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Your search keyword '"Gardner, Michael J"' showing total 287 results
Start Over Author "Gardner, Michael J" Publisher lippincott williams & wilkins
287 results on '"Gardner, Michael J"'

1. Integrated Dual Lag Screws Have Higher Reoperation Rates for Fixation Failure Than Single Lag Component Cephalomedullary Nails: A Retrospective Study of 2,130 Patients with Intertrochanteric Femoral Fractures.

Author

Gonzalez, Christian A., Van Rysselberghe, Noelle L., Whittaker, Mathew J., Ngo, Daniel, Michaud, John B., and Gardner, Michael J.

Abstract

Background: Previous studies comparing reoperation risk between integrated dual lag screw (IDL) and single lag component (SL) cephalomedullary nails (CMNs) in the treatment of intertrochanteric femoral fractures have demonstrated mixed results. The purpose of this study was to assess the rates of reoperation for fixation failure and all-cause reoperation in a large, multi-institutional cohort of patients with an intertrochanteric fracture treated with an IDL or SL CMN. We hypothesized that there would be no difference between the groups with respect to either of the reoperation rates. Methods: Adults (≥18 years old) who sustained an intertrochanteric fracture (AO/OTA 31A1 to 31A3) treated with an IDL or SL CMN between January 2014 and May 2021 at 1 of 13 Level-I trauma centers were included. Patients with <3 months of follow-up or pathologic fractures were excluded. Rates of reoperation were compared with use of the chi-square test and multivariable regression, controlling for age, gender, injury mechanism, fracture pattern, and postoperative neck-shaft angle. Results: A total of 2,130 patients met the inclusion criteria. The median age was 78 years, and 62.5% of patients were female. The cohort consisted of 287 patients (13.5%) with an IDL CMN and 1,843 patients (86.5%) with an SL CMN. A total of 99 patients (4.6%) had a reoperation of any type, of whom 29 (1.4% of all patients) had a reoperation for fixation failure. Compared with patients with an SL CMN, those with an IDL CMN had higher rates (4.2% versus 0.9%; p < 0.001) and odds (odds ratio [OR], 4.95 [95% confidence interval (CI), 2.29 to 10.69]; p < 0.001) of reoperation for fixation failure as well as higher rates (7.3% versus 4.2%; p = 0.021) and odds (OR, 1.83 [95% CI, 1.10 to 3.06]; p = 0.021) of all-cause reoperation. Conclusions: Intertrochanteric femoral fractures treated with an IDL CMN were associated with low but significantly higher rates and significantly higher odds of reoperation for fixation failure and all-cause reoperation compared with those treated with an SL CMN. We suggest caution to surgeons in the use of IDL CMNs for high-risk patients and recommend using SL CMNs for most patients with intertrochanteric femoral fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Locked Lateral Plating Versus Retrograde Nailing for Distal Femur Fractures: A Multicenter Randomized Trial.

Author

Dunbar, Robert P., Egol, Kenneth A., Jones, Clifford B., Ertl, Jan P., Mullis, Brian, Perez, Edward, Collinge, Cory A., Ostrum, Robert, Humphrey, Catherine, Gardner, Michael J., Ricci, William M., Phieffer, Laura S., Teague, David, Ertl, William, Born, Christopher T., Zonno, Alan, Siegel, Jodi, Sagi, Henry Claude, Pollak, Andrew, and Schmidt, Andrew H.

Published
2023
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24. Current Controversies in the Treatment of Geriatric Proximal Humeral Fractures.

Author

Mease, Samuel J., Kraeutler, Matthew J., Gonzales-Luna, Daniel C., Gregory, James M., Gardner, Michael J., and Choo, Andrew M.

Subjects
INTRAMEDULLARY fracture fixation, REVERSE total shoulder replacement, HUMERUS, SURGICAL robots, FUNCTIONAL assessment
Abstract

➤: Multiple studies comparing nonoperative and operative treatment for displaced proximal humeral fractures in the geriatric population have demonstrated minimal differences in functional outcomes. Factors such as surgeon experience as well as the quality and maintenance of the reduction may influence operative outcomes, and their impact on these findings merits further investigation.➤: In the treatment of 2 and 3-part fractures involving the surgical neck, intramedullary nailing has demonstrated functional outcomes that are comparable with those of open reduction and internal fixation (ORIF).➤: In the geriatric population, reverse total shoulder arthroplasty has demonstrated improved functional outcomes, with a decreased rate of reoperation, compared with hemiarthroplasty. Tuberosity repair has been shown to improve functional outcomes and range of motion after both procedures and should be performed at the time of arthroplasty.➤: Several authors have demonstrated the negative effect of osteopenia on outcomes after ORIF of proximal humeral fractures. Augmentative procedures, including cortical strut augmentation, are being investigated to address this issue; their role in the treatment of these fractures is unclear at this time. [ABSTRACT FROM AUTHOR]

Published
2021
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34. Does a Question Prompt List Improve Perceived Involvement in Care in Orthopaedic Surgery Compared with the AskShareKnow Questions? A Pragmatic Randomized Controlled Trial.

