Articles

Unusual anatomic variant of the axillary nerve challenging the deltopectoral approach to the shoulder: a case report

The deltopectoral approach is a well-described surgical approach to the proximal humerus and glenohumeral joint. One of the structures at risk during this approach is the axillary nerve. Typically, the axillar...

Authors: Richard A. Pizzo, Jeffrey Lynch, Donald M. Adams, Richard S. Yoon and Frank A. Liporace

Does the time of day in orthopedic trauma surgery affect mortality and complication rates?

Orthopedic trauma surgery has multiple, both patient-based and surgeon-based risk factors. Evaluating and modifying certain patient safety factors could mitigate some of these risks. This study investigates th...

Authors: Sascha Halvachizadeh, Henrik Teuber, Paolo Cinelli, Florin Allemann, Hans-Christoph Pape and Valentin Neuhaus

Risk factors for complications and adverse outcomes in polytrauma patients with associated upper extremity injuries

In terms of upper extremity fractures by patients with multiple injuires, a lot of studies have assessed the functional outcome following trauma to have less favorable outcomes in regards to functional recover...

Authors: Florin Allemann, Sandro Heining, Boris Zelle, Christian Probst and Hans-Christoph Pape

Artificial intelligence systems for complex decision-making in acute care medicine: a review

The integration of artificial intelligence (AI) into acute care brings a new source of intellectual thought to the bedside. This offers great potential for synergy between AI systems and the human intellect al...

Authors: Lawrence A. Lynn

Lessons learned for postoperative wound healing: respect the past and embrace the future

Authors: Boris A. Zelle and Philip F. Stahel

Cognition errors in the treatment course of patients with anastomotic failure after colorectal resection

Cognitive errors have a considerable effect on procedural outcome. They play a major role in situational judgement and decision making, especially during cognitively demanding tasks. As such they need to be co...

Authors: P. Vogel and D. H. V. Vogel

Variability in pelvic packing practices for hemodynamically unstable pelvic fractures at US level 1 trauma centers

Mortality from hemodynamically unstable pelvic fractures remains high. Guidelines offer varying care approaches including the use of pelvic packing (PP), which was recently adopted for potential control of ble...

Authors: Benoit Blondeau, Alessandro Orlando, Stephanie Jarvis, Kaysie Banton, Gina M. Berg, Nimesh Patel, Rick Meinig, Allen Tanner II, Matthew Carrick and David Bar-Or

The role of indocyanine green fluoroscopy for intraoperative bile duct visualization during laparoscopic cholecystectomy: an observational cohort study in 70 patients

Bile duct injury is the most feared complication during laparoscopic cholecystectomy. Real-time intraoperative imaging using indocyanine green (ICG) might reduce the risk of bile duct injury by improving visua...

Authors: Peter C. Ambe, Jens Plambeck, Victoria Fernandez-Jesberg and Konstantinos Zarras

Low-grade infections as a possible cause of arthrofibrosis after total knee arthroplasty

Arthrofibrosis after total knee arthroplasty represents a considerable burden for the patient and a therapeutic challenge for the practitioner. One possible cause discussed in the literature is a low-grade inf...

Authors: C. Brückner, E. Straube, I. Petersen, S. Sachse, P. Keller, F. Layher, G. Matziolis, U. Spiegl, D. Zajonz, M. Edel and A. Roth

Does time of surgery influence the rate of false-negative appendectomies? A retrospective observational study of 274 patients

Multiple disciplines have described an “after-hours effect” relating to worsened mortality and morbidity outside regular working hours. This retrospective observational study aimed to evaluate whether diagnost...

Authors: Kirit Singh, Michael S. J. Wilson and Maria Coats

Safety of selective nonoperative management for blunt splenic trauma: the impact of concomitant injuries

Nonoperative management for blunt splenic injury is the preferred treatment. To improve the outcome of selective nonoperative therapy, the current challenge is to identify factors that predict failure. Little ...

Authors: Michel Paul Johan Teuben, Roy Spijkerman, Taco Johan Blokhuis, Roman Pfeifer, Henrik Teuber, Hans-Christoph Pape and Luke Petrus Hendrikus Leenen

Safety and efficacy of a two-screw cephalomedullary nail for intertrochanteric femur fracture fixation: a retrospective case series in 264 patients

Recent advances have led to the design of a new cephalomedullary nail, which aims to decrease the risk of failures in patients with intertrochanteric hip fractures by allowing for insertion of two interdigitat...

