problems and defects, DePuy continued to promote and sell the Pinnacle metal on metal hip, and has not recalled the product.

Robotic Total Hip Replacement

January 19, 2012

David Padden, MD, Orthopedic Surgeon with the Holy Cross Medical Group, performs robotic total hip replacement via an anterior approach to the hip. With the use of the MAKO robot, Dr. Padden is able to perform total hip replacements that require minimal recovery time, without cutting muscle, so you can get back to living your life quicker. One of Dr. Padden's patients, Gregg, has undergone this surgery & tells us about his experience with this procedure & how it has restored his active life. Learn more about our award-winning Orthopedic Institute by visiting holycrossorthopedics.com. 

Knee Replacement Surgery Incidence Soars in Those Over Age 50

Researchers in Finland found that annual cumulative incidences of partial and total knee arthroplasty, commonly known as knee replacement surgery, rose rapidly over a 27-year period among 30 to 59 year-olds in that country, with the greatest increase occurring in patients aged 50 to 59 years. According to the study published in Arthritis & Rheumatism, a peer-reviewed journal of the American College of Rheumatology (ACR), incidences were higher in women throughout the study period.

Osteoarthritis (OA) is a highly disabling joint disease that according to a 2002 report by the World Health Organization (WHO) is the fourth leading cause of years lived with disability worldwide. In the U.S., experts say more than 10 million adults are affected by OA and for those with advanced disease arthroplasty may be the only treatment option to relieve the disabling pain and stiffness, and improve quality of life. In fact, the Agency for Healthcare Research and Quality reports that over 600,000 total knee replacements were performed in the U.S. in 2009 and a previous study estimates that number could grow by 673% to 3.48 million procedures by the year 2030.

Innovative Surgical Table Surface

January 18, 2012

BERCHTOLD announces the TABLEGARD® Patient Care System for surgical tables, composed of a proven alternating pressure mattress combined with a patient warming unit. The new TABLEGARD® with Quattro Therapy™ is an OR mattress that is designed for surgical tables which brings proven alternating pressure redistribution to the surgical suite. During the course of a cycle, one of every four mattress cells will deflate for a period and then re-inflate to the previous level; the patient is supported by 75 percent of the surface at all times providing an extremely stable surface for the surgical procedure. The cycle is then repeated in the next series of cells. The alternating pressure creating the subtle removing and reapplying of pressure allows blood to flow providing oxygenation to the tissue cells.

Pedicle screw insertion torque positively correlated with bone mineral density in osteoporotic patients

Lee J. J Bone Joint Surg. 2012. doi:10.1302/0301-620X.94B1.27032.

Bone mineral density is positively correlated with the maximum torque required to insert a pedicle screw during posterior lumbar screw fixation in patients with osteoporosis and osteopenia, according to recently published research.

In 181 patients with degenerative disease of the lumbar spine, researchers found positive correlations between bone mineral density (BMD) and T-values in the instrumented lumbar vertebrae, between mean BMD and T-values in the lumbar vertebrae and between mean BMD and T-values in the proximal femur, according to the abstract. Patients were analyzed by dual-energy X-ray absorptiometry and were measured during surgery for screw placement.

“The positive correlation between BMD and the maximum torque required to insert a pedicle screw suggests that preoperative assessment of BMD may be useful in determining the ultimate strength of fixation of a device, as well as the number of levels that need to be fixed with pedicle screws in patients who are suspected of having osteoporosis,” the authors wrote

Plating no more invasive than nailing for distal femoral shaft fractures

Plating no more invasive than nailing for distal femoral shaft fractures

WAILEA, Hawaii – Plating remains the best option for comminuted, intra-articular distal femur fractures, according to a presenter at Orthopedics Today Hawaii 2012 here.

“One can adapt the fixation to all fracture patterns, and there are no surprises. With new techniques, plating is no more invasive than nailing,” Andrew H. Schmidt, MD, said.

Although distal femur fractures are a relatively non-controversial injury with a well-understood fracture pattern, he said that questions remain about the defined operative indications, treatment principles and options. Research into the treatment of distal femoral fractures continues to evolve, Schmidt said, and there is limited evidence to base treatment choices.

