Breaking Barriers: A Brief Overview of Diversity in Orthopedic Surgery.
Authors: Day MA, Owens JM, Caldwell LS Abstract Diversity within the field of orthopedic surgery has been slow to progress, even well into the 21st century. Despite the barriers broken in 1932 by Ruth Jackson - the first female member of the American Academy of Orthopedic Surgeons (AAOS) - gender, racial and ethnic diversity continues to be lacking. Research has shown there are clear advantages of a diverse physician population, not only in medicine and patient care but in commercial industry as well. Although the representation of females and underrepresented minorities (URM) in orthopedics is increasing, it is do...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Factors Impacting Initial Arthroscopy Performance and Skill Progression in Novice Trainees.
Conclusions: Our study demonstrates that baseline arthroscopy performance correlates most highly with 3D video game experience. The ability of trainees to learn arthroscopy using a virtual reality simulator appears to be influenced more by those who have regularly participated in sports requiring hand eye coordination rather than video game use.Level of Evidence: III. PMID: 31413668 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Variability in Experience Performing Lower Extremity Amputations Between Surgical Residents: An Examination Of ACGME Case Logs.
Authors: Carender CN, Shamrock AG, An Q, Karam MD Abstract Background: There is a wide array of indications for lower extremity amputation (LEA) and inherent variability in operative experiences between surgical residents. Significant variation in resident surgical experience performing LEAs is possible. Objective: To identify inter- and intra-specialty trends and variability in LEA experience in graduating orthopedic surgery, general surgery, and vascular surgery residents from 2007-2017. Methods: Publicly available ACGME case log data for above knee amputation, below knee amputation, and transmetatarsal/ ...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Anatomic Syndesmotic and Deltoid Ligament Reconstruction with Flexible Implants: A Technique Description.
Authors: Hajewski CJ, Duchman K, Goetz J, Femino J Abstract The optimal fixation method for unstable syndesmosis (SYN) injuries remains a matter of debate between rigid screw fixation that stabilizes all three components of the syndesmosis but prohibits any motion, and flexible implants stabilizing by compression along the axis of the interosseous ligament. More recently additional repairs of the anterior or posterior SYN ligaments have been explored both clinically and biomechanically. The role for deltoid ligament (DL) repair or reconstruction in the setting of SYN injury remains controversial. However, the DL is...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Overlapping Surgery in Primary Total Knee Arthroplasty: Are 6-Week Complications Worse than Single Operating Room Scheduling?
Conclusions: This study demonstrates no differences in 6-week clinical or radiographic outcomes between patients undergoing primary TKA on single versus overlapping OR days. These results support the safe practice of overlapping surgical scheduling in high-volume primary TKA centers.Level of Evidence: III. PMID: 31413671 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Early Predictors of Microsurgical Reconstruction in Brachial Plexus Birth Palsy.
Authors: Shah AS, Kalish LA, Bae DS, Peljovich AE, Cornwall R, Bauer AS, Waters PM, Treatment and Outcomes of Brachial Plexus Injuries (TOBI) Study Group Abstract Background: Microsurgical reconstruction is indicated for infants with brachial plexus birth palsy (BPBP) that demonstrate limited spontaneous neurological recovery. This investigation defines the demographic, perinatal, and physical examination characteristics leading to microsurgical reconstruction. Methods: Infants enrolled in a prospective multicenter investigation of BPBP were evaluated. Microsurgery was performed at the discretion of the treatin...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Effectiveness of Nonoperative Treatment of the Symptomatic Accessory Navicular in Pediatric Patients.
Conclusions: The results of this study can be used by clinicians to frame discussions surrounding treatment options for symptomatic accessory navicular bones with both patients and their families.Level of Evidence: III. PMID: 31413673 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Open Vs. Closed Reduction in Type 2 Lateral Condyle Fractures.
This study aims to assess the outcomes between closed reduction and the more traditional open techniques for operative fractures. Methods: All lateral condyle fractures that required operative fixation (pins or screws) over a ten-year period were included. We compared open versus closed reduction for OR time, infection rate, AVN, nonunion, premature physeal closure, ulnohumeral angle, and interepicondylar width (IEW). Results: 28 patients were identified in the closed reduction group while 41 were identified in the open reduction group. Average displacement at surgery for these two groups was significantly differen...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Determining the Prevalence and Costs of Unnecessary Referrals in Adolescent Idiopathic Scoliosis.
Authors: Meirick T, Shah AS, Dolan LA, Weinstein SL Abstract Background: Adolescent idiopathic scoliosis (AIS) has been associated with unnecessary referrals, but the provider and patient costs associated with these referrals remain unknown. The purpose of this study was to determine the prevalence and associated costs of unnecessary referrals for AIS in a university hospital-based orthopaedic clinic. These data are required to estimate the cost-efficacy of scoliosis screening programs. Methods: We accessed the electronic medical records of all patients referred during 2013-2014 with suspected AIS. Spine radiog...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The Influence of Different Rotator Cuff Deficiencies on Shoulder Stability Following Reverse Shoulder Arthroplasty.