Authors: Boris A. Zelle, Antonio J. Webb, Christopher Matson, Michael Morwood, Khang H. Dang, Samuel S. Ornell, Gabrielle Gostigian, Cody M. Ramirez and Hassan Mir

Dexamethasone and postoperative hyperglycemia in diabetics undergoing elective hip or knee arthroplasty: a case control study in 238 patients

Dexamethasone has been routinely used in the pre-operative setting to enhance analgesia and decrease the incidence of nausea and vomiting in patients undergoing primary arthroplasty. However, dexamethasone has...

Authors: Robert S. O’Connell, Bryce N. Clinger, Erin E. Donahue, Francesco S. Celi and Gregory J. Golladay

Predictors of femoral shortening for pediatric developmental hip dysplasia surgery: an observational study in 435 patients

Open reduction of the congenitally dislocated hip may not be possible without femoral shortening. The goal of this study is to develop a prognostic prediction model for the need of femoral shortening in childr...

Authors: Nabil Alassaf

Neuroschistosomiasis mimicking lower back pain: case report of a rare differential diagnosis in a pediatric patient

Spinal myelitis is an infrequent manifestation of spinal cord infection. It is caused by the Schistosoma species, which are endemic in South America, part of the Middle East, and Africa.

Authors: Abdulrahman Hamad Al-Abdulwahhab, Abdulaziz Mohammad Al-Sharydah, Sari Saleh Al-Suhibani, Saeed Ahmad Al-Jubran, Ali Khalaf Al-Haidey, Abdulkhaliq Ibrahim Al-Hifzi and Wissam Al-Issawi

Intraoperative angioedema induced by angiotensin II receptor blocker: a case report

Angiotensin II receptor blockers are a class of antihypertensive agent that is developed to exclude the adverse effects of angiotensin converting enzyme inhibitors. However, as angiotensin II receptor blockers...

Authors: Ala”a Alhowary, Haitham Odat, Obada Alali and Ali Al-Omari

Complications of pelvic and acetabular fractures in 1331 morbidly obese patients (BMI ≥ 40): a retrospective observational study from the National Trauma Data Bank

There have been no large-scale epidemiological studies of outcomes and perioperative complications in morbidly obese trauma patients who have sustained closed pelvic ring or acetabular fractures. We examined t...

Authors: James T. Carson, Sabin G. Shah, Gezzer Ortega, Sorawut Thamyongkit, Erik A. Hasenboehler and Babar Shafiq

Incidence and causes of cancellations of elective operation on the intended day of surgery at a tertiary referral academic medical center in Ethiopia

Elective surgical case cancellation refers to any elective surgical case that is the list on the day prior to surgery but not operated upon as scheduled. Case cancellation has a major cause of psychological tr...

Authors: Melaku Desta, Addissu Manaye, Abiot Tefera, Atalay Worku, Alemitu Wale, Alemlanchi Mebrat and Negesso Gobena

Intraoperative real-time fluorescence angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report

Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of isc...

Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe and Konstantinos Zarras

Preserving the marginal mandibular branch of the facial nerve during submandibular region surgery: a cadaveric safety study

The marginal mandibular branch of the facial nerve is vulnerable to iatrogenic injuries during surgeries involving the submandibular region. This leads to significant post-operative morbidity. Studies assessin...

Authors: Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Yasith Mathangasinghe and Ajith Peiris Malalasekera

Safety and efficacy of a new thromboprophylaxis regiment for total knee and total hip replacement: a retrospective cohort study in 265 patients

Venous thromboembolism (VTE) remains a significant complication following knee and hip arthroplasty. National and international guidelines recommend pharmacological and mechanical thromboprophylaxis following ...

Authors: Mohammad Amre Fallaha, Sarkhell Radha and Sheena Patel

Transmigration of a retained surgical sponge: a case report

A retained surgical sponge remains a dreaded complication of modern surgery. Despite the increasing focus on patient safety instances of “a sponge being left in the abdomen”, are all too common in popular medi...

