The American journal of orthopedics
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Management of postsurgical analgesia is an important consideration in orthopedic procedures, including joint arthroplasty. Inadequate postsurgical analgesia is associated with increased hospital length of stay, delayed ambulation, and reduced exercise capacity. ⋯ Liposome bupivacaine has been well tolerated in clinical studies and has had a low rate of treatment-related adverse events. To date, there has been no signal of cardiac toxicity, chondrolysis, or delayed wound healing associated with liposome bupivacaine.
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Unstable proximal interphalangeal (PIP) joint fracture-dislocations, which can cause significant disability, can be treated with multiple techniques. Extension-block pinning (EBP) allows for early motion and is less technically demanding than alternative surgical treatments. In the study reported here, 12 patients with unstable dorsal PIP fracture-dislocations were treated with closed reduction of the PIP joint followed by percutaneous insertion of a Kirschner wire (K-wire) into the distal aspect of the proximal phalanx. ⋯ One patient developed a malunion, which was treated with corrective osteotomy. EBP is a simple, safe, and reproducible technique for unstable PIP fracture-dislocations. This technique yields outcomes similar to those reported for more complex surgical procedures.
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Chronic plantar fasciitis is a major health care problem worldwide and affects nearly 10% of the US population. Although most cases resolve with conservative care, the numerous treatments for refractory plantar fasciitis attest to the lack of consensus regarding these cases. ⋯ This is the first report of a plantar fascia partial release guided by ultrasonic energy delivered by a percutaneously inserted probe under local anesthesia. The procedure appears to be a safe, effective, well-tolerated treatment for a condition that is refractory to other options.