Pharmacologic Management of the Orthopaedic Trauma Patient

Browner, Bruce D.; Jupiter, Jesse B.; Levine, Alan M.; Trafton, Peter G.; Krettek, Christian

doi:10.1016/b978-1-4160-2220-6.10010-6

Cited by 35 publications

(85 citation statements)

References 160 publications

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“…The yield point is the point at which elastic behavior changes to plastic, and it essentially describes the safe functional load. Subtle changes in density, which can occur with aging, disease, use and disuse, greatly change strength and elastic modulus (Browner et al, 2009;Bucholz et al, 2005). Material properties of bone are generally separated into the material properties of the outer cortex and material properties of trabecular bone, which is found inside the cortex.…”

Section: Materials Propertiesmentioning

confidence: 99%

“…Cortical bone is stronger and stiffer when loaded in the longitudinal direction than in the transverse direction. This is related to the orientation of bone microstructure (Browner et al, 2009). The orientation of orbicular architecture corresponds with the orientation of the principle stress sustained by the tissue (Huiskes, 2000).…”

Section: Materials Propertiesmentioning

confidence: 99%

“…The literature on documenting the mechanical properties of bone in various forms of loading is extensive (Turner et al, 1998;Choi, 1990;Morgan et al, 2003;Rho et al, 1997;Nyman et al, 2006;Bonfield, 1987) Bone also exhibits viscoelastic behavior; bone strength depends on rate of loading and it exhibits creep and stress-relaxation. At higher strain rates, both ultimate strength and elastic modulus increase (Browner et al, 2009;Courtney et al, 1994;Bucholz et al, 2005;Currey, 2002). Under constant loads, bone will continue to deform or creep.…”

Section: Materials Propertiesmentioning

confidence: 99%

“…Since moment of inertia is proportional to the diameter of the structure to the 4 th power (Browner et al, 2009) small increases in external diameter of a long bone can markedly improve its resistance to bending and torsional loading (Bouxsein & Karasik, 2006). Resistance to compressive loading depends on the cross sectional area of bone; resistance to www.intechopen.com bending and torsional loads involves distributing bone material far from the neutral axis of bending or torsion (generally this axis is near the center of bone) (Bouxsein & Karasik, 2006).…”

mentioning

confidence: 99%

See 3 more Smart Citations

Biomechanics of Musculoskeletal Injury

Gitajn¹,

Rodriguez²

2011

Biomechanics in Applications

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Section: Materials Propertiesmentioning

confidence: 99%

Section: Materials Propertiesmentioning

confidence: 99%

Section: Materials Propertiesmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Biomechanics of Musculoskeletal Injury

Gitajn¹,

Rodriguez²

2011

Biomechanics in Applications

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“…In addition, fractures in elderly patients can be costly to manage, as they often require surgical intervention. However, the average lowenergy hip fracture and high-energy pelvic fracture, both included in DRG 536, are considerably different injuries with differing management courses and, likely, differing associated inpatient costs [10]. Owing to the common nature of these injuries, these differences in costs may account for substantial sums.…”

