Sports medicine and arthroscopy review
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Sports Med Arthrosc · Mar 2014
ReviewDistal radius fractures in athletes: approaches and treatment considerations.
Fractures of the distal radius are common injuries in both athletes and nonathletes. Management is dictated by the nature of the fracture and the patient's level of competition, age, and sport-specific demands. ⋯ However, no technique has proven superior to all others, and no single method of fixation will lead to acceptable results in all types of distal radius fractures. This study will highlight important considerations when treating distal radius fractures in athletes, describe the various fixation options available, and discuss our method for determining the fixation needs of each fracture.
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Sports Med Arthrosc · Mar 2014
ReviewManagement of scaphoid fractures in the athlete: open and percutaneous fixation.
Scaphoid fractures occur commonly in the athlete and should be treated with urgency to avoid undesired late complications. Magnetic resonance imaging may be helpful to make a prompt diagnosis so that an appropriate early treatment plan can be initiated. ⋯ Percutaneous techniques with or without arthroscopy assistance have been advocated as less invasive surgical approaches that may have an added benefit in the athlete. Displaced and unstable fractures should be approached with a volar or dorsal open technique to achieve and confirm an anatomic reduction before screw placement.
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Platelet-rich plasma (PRP) is increasingly used in Regenerative Medicine. The concept of PRP as a natural source of signaling molecules with paracrine effects in different cells is the basis for the increased PRP application as treatment for sports injuries. PRP recapitulates the principal functions of the natural healing response in orchestrating cell proliferation, differentiation, migration, and angiogenesis. ⋯ The clinical evaluation of alternative formulations can be extremely informative. Other unexplored issues include activation, redosing, and concomitant longitudinal tenotomies. Limiting factors for the acceptance of PRP are the lack of evidence of obvious clinical improvement and reimbursement.
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Sports Med Arthrosc · Sep 2013
ReviewICD 10: "what orthopedic surgeons should know, how it will affect them and the cost of implementation?".
Orthopedic surgeons will be required to use ICD-10-CM codes for reimbursement and to substantiate the medical necessity for their services beginning October 1, 2014. Implementation of ICD10 will require significant changes in the clinical and administrative processes of orthopedic offices and hospital practices. As in other countries, implementation added costs and resulted in disruptions in physician practices with concomitant decreases in productivity and practice revenue. ⋯ Changes anticipated in the diagnostic part of the ICD10 coding system are reviewed with examples pertinent to orthopedic surgeons. Many will need to improve the accuracy and specificity of their documentation by using anatomically precise nomenclature and obtaining a more detailed history and physical examination. This will require eliciting external causes of patients' problems, the precise activity of causation, and the place of occurrence.
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Shoulder arthroscopic procedures have become common in today's orthopedic practice. The safety of shoulder arthroscopy though well established, is not without complications both minor and significant. ⋯ General complications (ie, infection), those specific to shoulder arthroscopy (ie, positioning) and those associated with specific procedures (ie, failure) all have been recognized. The purpose of this article is to review the current literature regarding complications in shoulder arthroscopy, provide insight into the risk factors and types of complications and to provide guidelines on the prevention and management of complications if and when they occur.