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Find video protocols related to scientific articles indexed in Pubmed.
What outcomes are important for patients after pelvic trauma? Subjective responses and psychometric analysis of three published pelvic-specific outcome instruments.
J Orthop Trauma
PUBLISHED: 07-01-2014
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The measurement of functional outcomes in pelvic fracture patients remains difficult for authors. The authors aimed to test the construct validity, respondent burden, floor and ceiling effects, and patient perception of 3 previously published pelvic outcome questionnaires.
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Reoperation following open reduction and plate fixation of displaced mid-shaft clavicle fractures.
Injury
PUBLISHED: 01-31-2014
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Operative fixation of displaced, mid-shaft clavicle fractures has become an increasingly common practice. With this emerging trend, data describing patient outcomes with longer follow-up are necessary.
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Atypical femur fractures.
J Orthop Trauma
PUBLISHED: 01-31-2014
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Osteoporosis (OP) results from an imbalance between bone production and absorption that results in decreased bone mass and microstructural deterioration of the bone trabeculae, leading to diminished bone quality and fragility fractures. It is synonymous with decreased bone strength and affects millions of people worldwide. The most commonly prescribed drugs for the treatment of OP are the bisphosphonates (BPs). Long-term BP use may be associated with stress fractures of the subtrochanteric and shaft regions of the femur known as atypical femur fractures (AFFs). Although AFFs can be devastating, BPs have decreased the number of low-energy hip fractures and the number of vertebral and nonvertebral fractures that occur each year. Many trials and population-based studies have assessed the association between AFF and BP, and several studies have attempted to establish AFF's true incidence. The authors will summarize a few of the major studies and discuss their strengths and limitations. The findings of an association between BPs and AFFs have been variable and may reflect sample selection and measurement bias. AFFs are uncommon; the increase in risk associated with BP use is very small and does not outweigh the benefit of fracture prevention in patients with OP. Evidence for the efficacy of BPs for the prevention of fractures in postmenopausal women with OP is very strong, and the current clinical practice of using BPs as first-line therapy for these patients should be continued. Further information is required to determine the appropriate duration and time of discontinuation of BP therapy.
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The orthopaedic trauma patient experience: a qualitative case study of orthopaedic trauma patients in Uganda.
PLoS ONE
PUBLISHED: 01-01-2014
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The disability adjusted life years (DALYs) associated with injuries have increased by 34% from 1990 to 2010, making it the 10th leading cause of disability worldwide, with most of the burden affecting low-income countries. Although disability from injuries is often preventable, limited access to essential surgical services contributes to these increasing DALY rates. Similar to many other low- and middle-income countries (LMIC), Uganda is plagued by a growing volume of traumatic injuries. The aim of this study is to explore the orthopaedic trauma patient's experience in accessing medical care in Uganda and what affects the injury might have on the socioeconomic status for the patient and their dependents. We also evaluate the factors that impact an individual's ability to access an appropriate treatment facility for their traumatic injury. Semi-structured interviews were conducted with patients 18 year of age or older admitted with a fractured tibia or femur at Mulago National Referral Hospital in Kampala, Uganda. As limited literature exists on the socioeconomic impacts of disability from trauma, we designed a descriptive qualitative case study, using thematic analysis, to extract unique information for which little has been previously been documented. This methodology is subject to less bias than other qualitative methods as it imposes fewer preconceptions. Data analysis of the patient interviews (n?=?35) produced over one hundred codes, nine sub-themes and three overarching themes. The three overarching categories revealed by the data were: 1) the importance of social supports; 2) the impact of and on economic resources; and 3) navigating the healthcare system. Limited resources to fund the treatment of orthopaedic trauma patients in Uganda leads to reliance of patients on their friends, family, and hospital connections, and a tremendous economic burden that falls on the patient and their dependents.
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Understanding systematic reviews and meta-analyses in orthopaedics.
