This study demonstrates the use of an innovative traction suture holder in performing transanal endorectal pullthrough procedure for Hirschsprung's disease. The device was constructed by utilizing the Ilizarov external fixator ring used by orthopedic surgeons. Used in six patients, the appliance was able to provide adequate exposure of the anal mucosa during the performance of the procedure. Operative time was shorter as compared to that of previous surgeries done without using the appliance.

Operative Time ; Traction ; Orthopedic Surgeons ; Hirschsprung Disease ; Anal Canal ; Rectum ; Digestive System Surgical Procedures ; Sutures ; External Fixators ; Mucous Membrane

Recently, due to the unsatisfactory outcomes of several orthopedic surgical procedures, non-operative management of musculoskeletal diseases, including regenerative medicine, is becoming more attractive to orthopedic surgeons. Regarding the healing of musculoskeletal tissues, such as bone, cartilage and tendons, regenerative medicine aims to replace or promote tissue regeneration. Among them, therapy using stem cells, prolotherapy, platelet-rich plasma, and extracorporeal shockwave therapy are taking center stage. Numerous animal and clinical studies have been published and the number has increased exponentially in recent years. On the other hand, because regenerative medicine in the orthopedic field is still in the early stages, no definite methods for the procedures have been made and there is some controversy regarding their application to musculoskeletal disease. Therefore, more high quality studies including randomized studies should be performed to establish standards and evaluate their value in the orthopedic field.
Animals ; Cartilage ; Hand ; Musculoskeletal Diseases* ; Orthopedic Procedures ; Orthopedics ; Platelet-Rich Plasma ; Regeneration ; Regenerative Medicine* ; Stem Cells ; Surgeons ; Tendons

PURPOSE: To compare and analyze the rate of prevention of two venous thromboembolism prophylaxis guidelines in patients with artificial joint arthroplasty and hip joint fracture. Proper prophylaxis for preventing thromboembolism in orthopedic surgery is significant because of this fetal complication. MATERIALS AND METHODS: This study compared and retrospective analyzed the rate of prevention using the medical records and radiographs of patients who underwent orthopedic surgery from March 2009 to February 2011 according to the American College of Chest Physicians (ACCP) guidelines and from March 2012 to February 2014 according to the American Academy of Orthopedic Surgeons (AAOS) guidelines. RESULTS: The guidelines for venous thromboembolism prophylaxis have been applied to patients with artificial joint replacement and hip joint fracture, the compliance rate of the ACCP guidelines was 56.0% before surgery, 67.0% after surgery with chemical prophylaxis, and 80.5% with mechanical prophylaxis. In addition, the compliance rate of the AAOS guidelines was 74.1% with chemical prophylaxis, and 88.3% with mechanical prophylaxis, which was higher than the ACCP guidelines. The compliance rates of mechanical and chemical prophylaxis before and after surgery of the ACCP guidelines, and the compliance rate of mechanical and chemical prophylaxis of the AAOS guidelines were compared and analyzed. The results revealed statistical significance (p<0.05) before and after total knee replacement arthroplasty and hip joint fracture internal fixation and total high risk orthopedic surgery. CONCLUSION: Raising the compliance rate of prophylaxis of venous thromboembolism in high risk orthopedic surgery is necessary and people should follow the guidelines for a unified direction depending on which situation they are in.
Arthroplasty ; Arthroplasty, Replacement, Knee ; Compliance ; Hip Joint ; Humans ; Joints ; Medical Records ; Orthopedic Procedures ; Orthopedics ; Retrospective Studies ; Surgeons ; Thorax ; Thromboembolism ; Venous Thromboembolism

Unstable posterior acetabular fractures resulting from high energy trauma present major challenges to any orthopedic surgeon especially if the treatment has been delayed.
OBJECTIVE: The purpose of this paper is to describe the early results of delayed treatment of a series of patients with posterior acetabular fractures with concomitant hip dislocations, surgically approached using the Kocher-Langenbeck with a trochanteric flip osteotomy.
METHODS: Five (5) male patients (mean age 35.6 years, range 23-58 years) who sustained unstable posterior acetabular fractures, underwent surgical treatment using the Kocher-Langenbeck approach with the trochanteric flip osteotomy, during the period of May 2014 to October 2015. Clinical and radiographic evaluations of each patient were performed, while complications were documented.
RESULTS: Mean follow-up was 8 weeks (range 2-12 weeks). There was adequate exposure of the posterior and superior acetabulum in all patients. Post-operative radiographs in four of five patients were graded "anatomic" while hip range of motion of these four patients averaged 78.7% of the uninjured hip. One patient with "poor" reduction underwent a second operation to reserve a failure of the initial fixation using the same surgical approach. No other complications were reported.
CONCLUSION: This modified approach provides adequate exposure of both posterior and superior acetabulum and also allows inspection of the articular surfaces of both acetabulum and femoral head, which are limited in the standard Kocher-Lagenbeck approach. With excellent exposure, congruent reduction can readily be achieved while permitting early hip range of motion post-surgery.

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Acetabulum ; Femur ; Femur Head ; Follow-up Studies ; Hip Dislocation ; Hip Injuries ; Orthopedic Surgeons ; Osteotomy ; Range Of Motion, Articular

American Academy of Orthopaedic Surgeons (AAOS) just released the up-to-date , which has become the principles to care hip fractures in the elderly. In comparison to the Guideline 2014, considerable changes are made in terms of guideline composition and focused items. The interval of 7 years yielded dramatic progress in the care of geriatric hip fractures, including the recommendation of cemented femoral stems in hip arthroplasty due to displaced femoral neck fractures, cephalomedullary device for unstable intertrochanteric fractures and tranexamic acid to reduce blood loss and blood transfusion. Additionally, the individualized properties of the elderly with hip fractures should be noted to balance an early operation within 24 and 48 hours and patient safety. The interpretation of is helpful to comprehensively understand the progress of the care of geriatric hip fractures, thus to make orthopaedic surgeons master the key points of clinical practice, and to improve the quality of operations and decrease perioperative complications.
Aged ; Humans ; Arthroplasty, Replacement, Hip ; Femoral Neck Fractures/surgery* ; Fracture Fixation, Internal ; Hip Fractures/surgery* ; Orthopedic Surgeons ; Treatment Outcome ; United States ; Practice Guidelines as Topic

Adult ; Age Factors ; Burnout, Professional ; epidemiology ; Female ; Health Status ; Humans ; Male ; Marital Status ; Mental Health ; Occupational Health ; Orthopedic Surgeons ; statistics & numerical data ; Pain ; epidemiology ; Personnel Staffing and Scheduling ; Sex Factors ; Singapore ; epidemiology ; Social Behavior ; Stress, Psychological ; epidemiology ; Surveys and Questionnaires ; Work Schedule Tolerance