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Tosiaki Miyati - One of the best experts on this subject based on the ideXlab platform.
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1.0 s Ultrafast MRI in non-sedated infants after reduction with spica Casting for developmental dysplasia of the hip: a feasibility study
Journal of Children's Orthopaedics, 2016Co-Authors: Atsushi Fukuda, Kenichi Fukiage, Tohru Futami, Tosiaki MiyatiAbstract:Purpose The aim of this study was to first develop and use 1.0 s ultrafast magnetic resonance imaging (MRI) to confirm the location of the femoral head in non-sedated infants with developmental dysplasia of the hip (DDH) after reduction with spica Cast Application in clinical settings. Methods The ultrafast acquisition was achieved by employing a balanced steady-state free precession sequence and immobilizing the patient with dedicated sandbags. On completion of the ultrafast MRI study, all infants were sedated for conventional MRI scanning. Two orthopaedic surgeons retrospectively evaluated the image quality, result of the reduction and total MRI study time (including patient immobilization, coil setup, and scanning) in 14 DDHs of 13 infants (one with bilateral DDHs). Results Both reviewers stated that there were no motion artefacts for non-sedated infants during the ultrafast MRI and that the quality of both the ultrafast and conventional MRI images were acceptable to assess the femoral head location. Assessment of the reduction procedure resulted in two hips being categorized as ‘incomplete reduction’ requiring a re-reduction procedure. The total study time of ultrafast and conventional MRI was 6 ± 1 min and 14 ± 3 min, respectively ( P
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1.0 s Ultrafast MRI in non-sedated infants after reduction with spica Casting for developmental dysplasia of the hip: a feasibility study
Journal of Children's Orthopaedics, 2016Co-Authors: Atsushi Fukuda, Kenichi Fukiage, Tohru Futami, Tosiaki MiyatiAbstract:Purpose The aim of this study was to first develop and use 1.0 s ultrafast magnetic resonance imaging (MRI) to confirm the location of the femoral head in non-sedated infants with developmental dysplasia of the hip (DDH) after reduction with spica Cast Application in clinical settings.
Kenneth J. Noonan - One of the best experts on this subject based on the ideXlab platform.
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Cast and splint immobilization complications
Journal of The American Academy of Orthopaedic Surgeons, 2008Co-Authors: Matthew A. Halanski, Kenneth J. NoonanAbstract:AbstractDuring the past three decades, internal fixation has become increasingly popular for fracture management and limb reconstruction. As a result, during their training, orthopaedic surgeons receive less formal instruction in the art of extremity immobilization and Cast Application and removal.
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Cast and splint immobilization: complications.
Journal of The American Academy of Orthopaedic Surgeons, 2008Co-Authors: Matthew A. Halanski, Kenneth J. NoonanAbstract:During the past three decades, internal fixation has become increasingly popular for fracture management and limb reconstruction. As a result, during their training, orthopaedic surgeons receive less formal instruction in the art of extremity immobilization and Cast Application and removal. Casting is not without risks and complications (eg, stiffness, pressure sores, compartment syndrome); the risk of morbidity is higher when Casts are applied by less experienced practitioners. Certain materials and methods of ideal Cast and splint Application are recommended to prevent morbidity in the patient who is at high risk for complications with Casting and splinting. Those at high risk include the obtunded or comatose multitrauma patient, the patient under anesthesia, the very young patient, the developmentally delayed patient, and the patient with spasticity.
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Thermal injury with contemporary Cast-Application techniques and methods to circumvent morbidity
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Matthew A. Halanski, Ray Vanderby, Amy D. Halanski, Ashish L. Oza, Alejandro Munoz, Kenneth J. NoonanAbstract:Background: Thermal injuries caused by Application of Casts continue to occur despite the development of newer Cast materials. We studied the risk of these injuries with contemporary methods of immobilization. Methods: Using cylindrical and L-shaped limb models, we recorded the internal and external temperature changes that occurred during Cast Application. Variables that we assessed included the thickness of the Cast or splint, dip-water temperature, limb diameter and shape, Cast type (plaster, fiberglass, or composite), padding type, and placement of the curing Cast on a pillow. These data were then plotted on known time-versus-temperature graphs to assess the potential for thermal injury. Results: The external temperature of the plaster Casts was an average (and standard deviation) of 2.7° ± 1.9°C cooler than the internal temperature. The external temperature of twenty-four-ply Casts peaked at an average of 84 ± 42 seconds prior to the peak in the internal temperature. The average difference between the internal and external temperatures of the thicker (twenty-four-ply) Casts (4.9° ± 1.3°C) was significantly larger than that of the thinner (six and twelve-ply) Casts (1.5° ± 1°C) (p < 0.05). Use of dip water with a temperature of 24°C should be avoided. Splints should be cut to a proper length and not folded over. Placing the limb on a pillow during the curing process puts the limb at risk. Overwrapping of plaster in fiberglass should be delayed until the plaster is fully cured and cooled.
