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Background: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions.Methods: Following the 2010 earthquake in Haiti, an emergency physician was trained using the Emergency Physician's General Anesthesia Syllabus (EP GAS) to perform duties similar to those of certified registered nurse anesthetists. The emergency physician then provided anesthesia during surgical mission trips with an orthopaedic team from February 2011 to March 2017, in Milot, Haiti. This is a descriptive overview of this training program and prospectively collected data on the cohort of patients whom the surgical mission teams treated in Haiti during that time frame.Results: A single emergency physician anesthetist provided anesthesia for 71 of the 172 orthopaedic surgical cases, nearly doubling the number of cases that could be performed. This also allowed the anesthesiologists to focus on pediatric and more difficult cases. Both immediately after the surgical procedure and at 1 year, there were no serious adverse events for cases in which the emergency physician provided anesthesia.Conclusions: Given emergency physicians' baseline training in airway management and sedation, well-supervised and focused extra training under the vigilant supervision of a board-certified anesthesiologist may allow emergency physicians to be able to safely administer anesthesia. Using emergency physicians as anesthetists in this closely supervised setting could increase the number of surgical cases that can be performed in a disaster setting. [ABSTRACT FROM AUTHOR]

Introduction: Scientific studies on injury characteristics are rather common in professional football but not in amateur football despite the thousands of amateur football tournaments taking place worldwide each year. The purpose of this study was to evaluate the preparation and injury patterns of players of two different football skill levels who participated in an international amateur football tournament.Methods: In a prospective cohort study, an international amateur football tournament of medical doctors in 2011 was analysed with regard to training and warm-up preparation, the level of football played before the tournament and injury data during the tournament by means of standardised injury definitions and data samples for football.Results: Amateur players of registered football clubs had higher training exposure before the tournament (p < 0.001) than recreational players and had more frequently performed warm-up programmes (p < 0.001). Recreational football players showed a significantly higher overall injury incidence (p < 0.002), particularly of overuse injuries (p < 0.001), during the tournament than amateur players. In almost 75% of players in both groups, the body region most affected by injuries and complaints was the lower extremities. Orthopaedic and trauma surgeons had the lowest overall injury incidence and anaesthetists the highest (p = 0.049) during the tournament.Conclusion: For the first time, this study presents detailed information on the injury incidence and injury patterns of an amateur football tournament. Less-trained recreational players sustained significantly more injuries than better-trained amateur players, probably due to the lack of sufficient preparation before the tournament. Preventive strategies against overuse and traumatic injuries of recreational football players should start with regular training and warm-up programmes in preparation for a tournament. [ABSTRACT FROM AUTHOR]

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Abstract: The 23rd Annual Summer Meeting of the American Orthopaedic Foot and Ankle Society (AOFAS) was held 13–15 July 2007 at the Westin Harbour Castle Hotel in Toronto, Ontario, Canada. There were 538 registrants in attendance, including 182 individuals from 29 countries outside the United States. [Copyright &y& Elsevier]

Abstract: Orthopaedic surgery is an expanding surgical specialty with a potentially difficult patient population. Regional anaesthesia is becoming increasingly popular as it offers several advantages over general anaesthesia. Consider the following when deciding if a patient is suitable for regional anaesthesia: possible contradictions should be excluded and full consent obtained after an explanation of the intended procedure; the patient''s comfort in a noisy theatre environment for a prolonged period of time; a combination of a regional technique with sedation or a general anaesthetic is possibly indicated; the surgeon''s preference; the patient''s health; the duration of the intended procedure; the practice pattern of the hospital; and the expertise of the anaesthetist. Regional anaesthesia is best done by anaesthetists who are knowledgeable in the anatomy and nerve distribution, and have the dexterity to perform the necessary techniques. For upper limb surgery, interscalene blocks are ideally suited for shoulder and upper arm surgery, suprascapular nerve blocks for upper arm, elbow and radial side of forearm, and the infraclavicular and axillary block for hand, wrist and forearm surgery. Individual nerve blocks are best suited to a localized surgery of the hand, but do not cover tourniquet sites. Lower extremity surgery can be blocked centrally. However, it is associated with significant complications and possible bowel and bladder disturbance and bilateral limb immobility. For hip surgery a lumber plexus block offers many advantages. The three-in-one block is usually ineffective because it does not reliably block the lateral cutaneous nerve or the obturator nerve. For knee replacement surgery both femoral and sciatic nerve blockades are indicated, and the insertion of catheters is becoming more common. This offers much improved analgesia and earlier mobilization. Increased knowledge and practice in regional techniques has the benefit of improving analgesia and mobilization, shortens hospital stay and therefore has many advantageous cost implications as well as improving overall quality of care. [Copyright &y& Elsevier]

Background: The purpose of this systematic review was to critically appraise the literature on the accuracy of orthopaedic tests for the spine. Methods: Multiple orthopaedic texts were reviewed to produce a comprehensive list of spine orthopaedic test names and synonyms. A search was conducted in MEDLINE, MANTIS, CINAHL, AMED and the Cochrane Library for relevant articles from inception up to December 2005. The studies were evaluated using the tool for quality assessment for diagnostic accuracy studies (QUADAS). Results: Twenty-one papers met the inclusion criteria. The QUADAS scores ranged from 4 to 12 of a possible 14. Twenty-nine percent of the studies achieved a score of 10 or more. The papers covered a wide range of tests for spine conditions. Conclusion: There was a lack of quantity and quality of orthopaedic tests for the spine found in the literature. There is a lack of high quality research regarding the accuracy of spinal orthopaedic tests. Due to this lack of evidence it is suggested that over-reliance on single orthopaedic tests is not appropriate. [ABSTRACT FROM AUTHOR]

Copyright of Implantodontie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article discusses the substantial impact of obesity for hospitals, orthopedic practices, and individual patient outcomes, as well as measures to address these challenges. Special issues include anesthesia management pre- and intra-operatively, adapting surgical techniques, infection control, pain management, and hospital equipment. [ABSTRACT FROM PUBLISHER]

The article offers information on improving musculoskeletal system diseases with orthopaedic innovation. Topics discussed include advances in anesthesia and personalization of pain-medication prescription; potential of cell-based therapy, regenerative medicine, and genomic science; and seed-funding for research.