Use of external fixation for juxta-articular fractures in children.

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Abstract

[Indexed for MEDLINE] 15. Crit Care Clin. 2020 Oct;36(4):617-630. doi: 10.1016/j.ccc.2020.07.003. Orthopedic Principles to Facilitate Enhanced Recovery After Cardiac Surgery. Gerdisch MW(1), Allen KB(2), Naka Y(3), Bonnell MR(4), Landolfo KP(5), Grehan J(6), Grubb KJ(7), Cohen DJ(8), Guy TS(9), Patel NC(10), Thourani VH(11). Author information: (1)Department of Cardiothoracic Surgery, Franciscan Health Heart Center, 5255 East Stop 11 Road, Suite 200, Indianapolis, IN 46237, USA. Electronic address: mgerdisch@openheart.net. (2)Department of Cardiothoracic Surgery, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, 4320 Wornall Road, Suite 50-II, Kansas City, MO 64111, USA. (3)Division of Cardiothoracic Surgery, Department of Surgery, Columbia University Medical Center, 630 W 168th St, New York, NY 10032, USA. (4)Department of Cardiothoracic Surgery, University of Toledo, 1735 W Rocket Dr, Toledo, OH 43607, USA. (5)Department of Cardiothoracic Surgery, Mayo Clinic, 4500 San Pablo Road - Davis 321N, Jacksonville, FL 32224, USA. (6)Department of Cardiothoracic Surgery, Allina Health, 225 Smith Ave N, Nasseff Specialty Center, Suite 400, St Paul, MN 55102, USA. (7)Department of Cardiothoracic Surgery, Emory University, 550 Peachtree St NE, Davis Fischer 4th Floor, Atlanta, GA 30308, USA. (8)Department of Cardiology, Saint Luke's Mid America Heart Institute, University of Missouri-Kansas City School of Medicine, 4320 Wornall Road, Suite 50-II, Kansas City, MO 64111, USA. (9)Department of Surgery, Division of Cardiac Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, 1025 Walnut St, Suite 607, Philadelphia, PA 19107, USA. (10)Department of Cardiothoracic Surgery, Lenox Hill Hospital, 130 East 77th Street, 4th Floor, New York, NY 10075, USA. (11)Department of Cardiovascular Surgery, Marcus Heart and Vascular Center, Piedmont Heart Institute, 95 Collier Road, Suite 5015, Atlanta, GA 30309, USA. Enhanced recovery after surgery (ERAS) protocols recognize early postoperative mobilization as a driver of faster postoperative recovery, return to normal activities, and improved long-term patient outcomes. For patients undergoing open cardiac surgery, an opportunity for facilitating earlier mobilization and a return to normal activity lies in the use of improved techniques to stabilize the sternal osteotomy. By following the key orthopedic principles of approximation, compression, and rigid fixation, a more nuanced approach to sternal precaution protocols is possible, which may enable earlier patient mobilization, physical rehabilitation, and recovery. Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.ccc.2020.07.003