The Journal of bone and joint surgery. American volume
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Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. ⋯ Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.
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J Bone Joint Surg Am · Feb 2018
What Leads to Lead: Results of a Nationwide Survey Exploring Attitudes and Practices of Orthopaedic Surgery Residents Regarding Radiation Safety.
Excessive radiation to health-care providers has been linked to risks of cancer and cataracts, but its negative effects can be substantially reduced by lead aprons, thyroid shields, and leaded glasses. Hospitals are required to provide education and proper personal protective equipment, yet discrepancies exist between recommendations and compliance. This article presents the results of a survey of U.S. orthopaedic surgery residents concerning attitudes toward radiation exposure and personal protective equipment behavior. ⋯ Radiation exposure is associated with increased risk of serious health problems. Our findings identified that the availability of lead personal protective equipment leads to increased compliance among residents surveyed. In addition to yearly occupational hazard training specific to orthopaedic surgery, greater efforts by residency programs and hospitals are needed to improve access to lead personal protective equipment and compliance for orthopaedic residents.
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J Bone Joint Surg Am · Feb 2018
Effect of Posterior Malleolus Fracture on Syndesmotic Reduction: A Cadaveric Study.
Syndesmotic malreduction and fractures of the posterior malleolus negatively influence outcomes of rotational ankle fractures. Recent data have shown that posterior malleolus fixation contributes to the stability of the syndesmosis. The purpose of this study was to analyze syndesmotic reduction within the context of different sizes of posterior malleolus fracture fragments and different qualities of reduction. ⋯ When posterior malleolus fractures occur with syndesmotic injury, anatomic fracture reduction and fixation are paramount as they can affect syndesmotic reduction, especially with larger fragments.
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J Bone Joint Surg Am · Feb 2018
Excess Opioid Medication and Variation in Prescribing Patterns Following Common Orthopaedic Procedures.
Postoperative pain management in orthopaedic surgery accounts for a substantial portion of opioid medications prescribed in the United States. Understanding prescribing habits and patient utilization of these medications following a surgical procedure is critical to establishing appropriate prescribing protocols that effectively control pain while minimizing unused opioid distribution. We evaluated prescribing habits and patient utilization following elective orthopaedic surgical procedures to identify ways of improving postoperative opioid-prescribing practices. ⋯ Prescribing patterns vary widely, and a large amount of opioid medications remains unused following elective orthopaedic surgical procedures. Effective prescribing protocols are needed to limit this source of potential abuse and opioid diversion within the community.
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J Bone Joint Surg Am · Feb 2018
The Cost-Effectiveness of Surgical Fixation of Distal Radial Fractures: A Computer Model-Based Evaluation of Three Operative Modalities.
There is no consensus on the optimal fixation method for patients who require a surgical procedure for distal radial fractures. We used cost-effectiveness analyses to determine which of 3 modalities offers the best value: closed reduction and percutaneous pinning, open reduction and internal fixation, or external fixation. ⋯ Economic Level III. See Instructions for Authors for a complete description of levels of evidence.