bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reliability of Radiographic Union Scoring in Humeral Shaft Fractures
Authors: Schneble Christopher A. , Li Don T. , Kahan Joseph , Brand Jordan , Socci Adrienne , Haims Andrew , Yoo Brad J. 
Published: May 2020

Objectives:
To establish the reliability of 2 radiographic union scoring systems for nonoperative humeral shaft fractures.

Design:
Retrospective medical record review. Patients identified had humeral shaft fractures and radiographs at various follow-up time points, which were graded according to the both the standard (RUST) and modified radiographic union scoring systems (mRUST).

Setting:
A single North American Level-1 Trauma center in Connecticut, including emergency department and clinic follow-up visits.

Patients/Participants:
Forty-five adult patients (162 image sets) met the following inclusion criteria: diaphyseal humerus fracture, initial nonoperative management, and greater than 2 weeks of follow-up with imaging.

Intervention:
All 162 image sets of anterior–posterior and lateral radiographs were scored and divided into 4 tiers based on increasing score. Anterior–posterior and lateral image sets were randomly selected from each tier for a total of 50 that were then scored by 7 different reviewers using both the RUST and mRUST systems.

Main Outcome Measures:
The intraclass correlation coefficients for the cortical and system scores for the RUST and mRUST systems.

Results:
Interobserver reliability was 0.795 for the RUST system and 0.801 for mRUST. Intraobserver reliability was 0.909 for RUST and 0.949 for mRUST. For mRUST, 92% of values were within ± 1 point from each other.

Conclusions:
The RUST and mRUST systems can be applied to humeral shaft fractures with excellent reliability. They have the potential to assist in the diagnosis of humeral shaft union by providing an objective and standardized method to assess healing of bone over time.
Coronal Remodeling Potential of Pediatric Distal Radius Fractures
Authors: Lynch Kyle A. , Wesolowski Michael , Cappello Teresa 
Published: May 2020

Background:
Distal radius fractures in the pediatric population are common injuries with a remarkable capability to remodel. The degree of angulation that can reasonably be expected to remodel is controversial though, particularly when it comes to angulation in the coronal plane. The purpose of this study was to quantify the rate of coronal remodeling, via the distal radius physis, present in a retrospective cohort of skeletally immature patients with coronally angulated distal radius fractures.

Methods:
A retrospective chart review was performed to identify skeletally immature patients treated for an angulated distal radius fracture with over 10 degrees of angulation in the coronal plane during the healing process at a single institution by either a pediatric orthopaedic surgeon or an orthopaedic trauma surgeon from 2009 to 2018. Coronal angulation was measured at every visit where radiographs were available from time of injury to the final follow-up visit to determine the rate of remodeling.

Results:
In total, 36 patients with distal radius fractures with a mean age of 7.93 years (range, 4 to 12 y) at the time of injury were identified. The median peak angulation during the healing process in the coronal plane was 17 degrees (range, 12.4 to 30.4 degrees). The mean follow-up period was 6.4 months from the time of maximum angulation to the final visit. The median time from cast removal to final follow-up was 6.59 months (range, 2.5 to 8.72 mo). At final follow-up, the median coronal angulation was 3.35 degrees (range, 0.24 to 14.0 degrees). At the 95% confidence level, remodeling rates ranged from 2.00 to 2.59 degrees per month. The mean rate of coronal angulation remodeling from maximum angulation to final follow-up was 2.30 degrees per month.

Conclusions:
Distal radius fractures have a large capacity to remodel in the pediatric population. This remodeling occurs in a predictable and reliable manner, even in the coronal plane. On the basis of this study, coronal angulation was shown to remodel at a rate of at least 2 degrees per month for the first 6 months following the injury, which should likely continue at a similar rate for the first year after the injury. Repeat manipulation is not indicated in skeletally immature patients where the maximum coronal angulation is <24 degrees, which provides a conservative estimate of the amount of remodeling that can be expected to occur in the first year after fracture.

