Search this website

Hugo Sanchez, MD

Subscribe to Hugo Sanchez, MD  feed Hugo Sanchez, MD
NCBI: db=pubmed; Term=(sanchez hb[Author]) AND (John Peter Smith[Affiliation] OR JPS Health Network[Affiliation] OR JPS [Affiliation] NOT Japan Pancreas Society[Affiliation])
Updated: 14 hours 7 min ago

Single-stage bilateral distal femur replacement for traumatic distal femur fractures.

Thu, 05/02/2019 - 07:44
Related Articles

Single-stage bilateral distal femur replacement for traumatic distal femur fractures.

Arthroplast Today. 2019 Mar;5(1):26-31

Authors: Neal DC, Sambhariya V, Tran A, Rahman SK, Dean TJ, Wagner RA, Sanchez HB

Abstract
Treatment of periprosthetic distal femur fractures and comminuted intraarticular distal femur fractures with previous arthritis remains a difficult challenge for orthopedic surgeons. Previous case series have shown that distal femur replacement (DFR) can effectively compensate for bone loss, relieve knee pain, and allow for early ambulation in both of these fracture patterns. Owing to the typical low-energy mechanism of these injuries, a bilateral injury treated with DFR is rarely encountered. We present a patient with traumatic open left Rorabeck III/Su III periprosthetic distal femur fracture and closed right intraarticular distal femur fracture (AO fcation 33-C2) with end-stage arthrosis treated with single-stage bilateral DFR. We suggest that in patients with similar injuries, single-stage bilateral DFR can provide the benefits of early mobilization and accelerated recovery.

PMID: 31020017 [PubMed]

Corrigendum to "Reliability of the classification of proximal femur fractures: Does clinical experience matter?" [Injury 49 (1) (2018) 819-823].

Wed, 03/27/2019 - 23:38
Related Articles

Corrigendum to "Reliability of the classification of proximal femur fractures: Does clinical experience matter?" [Injury 49 (1) (2018) 819-823].

Injury. 2019 Mar 19;:

Authors: Crijns TJ, Janssen SJ, Davis JT, Ring D, Sanchez HB, Science of Variation Group

PMID: 30902425 [PubMed - as supplied by publisher]

The Radiographic Prepatellar Fat Thickness Ratio Correlates With Infection Risk After Total Knee Arthroplasty.

Wed, 02/20/2019 - 13:28
Related Articles

The Radiographic Prepatellar Fat Thickness Ratio Correlates With Infection Risk After Total Knee Arthroplasty.

J Arthroplasty. 2018 07;33(7):2251-2255

Authors: Wagner RA, Hogan SP, Burge JR, Bates CM, Sanchez HB

Abstract
BACKGROUND: Obesity has been associated with complications after a total knee arthroplasty (TKA). Surgical site infection (SSI) after TKA is one of the feared complications as it increases revision rates, costs, and stress to the patient. There is conflicting evidence in the literature regarding body mass index (BMI) and risk of infection after TKA, and some studies have suggested that site-specific fat distribution may be a better metric for determining risk of postoperative infections. Here, we investigate the correlation of soft tissue distribution about the knee to SSI after TKA.
METHODS: We retrospectively review 572 patients who underwent primary TKA at a single institution from 2006 to 2010. We introduce the prepatellar fat thickness ratio (PFTR) as a radiographic means to quantitatively assess fat distribution about the knee and evaluate this measurement's ability to assess the risk of developing an SSI after TKA.
RESULTS: The PFTR was shown to be a better predictor of SSI than BMI in both the univariate (P = .05) and multivariate (P = .01) analyses.
CONCLUSION: Although BMI cannot fully account for variations in adipose distribution, the PFTR may account for this variability and may be a helpful tool for assessing a patient's preoperative risk of SSI after TKA.

PMID: 29555491 [PubMed - indexed for MEDLINE]

Lower Bone Mineral Density is Associated with Intertrochanteric Hip Fracture.

