RESUMO
BACKGROUND: This study aims to provide insight regarding the different qualities of international medical graduates (IMGs) involved in US orthopedic residency programs. METHODS: Orthopedic residency programs accredited by the ACGME and listed in the AMA database were screened. Data on program size and location, IMG year of training, the geographic region of IMG's medical schools, their research experiences and number of gap years were included. RESULTS: A total of 167(80.3%) orthopedic residency programs were included. A total of 3838 residents were identified, of which 44 (1.15%) were IMGs. The United Kingdom and Ireland had the highest number of matched IMGs with four (9.1%) each. Massachusetts was the state with the highest number of enrolled IMGs. On average, IMGs had 26.3 publications and joined US orthopedic residency 4.66 years following medical school graduation. CONCLUSION: Despite the many hurdles experienced by IMGs, a decent number succeeds in matching into US orthopedic residency programs each year.
Assuntos
Internato e Residência , Humanos , Estados Unidos , Médicos Graduados Estrangeiros , Educação de Pós-Graduação em Medicina , Avaliação Educacional , Faculdades de MedicinaRESUMO
The subacromial balloon spacer is a novel treatment option for the management of massive irreparable rotator cuff tears. This device is introduced into the glenohumeral joint and acts to alleviate the acromiohumeral impingement, caused by the massive irreparable rotator cuff tear. The device also redistributes the tension around the adjacent muscles in the joint, allowing them to compensate for the torn rotator cuff tendons. By doing so, the balloon can act as a "rehabilitation accelerator", ultimately resulting in improved shoulder pain and function. Adherence to balloon indications when selecting the appropriate patient is necessary, and these include an irreparable posterosuperior rotator cuff tear, with preserved subscapularis function, minimal to no osteoarthritis, and the ability to forward flex to 90 degrees. Clinical studies have demonstrated promising potential regarding the benefit of the balloon, with numerous studies demonstrating great outcomes after its implantation. Nevertheless, future research remains necessary to render the evidence behind its utility unequivocal.
Assuntos
Osteoartrite , Lesões do Manguito Rotador , Articulação do Ombro , Humanos , Lesões do Manguito Rotador/cirurgia , Manguito Rotador/cirurgia , Dor de Ombro/terapiaRESUMO
BACKGROUND: Calcaneal apophysitis is an overuse injury in pediatric patients that causes heel pain and reduction in function. The aim of this study is to explore this condition and offer medical insight into its presentation and symptomatology, along with current treatment options. METHODS: We explored PubMed/Medline for studies involving calcaneal apophysitis in pediatric patients. The search included all articles published from database inception until June 1, 2021. We only included articles published in English. Clinical information and demographics extracted from the reported studies were analyzed and assessed. RESULTS: Only 28 studies met our criteria, with a total of 1,362 cases. Of the cases reported, 973 affected boys (71.4%). Presentation was bilateral in 589 cases (43.2%) and unilateral in 433 cases (31.8%). Radiographic imaging was used for the diagnosis of 358 cases (26.3%). All reported treatment modalities were conservative, and these included physical therapy and rest, kinesiotherapy and taping, and orthotic devices. A total of 733 cases (53.7%) reported improved outcomes,32 cases (2.3%) reported no improvement, and the remainder of cases did not report prognostic outcomes (44%). CONCLUSIONS: Calcaneal apophysitis is an overuse disease commonly found in the pediatric population. Educating parents and coaches with regard to its symptomatology, etiology, and treatment is essential to diagnose the condition earlier and provide better outcomes.
Assuntos
Calcâneo , Doenças do Pé , Masculino , Humanos , Criança , Calcâneo/diagnóstico por imagem , Doenças do Pé/epidemiologia , Dor/etiologia , Aparelhos Ortopédicos , RadiografiaRESUMO
Massive irreparable rotator cuff tears are difficult to treat. Several different treatment options have been explored in the orthopedic realm. A 69-year-old male with a massive irreparable rotator cuff tear was originally treated with a subacromial balloon spacer around five years prior to presentation. The patient started having increasing shoulder discomfort. Treatment options were discussed following review of MRI results and the patient decided to move forward with a second balloon spacer. The patient underwent his revision procedure and noted significant improvement in his pain and function on follow-up. Revision subacromial balloon spacers constitute an effective surgical treatment option that may slow the progression of rotator cuff arthropathy and relieve pain and dysfunction in the setting of massive irreparable rotator cuff tears.