J Am Acad Orthop Surg
PUBLISHED: 04-03-2013
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The systematic literature review is a powerful tool for summarizing and evaluating current knowledge related to a specific research question. Systematic reviews have many advantages over traditional narrative reviews. A meta-analysis of data from a systematic review can provide a better estimate of a treatment effect than can individual studies. To ensure quality conclusions, rigorous methods must be applied to systematic reviews, such as formulation of a specific research question, systematic literature search, selection and assessment of included studies, data extraction, quality assessment of included studies, meta-analysis and presentation of results, and formation of conclusions. Threats to the internal validity and generalizability of the conclusions of systematic reviews include lack of clarity or appropriateness of the research question, poor quality of the included studies, heterogeneity of results between studies, inappropriate conclusions, and inappropriate application in clinical practice.
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Incidence, risk factors, and diagnostic evaluation of postoperative fever in an orthopaedic trauma population.
J Orthop Trauma
PUBLISHED: 02-16-2013
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To determine the incidence of positive diagnostic evaluations during the management of postoperatively febrile orthopaedic trauma patients. A secondary objective was to describe the incidence and risk factors for postoperative fever.
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Levels of evidence at the orthopaedic trauma association annual meetings.
J Orthop Trauma
PUBLISHED: 01-05-2013
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To examine the strength of evidence presented at the Orthopaedic Trauma Association (OTA) annual meetings before and after the level of evidence guidelines became popular in the literature.
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Preference-based quality of life of end-stage ankle arthritis treated with arthroplasty or arthrodesis.
Foot Ankle Int
PUBLISHED: 07-29-2010
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Health state values, or "utilities, are an important preference-based measure of quality of life used by health economists. This study describes the utilities reported by a multicenter cohort of subjects with end-stage ankle arthritis treated with ankle arthrodesis or total ankle arthroplasty.
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Iatrogenic ulnar nerve injury after the surgical treatment of displaced supracondylar fractures of the humerus: number needed to harm, a systematic review.
J Pediatr Orthop
PUBLISHED: 06-25-2010
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Supracondylar fractures of the humerus are common pediatric elbow injuries. Most displaced or angulated fractures are treated by closed reduction and percutaneous pinning, with either a crossed pin or lateral pin configuration. The purpose of this study was to conduct a systematic review to determine if there is an increased risk of iatrogenic nerve injury associated with the crossed pin configuration.
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Patient-reported outcome instruments for femoroacetabular impingement and hip labral pathology: a systematic review of the clinimetric evidence.
Arthroscopy
PUBLISHED: 04-26-2010
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The purpose of this study is to systematically review the content and clinimetric evidence (rigor of rating scales and indexes for the description of clinical phenomena) of published patient-reported outcome (PRO) instruments used to assess femoroacetabular impingement (FAI) and labral hip pathology.
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Treatment preferences for displaced three- and four-part proximal humerus fractures.
J Orthop Trauma
PUBLISHED: 03-26-2010
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To assess the treatment preferences of orthopaedic surgeons for displaced three- and four-part proximal humerus fractures.
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The reliability and validity of the Disabilities of Arm, Shoulder, and Hand, EuroQol-5D, Health Utilities Index, and Short Form-6D outcome instruments in patients with proximal humeral fractures.
J Shoulder Elbow Surg
PUBLISHED: 03-01-2010
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The Disabilities of Arm, Shoulder, Hand (DASH), EuroQol-5D (EQ-5D), Health Utilities Index Mark 3 (HUI3), and Short Form (SF)-6D questionnaires are reliable and valid measures of functional outcome and health state values in patients with proximal humeral fractures.
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Single-dose versus multiple-dose antibiotic prophylaxis for the surgical treatment of closed fractures.
Acta Orthop
PUBLISHED: 02-13-2010
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Recent meta-analyses have suggested similar wound infection rates when using single- or multiple-dose antibiotic prophylaxis in the operative management of closed long bone fractures. In order to assist clinicians in choosing the optimal prophylaxis strategy, we performed a cost-effectiveness analysis comparing single- and multiple-dose prophylaxis.