Conclusions: This study helps clarify how different rotator cuff deficiencies influence shoulder stability following RSA and can ultimately help predict which patients may be at greater risk for impingement-related scapular notching and subluxation. Clinical Relevance: Surgeons should carefully consider the nature of the rotator cuff deficiency and its influence on impingement and instability when planning for RSA.Level of Evidence: V. PMID: 31413676 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Predictors of Clinical Benefits and One-Year Functional Outcomes Following Shoulder Arthroplasty.
This study assessed the effect of residual pain, age, sex, diabetes, hypertension, and depression on changes and status at one-year following arthroplasty with respect to shoulder function and overall physical and mental health status. Methods: A retrospective analysis of a prospective cohort of 140 patients tested preoperatively and one-year following shoulder arthroplasty was conducted at our tertiary hospital. Pearson's correlations and multiple regression analysis were performed to test the impact of predictors on shoulder pain and function assessed using the American Shoulder and Elbow Surgery (ASES) questionnaire...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Rare Post Traumatic Kyphoscoliosis of the Thoracolumbar Spine After Posterior Fusion for Adolescent Idiopathic Scoliosis: A Case Report and Review of the Literature.
Conclusions: Fractures after posterior spinal fusion for idiopathic scoliosis are rare and evidence for the appropriate management remains limited in the literature.Level of Evidence: V. PMID: 31413678 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The Deformity TLIF: Bilateral Facetectomy and Osteotomy Closure with a Hinged Table.
Conclusions: A comparison of pre- and post-operative lateral radiographs showed 27° segmental lordosis correction, and intra-operative fluoroscopy showed correlation between extension of the table and segmental lordosis correction. Bilateral facetectomy and TLIF allows for segmental lordosis correction. Use of the hinged table allowed for ideal positioning during the decompression and controlled osteotomy closure with close correlation between table position and segmental alignment.Level of Evidence: V. PMID: 31413679 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Acute Onset Atypical Severe Scoliosis: A Case Report.
Conclusions: Every child who presents with atypical scoliosis should have a complete physical examination and appropriate imaging studies seeking an underlying cause.Level of Evidence: V. PMID: 31413680 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Outcomes of Hip Arthroscopy in the Medicare Patient: A Growing Population.
Conclusion: Relatively few numbers of Medicare patients underwent hip arthroscopy during the time interval evaluated (0.3% when compared to THA utilization). 2.2% underwent a subsequent revision arthroscopy or THA with many occurring soon after the procedure and for the diagnosis of hip OA demonstrating the need to better define indications in this population. This study should provide baseline utilization and outcome trends for future studies.Level of Evidence: IV. PMID: 31413681 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Rates and Risk Factors for Revision Hip Arthroscopy.
Authors: West CR, Bedard NA, Duchman KR, Westermann RW, Callaghan JJ Abstract Background: Revision hip arthroscopy often serves as a measure for a failed primary hip arthroscopy procedure. The purpose of this study was to examine the rate, timing, and risk factors for revision hip arthroscopy using a large national database. Methods: The Humana administrative claims dataset was reviewed from 2007 through the second quarter of 2015 to identify patients undergoing hip arthroscopy using Current Procedural Terminology (CPT) codes and laterality modifiers. Patients with subsequent ipsilateral revision hip arthroscop...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Intra-Articular Pathology Associated with Acute and Chronic Anterior Cruciate Ligament Reconstruction.
Conclusions: Data from this prospective cohort suggest that with increasing time from ACL injury to ACL-R, medial meniscus pathology increases, with a lower likelihood of meniscal repair in all patients undergoing ACL-R. However, this finding is no longer statistically significant when considering only patients undergoing primary ACL-R. Age appears to play an important role in whether concomitant pathology develops following ACL rupture. Given these findings, early intervention may increase the ability to repair medial meniscus tears in the setting of ACL-R, but this conclusion is less supported in primary ACL-R.Level of E...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The Effect of Non-Steroidal Anti-Inflammatory Drugs on Tendon-to-Bone Healing: A Systematic Review with Subgroup Meta-Analysis.
Conclusions: The current literature does not provide sufficient evidence for or against the use of NSAIDs following acute injury or surgical repair of the tendon-bone interface.Level of Evidence: IV. PMID: 31413684 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Computer Navigation for Pediatric Femoral ACL Tunnel Placement.
Authors: Popkin CA, Chan CM, Nowell JA, Crowley SG, Wright M, Ahmad CS Abstract Background: To compare accuracy, time and radiation exposure of pediatric femoral tunnel placement using computer navigation with a traditional freehand technique. Methods: A single all-epiphyseal femoral tunnel was placed in the distal femur of 20 Sawbones™ adolescent knee models. Ten tunnels were drilled using standard fluoroscopic guidance (FG). An additional 10 tunnels were drilled using 3D fluoroscopic computer navigation (CN). Both techniques aimed to match an exact point described by the quadrant system of Bernard. Time...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