Section: Introductionmentioning

confidence: 99%

Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement

Samuel

Webb

Lukasiewicz

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Medicare currently reimburses hospitals for inpatient admissions with ''bundled'' payments based on patient Diagnosis-related Groups (DRGs) regardless of true hospital costs. At present, DRG 536 (fractures of the hip and pelvis) includes a broad spectrum of patients with orthopaedic trauma, likely with varying inpatient resource utilization. With the growing incidence of fractures in the elderly, inadequate reimbursements from Medicare for certain patients with DRG 536 may lead to growing financial strain on healthcare institutions caring for these patients with higher costs. Questions/purposes The purposes of the study were to determine whether (1) inpatient length of stay; (2) intensive care unit stay; and (3) ventilator time differ among subpopulations with Medicare DRG 536. Methods A total of 56,683 patients, 65 years or older, with fractures of the hip or pelvis were identified in the 2011 and 2012 National Trauma Data Bank. This clinical registry contains data on trauma cases from more than 900 participating trauma centers, allowing analysis of resource One of the authors certifies that he (AMS) or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from Orthopaedic Trauma Association (Rosemont, IL). One of the authors certifies that he (JML) or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount of less than USD 10,000 from Bone Therapeutics (Charleroi, Belgium), an amount of less than USD 10,000 from Kuros (Zurich,Switzerland), an amount of less than USD 10,000 from ISTO Technologies (St Louis, MO, USA), an amount of less than USD 10,000 from Emcyte (Fort Myers, FL, USA), an amount of less than USD 10,000 from Royal Marketing Inc (Westmount, Quebec, Canada), an amount of less than USD 10,000 from Graftys (Chicago, IL, USA), an amount of USD 100,000-USD 1,000,000 from Merck (Kenilworth, NJ, USA), and an amount of USD 100,000-USD 1,000,000 from National Institutes of Health (Bethesda, MD, USA). One of the authors certifies that he (JNG) or a member of his or her immediate family, has received or may receive payments or benefits, during the study period, an amount of USD 10,000-USD 100,000 from Bioventus (Durham, NC, USA), an amount of USD 10,000-USD 100,000 from Harvard Clinical Research Institute (Boston, MA, USA), an amount of USD 10,000-USD 100,000 from ISTO Technologies (St Louis, MO, USA), an amount of less than USD 10,000 from Medtronic (Minneapolis, MN, USA), an amount of USD 10,000-USD 100,000 from Stryker (Kalamazoo, MI, USA), an amount of less than USD 10,000 from Affinergy (Durham, NC, USA), an amount of USD 10,000-USD 100,000 from Alphatec (Carlsbad, CA), an amount of less than USD 10,000 from DePuy (Raynham, MA, USA), an amount of less than USD 10,000 from Powered Research (Research Triangle Park, NC, USA), an amount of less than USD 10,000 from KCI (San Antonio, TX, USA), an amount of less than USD 10,000...

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Biomechanical Comparison of Two Pediatric Blade Plate Designs in Proximal Femoral Osteotomies

et al. 2019

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Background Blade plates are frequently used for internal fixation following proximal femoral varus rotational osteotomy to treat hip dysplasia in children with cerebral palsy. Recently, cannulated blade plates with the option for a proximal locking screw have demonstrated ease of insertion and low complication rates. Although there are two commonly used blade plates with a proximal screw option, no comparison of their biomechanical profiles has been undertaken. Questions/Purposes Our study sought to compare the structural properties under axial loading, as well as the biomechanical contribution of a proximal screw, of two different 90° cannulated blade plates designed for pediatric proximal femurs. Plate A has a hole distal to the blade designed to attach a plate inserter, through which a 3.5-mm non-locking cortical screw could be placed. Plate B has a threaded hole distal to the blade designed to accept a 3.5-mm locking screw. Methods Plate A and plate B were inserted into 33 left pediatric synthetic proximal femurs. Axial loading to failure of plate A with and without a proximal screw was compared to that of plate B with and without a proximal screw. An additional 10 samples using plate B, with and without a proximal locking screw, were tested in tension to quantify the effect of the proximal screw on pullout strength. Results Plate B failed at a higher axial load than plate A. The addition of a proximal screw did not affect the axial load to failure for either plate. Pullout testing revealed that blade plates fixed with the proximal screw failed in tension at a significantly higher load (856.3 ± 120.9 N) than those without proximal fixation (68.1 ± 9.3 N, p < 0.001). Conclusions Plate B failed at a higher axial load in biomechanical testing, likely related to differences in its design. The addition of a proximal screw did not increase the axial loading properties of the blade plate construct but did increase the pullout strength by a factor of 12. These results may be used to influence implant selection and post-operative rehabilitation following proximal femoral osteotomies in children.

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Pharmacologic Management of the Orthopaedic Trauma Patient

Cited by 35 publications

References 160 publications

Biomechanics of Musculoskeletal Injury

Biomechanics of Musculoskeletal Injury

Variation in Resource Utilization for Patients With Hip and Pelvic Fractures Despite Equal Medicare Reimbursement

Biomechanical Comparison of Two Pediatric Blade Plate Designs in Proximal Femoral Osteotomies

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