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Does objective shoulder impairment explain patient-reported functional outcome? A study of proximal humerus fractures.
J Shoulder Elbow Surg
PUBLISHED: 01-18-2010
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Following a healed proximal humerus fracture, patient-reported outcome is predicted by objective physical examination findings. Range of motion and strength thresholds can correctly identify subjects with normal functioning shoulders.
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A systematic review of thromboprophylaxis for pelvic and acetabular fractures.
J Orthop Trauma
PUBLISHED: 04-25-2009
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Pelvic and acetabular fractures have been identified as risk factors for deep venous thrombosis (DVT) and thromboembolic complications. A systematic review was performed to evaluate the effectiveness of thromboprophylactic strategies to prevent DVT or pulmonary embolism (PE) after pelvic or acetabular fractures.
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Intrathecal pressure monitoring and cerebrospinal fluid drainage in acute spinal cord injury: a prospective randomized trial.
J Neurosurg Spine
PUBLISHED: 03-27-2009
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Ischemia is an important factor in the pathophysiology of secondary damage after traumatic spinal cord injury (SCI) and, in the setting of thoracoabdominal aortic aneurysm repair, can be the primary cause of paralysis. Lowering the intrathecal pressure (ITP) by draining CSF is routinely done in thoracoabdominal aortic aneurysm surgery but has not been evaluated in the setting of acute traumatic SCI. Additionally, while much attention is directed toward maintaining an adequate mean arterial blood pressure (MABP) in the acute postinjury phase, little is known about what is happening to the ITP during this period when spinal cord perfusion pressure (MABP - ITP) is important. The objectives of this study were to: 1) evaluate the safety and feasibility of draining CSF to lower ITP after acute traumatic SCI; 2) evaluate changes in ITP before and after surgical decompression; and 3) measure neurological recovery in relation to the drainage of CSF.
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MEDLINE, EMBASE, and Cochrane index most primary studies but not abstracts included in orthopedic meta-analyses.
J Clin Epidemiol
PUBLISHED: 01-11-2009
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To test the hypothesis that all primary studies used in orthopedic meta-analyses are indexed in MEDLINE or EMBASE.
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Surgical fixation vs nonoperative management of flail chest: a meta-analysis.
J. Am. Coll. Surg.
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Flail chest is a life-threatening injury typically treated with supportive ventilation and analgesia. Several small studies have suggested large improvements in critical care outcomes after surgical fixation of multiple rib fractures. The purpose of this study was to compare the results of surgical fixation and nonoperative management for flail chest injuries.
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Contribution of flexor pollicis longus to pinch strength: an in vivo study.
J Hand Surg Am
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To estimate the contribution of the flexor pollicis longus (FPL) to key pinch strength. Secondary outcomes include tip pinch, 3-point chuck pinch, and grip strength.
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Orthopaedic trauma care in Haiti: a cost-effectiveness analysis of an innovative surgical residency program.
Value Health
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In an effort to sustainably strengthen orthopaedic trauma care in Haiti, a 2-year Orthopaedic Trauma Care Specialist (OTCS) program for Haitian physicians has been developed. The program will provide focused training in orthopaedic trauma surgery and fracture care utilizing a train-the-trainer approach. The purpose of this analysis was to calculate the cost-effectiveness of the program relative to its potential to decrease disability in the Haitian population.
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The tactics of large randomized trials.
J Bone Joint Surg Am
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Single-center studies and small randomized controlled trials often provide contradictory or inconclusive results. In contrast, large randomized controlled trials are designed to definitively answer a relevant and practice-changing research question. These studies rely on large sample sizes to gain adequate precision of the results and substantial funding to support the research infrastructure necessary to minimize bias. Tactics for successfully completing a large randomized controlled trial are outlined with examples from recent orthopaedic trials.