Сравнительное исследование проксимального бедренного гвоздя с антиротацией и реконструктивного гвоздя при лечении оскольчатых переломов проксимальнеого отдела бедра

Comparative Study of the Proximal Femoral Nail Antirotation Versus the Reconstruction Nail in the Treatment of Comminuted Proximal Femoral Fracture

Сравнительное исследование проксимального бедренного гвоздя с антиротацией и реконструктивного гвоздя при лечении оскольчатых переломов проксимальнеого отдела бедра (пока без перевода)

ORTHOPEDICS January 2012;35(1):41

by Fu-Ting Huang, MD; Kai-Cheng Lin, MD; Shan-Wei Yang, MD; Jenn-Huei Renn, MD

Abstract

The purpose of our study was to compare the proximal femoral nail antirotation (PFNA; Synthes, Paoli, Pennsylvania) with a reconstruction nail (Recon; Zimmer, Warsaw, Indiana) in the treatment of comminuted proximal femoral fractures. Between 2003 and 2010, twenty-three consecutive patients with AO/Orthopaedic Trauma Association 31-A3 fractures combined with proximal 32 fractures who had a minimum 18-month follow-up were evaluated retrospectively. There were 10 patients (age range, 18-74 years) in the Recon nail group and 13 patients (age range, 22-90 years) in the PFNA nail group. Patients treated with Recon nails experienced a longer operation time (P=.006) and more blood loss (P=.012) than patients treated with the PFNA nail. On postoperative radiographs, the change in the neck-shaft angle was 8.8° in the Recon nail group and 4.7° in the PFNA nail group (P=.048). The fracture union time averaged 31.8 weeks in the Recon nail group and 21.5 weeks in the PFNA nail group (P=.148). More patients in the Recon nail group underwent major or minor reoperation (P=.038) compared with the PFNA nail group. No implant failure occurred in either group. The functional results were similar in the 2 groups. For the treatment of comminuted proximal femoral fractures, use of either the PFNA and Recon nail is clinically effective. However, the PFNA nail provides a shorter operation time, less blood loss, and better realignment ability and reduces the incidence of reoperation. Therefore, the PFNA nail can be considered a better device than the Recon nail

Пластина с угловой стабильностью для проксимального отдела бедра с канюлированными винтами в лечении перелома шейки бедра

Proximal Femoral Locking Plate With Cannulated Screws for the Treatment of Femoral Neck Fractures

Пластина с угловой стабильностью для проксимального отдела бедра с канюлированными винтами в лечении перелома шейки бедра (пока без перевода)

by Dasheng Lin, MD; Kejian Lian, MD; Zhenqi Ding, MD; Wenliang Zhai, MD; Jiayuan Hong, MD

Abstract

The purpose of this study was to evaluate the efficacy and safety of the proximal femoral locking plate with cannulated screws for the treatment of femoral neck fractures. A prospective study was performed in 41 patients with femoral neck fractures treated with a proximal femoral locking plate with cannulated screws between January 2005 and December 2008. Twenty-five men and 16 women had a mean age of 47 years (range, 21-65 years). The time from injury to surgery ranged from 2 hours to 7 days. Three patients had a Garden type I fracture, 9 a type II, 18 a type III and 11 a type IV. Operative time, intraoperative blood loss, fracture healing time, Harris Hip Score for hip function, and complications were recorded to evaluate treatment effects.

Mean operative time was 63.6 minutes (range, 40-90 minutes), with mean intraoperative blood loss of 84.2 mL (range, 50-200 mL). Mean time to union was 15.5 weeks (range, 12-36 weeks). Two patients (Garden type III and type IV) did not achieve union, and 4 patients (1 Garden type III and 3 type IV) had avascular necrosis of the femoral head. In patients with nonunion, 1 (Garden type III) underwent intertrochanteric osteotomy, and the other underwent total hip replacement (THR). In patients with avascular necrosis, 2 required THR and the others (1 Garden type III) required no further surgery. Twenty-six (63%) patients had excellent results, 8 (20%) had good results, 3 (7%) had moderate results, and 4 (10%) had poor results. These findings suggest that the proximal femoral locking plate with cannulated screws for the treatment of femoral neck fractures is effective and results in fewer complications, especially for Garden type I, II, and III fractures