AAOS Now, January 2015
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NASS Meeting Delivers Education, Excitement
The North American Spine Society (NASS) held its 29th Annual Meeting at San Francisco’s Moscone Center, Nov. 11–15, 2014. Program chairs Charles A. Reitman, MD and Michael Reed, DPT, OCS, and the Program committee assembled an excellent program mixing reports on surgical and nonsurgical spine care with the latest research, along with symposia and debates. Special speakers NASS President William C.
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Timing of Motor Nerve Function Recovery in Children with Severe Supracondylar Humerus Fractures
Data presented at the American Society for Surgery of the Hand annual meeting indicate that most motor nerve injuries associated with pediatric supracondylar humerus fractures improve within 3 to 6 months, although recovery may be delayed in patients with more than one injured nerve. Supracondylar humerus fractures in children are primarily isolated injuries; however, patients with more severe extension-type fractures may experience concomitant nerve deficits, primarily of the median nerve.
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Preventing Rebound Pain After Ankle Fracture
Patients who receive a single-injection nerve block when undergoing surgery for an ankle fracture frequently experience “rebound pain” as the block wears off. According to the results of a study presented at the 2015 annual meeting of the Orthopaedic Trauma Association, use of a continuous infusion of regional anesthetic can not only alleviate rebound pain but also reduce the need for narcotic analgesia following surgery. According to David Y.
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Study: Hematoma Aspiration Does Not Reduce Pain in Ankle Fracture
A study to determine whether aspiration of hematoma and hemarthrosis in an ankle fracture would decrease pain and the need for pain medication found that aspiration did not result in decreased pain scores or opioid usage in patients. The results of the prospective, double-blind, randomized placebo-controlled trial were presented by S. Andrew Sems, MD, of the Mayo Clinic, at the 2014 annual meeting of the Orthopaedic Trauma Association.
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The Role of Ultrasound-Guided Injections in Orthopaedic Sports Medicine: Upper Extremity
The use of ultrasound to evaluate musculoskeletal structures was first reported in 1958. Since then, its use has grown exponentially, particularly in the office setting. Ultrasound enables physicians to reliably visualize soft-tissue structures including muscle bellies, tendons, ligaments, arteries, and nerves, as well as identify any pathologic changes within these structures.
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Patellofemoral Arthroplasty in 2015
One of my mentors once said, “If I only did what I did in residency, I wouldn’t be doing any surgery anymore.” Having finished my fellowship more than 12 years ago, I never would have guessed at the evolution that would occur in my surgical practice or predicted a practice profile such as I have today. One specific example is the use of patellofemoral arthroplasty.
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Taking the Next Step in Improving Value
Dr. Bozic, who addressed members of the Board of Councilors and Board of Specialty Societies at their 2014 fall meeting, noted that all current value-based payment strategies require a definition of “quality,” and emphasized that performance measures will play an important role in determining how physicians are paid going forward. Input from AAOS members as well as members of orthopaedic specialty societies, he stated, must guide development of performance measures.
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Unlocking the “Black Box” of Concussion
The National Football League (NFL) has come under increasing scrutiny for its response to traumatic brain injuries (TBIs) sustained by players as the result of concussions. The long-term prognosis for players who have suffered repeated TBIs can vary, but the condition is associated with a range of outcomes that run the gamut from mild cognitive deficits to chronic traumatic encephalopathy (CTE).