Level of Evidence:
Level III—retrospective comparative study.
Comparison of Clinical Outcomes Between Posterior Instrumented Fusion With and Without Interbody Fusion for Isthmic Spondylolisthesis
Authors: Chan Vivien , Nataraj Andrew , Bailey Christopher , Abraham Edward , Soroceanu Alex , Johnson Michael , Paquet Jérôme , Christie Sean , Stratton Alexandra , Hall Hamilton , Manson Neil , Rampersaud Y. Raja , Thomas Kenneth , Fisher Charles 
Published: May 2020

Study Design:
A multicenter ambispective study using the Canadian Spine Outcomes and Research Network to compare clinical outcomes in adult patients with isthmic spondylolisthesis who received surgery.

Objective:
The purpose of this study is to compare 1-year postoperative clinical outcomes between posterior instrumented fusion with and without interbody fusion in patients with isthmic spondylolisthesis.

Summary of Background Data:
Despite the increased use of interbody fusion in patients with isthmic spondylolisthesis, clinical superiority has not been demonstrated. It remains unclear what the optimal surgical approach is for this population.

Materials and Methods:
The primary outcome was changed in leg pain at 1 year. Secondary outcomes were changed in Oswestry Disability Index, Short Form-12 Physical Component Score, and back pain at 1-year postoperative follow-up, estimated intraoperative blood loss, length of surgery, length of stay, number of transfusions, and adverse events. Descriptive statistics, Student t test, χ2 test, and stepwise multivariable regression were used for analysis.

Results:
In total, 300 patients were included in this study. Of the 300 patients, 252 received posterolateral instrumented fusion with interbody fusion and 48 received posterolateral instrumented fusion alone. There were no significant differences in primary and secondary clinical outcomes at 1-year postoperative follow-up between the 2 groups. There were no significant differences in estimated blood loss (441 vs. 356 mL), length of surgery (210 vs. 224 min), length of stay (4 vs. 4 d), rate of transfusions (5.6% vs. 8.3%), and number of adverse events (33% vs. 23%) between patients who received interbody fusion and patients who did not. The addition of interbody fusion was not a significant variable for primary and secondary clinical outcomes in the stepwise multivariable regression analysis.

Conclusions:
There were no significant differences in clinical outcomes at 1 year or in the number of early complications between patients who received posterolateral fusion or posterior/transformational lumbar interbody fusion.

Level of Evidence:
Level III.
Decompressive Craniectomy Is Associated With Good Quality of Life Up to 10 Years After Rehabilitation From Traumatic Brain Injury
Authors: Rauen Katrin , Reichelt Lara , Probst Philipp , Schäpers Barbara , Müller Friedemann , Jahn Klaus , Plesnila Nikolaus 
Published: May 2020

Objectives:
Traumatic brain injury is the number one cause of death in children and young adults and has become increasingly prevalent in the elderly. Decompressive craniectomy prevents intracranial hypertension but does not clearly improve physical outcome 6 months after traumatic brain injury. However, it has not been analyzed if decompressive craniectomy affects traumatic brain injury patients’ quality of life in the long term.

Design:
Therefore, we conducted a cross-sectional study assessing health-related quality of life in traumatic brain injury patients with or without decompressive craniectomy up to 10 years after injury.

Setting:
Former critical care patients.

Patients:
Chronic traumatic brain injury patients having not (n = 37) or having received (n = 98) decompressive craniectomy during the acute treatment.

Measurements and Main Results:
Decompressive craniectomy was necessary in all initial traumatic brain injury severity groups. Eight percent more decompressive craniectomy patients reported good health-related quality of life with a Quality of Life after Brain Injury total score greater than or equal to 60 compared with the no decompressive craniectomy patients up to 10 years after traumatic brain injury (p = 0.004). Initially, mild classified traumatic brain injury patients had a median Quality of Life after Brain Injury total score of 83 (decompressive craniectomy) versus 62 (no decompressive craniectomy) (p = 0.028). Health-related quality of life regarding physical status was better in decompressive craniectomy patients (p = 0.025). Decompressive craniectomy showed a trend toward better health-related quality of life in the 61–85-year-old reflected by median Quality of Life after Brain Injury total scores of 62 (no decompressive craniectomy) versus 79 (decompressive craniectomy) (p = 0.06).

