bluuebunny/crossref_metadata_2025_split huggingface dataset:
Posttraumatic Heterotopic Ossification of the Hip
Authors: Behery Omar A. , Dai Amos Z. , McLaurin Toni M. 
Published: July 2018

Introduction:
Posttraumatic heterotopic ossification (HO) of the hip frequently follows acetabular fracture and hip surgery and can become symptomatic, with significant pain and limited range of motion (ROM). Definitive treatment may require surgical excision, which can result in serious complications if not planned and executed appropriately.

Methods:
Surgical excision of posttraumatic hip HO requires appropriate indications, preoperative planning, and intraoperative guidance using fluoroscopy to maximize excision of HO and minimize complications. This video presents a case of severe posttraumatic hip HO, indications and technique of surgical excision using fluoroscopic guidance, postoperative protocol, and the patient's clinical follow-up.

Results:
Surgical excision along with appropriate postoperative HO prophylaxis and immediate mobilization resulted in significant improvement in hip ROM and return to activities of daily living without complications or recurrence. Intraoperative blood loss can be significant and should be appropriately planned for preoperatively.

Conclusions:
Posttraumatic hip HO can cause significantly limited hip ROM and pain with resulting disability. Surgical excision of posttraumatic hip HO in a preserved hip joint can be successful in restoring hip ROM and function. Appropriate postoperative HO prophylaxis can prevent recurrence.
Use of the 95-degree Angled Blade Plate to Treat a Proximal Femur Fracture
Authors: Hartline Braden E. , Achor Timothy S. 
Published: July 2018

Summary:
There are a variety of ways to treat high-energy proximal femur fractures, including intramedullary nails and laterally based plates. Although each have distinct advantages and disadvantages, fracture reduction and avoiding varus alignment are critical. For some fractures, the blade plate is a reliable, straightforward implant to treat these injuries. This article and the accompanying video describe the surgical technique of using a 95-degree angled blade plate to treat an acute high-energy proximal femur fracture.
Ankle Spanning External Fixator Application
Authors: McAndrew Christopher M. , Ricci William M. , Miller Anna N. , Avery Matthew C. 
Published: July 2018

Summary:
A 2-stage approach to treatment of tibia pilon fractures was reported in the 1990s and popularized over the ensuing decade to help avoid catastrophic soft-tissue complications experienced with one-stage open reduction and internal fixation. This approach can be expanded to the treatment of other high-energy injuries of the hind foot, with variation in external fixator application as needed. Key factors to maximize the utility and decrease complications of the external fixation stage include the following: (1) anatomic reduction of the talus under the long axis of the tibia in the coronal and sagittal planes, (2) strategic application of Schantz pins to resist deforming forces resulting from the injury, and (3) external fixation outside the zone of injury and definitive surgical treatment. This video demonstrates concepts and tactics to obtain and maintain fracture reduction with an external fixator with examples of a complex combined plafond and talus injury, as well as a more typical Orthopaedic Trauma Association/Arbeitsgemeinschaft fur Osteosynthesefragen C-type pilon fracture.
Shoulder Arthrodesis
Authors: Legato Joseph M. , O'Connell Megan , Fuller David A. 
Published: July 2018

Purpose:
The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries.

Methods:
A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers–Danlos syndrome is shown undergoing a shoulder arthrodesis. The video demonstrates intraoperative patient positioning, approach, shoulder osseous and articular preparation, implant placement (narrow 4.5 dynamic compression plate), and wound closure. The video includes a brief case history with preoperative radiographic imaging, indications, and patient outcome with postoperative radiographic imaging.

Results:
The video is 11 minutes, 34 seconds in time.

Conclusion:
This video demonstrates a left shoulder arthrodesis with successful glenohumeral positioning of 30 degrees/30 degrees/30 degrees flexion, abduction, and internal rotation, respectively, and functional ability to reach the mouth and top of the head.
Intraoperative CT and Surgical Navigation for Iliosacral Screws: Technique for Patients With Sacral Dysmorphism
Authors: Khan Jannat M. , Lara Daniel L. , Marquez-Lara Alejandro , Rosas Samuel , Hasty Eddy , Pilson Holly T. 
Published: July 2018