A Biomechanical Comparison of Varying Base Knot Configurations with Different Overhand/Underhand Combinations of Reversing Half-Hitches on Alternating Posts After Basic Instructional Training.
Conclusions: Arthroscopic base knot configurations paired with different overhand/underhand stacking combinations of RHAPs yielded knot capable of secure tissue fixation. A short instructional training period appears to be sufficient for inexperienced individuals to learn easier base knot configurations, more challenging and complicated knots, however, may require training in a more gradual fashion. Clinical Relevance: The findings of this study provide information that the importance of hands-on experience for inexperienced individuals, such as residents, in performing arthroscopic knot tying, and that can lead to imp...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

A Biomechanical Analysis of Tibial Fixation Methods in Hamstring-Graft Anterior Cruciate Ligament Reconstruction.
Conclusions: Tibial fixation with an interference screw demonstrated superior biomechanical properties for cyclic testing compared to the suspension button and Tape Locking Screw. Load to failure did not differ between groups, and there were no significant biomechanical differences between the suspension button and Tape Locking Screw fixation devices. Clinical Relevance: Despite the initial biomechanical differences, all three fixation devices exhibited mean loads to failure and cyclic displacements below clinically relevant thresholds of failure. These data suggest all three fixation methods are viable options for ach...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Arthroscopic Hip Joint Assessment can Impact the Indications for PAO Surgery.
Authors: Wasko M, Nepple JJ, Clohisy JC, Pascual-Garrido C Abstract Background: The purpose of this study was to analyze clinical, radiographic and intraoperative disease characteristics of patients with symptomatic acetabular dysplasia in which periacetabular osteotomy (PAO) was contraindicated due to advanced intraarticular findings at the time of disease staging hip arthroscopy (HA). Methods: A prospective cohort was used to identify all patients who were scheduled for a PAO and concomitant hip arthroscopy for the treatment of symptomatic acetabular dysplasia. From a total of 286 patients (286 hips), 11 pati...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

