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Early post operative pain management in orthopedics

Stephanie R Albin, Shane L Koppenhaver, Drew H Van Boerum, Thomas G McPoil, James Morgan, Julie M Fritz
Study design: Randomized clinical trial. Background: Patients with fractures to the talus and calcaneus report decreased functional outcomes and develop long-term functional limitations. Although physical therapy is typically not initiated until six weeks after fixation, there's little research on the optimal time to initiate a formal physical therapy program. Objectives: To assess whether initiating physical therapy including range of motion (ROM) and manual therapy two weeks post-operatively (EARLY) vs...
July 2018: Journal of Manual & Manipulative Therapy
W Schmelling, J N Poulsen, L Christrup, P Gazerani
Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain...
December 29, 2017: Scandinavian Journal of Pain
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
2017: International Journal of Surgery Case Reports
Masataka Enomoto, Patricia D Kigin, David Bledsoe, Robyn Slone, Jonathan Hash, Charles E Smith, B Duncan X Lascelles
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods...
January 24, 2017: BMC Veterinary Research
P Chaudier, M Bourdin, J Gauthier, M H Fessy, J L Besse
While many forefoot procedures may be performed as a day case, there are no specific guidelines as to which procedures are suitable. This study assessed the early post-operative pain after forefoot surgery performed a day case, compared with conventional inpatient management. A total of 317 consecutive operations performed by a single surgeon were included in the study. Those eligible according to the criteria of the French Society of Anaesthesia (SFAR) were managed as day cases (127; 40%), while the remainder were managed as inpatients...
December 2015: Bone & Joint Journal
Caio Nery, Fernando C Raduan, Fernanda Catena, Tania Szejnfeld Mann, Marco Antonio Percope de Andrade, Daniel Baumfeld
BACKGROUND: To the present day, literature has only discussed how to treat extensive plantar plate and collateral ligament lesions, with gross joint subluxation and obvious clinical instability. The treatment options for early stages of the disease with minor injuries and subtle instabilities have not been described. The main purpose of this prospective study is to evaluate the efficacy of the combination of the arthroscopic radiofrequency shrinkage and distal Weil osteotomy in the treatment of subtle metatarsophalangeal joint instability...
November 19, 2015: Journal of Orthopaedic Surgery and Research
Ezzat H Fouly, Ahmed F Sadek, Mohammed F Amin
BACKGROUND: The aim of surgical management of Kienböck's disease has been proposed to slow the progressive osteonecrosis and secondary carpal damage. The aim of this case series was to evaluate the results of a new technique, combining distal capitate shortening with capitometacarpal fusion for the treatment of Kienböck's disease (Lichtman stage II or stage IIIA) in neutral ulnar variance patients. METHODS: From 2009 to 2012, 12 patients (mean age: 25 ± 7.6 years) were enrolled in this series...
October 11, 2014: Journal of Orthopaedic Surgery and Research
Nicholas Eastley, Martyn Newey, Robert U Ashford
Developments in oncological and medical therapies mean that life expectancy of patients with metastatic bone disease (MBD) is often measured in years. Complications of MBD may dramatically and irreversibly affect patient quality of life, making the careful assessment and appropriate management of these patients essential. The roles of orthopaedic and spinal surgeons in MBD generally fall into one of four categories: diagnostic, the prophylactic fixation of metastatic deposits at risk of impending fracture (preventative surgery), the stabilisation or reconstruction of bones affected by pathological fractures (reactive surgery), or the decompression and stabilisation of the vertebral column, spinal cord, and nerve roots...
September 2012: Surgical Oncology
P Brindza, R Chaloupka, R Grosman
PURPOSE OF THE STUDY: The aim of the study was to evaluate the group of patients operated on for chordoma at our department. We present diagnostic and surgical management options relevant to the localisation of chordoma in the spine, and evaluate the results in terms of post-operative complications, tumour recurrence and patient survival. MATERIAL AND METHODS: Between 1989 and 2002 a total of 20 patients diagnosed with chordoma were treated. There were 15 men and five women with an average age of 53 years...
October 2009: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
D R Smith
Pericarditis is a common clinical entity which has been reported frequently in association with numerous disease processes. However, pericarditis following blunt thoracic trauma is exceedingly rare and difficult to diagnosis. An 18 year-old female was transferred to UAB Hospital for evaluation and management of multiple injuries following a high-speed single-vehicle motor vehicle accident. Injuries included a fractured right tibia and femur, pelvic fracture, and a right pulmonary contusion with rib fractures...
March 1995: Alabama Medicine: Journal of the Medical Association of the State of Alabama
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