Summary:
Percutaneous iliosacral screw (IS) fixation for pelvic ring injuries with the use of an O-arm imaging system has been associated with decreased procedure time and improved accuracy of IS screw placement compared with the use of fluoroscopic guidance. Specifically, patients with sacral dysmorphism require identification of safe bony sacral corridors, using specific anatomical measurements, to decrease the likelihood of complications such as screw perforation. Intraoperative computed tomography imaging and navigation can aid in safe and accurate IS screw fixation in patients with difficult anatomy.
Open Reduction and Internal Fixation of the Femoral Head via the Smith–Petersen Approach
Authors: Ricci William M. , McAndrew Christopher M. , Miller Anna N. , Avery Matthew C. 
Published: July 2018

Summary:
Pipkin described femoral head fractures in the 1950s, but controversy still exists regarding indications for surgery and approaches for operative treatment of femoral head fractures. Clear indications for operative intervention include inability to reduce the hip with closed methods, a nonconcentric reduction, fracture fragments within the articulating surface of the hip, and associated injuries (acetabulum and femoral neck fractures) with their own indications for surgery. The anterior approach described by Smith–Petersen has been modified (using only the distal portion) and used to visualize, clean, reduce, and fix these fractures with and without anterior dislocation of the hip.
ORIF Pilon via Posteromedial and Anterolateral Approaches
Authors: McAndrew Christopher M. , Ricci William M. , Miller Anna N. , Avery Matthew C. 
Published: July 2018

Summary:
Tibial pilon fractures are complex injuries of soft tissue and bone that challenge patients and surgeons. Outcomes following this injury are guarded, and complications are frequently reported. Soft-tissue compromise at the time of injury is potentially amplified with surgical trauma, necessitating thorough evaluation, preoperative planning, and expertise to minimize complications and maximize outcomes. Understanding angiosome anatomy and typical fracture patterns (and their variations) allows for design of surgical tactics that accomplish these goals.
Range of Motion Improvement Following Surgical Management of Knee Arthrofibrosis in Children and Adolescents
Authors: Fabricant Peter D. , Tepolt Frances A. , Kocher Mininder S. 
Published: July 2018

Background:
Arthrofibrosis of the knee is well-described in adults as a potentially debilitating postoperative complication following anterior cruciate ligament reconstruction, total knee arthroplasty, or fracture fixation. Knee arthrofibrosis in children and adolescents, however, has received little attention. The primary purpose of this study was to report improvements in range of motion (ROM) following lysis of adhesions and manipulation under anesthesia (LOA/MUA) in children and adolescents with knee arthrofibrosis, and, secondarily, to evaluate for any effect of preoperative dynamic splinting on ROM outcomes.

Methods:
Ninety patients aged 18 years and below (mean, 14.4±3.5) and 31% male who underwent LOA/MUA at an urban tertiary care hospital following prior knee surgery were evaluated. Demographic, clinical, ROM, and revision data were compiled. Primary outcome was absolute ROM. Secondarily, ROM was analyzed as a categorical variable with “Full ROM” defined to be −5 to 130 degrees or better, “functional” ROM was defined as unable to obtain −5 to 130 degrees but not requiring revision, and “failure” defined as resulting in revision arthrofibrosis surgery. t tests and χ2 analyses were used to compare ROM and count variables between dynamic splinting subgroups.

Results:
Mean time from index surgery to LOA/MUA was 6.0±4.4 months, and follow-up was 42±56 months. Index procedures included anterior cruciate ligament reconstruction (N=33), tibial spine arthroscopic reduction and internal fixation (N=18), fracture fixation (N=17), soft tissue repair (N=17), and multiligament reconstruction (N=5). In total, 68 subjects (76%) had any flexion loss, 57 subjects (63%) had any extension loss, and 40 subjects (44%) had both flexion and extension loss.
Fifty-six subjects (62%) had full ROM at final follow-up, 25 subjects (28%) had functional ROM, and 9 subjects (10%) required revision. No demographic, clinical, or surgical variable was predictive of treatment failure. Patients who underwent dynamic splinting preoperatively (N=46; 51%) had greater preoperative flexion (99±16 vs.77±34 degrees; P=0.001), but no difference in flexion at final follow-up (121±20 vs.128±11 degrees; P=0.08). Failure was not associated with time from index procedure to LOA/MUA, and the proportion who regained full ROM postoperatively was equivalent between those who had dynamic splinting and those who did not (65% vs. 59%; P=0.70).

Conclusions:
LOA/MUA for children with arthrofibrotic knees results in significant improvements in ROM with 90% revision-free success. Preoperative dynamic or static progressive splinting improves preoperative flexion but does not affect postoperative range of motion or failure rate.