Conclusions:
Our results suggest that decompressive craniectomy is associated with good health-related quality of life up to 10 years after traumatic brain injury. Thus, decompressive craniectomy may have an underestimated therapeutic potential after traumatic brain injury.
A Case for a Local Flap as Primary Reconstruction for Hidradenocarcinoma of the Leg
Authors: McMains Conner J. , Hung Rex W. , Deng Tom , Masden Derek L. 
Published: May 2020

Summary:
Hidradenocarcinomas are rare, aggressive sweat gland tumors typically occurring in the scalp and upper extremities. They have rarely been described in the lower extremity. Due to their rarity, there is little consensus on optimal adjuvant therapy for these tumors after resection. Regardless, it is important to plan tumor excision and subsequent reconstruction with adjuvant therapy in mind. This case report describes a patient for whom a local muscle flap with skin graft provided adequate wound coverage after excision of hidradenocarcinoma and negative-pressure wound therapy. The surgical site then withstood adjuvant radiation therapy. When radiation is planned to a wound bed after tumor excision, a local muscle flap is the excellent first choice over skin graft alone regardless of wound bed characteristics.
The Whole Glove Tourniquet Technique Revisited With Video Instruction
Authors: Steve Anna K. , Shine Julien J. , Nickerson Duncan 
Published: May 2020

Summary:
This article revisits the whole glove tourniquet technique with video instruction. The whole glove tourniquet is a digital device that can be used to improve patient safety during hand surgery procedures performed under local anesthesia. Major benefits include of using this device are lower risk of the tourniquet being inadvertently left on the finger after completion of the procedure and improved sterile field in patients with heavily soiled extremities. The procedure is simple to use and does not require any specialized equipment, making it ideal for a wide variety of economic environments.
New Simple Technique for Syndactyly Release
Authors: Grahn Petra M. , Nietosvaara Noora N. , Sommarhem Antti J. , Nietosvaara Yrjana A. 
Published: May 2020

Background:
Can good functional and cosmetic result be achieved in syndactyly separation using a straight midline incision with a hexagonal dorsal skin flap?

Methods:
We performed 39 web reconstructions at a median of 20 months of age (11–43 months) to 26 consecutive children (21 male) with 30 simple, 4 complex, and 5 complicated syndactylies. Eighteen of the simple syndactylies were incomplete, ending at the proximal interphalangeal joint in 15 and at the distal interphalangeal joint in 3. Inguinal skin grafts were used in 2 children with either complex or complicated syndactyly. Operation time was recorded. Complications were registered. Height of the new web spaces was calculated. Parents’ satisfaction on both functional and cosmetic outcome was assessed using a Visual Analog Scale from 0 to 100.

Results:
Duration of one web reconstruction ranged from 50 to 95 minutes in simple incomplete, 56 to 135 in simple complete, 116 to 151 in complex, and 72 to 123 in complicated syndactylies. One child had a self-induced bilateral postoperative infection that lead to web creep. Two patients developed hypertrophic scars, which responded well to silicone treatment. Mean cosmetic and functional Visual Analog Scale scores were 87 (45–100) and 92 (63–100), respectively, at a mean follow-up of 1.3 years (range, 0.5–3.7).

Conclusion:
Web reconstruction using a hexagonal dorsal skin flap and straight midline incisions with closure at mid-lateral lines is safe, with good cosmetic and functional outcome in our short-term follow-up.
Radiofrequency-Assisted Endofistulectomy: Treating Coexisting Lacrimal Fistulae During Endoscopic Dacryocystorhinostomy
Authors: Bothra Nandini , Ali Mohammad Javed 
Published: May 2020

Purpose:
To assess the efficacy of radiofrequency-assisted endofistulectomy in patients with lacrimal fistulae communicating with the lacrimal sac.

Methods:
Retrospective interventional case series of patients undergoing endoscopic dacryocystorhinostomy with endofistulectomy from June 2016 to January 2020 were studied. The indications of endoscopic dacryocystorhinostomy were associated refractory complex congenital nasolacrimal duct obstructions and primary-acquired nasolacrimal duct obstruction. The communication of the fistulae with the lacrimal sac was ascertained. Specific surgical parameters and technique were used, and the variables assessed include patient demographics, clinical presentation, indications, surgical technique, recurrences, and outcomes.

Results:
Six eyes of 6 patients with mean age of 23.33 years underwent radiofrequency-assisted endofistulectomy. The surgical technique was found to be minimally invasive, easy to perform with multiple advantages like absence of a skin incision, targeting of the complete extent of the fistula, and complete closure of the external and internal openings of the fistulae. At 4 weeks, dacryocystorhinostomy ostium was well mucosalized and patent with a dynamic common canalicular opening. The fistula site had healed well with no epiphora or discharge or residual scarring.