Tue, 01/15/2019 - 10:54
Related Articles

Lower Bone Mineral Density is Associated with Intertrochanteric Hip Fracture.

Arch Bone Jt Surg. 2018 Nov;6(6):517-522

Authors: Bernstein DN, Davis JT, Fairbanks C, McWilliam-Ross K, Ring D, Sanchez HB

Abstract
Background: A better understanding of how bone mineral density and vitamin D levels are associated with femoral neck and intertrochanteric hip fractures may help inform healthcare providers. We asked: 1) In patients age ≥ 55 years, is there a difference in quantitative ultrasound of the heel (QUS) t-score between patients with fractures of the femoral neck and those with fractures of the intertrochanteric region, accounting for other factors 2) In patients age ≥ 55 years, is there a difference in vitamin D level between those with fractures of the femoral neck and those with fractures of the intertrochanteric region, accounting for other factors? 3) Is there an association between vitamin D level and QUS t-score?
Methods: In this retrospective cohort study, 1,030 patients were identified using CPT codes for fixation of hip fractures between December 2010 and September 2013. Patients ≥ 55 years of age who underwent operative management for a hip fracture following a fall from standing height were included. Three orthopaedic surgeons categorized fracture type using patient radiographs. Upon hospital admission, QUS t-scores and vitamin D levels were determined. Descriptive statistics, bivariate analyses and multivariable regression were performed.
Results: Accounting for potential confounders, patients with lower QUS t-scores were more likely to have intertrochanteric femur fractures than femoral neck fractures. In a bivariate analysis, there was no association between vitamin D level and either fracture type. There was no association between vitamin D level and bone mineral density.
Conclusion: Patients with lower bone density that fracture their hips are more likely to fracture in the intertrochanteric region than the femoral neck, but vitamin D levels are unrelated. Awareness of this association emphasizes the importance of bone mineral density screening to assist with intertrochanteric hip fracture prevention.
Level of evidence: III.

PMID: 30637307 [PubMed]

Longer Length of Stay Increases 1-year Readmission Rate in Patients Undergoing Hip Fracture Surgery.

Tue, 01/15/2019 - 10:54
Related Articles

Longer Length of Stay Increases 1-year Readmission Rate in Patients Undergoing Hip Fracture Surgery.

Arch Bone Jt Surg. 2018 Nov;6(6):492-500

Authors: Crijns TJ, Caton T, Teunis T, Davis JT, McWilliam-Ross K, Ring D, Sanchez HB

Abstract
Background: Proximal femur fractures are prevalent among the elderly and associated with substantial morbidity, mortality, and early readmission. Early readmission is gaining popularity as a measure of quality of hospital care and can lower reimbursement. A better understanding of the patient and treatment characteristics associated with readmission may help inform program improvement initiatives. This study tested the primary null hypothesis that length of stay is not associated with higher rates of readmission within 30 days and 1 year in patients having operative treatment of a proximal femur fracture, accounting for discharge destination and other factors.
Methods: We performed a secondary analysis on a database of 1,061 adult patients, age 55 years or older, admitted for treatment of a proximal femoral fracture in an urban level 2 trauma center. Multivariable logistic and linear regression models were created to account for the influence of age, sex, race, BMI, American Society of Anesthesiologists score (ASA), fracture type (AO/OTA), fixation type, operating surgeon, operative duration, and discharge destination.
Results: In multivariable logistic regression analysis, treatment by surgeon 4 was independently associated with a lower 30-day readmission rate. Higher one-year readmission rate was associated with a longer length of stay, ASA class 3, 4 and 5.
Conclusion: The observation that patients cared for by specific surgeons are more likely to experience readmission within one year of surgery for a fracture of the proximal femur, suggests that program improvements to identify and disseminate best practices might reduce readmission rates.
Level of evidence: III.

PMID: 30637304 [PubMed]