An Elevated Metrorail as a Source of Orthopedic Injuries and Death at a Level-I Trauma Center.
Conclusions: Metrorail systems are unique sources of orthopaedic injuries requiring high rates of critical care and surgical intervention. Patients sustain multiple injuries, many with amputations. With this mechanism, there is a high rate of open fractures and suicide. Trauma centers should emphasize an extensive evaluation of orthopaedic injuries in this patient setting.Level of Evidence: II. PMID: 31413689 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Treatment of Distal Fibular Malunion with Corrective Osteotomy: Yablon Revisited.
Authors: Chang G, Buckley PS, Krieg JC Abstract Yablon originally described that late posttraumatic degenerative ankle arthritis was due to ongoing tibio-talar joint incongruity, and more importantly that anatomic reduction of the lateral malleolus was key to anatomic reduction of the ankle joint, as the talus "faithfully followed that of the lateral malleolus." Ankle fractures involving the lateral malleolus, left unreduced, can lead to malunion and posttraumatic degenerative arthritis. Treatment of this often includes a fibular osteotomy to restore length and rotation. We revisit Yablon's original princ...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Operative Versus Nonoperative Management Of Traumatic Arthrotomies from Civilian Gunshot Wounds.
Conclusions: In select patients, nonoperative treatment with wound care and antibiotics may be sufficient for preventing infection after GSW-related traumatic arthrotomies. Findings of randomized studies and treatment algorithms are needed to further evaluate this relatively common injury.Level of Evidence: IV. PMID: 31413691 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Use of CT Vs. MRI for Diagnosis of Hip or Pelvic Fractures in Elderly Patients After Low Energy Trauma.
Conclusions: Our study suggests CT may be adequate to rule out hip and pelvic fractures in this patient population. CT may be preferable to MRI based on decreased time spent in the ED and the large percentage of elderly patients with contraindications to MRI.Level of Evidence: III. PMID: 31413692 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Radiographic Enchondroma Surveillance: Assessing Clinical Outcomes and Costs Effectiveness.
In conclusion, enchondroma growth was a rare event and typically occurred at two years follow-up in our series. Given the low risk for malignant transformation, we propose surveillance with plain radiographic follow-up for stable enchondromas every 3-6 months for the first year and then annually for at least three years of total follow-up. The most significant costs savings can be made by limiting MRI imaging in the absence of clinical or radiographic concern. Additional studies are needed to determine the long-term risk of growth or declaration of chondrosarcoma.Level of Evidence: IV. PMID: 31413693 [PubMed - in proce...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Evidence of Selection Bias and Non-Response Bias in Patient Satisfaction Surveys.
Conclusions: Demographically, patients who were administered and patients who responded to PG surveys differed from the overall population of patients seen in an outpatient orthopedic setting, evidencing both selection and non-response bias. Because of these differences, and considering the small number of survey returned, caution should be exercised when interpreting and applying these data.Level of Evidence: III. PMID: 31413694 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Gender Preferences of Patients When Selecting Orthopaedic Providers.
Conclusions: The majority of patients did not have a preference for the gender of their orthopaedic surgeon. 16.1% of patients had a preference, and the majority of these patients preferred female surgeons. Preferences for a specific gender were seen that varied based on the subspecialty. Efforts at increasing gender diversity in orthopaedics should continue to be a major goal.Level of Evidence: III. PMID: 31413695 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Midlevel Providers in Orthopaedic Surgery: The Patient's Perspective.
Conclusions: As health care becomes increasingly consumer-centric and value-driven, a databased utilization of midlevel staff will allow orthopaedic physicians to optimize efficiency and patient satisfaction. Surgeons may consider our results in division of clinical duties among midlevel staff since patients had specific preferences regarding which services should be physician-provided or midlevel-provided. Orthopaedic surgeons may also consider including the midlevel provider in marketing efforts, as most patients considered the midlevel provider's training background when initially choosing a surgeon and perceived PAs to...
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

For Epublication this Fall.
Authors: PMID: 31413697 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Iowa Orthopedic Journal Editors Emeriti.
Authors: PMID: 31413698 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

2019 IOJ Editors' Note.
Authors: Compton JT, Hendrickson N PMID: 31413699 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

2019 Graduating Orthopedic Residents.
Authors: PMID: 31413700 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

2019-2020 Department of Orthopedics and Rehabilitation Schedule of Lectureships and Conferences.
Authors: PMID: 31413701 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Department of Orthopedics and Rehabilitation Staff 2018-19.
Authors: PMID: 31413702 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

