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Exploring versatile applications of a vacuum-assisted bone harvester in orthopedic surgery.

BACKGROUND: Orthopedic procedures often require removing bone or pathological tissue, with traditional methods involving instruments like curettes and rongeurs. However, these methods can be time-consuming and lead to increased blood loss. To mitigate these side effects, vacuum-assisted tools have been developed to aid in tissue removal. These devices enable surgeons to suction tissue without discarding it, potentially improving outcomes in conditions such as osteomyelitis or tumor removal while enabling collection of the material for downstream applications. Despite limited research, vacuum-a

Evaluating the Impact of Insurer-Sponsored Health Coaching on Hospitalization and Costs in India: A Retrospective Cohort Study.

Health coaching programs are emerging as a promising intervention to improve disease management and reduce healthcare costs, particularly in the context of insurer-sponsored wellness initiatives. While such programs have shown positive outcomes in Western healthcare settings, their effectiveness in India remains underexplored. This study examines the impact of a health coaching program implemented by a prominent Indian health insurer (Aditya Birla Health Insurance), focusing on hospitalization rates and claims paid among high-risk policyholders. To assess the intervention's effectiveness, a re

Fractures and survival in multiple myeloma: results from a population-based study.

Multiple myeloma causes lytic bone lesions and fractures. The impact of fractures on multiple myeloma (MM) survival is unclear. The aim of this study was to evaluate the effect of fractures on survival in MM using data from MM patients diagnosed in Sweden in the years 1990-2013, identified from the Swedish Cancer Registry. Information on date of birth, MM diagnosis, fractures, and death was collected from central registries. A Cox regression model was used to compare survival in patients with and without a fracture at MM diagnosis and another Cox model was used with fracture as a time-dependen

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… fracture (1.07; 95%CI: 0.79-1.44) ( Figure 4 ). … In addition to this, we found that ankle fractures were not associated with survival in MM, highlighting the fact that our findings are specific to MM-related or osteoporotic fractures and not all fractures in general. …

The role of vitamin D and vitamin D deficiency in orthopaedics and traumatology-a narrative overview of the literature.

Vitamin D is considered to play an important role in musculoskeletal health. It's classical function is the regulation of calcium and phosphate homeostasis, thus ensuring a balanced bone metabolism that is characterised by an equal amount of bone resorption and bone formation. In the past decades, a plethora of pre-clinical and clinical studies reporting on potential health-beneficial properties of vitamin D have emerged. Moreover, there is an abundance of reports highlighting vitamin D deficiency and insufficiency in patients with almost innumerable diseases. Further, it is estimated that mor

Patient-Reported Outcomes After Intramedullary Nailing of Oncologic Impending or Pathologic Fractures With Carbon Fiber or Titanium Implant.

INTRODUCTION: Despite the benefits of intramedullary nailing (IMN) of impending or pathologic fractures in oncologic patients, literature on patient-reported outcomes (PROs) is scarce in patients treated with carbon fiber (CF) nails. Our study compared postoperative PROs after IMN with CF or titanium implants. METHODS: We conducted a retrospective propensity score-matched cohort study of patients treated at our institution with CF or titanium nails for impending or pathologic fractures from metastatic bone disease. Patient-Reported Outcomes Measurement Information System (PROMIS) Global Healt

Metatarsal metastasis from clear cell renal cell carcinoma: a case report and literature review.

BACKGROUND: Bone metastasis is known to occur in some patients with cancer, usually in the spine, pelvis or ribs, and less than 0.01% of patients have metastases in the foot bone, so metatarsal metastasis is quite rare. The initial symptoms of osseous metastases are swelling, pain, or both. CASE PRESENTATION: We report a 68-year-old man with solitary metatarsal metastasis 26 months after a diagnosis of renal clear cell carcinoma. The patient suffered intermittent swelling of his right foot and pain for one year due to trauma and was not treated. The doctor attributed the symptoms to trauma, a

Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan.

BackgroundMalignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area.MethodsTo improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University H

Intercalary Resection of the Tibia for Primary Bone Tumors: Are Vascularized Fibula Autografts With or Without Allografts a Durable Reconstruction?

BACKGROUND: Reconstruction with vascularized fibula grafts (VFG) after intercalary resection of sarcoma may offer longevity by providing early graft-host union and fracture healing. The ability of the fibula to hypertrophy under mechanical stress, as well as vascularized bone in the area, may also be advantageous, given that soft tissues may be compromised because of resection, chemotherapy, or radiation therapy. VFG with a massive allograft combines the primary mechanical stability of the graft with the biological potential of the vascularized fibula; however, complications and the durability

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… Scannell Rady Children’s Hospital, San Diego, CA, USA OP-250 11:37 AM–11:41 AM Identification of and response to growth arrest following pediatric ankle fractures Charles T Mehlman, Jaime Rice Denning, Shital N Parikh, Junichi Tamai , Dayna Phillips Cincinnati Children’s Hospital Medical Center …

Rare Causes of Musculoskeletal Pain: Thinking beyond Common Rheumatologic Diseases.

OBJECTIVES: Rare metabolic bone diseases can present with symptoms mimicking more common rheumatological conditions including spondyloarthritis, osteoarthritis, and fibromyalgia. Increasing awareness of these rare diseases within the rheumatology community is vital to ensure that affected patients are diagnosed and appropriately treated. The literature includes several reports of tumour-induced osteomalacia initially diagnosed as rheumatic disease, but other rare diseases such as X-linked hypophosphatemia (XLH) and hypophosphatasia (HPP) also deserve attention. Here, we describe two cases of a

Guillain-Barré syndrome in patients with multiple myeloma: three cases report and literature review.