Level of Evidence:
Level II.
Population-based Risk Factors for the Development of Degenerative Disk Disease
Authors: Steelman Theodore , Lewandowski Louis , Helgeson Melvin , Wilson Kevin , Olsen Cara , Gwinn David 
Published: July 2018

Study Design:
This is a retrospective case control study.

Objective:
Identify risk factors and assess their relative impact on the development of degenerative disk disease (DDD).

Summary of Background Data:
DDD is responsible for widespread disability in the civilian and military population. Despite the impact of low back pain and DDD, its multifactorial etiology is not entirely understood.

Materials and Methods:
The Defense Medical Surveillance System was searched for military members with the diagnosis of DDD as identified with the use of International Classification of Disease, 9th Revision (ICD-9) codes. These patients were compared with an age-matched and sex-matched control of military members without DDD from the Defense Medical Surveillance System. The prevalence of risk factors (obesity, hip, and knee osteoarthritis, tobacco dependence, diabetes, and type of employment) was then determined for both groups. In total, 160,911 patients with DDD were identified compared with 315,225 controls. Multivariate conditional logistical regression analysis was utilized to determine odds ratio (OR) for these groups based on data matched by age and sex and were adjusted for military rank and race/ethnicity.

Results:
Diabetes showed an OR of 1.469 [confidence interval (CI), 1.350–1.598]. Hip and knee arthritis produced an OR of 2.925 (CI, 2.685–3.187) and tobacco dependency showed an OR of 1.799 (CI, 1.762–1.836). The comparison of overweight to normal body mass index produced an OR of 1.334 (CI, 1.307–1.361) and the analysis of obese to normal body mass index had an OR of 1.556 (CI, 1.497–1.618). There failed to be a clinically significant association between military duty assignments and the presence of DDD.

Conclusions:
Our research failed to show a clinical significance association between military duty assignment and DDD. However, we were able to identify a significant association between concomitant hip and knee osteoarthritis, obesity, diabetes, and tobacco dependency with the development of DDD.

Level of Evidence:
Level IV.
Outcomes in Patients With Severe West Nile Neuroinvasive Disease
Authors: Hawkes Maximiliano A. , Carabenciov Ivan D. , Wijdicks Eelco F. M. , Rabinstein Alejandro A. 
Published: July 2018

Objective:
To assess the long-term outcomes of patients hospitalized with severe West Nile neuroinvasive disease.

Design:
Retrospective cohort.

Setting:
Patients admitted to a referral center (Saint Mary’s Hospital, Mayo Clinic).

Participants:
Twenty-six patients with West Nile neuroinvasive disease were identified by retrospective search of electronic database of Saint Mary’s Hospital from January 1999 to November 2016.

Interventions:
Retrospective electronic medical records review and prospective telephone follow-up.

Measurements and Main Results:
Functional disability and cognitive outcomes were evaluated with the modified Rankin Scale and the Telephone Interview for Cognitive Status scores. Data on the time that the patient returned home after the hospitalization for West Nile neuroinvasive disease and the time of return to work were also collected. We identified 26 patients (81% males), 59 ± 17 years old. After a median hospital stay of 14.5 days (3–126), four patients died and 90% of survivors had a modified Rankin Scale of 3–5. Two additional patients died, and 80% of survivors had a modified Rankin Scale of 0–2 after a median follow-up of 73 months (1–144). Seven patients had cognitive impairment, which was severe in two of them. The combination of encephalitis and acute flaccid paralysis at presentation was associated with lower likelihood of returning home within 1 month after discharge (p < 0.01). Patients who required mechanical ventilation were more likely to have a modified Rankin Scale of 3–5 at last follow-up (p = 0.03), less likely to return home within 1 month of discharge (p < 0.01), less likely to return to their jobs (p < 0.01), and showed a trend toward having cognitive impairment (p = 0.05).