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thermal injury with contemporary Cast Application techniques and methods to circumvent morbidity
Journal of Bone and Joint Surgery American Volume, 2007Co-Authors: Matthew A. Halanski, Ray Vanderby, Amy D. Halanski, Ashish L. Oza, Alejandro Munoz, Kenneth J. NoonanAbstract:Background: Thermal injuries caused by Application of Casts continue to occur despite the development of newer Cast materials. We studied the risk of these injuries with contemporary methods of immobilization. Methods: Using cylindrical and L-shaped limb models, we recorded the internal and external temperature changes that occurred during Cast Application. Variables that we assessed included the thickness of the Cast or splint, dip-water temperature, limb diameter and shape, Cast type (plaster, fiberglass, or composite), padding type, and placement of the curing Cast on a pillow. These data were then plotted on known time-versus-temperature graphs to assess the potential for thermal injury. Results: The external temperature of the plaster Casts was an average (and standard deviation) of 2.7° ± 1.9°C cooler than the internal temperature. The external temperature of twenty-four-ply Casts peaked at an average of 84 ± 42 seconds prior to the peak in the internal temperature. The average difference between the internal and external temperatures of the thicker (twenty-four-ply) Casts (4.9° ± 1.3°C) was significantly larger than that of the thinner (six and twelve-ply) Casts (1.5° ± 1°C) (p < 0.05). Use of dip water with a temperature of <24°C avoided Cast temperatures that can cause thermal injury regardless of the thickness of the plaster Cast. A dip-water temperature of 50°C combined with a twenty-four-ply Cast thickness consistently yielded temperatures high enough to cause burns. Use of splinting material that was folded back on itself was associated with a significant risk of thermal injury. Likewise, placing a Cast on a pillow during curing resulted in temperatures in the area of pillow contact that were high enough to cause thermal damage, as did overwrapping of a curing plaster Cast with fiberglass. Attempts to decrease internal temperatures with the Application of isopropyl alcohol to the exterior of the Cast did not decrease the risk of thermal injury. Conclusions: Excessively thick plaster and a dip-water temperature of >24°C should be avoided. Splints should be cut to a proper length and not folded over. Placing the limb on a pillow during the curing process puts the limb at risk. Overwrapping of plaster in fiberglass should be delayed until the plaster is fully cured and cooled.
K Mcdonald - One of the best experts on this subject based on the ideXlab platform.
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does formal education and training of staff reduce the operation rate for fractures of the distal radius evidence from a level 1 trauma centre
Orthopaedic Proceedings, 2018Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:IntroductionFractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates.MethodsRetrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the nex...
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Does formal education and training of staff reduce the operation rate for fractures of the distal radius? Evidence from a level 1 trauma centre
2018Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:IntroductionFractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates.MethodsRetrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the nex...
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does formal education and training of staff reduce the operation rate for fractures of the distal radius
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland, 2013Co-Authors: K Mcdonald, B Gallagher, Lynn Murphy, Niall EamesAbstract:Abstract Background Fractures of the distal radius are one of the most common extremity fractures, and operation rates are increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates. Methods Retrospective data was extracted from FORD (Fracture Outcome and Research Database), including: number of fractures, number of fractures undergoing ORIF, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by two separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that six-month period. Exclusion criteria included bilateral injuries, and polytrauma patients. Results A total of 1623 distal radial fractures were treated in our unit over the 12-month period, with 71 undergoing ORIF in the first 6 months and 39 in the second 6 months, this was statistically significant ( p = 0.0009). Our study found that formal teaching and education significantly reduced the operation rate for distal radial fractures. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Conclusion Our study proves that just 1 h of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients.
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does formal education and training of staff reduce the operation rate for fractures of the distal radius evidence from a level 1 trauma centre
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:Introduction Fractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates. Methods Retrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that 6 month period. Exclusion criteria included bilateral injuries, and polytrauma patients. Results A total of 1712 distal radial fractures were treated in our unit over the 12 month period, with 71 undergoing ORIF in the first 6 months and 37 in the second 6 months. Our study found that formal teaching and education of medical staff significantly reduced the operation rate for distal radial fractures in our unit. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Conclusion In today9s busy hospital environment it is sometimes all too easy to overlook the training of junior medical staff, our study proves that just 1 hour of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients.