Authors: Tushar Patial, Namit Rathore, Angesh Thakur, Digvijay Thakur and Kanika Sharma

Retained surgical sponges: a descriptive study of 319 occurrences and contributing factors from 2012 to 2017

Unintended retention of foreign bodies remain the most frequently reported sentinel events. Surgical sponges account for the majority of these retained items. The purpose of this study was to describe reports ...

Authors: Victoria M. Steelman, Clarissa Shaw, Laurel Shine and Abbey J. Hardy-Fairbanks

Comparison of flow pressures in different 3-way infusion devices: an in-vitro study

The use of multiple infusions through one cannula is an increasingly common practice in anaesthesia. High pressures in the line often lead to occlusion alarms and pump disconnection. In this study, we aim to d...

Authors: Jonathan Chua and Arun Ratnavadivel

An improved technical trick for identification of the thoracodorsal nerve during axillary clearance surgery: a cadaveric dissection study

Accurate anatomical landmarks to locate the thoracodorsal nerve are important in axillary clearance surgery.

Authors: Dimonge Joseph Anthony, Basnayaka Mudiyanselage Oshan Deshanjana Basnayake, Nambunanayakkara Mahapalliyaguruge Gagana Ganga, Yasith Mathangasinghe and Ajith Peiris Malalasekera

Development of an emergency general surgery process improvement program

The Joint Trauma System has demonstrated improved outcomes through coordinated research and process improvement programs. With fewer combat trauma patients, our military American College of Surgeons level 2 tr...

Authors: Matthew J. Bradley, Angela T. Kindvall, Ashley E. Humphries, Elliot M. Jessie, John S. Oh, Debra M. Malone, Jeffrey A. Bailey, Philip W. Perdue, Eric A. Elster and Carlos J. Rodriguez

The grass is not always greener: a multi-institutional pilot study of marijuana use and acute pain management following traumatic injury

Widespread legislative efforts to legalize marijuana have increased the prevalence of marijuana use and abuse. The effects of marijuana on pain tolerance and analgesic pain management in the acute pain setting...

Authors: Kristin Salottolo, Laura Peck, Allen Tanner II, Matthew M. Carrick, Robert Madayag, Emmett McGuire and David Bar-Or

Intra-articular injection of the anti-inflammatory compound LMWF-5A in adults with severe osteoarthritis: a double-blind prospective randomized controlled multi-center safety and efficacy trial

There are limited efficacious treatment options for severe osteoarthritis of the knee (OAK). The Low Molecular Weight Fraction of 5% human serum Albumin (LMWF-5A) is in development to treat severe OAK. This st...

Authors: Kristin Salottolo, Brian Cole and David Bar-Or

Use of reprocessed external fixators in orthopaedic surgery: a survey of 243 orthopaedic trauma surgeons

The increasing financial burden of orthopaedic implants on our health care system has prompted cost-control measures, such as implant reprocessing. The purpose of this study was to describe the current usage b...

Authors: Sorawut Thamyongkit, Malick Bachabi, John M. Thompson, Babar Shafiq and Erik A. Hasenboehler

Assessment of attitudes towards future implementation of the “Surgical Risk Preoperative Assessment System” (SURPAS) tool: a pilot survey among patients, surgeons, and hospital administrators

Risk assessment in surgery is essential to guide treatment decisions but is highly variable in practice. Providing formal preoperative risk assessment to surgical teams and patients may optimize understanding ...

Authors: Anne Lambert-Kerzner, Kelsey Lynett Ford, Karl E. Hammermeister, William G. Henderson, Michael R. Bronsert and Robert A. Meguid

Incidence of total knee replacement subsequent to intra-articular injection of the anti-inflammatory compound LMWF-5A versus saline: a long-term follow-up study to a randomized controlled trial

The disease modifying potential of osteoarthritis therapies are of increasing interest, including their effects on delaying total knee replacement (TKR). To date, there have been no studies to determine the ef...

Authors: John Schwappach, Joseph Schultz, Kristin Salottolo and David Bar-Or

The diagnostic value of 99m-Tc GSA scintigraphy for liver function and remnant liver volume in hepatic surgery: a retrospective observational cohort study in 27 patients

The aim was to analyze hepatic hypertrophy after portal vein embolization (PVE) and Associating Liver Partition with Portal vein ligation for Staged hepatectomy (ALPPS) to determine whether clinical circumstan...