Conclusions:
Despite having poor outcomes at discharge, most West Nile neuroinvasive disease survivors with severe early disability can recover functional independence in the long term, justifying aggressive support during the acute phase and extensive rehabilitation efforts.
Low Interleukin-7 Receptor Messenger RNA Expression Is Independently Associated With Day 28 Mortality in Septic Shock Patients*
Authors: Delwarde Benjamin , Peronnet Estelle , Venet Fabienne , Cerrato Elisabeth , Meunier Boris , Mouillaux Julie , Lepape Alain , Pachot Alexandre , Rimmelé Thomas , Monneret Guillaume , Textoris Julien 
Published: July 2018

Objectives:
Septic shock is the primary cause of death in ICUs. A better comprehension of its pathophysiology, in particular, the immune alteration mechanisms, opened new therapeutic perspectives such as the recombinant interleukin-7. The use of biomarkers could improve the identification of eligible patients for this therapy. The soluble form of the interleukin-7 appears as a promising candidate in this regard since an association between its high plasmatic level and mortality in critically ill patients has been demonstrated. Because there are no data available on the transcriptional regulation of the interleukin-7 receptor in such patients, this study aimed to explore the expression level of different interleukin-7 receptor transcripts after septic shock and evaluate their association with mortality.

Design:
Retrospective discovery cohort (30 patients) and validation cohort (177 patients).

Setting:
Two French ICUs (discovery study) and six French ICUs (validation study).

Patients:
Adult septic shock patients.

Interventions:
None.

Measurements and Main Results:
The quantification of several interleukin-7 receptor transcripts using specific reverse transcription quantitative polymerase chain reaction designs allowed for global evaluation of interleukin-7 receptor gene expression in whole blood. In the discovery cohort, all interleukin-7 receptor transcripts studied were expressed at lower levels in septic shock patients than in healthy volunteers. Interleukin-7 receptor gene expression at day 3 after septic shock diagnosis was associated with day 28 mortality. Patients at a lower risk of death showed higher expression levels. These results were confirmed in the independent validation cohort. Interestingly, using a threshold obtained on the discovery cohort, we observed in the validation cohort a high negative predictive value for day 28 mortality for the transcript encoding the membrane form of interleukin-7 receptor (0.86; 95% CI, 0.79–0.93).

Conclusions:
Interleukin-7 receptor transcripts appear as biomarkers of impaired adaptive immune response in septic shock patients and as a promising tool for patient stratification in clinical trials evaluating immunoadjuvant therapies.
Pathophysiology of Muscle in Pulmonary and Cardiovascular Conditions
Authors: Kasawara Karina Tamy , Castellanos Maria Miñana , Hanada Masatoshi , Reid W Darlene 
Published: July 2018

Purpose:
To provide an overview of skeletal muscle pathophysiology in pulmonary and cardiovascular conditions commonly managed by physical therapists.

Summary of Key Points:
This review describes the muscle pathophysiology associated with congestive heart failure, chronic obstructive pulmonary disease, interstitial lung disease, cystic fibrosis, intensive care unit–acquired weakness, immobilization, and aging. Causes of poor muscle performance are multifactorial; disease-specific and generic factors can contribute to the etiology. The time course of deterioration of peripheral and ventilatory muscle may each follow a distinctive course dependent on disease severity, its progression, and other influencing factors. Generic factors that are common in many respiratory and cardiovascular conditions are systemic inflammation and oxidative stress leading to peripheral and ventilatory muscle dysfunction that is accentuated by reduced physical activity. Loss of muscle function associated with aging is also reflected in both peripheral and ventilatory muscles. Evidence of how exercise training can counter the deleterious effects of disease on physical function is outlined.

Statement of Conclusions:
Patients with pulmonary and cardiovascular conditions may experience atrophy and weakness due to macroscopic, cellular, and metabolic alterations. Physical therapy interventions to improve muscle function need to consider the potential reversibility and related time course of the underlying pathophysiology of muscle dysfunction.
0.01% Hypochlorous Acid as an Alternative Skin Antiseptic: An In Vitro Comparison
Authors: Anagnostopoulos Apostolos G. , Rong Andrew , Miller Darlene , Tran Ann Q. , Head Trajen , Lee Michael C. , Lee Wendy W. 
Published: July 2018

OBJECTIVE
Compare the in vitro efficacy of hypochlorous acid 0.01% (HA), povidone iodine 5% (PI), chlorhexidine gluconate 4% (CHG), and isopropyl alcohol 70% (IPA) against common skin microorganisms.

MATERIALS AND METHODS
Time-kill studies were conducted against methicillin-susceptible Staphylococcus aureus (MSSA) and Staphylococcus epidermidis (MSSE), methicillin-resistant S. aureus (MRSA) and S. epidermidis (MRSE), Candida albicans, Corynebacterium species (striatum and amycolatum), Propionibacterium acnes, Pseudomonas aeruginosa, Streptococcus pyogenes, Staphylococcus capitis, and Staphylococcus xylosus.