Conclusion:
Radiofrequency-assisted endofistulectomy is a minimally invasive and viable alternative to incisional fistulectomy in select group of patients of congenital or acquired fistulae which communicate with the lacrimal sac.
Lateral Tarsoconjunctival Flap Suspension Treatment of Post Blepharoplasty Lower Eyelid Retraction
Authors: Conger Jordan R. , Grob Seanna R. , Limongi Roberto M. , Tao Jeremiah P. 
Published: May 2020

Purpose:
To describe and evaluate the use of a lateral tarsoconjunctival suspension flap (TCSF) for the management of post blepharoplasty lower eyelid retraction.

Methods:
Two-center, retrospective chart review of patients who received a lateral TCSF between 2010 and 2018 for correction of post blepharoplasty lower eyelid retraction. The postoperative follow-up was a minimum of 3 months. Pre- and postoperative lower eyelid position (margin reflex distance 2 on standard photographs), degree of ocular surface disease, symptoms, complications, and need for further intervention were recorded. Pre- and postoperative photographs were scored using an objective grading system for cosmetic surgical results (MDACS).

Results:
Forty-eight eyelids from 30 patients met inclusion criteria for this study. Twenty (67%) of the patients were female. Age ranged from 55 to 89 (mean, 73.2). After the TCSF, ocular surface exposure improved in all cases. Lower eyelid retraction (average margin reflex distance 2 pre- vs. postintervention) improved in 98% of cases. Objective scoring of appearance improved; the mean MDACS score was 8 pre- and 3 post-TCSFs (p < 0.0001). One patient required midface lift and lateral canthoplasty 7 months later for undercorrected eyelid retraction. Another case required partial resection due to visibility of the flap in the interpalpebral zone. Postoperative pyogenic granulomas were noted in 8% (4/48) of eyelids.

Conclusions:
The lateral TCSF was safe and effective in improving both functional and esthetic parameters in this series of post blepharoplasty eyelid retraction patients.
Ophthalmic Surgeries and Systemic Medical Conditions Associated With the Development of Involutional Ptosis
Authors: Cohen Liza M. , Campbell Benjamin C. , Esfandiari Mahtash , Goldberg Robert A. , Rootman Daniel B. 
Published: May 2020

Purpose:
To investigate the associations between systemic medical conditions and types of ocular surgery and the development of aponeurotic ptosis.

Methods:
In this case-control observational cohort study, the relative prevalence of involutional ptosis in a large population of adult patients was assessed. Deidentified patient data from a 10-year time period was obtained from the electronic medical records of 5 large academic medical centers. Patients were selected based on ICD9 and ICD10 codes for involutional ptosis. Control patients were age and gender matched and randomly selected from a general adult population. Systemic comorbidities were determined based on ICD9 and ICD10 codes, and prior ocular surgeries based on CPT codes. The influence of systemic comorbidities and ocular surgery was examined utilizing logistic regression analysis.

Results:
The study cohort consisted of 8297 adult patients with involutional blepharoptosis and 13,128 matched controls. The average age was 65 years. The 3 significant risk factors for developing ptosis were ocular surgery, hyperthyroidism, and type II diabetes with odds ratios of 4.2, 2.5, and 1.45, respectively (p < 0.05). Strabismus, cornea, and glaucoma surgeries were more highly associated with developing ptosis (p < 0.05). Strabismus surgery had the greatest odds ratio of 3.37, followed by cornea surgery at 2.31, and glaucoma surgery at 1.56.

Conclusions:
Involutional ptosis is likely a multifactorial process. This study demonstrates that risk factors for the development of ptosis include ocular surgery, specifically strabismus, cornea, and glaucoma surgery, as well as hyperthyroidism and type II diabetes.
Interleukin-10 resolves pain hypersensitivity induced by cisplatin by reversing sensory neuron hyperexcitability
Authors: Laumet Geoffroy , Bavencoffe Alexis , Edralin Jules D. , Huo Xiao-Jiao , Walters Edgar T. , Dantzer Robert , Heijnen Cobi J. , Kavelaars Annemieke 
Published: May 2020