Authors: Naokazu Chiba, Kei Yokozuka, Shigeto Ochiai, Takahiro Gunji, Masaaki Okihara, Toru Sano, Koichi Tomita, Rina Tsutsui and Shigeyuki Kawachi

Predictors of hydrocephalus as a complication of non-traumatic subarachnoid hemorrhage: a retrospective observational cohort study in 107 patients

The predictors of shunt dependency such as amount of subarachnoid blood, acute hydrocephalus (HC), mode of aneurysm repair, clinical grade at admission and cerebro spinal fluid (CSF) drainage in excess of 1500...

Authors: Juan Manuel Vinas Rios, Martin Sanchez-Aguilar, Thomas Kretschmer, Christian Heinen, Fatima Azucena Medina Govea, Sanchez-Rodriguez Jose Juan and Thomas Schmidt

Incidence of early postoperative complications requiring surgical revision for recurrent lumbar disc herniation after spinal surgery: a retrospective observational study of 9,310 patients from the German Spine Register

The recurrence rate in lumbar disc herniations (LDH) has been reported between 5 and 25%. There are only few data about this phenomenon that occurs within days of the initial operation. We analyse early recurr...

Authors: Juan Manuel Vinas-Rios, Martin Sanchez-Aguilar, Fatima Azucena Medina Govea, Viktor Von Beeg-Moreno and Frerk Meyer

A novel technique of harmonic tissue dissection reduces seroma formation after modified radical mastectomy compared to conventional electrocautery: a single-blind randomized controlled trial

Seroma is the most frequent postoperative complication following breast cancer surgery. Our aim was to evaluate the effect of the harmonic focus scalpel versus electrocautery in reducing seroma formation post-...

Authors: Mohammed Faisal, Hamada Fathy, Hamdy Shaban, Sameh T. Abuelela, Ahmed Marie and Islam Khaled

Mechanical failure of a femoral lengthening nail: a case report

This case report describes the mechanical failure of a femoral lengthening nail in order to allow early recognition and prevent its occurrence.

Authors: WeiWei Wu and Kevin M. Kuhn

Self-assessment of surgical ward crisis management using video replay augmented with stress biofeedback

We aimed to explore the feasibility and attitudes towards using video replay augmented with real time stress quantification for the self-assessment of clinical skills during simulated surgical ward crisis mana...

Authors: Pasha Normahani, Nita Makwana, Wilhelm von Rosenberg, Sadie Syed, Danilo P. Mandic, Valentin Goverdovsky, Nigel J. Standfield and Usman Jaffer

Assessment of postoperative complications using E-PASS and APACHE II in patients undergoing oral and maxillofacial surgery

The prediction of postoperative complications is important for oral and maxillofacial surgeons. We herein aimed to evaluate the efficacy of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) an...

Authors: Kiyohide Ishihata, Yasuyuki Kakihana, Takuya Yoshimura, Juri Murakami, Soichiro Toyodome, Hiroshi Hijioka, Etsuro Nozoe and Norifumi Nakamura

Non-retrieval of inferior vena cava filters as a patient safety concern: evaluation of a new process improvement project to increase retrieval rates in a vascular and interventional radiology clinic

Retrieval of inferior vena cava filters (IVCFs) is important to decrease the long-term risk of complications associated with indwelling devices. Our hospital experienced low retrieval rates and implemented a l...

Authors: Joshua Brown, Jeffery Talbert, Ryan Pennington, Qiong Han and Driss Raissi

Quality of life after antegrade intramedullary nail fixation of humeral fractures: a survey in a selected cohort of Brazilian patients

The treatment of humeral fractures remains controversial. Systematic reviews demonstrate similar results between dynamic compression plating and locked intramedullary nailing in the surgical treatment of these...

Authors: Luiz Fernando Cocco, Benno Ejnisman, Paulo Santoro Belangero, Moises Cohen and Fernando Baldy dos Reis

Incidence and root causes of delays in emergency orthopaedic procedures: a single-centre experience of 36,017 consecutive cases over seven years

Emergency surgery is unplanned by definition and patients are scheduled for surgery with minimal preparation. Some patients who have sustained emergency orthopaedic trauma or other conditions must be operated ...