RESULTS
Methicillin-resistant S. aureus: Bactericidal effect was immediate for HA and IPA. For PI and CHG, the effect occurred at 1 and 10 minutes, respectively. Methicillin-resistant S. epidermidis: Hypochlorous acid, IPA, and PI had immediate bactericidal effects, whereas CHG required 1 minute. Methicillin-susceptible Staphylococcus aureus: All agents had bactericidal effects at 1 minute. C. species, S. pyogenes, P. aeruginosa, and P. acnes: All antiseptics demonstrated immediate bactericidal effects. Methicillin-susceptible Staphylococcus epidermidis and S. capitis: Hypochlorous acid and IPA had immediate effect, whereas PI and CHG required 1 minute. C. albicans: Hypochlorous acid, IPA, and PI were immediately bactericidal, whereas CHG required 1 minute. S. xylosus: Hypochlorous acid and CHG were immediately bactericidal, whereas IPA and PI required 1 and 2 minutes, respectively.

CONCLUSION
In vitro studies of HA 0.01% were observed to have equal or more efficacious antiseptic properties compared with IPA, CHG, and PI. Future studies will be needed to investigate its role in periocular use.
Responses to Topical Diphenylcyclopropenone as an Adjunct Treatment for In-Transit Melanoma: A Tertiary Referral Center Experience
Authors: Veverka Kevin K. , Jakub James W. , Baum Christian L. 
Published: July 2018

BACKGROUND
In-transit cutaneous metastases occur in 5% to 10% of patients with melanoma. Recently, topical diphenylcyclopropenone (DPCP) has been described as a treatment option.

OBJECTIVE
To evaluate efficacy of DPCP in treatment of in-transit cutaneous melanoma.

METHODS
The authors retrospectively reviewed the records of 13 consecutive patients with in-transit metastases treated with topical DPCP between March 1, 2013, and January 31, 2017. The authors recorded the response of in-transit cutaneous melanoma lesions treated with DPCP measured by clinical examination.

RESULTS
Among the 13 patients, 9 patients completed at least a 1-month course of DPCP treatment. Of these 9 patients, 6 (66.7%) maintained either stable disease or had a partial or complete regression, and 3 (33.3%) had progressive disease. Patients with less burden of disease (e.g., <15 lesions) responded more favorably than those with a greater burden of disease (e.g., >25 lesions or plaques). Both patients who received DPCP alone had progression of their cutaneous lesions. One patient who did not become sensitized to DPCP died within 2 months, and his anergy likely reflecting immense burden of disease.

CONCLUSION
Topical DPCP is a low-cost, patient-applied treatment option for in-transit melanoma, most effective for patients with relatively low tumor burden and localized disease.
Perfluorooctanoate and Perfluorooctanesulfonate plasma concentrations and survival after prostate and bladder cancer in a population-based study
Authors: Roswall Nina , Larsen Signe Benzon , Sørensen Mette , Tjønneland Anne , Raaschou-Nielsen Ole 
Published: July 2018

Background:
Perfluorooctanoate (PFOA) and perfluorooctanesulfonate (PFOS) are synthetically produced chemicals, which have been linked to cancer in animal studies, whereas the evidence in humans is merely suggestive. We investigated the association between PFOA and PFOS concentrations in plasma samples and mortality in two survivor cohorts of prostate and bladder cancer patients.

Methods:
We included 688 prostate and 307 bladder cancer cases diagnosed between baseline (1993–97) and July 1, 2006 in the Danish Diet, Cancer and Health cohort. PFOA and PFOS concentrations in plasma samples taken at baseline were measured using high-pressure liquid chromatography. We used Cox proportional hazards models to estimate mortality rate ratios.

Results:
Between diagnosis and February 1, 2016, 356 prostate and 149 bladder cancer cases died. We found no association between PFOA or PFOS concentrations and survival among prostate cancer cases. This was regardless of prognostic factors. For bladder cancer cases, there was an inverse association between PFOA and PFOS and subsequent mortality. Associations were similar for both overall and bladder cancer-specific mortality.

Conclusions:
The results of the present study does not suggest an association between PFOA or PFOS concentrations and survival among prostate cancer patients. In contrast, they may be inversely associated with both overall and bladder cancer–specific mortality in bladder cancer patients. However, this finding requires replication in further studies before firm conclusions can be drawn.