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Does formal education and training of staff reduce the operation rate for fractures of the distal radius? Evidence from a level 1 trauma centre
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:Introduction Fractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates. Methods Retrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that 6 month period. Exclusion criteria included bilateral injuries, and polytrauma patients. Results A total of 1712 distal radial fractures were treated in our unit over the 12 month period, with 71 undergoing ORIF in the first 6 months and 37 in the second 6 months. Our study found that formal teaching and education of medical staff significantly reduced the operation rate for distal radial fractures in our unit. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Conclusion In today9s busy hospital environment it is sometimes all too easy to overlook the training of junior medical staff, our study proves that just 1 hour of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients.
G Mclorinan - One of the best experts on this subject based on the ideXlab platform.
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does formal education and training of staff reduce the operation rate for fractures of the distal radius evidence from a level 1 trauma centre
Orthopaedic Proceedings, 2018Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:IntroductionFractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates.MethodsRetrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the nex...
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Does formal education and training of staff reduce the operation rate for fractures of the distal radius? Evidence from a level 1 trauma centre
2018Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:IntroductionFractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates.MethodsRetrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the nex...
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does formal education and training of staff reduce the operation rate for fractures of the distal radius evidence from a level 1 trauma centre
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:Introduction Fractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates. Methods Retrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that 6 month period. Exclusion criteria included bilateral injuries, and polytrauma patients. Results A total of 1712 distal radial fractures were treated in our unit over the 12 month period, with 71 undergoing ORIF in the first 6 months and 37 in the second 6 months. Our study found that formal teaching and education of medical staff significantly reduced the operation rate for distal radial fractures in our unit. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Conclusion In today9s busy hospital environment it is sometimes all too easy to overlook the training of junior medical staff, our study proves that just 1 hour of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients.
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Does formal education and training of staff reduce the operation rate for fractures of the distal radius? Evidence from a level 1 trauma centre
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: K Mcdonald, B Gallagher, G MclorinanAbstract:Introduction Fractures of the distal radius are one of the most common extremity fractures encountered in A&E departments and general adult fracture clinics. Over the last 10 years the rate of operation for distal radial fractures has been steadily increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate Cast Application could result in a reduction in operation rates. Methods Retrospective data was extracted from FORD (Fracture Outcome and Research Database). Data included: the number of fractures in a 6 month period, number of fractures undergoing ORIF in that period, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by 2 separate reviewers. Information regarding adequate fracture reduction, adequate Cast Application (using Gap Index calculation), and appropriate plaster Cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that 6 month period. Exclusion criteria included bilateral injuries, and polytrauma patients. Results A total of 1712 distal radial fractures were treated in our unit over the 12 month period, with 71 undergoing ORIF in the first 6 months and 37 in the second 6 months. Our study found that formal teaching and education of medical staff significantly reduced the operation rate for distal radial fractures in our unit. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Conclusion In today9s busy hospital environment it is sometimes all too easy to overlook the training of junior medical staff, our study proves that just 1 hour of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients.
Atsushi Fukuda - One of the best experts on this subject based on the ideXlab platform.
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1.0 s Ultrafast MRI in non-sedated infants after reduction with spica Casting for developmental dysplasia of the hip: a feasibility study
Journal of Children's Orthopaedics, 2016Co-Authors: Atsushi Fukuda, Kenichi Fukiage, Tohru Futami, Tosiaki MiyatiAbstract:Purpose The aim of this study was to first develop and use 1.0 s ultrafast magnetic resonance imaging (MRI) to confirm the location of the femoral head in non-sedated infants with developmental dysplasia of the hip (DDH) after reduction with spica Cast Application in clinical settings. Methods The ultrafast acquisition was achieved by employing a balanced steady-state free precession sequence and immobilizing the patient with dedicated sandbags. On completion of the ultrafast MRI study, all infants were sedated for conventional MRI scanning. Two orthopaedic surgeons retrospectively evaluated the image quality, result of the reduction and total MRI study time (including patient immobilization, coil setup, and scanning) in 14 DDHs of 13 infants (one with bilateral DDHs). Results Both reviewers stated that there were no motion artefacts for non-sedated infants during the ultrafast MRI and that the quality of both the ultrafast and conventional MRI images were acceptable to assess the femoral head location. Assessment of the reduction procedure resulted in two hips being categorized as ‘incomplete reduction’ requiring a re-reduction procedure. The total study time of ultrafast and conventional MRI was 6 ± 1 min and 14 ± 3 min, respectively ( P
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1.0 s Ultrafast MRI in non-sedated infants after reduction with spica Casting for developmental dysplasia of the hip: a feasibility study
Journal of Children's Orthopaedics, 2016Co-Authors: Atsushi Fukuda, Kenichi Fukiage, Tohru Futami, Tosiaki MiyatiAbstract:Purpose The aim of this study was to first develop and use 1.0 s ultrafast magnetic resonance imaging (MRI) to confirm the location of the femoral head in non-sedated infants with developmental dysplasia of the hip (DDH) after reduction with spica Cast Application in clinical settings.