Author

Mariano, David J., Liu, Adam, Eppler, Sara L., Gardner, Michael J., Hu, Serena, Safran, Marc, Chou, Loretta, Amanatullah, Derek F., and Kamal, Robin N.

Subjects
RANDOMIZED controlled trials, ORTHOPEDIC surgery, PATIENT preferences, DEMOGRAPHIC characteristics
Abstract

Background: Most conditions in orthopaedic surgery are preference-sensitive, where treatment choices are based on the patient's values and preferences. One set of tools increasingly used to help align treatment choices with patient preferences are question prompt lists (QPLs), which are comprehensive lists of potential questions that patients can ask their physicians during their encounters. Whether or not a comprehensive orthopaedic-specific question prompt list would increase patient-perceived involvement in care more effectively than might three generic questions (the AskShareKnow questions) remains unknown; learning the answer would be useful, since a three-question list is easier to use compared with the much lengthier QPLs.Question/purpose: Does an orthopaedic-specific question prompt list increase patient-perceived involvement in care compared with the three generic AskShareKnow questions?Methods: We performed a pragmatic randomized controlled trial of all new patients visiting a multispecialty orthopaedic clinic. A pragmatic design was used to mimic normal clinical care that compared two clinically acceptable interventions. New patients with common orthopaedic conditions were enrolled between August 2019 and November 2019 and were randomized to receive either the intervention QPL handout (orthopaedic-specific QPL with 45 total questions, developed with similar content and length to prior QPLs used in hand surgery, oncology, and palliative care) or a control handout (the AskShareKnow model questions, which are: "What are my options? What are the benefits and harms of those options? How likely are each of those benefits and harms to happen to me?") before their visits. A total of 156 patients were enrolled, with 78 in each group. There were no demographic differences between the study and control groups in terms of key variables. After the visit, patients completed the Perceived Involvement in Care Scale (PICS), a validated instrument designed to evaluate patient-perceived involvement in their care, which served as the primary outcome measure. This instrument is scored from 0 to 13, with higher scores indicating higher perceived involvement.Results: There was no difference in mean PICS scores between the intervention and control groups (QPL 8.3 ± 2.3, control 8.5 ± 2.3, mean difference 0.2 [95% CI -0.53 to 0.93 ]; p = 0.71.Conclusion: In patients undergoing orthopaedic surgery, a QPL does not increase patient-perceived involvement in care compared with providing patients the three AskShareKnow questions. Implementation of the three AskShareKnow questions can be a more efficient way to improve patient-perceived involvement in their care compared with a lengthy QPL.Level Of Evidence: Level II, therapeutic study. [ABSTRACT FROM AUTHOR]

Published
2021
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41. Deltopectoral Approach for Arthroplasty After Early Failed Proximal Humerus Fixation Via Deltoid Split Heals Uneventfully.

Author

DeBaun, Malcolm R., Goodnough, L. Henry, Gatewood, Corey, Gardner, Michael J., and Abrams, Geoffrey D.

Subjects
HUMERUS, ARTHROPLASTY, TOTAL shoulder replacement, FRACTURE healing, INTRAMEDULLARY rods, HOSPITAL emergency services, STAIRS
Abstract

Case: A 57-year-old male carpenter sustained a 2-part displaced proximal humerus fracture of his nondominant arm with varus angulation after a fall down the stairs. Fifteen days postinjury, the patient underwent direct reduction and surgical fixation with an intramedullary cage implant via a deltoid split approach. Nine days postsurgery, the patient presented to the emergency department after another fall with failed fixation. Two weeks after index surgery, he was revised to a reverse total shoulder arthroplasty via a deltopectoral approach and healed both incisions uneventfully. Conclusion: A deltopectoral approach performed acutely after a deltoid split approach for fracture can heal uneventfully. [ABSTRACT FROM AUTHOR]

Published
2020
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