Abstract
Understanding the mechanisms that drive transition from acute to chronic pain is essential to identify new therapeutic targets. The importance of endogenous resolution pathways acting as a “brake” to prevent development of chronic pain has been largely ignored. We examined the role of interleukin-10 (IL-10) in resolution of neuropathic pain induced by cisplatin. In search of an underlying mechanism, we studied the effect of cisplatin and IL-10 on spontaneous activity (SA) in dorsal root ganglia neurons. Cisplatin (2 mg/kg daily for 3 days) induced mechanical hypersensitivity that resolved within 3 weeks. In both sexes, resolution of mechanical hypersensitivity was delayed in Il10
−/− mice, in WT mice treated intrathecally with neutralizing anti-IL-10 antibody, and in mice with cell-targeted deletion of IL-10R1 on advillin-positive sensory neurons. Electrophysiologically, small- to medium-sized dorsal root ganglia neurons from cisplatin-treated mice displayed an increase in the incidence of SA. Cisplatin treatment also depolarized the resting membrane potential, and decreased action potential voltage threshold and rheobase, while increasing ongoing activity at −45 mV and the amplitude of depolarizing spontaneous fluctuations. In vitro addition of IL-10 (10 ng/mL) reversed the effect of cisplatin on SA and on the depolarizing spontaneous fluctuation amplitudes, but unexpectedly had little effect on the other electrophysiological parameters affected by cisplatin. Collectively, our findings challenge the prevailing concept that IL-10 resolves pain solely by dampening neuroinflammation and demonstrate in a model of chemotherapy-induced neuropathic pain that endogenous IL-10 prevents transition to chronic pain by binding to IL-10 receptors on sensory neurons to regulate their activity.
Applying Telehealth Technologies and Strategies to Provide Acute Care Consultation and Treatment of Patients With Confirmed or Possible COVID-19
Authors: Exum Emelia , Hull Brian L. , Lee Alan Chong W. , Gumieny Annie , Villarreal Christopher , Longnecker Diane 
Published: May 2020

Background and Purpose:
The COVID-19 pandemic continues to grow, with 19% of total confirmed patients classified as severe or critical experiencing complications such as dyspnea, hypoxia, acute respiratory distress syndrome, or multiorgan failure. These complications require rehabilitative care. Considering the contagious nature of COVID-19 and the necessity to decrease the volume of health care professionals entering confirmed COVID-19 patient rooms and becoming a potential disease vector, can audiovisual technologies employed by telehealth and telerehabilitation help?

Case Description:
This case discusses the Baylor Scott and White Institute for Rehab (BSWIR) Physical Medicine and Rehabilitation (PMR) department COVID-19 acute care therapy team's creation of a telehealth strategy to provide early rehabilitative intervention without increasing the odds of disease transmission.

Outcomes:
The COVID-19 therapy team created a simple process for identifying and triaging care for patients with possible or confirmed COVID-19. These patients were evaluated and treated by the dedicated team using telehealth strategies. A structured risk-benefit analysis was used to determine when in-room care was indicated.

Discussion:
Acute care physical therapy, occupational therapy, and speech-language pathology telehealth strategies can add value by mitigating COVID-19–related harm and influencing recovery, while not unnecessarily becoming additional disease vectors consuming personal protective equipment. COVID-19 is not only an aggressive respiratory illness similar to acute respiratory distress syndrome but also highly contagious and a risk for health care providers. Telehealth strategies allow therapists to intervene early, opening the possibility to maximize recovery and prevent harm or decompensation. Telehealth strategies can be more prevention-focused while the patient is experiencing relatively good health with goals to maximize strength and endurance before the disease process evolves to critical illness. As COVID-19 progresses, therapy can help mitigate potential complications associated with prolonged intensive care unit stay and ventilator management.
Molluscum Contagiosum
Authors: Coyner Theresa 
Published: May 2020

ABSTRACT
Molluscum contagiosum (MC) is a common dermatology condition affecting the worldwide population. MC is caused by the MC virus, a member of the Poxviridae family. The virus predominantly affects children, sexually active adolescents and young adults, individuals involved in contact sports, and immunocompromised individuals. The condition is self-limited and will eventually clear spontaneously without treatment. Many individuals do elect treatment, and management strategies are discussed along with potential side effects. Selected treatment outcomes printed in a recent Cochrane systematic review are summarized.