BackgroundMultiple myeloma (MM) with Guillain-Barré syndrome (GBS) is relatively rare, and the specific mechanism is still unclear. The previous infection, surgery, and medication use may have contributed to the occurrence of GBS. The use of bortezomib in patients with MM can easily lead to peripheral neuropathy, which is similar to the symptoms of GBS, making it challenging to diagnose GBS.Cases presentationThree patients with IgA type MM experienced lower limb weakness during treatment. Combined with lumbar puncture, nerve conduction studies, and other tests, the diagnosis was confirmed as G

Corticosteroid-associated osteonecrosis in paediatric compared with adult patients: are they the same disease?

Osteonecrosis of the femoral head (ONFH) is a debilitating condition with a poorly characterized pathogenesis. Among the reported aetiologies, excessive alcohol consumption and corticosteroid administration are leading causes. Corticosteroids are often administered as a life-saving treatment for primary oncological or autoimmune conditions, but the subsequent development of ONFH can significantly impair the quality of life of both paediatric and adult patients. This review provides a comprehensive summary and critical analysis of recent advances in the understanding of corticosteroid-associate

Secondary fracture prevention in primary care: a narrative review.

The global burden of osteoporosis continues to rise with an ageing population. Untreated osteoporotic fractures not only heighten the risk of subsequent fractures but are associated with excess mortality. Although primary care guidelines consistently stress the importance of secondary fracture prevention, fewer than 20% of patients are appropriately treated for osteoporosis following an initial osteoporotic fracture. This worldwide phenomenon is known as the osteoporosis care gap. This literature review examines the barriers to secondary fracture prevention in primary care and evaluates the ef

Non-union after bisphosphonate-associated atypical femoral fractures: a review of the current literature.

BACKGROUND: This article explores the mechanism of action of atypical femoral fractures (AFF), specifically focussing on osteoporosis, management challenges, and the implications for clinical practice. Non-union of AFF can result in severe pain, deformity and restricted mobility-all of which will have a detrimental impact on the patients' quality of life. PURPOSE: This review consolidates the current literature regarding non-union after bisphosphonate-associated atypical femoral fractures, providing a revision tool for higher examinations. METHOD/FINDINGS: An extensive search strategy was co

Саркоидоз и повышенный риск сопутствующих заболеваний и смертности в Швеции.

ВВЕДЕНИЕ: Саркоидоз — это системное воспалительное заболевание с неясной этиологией, включающее образование гранулом. В большинстве случаев оно затрагивает легкие и лимфоузлы в грудной полости. Саркоидоз может протекать в острой или хронической форме, каждая из которых имеет различные клинические проявления и прогноз. МЕТОДЫ: Кейс-контрольное исследование коморбидности и морбидности у лиц, диагностированных с саркоидозом (код ICD10 D86) в Швеции с 2007 по 2016 год. Контроли были сопоставлены с случаями в соотношении 2:1 по возрасту, полу и району диагностики. Данные собрали из Шведского нацио

Exosomes in the Repair of Bone Defects: Next-Generation Therapeutic Tools for the Treatment of Nonunion.

Nonunion with bone defects, a common complication after long bone fracture, is a major challenge for orthopaedic surgeons worldwide because of the high incidence rate and difficulties in achieving successful treatment. Bone defects are the main complications of nonunion. The conventional biological treatments for nonunion with bone defects involve the use of autologous bone grafts or bone graft substitutes and cell-based therapy. Traditional nonunion treatments have always been associated with safety issues and various other complications. Bone grafts have limited autologous cancellous bone an

Tibial Lengthening with a Motorized Intramedullary Lengthening Nail.

BACKGROUND: Tibial lengthening with use of a motorized intramedullary lengthening nail (MILN) provides precise deformity correction and distraction osteogenesis without requiring external fixation1. A MILN can be utilized for many etiologies requiring lengthening, such as congenital (e.g., short stature, limb deficiency) or acquired (e.g., post-infectious, traumatic)2. The present video article describes the surgical technique for MILN use in the tibia in a skeletally mature patient with use of the Precice System (Globus Medical). DESCRIPTION: The preoperative patient evaluation starts with a

Primary Angiosarcoma of Humerus - A Case Report and Literature Review.

INTRODUCTION: When the fracture fails to heal for more than 12 months, it is called chronic non-union. Surgical intervention becomes mandatory to get this type of fracture healed. We are reporting our results in a case of congenital pseudoarthrosis of the tibia (CPT) having chronic non-union of 18 years duration with superadded infection following attempted surgery, using Ilizarov technology. We shall highlight the problems found during the course of treatment and different strategies to tackle them. CASE PRESENTATION: An 18-year-old female, born with CPT of the right tibia with neurofibromat

Disappearance of femoral head shortly after femoral neck fracture: a case report and literature review.

This case report describes a woman in her 70s who presented with a 3-month history of hip pain and inability to walk. Upon admission, she was diagnosed with the extremely rare condition of complete femoral head disappearance. A comprehensive examination was conducted to determine the cause and devise an effective treatment strategy, taking the patient's medical history into account. Through interdisciplinary discussions, occult infection and other potential causes were ruled out. The femoral head disappearance was ultimately determined to be due to wear, ischemia, and absorption following a fr

Reducing diagnostic delay in hypophosphatasia: a case series of 14 patients presenting to general rheumatology.

OBJECTIVES: Hypophosphatasia (HPP) is a rare genetic metabolic bone disease that can cause chronic pain and fractures. Its hallmark is a persistently low serum ALP. HPP is now recognised by many osteoporosis specialists, but other specialists, such as rheumatologists and primary care physicians, may be less aware of this condition, causing diagnostic delay and possible harm to these patients. Our objective was to highlight features that can reduce this delay. METHODS: We retrospectively analysed 14 patients that presented with musculoskeletal pain to general rheumatology clinic at St. George'