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Is larger scoliosis curve magnitude associated with increased perioperative health-care resource utilization?: a multicenter analysis of 325 adolescent idiopathic scoliosis curves.
J Bone Joint Surg Am
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The treatment of patients with large adolescent idiopathic scoliosis curves has been associated with increased surgical complexity. The purpose of this study was to determine whether surgical correction of larger adolescent idiopathic scoliosis curves increased the utilization of health-care resources and to identify potential predictors associated with increased perioperative health-care resource utilization.
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Is surgical fixation for stress-positive unstable ankle fractures cost effective? Results of a multicenter randomized control trial.
J Orthop Trauma
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A recent multicenter randomized control trial demonstrated similar quality of life at 1 year after open reduction and internal fixation (ORIF) compared with nonoperative treatment for stress-positive unstable isolated lateral malleolar fractures. We sought to determine the cost-effectiveness of ORIF compared with nonoperative management of these isolated lateral malleolar fractures.
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Methodology and interpretation of radiographic outcomes in surgically treated pelvic fractures: a systematic review.
J Orthop Trauma
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To identify and evaluate previously described methods for the measurement, and interpretation, of radiographic outcomes of operatively treated pelvic fractures.
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Radiographic Displacement in Pelvic Ring Disruption: Reliability of Three Previously Described Measurement Techniques.
J Orthop Trauma
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BACKGROUND:: The literature in pelvic ring disruptions is based largely on non-standardized, and non-validated radiographic outcomes. A thorough review of the literature revealed only three described methods for measuring radiographic displacement, and one frequently used grading system for displacement. We aimed to test the reliability of these previously published radiographic measurement methods and grading system. METHODS:: Five separate observers measured radiographic displacement on the standardized pre and post-operative antero-posterior, inlet and outlet views of 25 patients with surgically treated Tile B and C pelvic fractures. The readers measured their initial impression based on the Tornetta and Matta grading system (Excellent, Good, Fair and Poor). Next, they measured displacement using the Inlet and Outlet Ratio as described by Sagi, The Cross Measurement technique as described by Keshishyan, and The Absolute Displacement Method (ADM) as described by Lefaivre. The millimeter measurement obtained by the ADM was converted using the Tornetta and Matta grading system. Each continuous measure was compared for inter-observer reliability using intra-class correlations, and the categorical outcomes were compared using a kappa statistic. Finally, the relationship of the initial impression to the grade as determined by the ADM was compared using kappa agreement. RESULTS:: The agreement among observers based on initial impression was poor (kappa statistic 0.306), but was fair among those reductions that were excellent (k = 0.495). Using the Sagi method the reliability ICC was moderate for the post-operative inlet (0.515, 95% CI 0.338-0.702) and outlet ratios (0.594, 95%CI 0.423-0.760), but almost perfect in pre-operative radiographs (Inlet: 0.814, 95% CI 0.703-0.901, Outlet: 0.863, 95% CI 0.775-0.929). The ICC for all interpretations of the Keshishyan technique were excellent, but were highest when considered as a ratio (Pre-op: 0.938, 95% CI 0.894-0.969, Post-op: 0.912, 95% CI 0.850-0.955). Using the ADM, the location and film used for measurement had poor agreement, and the ICC for the measurement in mm was moderate (pre-op: 0.522, 95% CI 0.342-0.708, post-op: 0.432, 95% CI 0.255-0.634), and the Kappa agreement poor when converted using the Tornetta and Matta scale (k=0.2190). The agreement between the impression and the converted grade from the ADM was poor (k=0.2520) CONCLUSIONS:: Radiographic measurement in pelvic xrays to date has been non-validated, and we found the inter-observer reliability on common methods, including overall impression and absolute displacement in mm, to be poor. The inlet/outlet ratio as described by Sagi was reliable only with wide displacement. The cross measurement technique allows least observer choice, and had excellent reliability, but does not give a measurement that we can easily interpret based on convention in pelvic fracture description.
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What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.