Authors: Ulla Caesar, Jon Karlsson and Elisabeth Hansson

Novel concept of a modular hip implant could contribute to less implant failure in THA: a hypothesis

The modularity in total hip arthroplasty (THA) allows orthopaedic surgeons for an exact reconstruction of hip biomechanical parameters especially in revision and tumor arthroplasty. Modular structured femoral ...

Authors: Ronny Grunert, Stefan Schleifenbaum, Robert Möbius, Michael Kopper, Christian Rotsch, Welf-Guntram Drossel, Niels Hammer and Torsten Prietzel

A rare case of Candida parapsilosis osteomyelitis: a literature review and proposed treatment algorithm

Candida parapsilosis is a rare opportunistic pathogen that can be found in immunosuppressed patients. There are seldom-reported cases of fungal osteomyelitis surrounding orthopedic imp...

Authors: John Michael Yingling, Li Sun, Richard Yoon and Frank Liporace

A retrospective comparison of intraoperative CT and fluoroscopy evaluating radiation exposure in posterior spinal fusions for scoliosis

Radiation exposure is a concern in the field of medicine. Deformity spine surgeons depend on modalities that have high exposure through scoliosis x-rays or computed tomography. The use of fluoroscopy has incre...

Authors: Jacob Riis, Rebecca R. Lehman, Robert A. Perera, John Ryan Quinn, Patricia Rinehart, Hans Robert Tuten and Victoria Kuester

Exploring unnecessary invasive procedures in the United States: a retrospective mixed-methods analysis of cases from 2008-2016

Unnecessary invasive procedures risk harming patients physically, emotionally, and financially. Very little is known about the factors that provide the motive, means, and opportunity (MMO) for unnecessary proc...

Authors: James M. DuBois, John T. Chibnall, Emily E. Anderson, Heidi A. Walsh, Michelle Eggers, Kari Baldwin and Kelly K. Dineen

Surgical retrieval of a swallowed denture in a schizophrenic patient: a case report

Accidental foreign body ingestion is a common phenomenon in children between 6 months to 6 years of age. In adults, foreign body ingestion is commonly observed in the geriatric population and in patients with ...

Authors: Johannes Dörner, Herbert Spelter, Hubert Zirngibl and Peter C. Ambe

Predicting hepatic failure with a new diagnostic technique by preoperative liver scintigraphy and computed tomography: a pilot study in 123 patients undergoing liver resection

A novel index, total liver LU15, has been identified as a surrogate marker for liver function. We evaluated the ability of preoperative remnant liver LU15 values to predict postoperative hepatic failure.

Authors: Naokazu Chiba, Motohide Shimazu, Kiminori Takano, Go Oshima, Koichi Tomita, Toru Sano, Masaaki Okihara, Yosuke Ozawa, Kosuke Hikita, Takahiro Gunji, Yuta Abe, Kiyoshi Koizumi and Shigeyuki Kawachi

The 10^th anniversary of patient safety in surgery

Authors: Philip F. Stahel, Wade R. Smith, Ernest E. Moore, Philip S. Mehler, Sebastian Weckbach, Fernando J. Kim, Nathan Butler, Hans-Christoph Pape, Ted J. Clarke, Martin A. Makary and Pierre-Alain Clavien

Length of stay, costs, and complications in lumbar disc herniation surgery by standard PLIF versus a new dynamic interspinous stabilization technique

The number of lumbar spine surgeries has been increasing during the last 20 years, which also leads to an increase in hospital costs and complications related to surgery. Therefore, there is a greater concern ...

Authors: Manuel Segura-Trepichio, David Candela-Zaplana, José Manuel Montoza-Nuñez, Antonio Martin-Benlloch and Andreu Nolasco

Incidence, root cause, and outcomes of unintentionally retained intraabdominal surgical sponges: a retrospective case series from two hospitals in Togo

The term gossypiboma refers to a sponge that has been forgotten in the surgical field. It is the most common retained surgical item, and constitutes a continuing problem for surgical safety. We performed a hos...

Authors: Boyodi Tchangai, Mazamaesso Tchaou, Iroukora Kassegne and Kpatekana Simlawo