2019 Graduating Fellows.
Authors: PMID: 31413703 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

New Orthopedic Faculty.
Authors: PMID: 31413704 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The 2019 Michael Bonfiglio Award for Student Research in Orthopaedic Surgery: The 2019 Iowa Orthopaedic Society Medical Student Research Award for Musculoskeletal Research.
Authors: Clark CR PMID: 31413705 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Diversity in Orthopedics.
Authors: PMID: 31413706 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 16, 2019 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Leland G. Hawkins, MD-His Life and Orthopaedic Legacy: Talus Fractures and the Hawkins Classification.
Authors: Day MA, Compton JT, Buckwalter JA Abstract The long history of excellence and continued success of the University of Iowa Department of Orthopedics and Rehabilitation is due to the dedication and talent of generations of faculty, residents and staff. Many former Iowa Orthopedic residents have made significant contributions and become leaders in Orthopedic surgery. An orthopedic surgeon and scholar with roots at the University of Iowa deserving of tribute is Dr. Leland Greene Hawkins. His seminal investigation and interest in fractures of the talus established the well-known Hawkins Classification for talar...
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The Economic Burden of Residency Interviews on Applicants.
Conclusions: Senior medical students incur substantial costs to participate in residency interviews, often adding to already burdensome educational debt. We encourage residency programs, especially those in competitive specialty fields, to pursue cost reduction strategies. Additionally, medical schools should provide financial counseling to allow students to anticipate interview costs. PMID: 30104919 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Mycobacterium Tuberculosis Monoarthritis of the Knee in Children: A Case Report.
Authors: Carender CN, Akoh CC, Kowalski HR Abstract Mycobacterium tuberculosis monoarthritis is a rare form of TB, occurring in 1-2% of cases in the United States. Delays in definitive diagnosis and subsequent treatment are common. While case reports of tuberculous arthritis have been presented in international literature, there is a relative paucity of literature from within the United States. Given the difficulty in diagnosis and adverse outcomes of delayed diagnosis, we present the case of an 11-year-old otherwise healthy male with isolated monoarticular TB septic arthritis of the right knee. A discussion, inclu...
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Bone Mineral Density T-Scores Derived from CT Attenuation Numbers (Hounsfield Units): Clinical Utility and Correlation with Dual-energy X-ray Absorptiometry.
Authors: Hendrickson NR, Pickhardt PJ, Del Rio AM, Rosas HG, Anderson PA Abstract Background: Clinical computed tomography (CT) studies performed for other indications can be used to opportunistically assess vertebral bone without additional radiation or cost. Reference values for young women are needed to evaluate diagnostic accuracy and track changes in CT bone mineral density values across the lifespan. The purpose of this study was to determine reference values for lumbar trabecular CT attenuation (Hounsfield units [HU]) and determine the diagnostic accuracy of HU T-scores (T-scoreHU) for identifying individual...
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Overuse of Magnetic Resonance Imaging in the Diagnosis and Treatment of Moderate to Severe Osteoarthritis.
Conclusions: In this study, 13.1% of patients with radiographically obvious knee OA obtained an MRI prior to referral for TKA. Non-physicians and non-academic physicians were more likely to order MRI scans. Improved education for referring providers may be necessary to decrease overuse of MRI in the diagnosis of moderate to severe arthritis. Level of Evidence: Level II. PMID: 30104922 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Evaluation of Orthopaedic Trauma Fellowship Web Sites and an Assessment of 21 Content Domains.
Conclusions: Inadequacies exist in the accessibility and content of OTA accredited Orthopaedic Trauma Fellowship web sites. We draw attention to 21 standard content areas pertinent to applicants that could be considered by the OTA and individual programs to include on their respective web sites. Standardization across web sites may allow for a more direct comparison between programs and improve the match process. Level of Evidence: Review Article. PMID: 30104923 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Unintentional Firearm Injuries Remain Prevalent Over a 12 Year Experience at a Rural Midwestern Level 1 Trauma Center.
This study was undertaken to highlight the unique spectrum of firearm injuries seen at a rural level 1 trauma center to provide insight into prevalence, mechanism of injury, and seasonal variation. An IRB-approved retrospective study was performed of the trauma registry at a rural Level 1 hospital to identify all patients with firearm injuries from January 2002 to May 2014. Data obtained for each patient included demographics, injury date, a brief injury summary, and results of drug/ alcohol screening. Chart review was performed to confirm accuracy of the database and descriptive statistics were calculated to compare subgr...
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Do Orthopedic Trauma Surgeons Adhere to AAOS Guidelines when Treating Distal Radius Fractures?
Conclusions: When compared to the AAOS CPG and AUC, orthopedic trauma surgeons generally followed accepted treatment guidelines. Differing practices between surgeons with 10 years in practice may be reflective of what is taught in residency training programs. PMID: 30104925 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

The Telescoping Hip Plate for Treatment of Femoral Neck Fracture: Design Rationale, Surgical Technique and Early Results.
This article details the design rationale, surgical technique and early postoperative results of a new hybrid implant used for the treatment of both displaced and nondisplaced femoral neck fractures. PMID: 30104926 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research

Set it and Forget it: Diaphyseal Fractures of the Humerus Undergo Minimal Change in Angulation After Functional Brace Application.
Conclusion: Humeral shaft fractures treated non-operatively heal with minimal change in angulation after brace application. If angulation on the post-brace radiograph is acceptable and there is no history of repeat trauma and no cosmetic deformity, radiographs may be utilized less frequently. Patients should be evaluated via history and physical exam at follow-up prior to the 6-week point, at which time regular radiographs (6 week, 3 month, 6 month, 12 month) should commence. PMID: 30104927 [PubMed - in process] (Source: Iowa orthopaedic journal)
Source: Iowa orthopaedic journal - August 15, 2018 Category: Orthopaedics Tags: Iowa Orthop J Source Type: research