Medialized Trochanteric Entry Nailing Is a Safe and Effective Method for High-Energy Subtrochanteric Femur Fracture Treatment
Summary: (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Technical Trick Source Type: research

Characteristics and Effectiveness of Postoperative Rehabilitation Strategies in Ankle Fractures: A Systematic Review
Conclusions: Late weight-bearing has been the most common postoperative approach reported in the past 10 years. The variety of definitions around weight-bearing and the lack of details of rehabilitation regimens limit replication and affect current clinical practice. The authors propose to adopt consistent definitions and terminology around postoperative practices such as weight-bearing to improve evidence for effectiveness and ultimately patient outcomes. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Review Article Source Type: research

The Use of Tranexamic Acid in Hip Fracture Surgery—A Systematic Review and Meta-analysis
Objectives: To analyze the effect of intravenous tranexamic acid (TXA) on blood transfusion requirements in adult patients undergoing hip fracture surgery. Secondary aim was to evaluate the safety by assessing thromboembolic events. Data Sources: Cochrane Central Register of Controlled Trials, Medline, PubMed, and Embase were searched for randomized controlled trials published in English from 2010. Study Selection: Studies eligible for inclusion were randomized controlled trials that analyzed the use of intravenous TXA on blood transfusion requirement in hip fracture surgery. Data Extraction: Title...
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Review Article Source Type: research

Concurrent Mental Illness and Financial Barriers to Mental Health Care Among a Nationally Representative Sample of Orthopaedic Trauma Survivors
Conclusions: Approximately one half of orthopaedic trauma survivors with severe mental illness face financial barriers to some form of mental health services. Younger, minority, and low socioeconomic status patients are most affected. These data suggest the presence of postdiagnosis disparities in mental health access that may be improved through direct provision and subsidization of integrated mental health support services for high-risk populations. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Syndesmosis Malposition Assessed on Weight-Bearing CT Is Common After Operative Fixation of Intra-articular Distal Tibia Plafond Fracture
Conclusions: Measurement techniques for syndesmosis position on WBCT were reliable after operative fixation of distal tibia plafond fracture. Syndesmosis malposition is common after these injuries and predicted impaired physical function. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

What Is the Rate of Displacement of Occult Posterior Malleolus Fractures in Nailed Tibial Shaft Fractures?
Conclusions: The incidence of radiographically observable PMF associated with tibial shaft fractures is high, even without a preoperative computed tomography screening protocol in place. In patients without an appreciable PMF on injury films, less than 1% (2/600) had displacement of a large, clinically significant PMF with nail placement. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Length Unstable Femoral Shaft Fractures in Children: It's Time for a New Definition
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Invited Commentary Source Type: research

Effect of Length Stability on Complications in the Treatment of Preadolescent Diaphyseal Femur Fractures Treated With Elastic Stable Intramedullary Nailing
Conclusions: Preadolescent children younger than 10 years do not experience increased complications after ESIN of length unstable femur fractures [odds ratio (OR) = 1.68 (0.18–16.87), P = 0.65]. Length unstable femur fractures are not at increased risk of more complications [OR = 0.90 (0.26–2.92), P = 0.87], early femoral shortening [OR = (0.42–2.02), P = 0.85], or leg length discrepancy [OR = (0.13–1.56), P = 0.21] when treated with ESIN. Level of Evidence: Prognostic Level III. See Instructions for Authors for complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Treatment of Diaphyseal Tibial Fractures Distal to a Total Knee Arthroplasty by Intramedullary Nailing Is Safe and Effective
Conclusion: Overall, we report on the largest cohort in the literature undergoing IMN of a tibial shaft fracture distal to a TKA. We demonstrate that IMN of diaphyseal tibial fractures distal to a TKA can be performed safely. We additionally demonstrate that this treatment is highly effective in achieving fracture union with no arthroplasty-related complications. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Rethinking Conservative Treatment of Humeral Diaphyseal Fractures in Elderly Patients With Dementia
Objectives: To assess outcomes and complications of conservatively managed humeral diaphyseal fractures in elderly patients, with an emphasis on the subgroup diagnosed with dementia. Design: Retrospective. Setting: Upper extremity surgery unit at an academic Level I trauma center. Patients/Participants: Consecutive patients 65 years of age and older who were managed conservatively for humeral diaphyseal fractures between 2007 and 2015. Intervention: Conservatively managed humeral diaphyseal fractures. Main Outcome Measurements: Complications and radiographic outcomes. Results: ...
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Outcomes of Reamed Intramedullary Nailing for Lower Extremity Diaphyseal Fractures in COVID-Positive Patients: A Multi-institutional Observational Study
Conclusion: In this multi-institutional review of COVID-positive patients undergoing reamed IMN, there were no thromboembolic events. All patients developing pulmonary complications (ARDS or pneumonia) had baseline chronic obstructive pulmonary disease, were immune compromised, or sustained polytraumatic injuries with new injury severity score of>20. Given this, it seems reasonable to continue using reamed IMN for tibial and femoral shaft fractures after evaluation for COVID severity, comorbidities, and other injuries. Levels of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete descript...
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

Commentary on: Does Hip Fracture Admitting Service Affect Proper Deep Venous Thrombosis Prophylaxis? An Investigation at a Level 1 Trauma Center
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Invited Commentary Source Type: research

Does Hip Fracture Admitting Service Affect Proper Deep Venous Thrombosis Prophylaxis? An Investigation at a Level 1 Trauma Center
Objective: To examine if rates of appropriate thromboprophylaxis prescribing at the time of discharge would be higher in patients admitted to the orthopaedic service. Second, to see if improvements could be made in the rates of these missed events after a structured intervention. Design: Retrospective Cohort Study, Prospective Interventional. Setting: Level 1 Academic Hospital. Patients: Two hundred forty-six patients undergoing a hip hemiarthroplasty for femoral neck fracture discharged to an extended care facility. Intervention: A letter was sent to the internal quality control committee d...
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

A Prospective Randomized Controlled Trial Comparing Enoxaparin & Rivaroxaban for Venous Thromboembolism Prophylaxis in Orthopaedic Trauma
Conclusion: The results of this randomized controlled trial demonstrate that patients with surgical orthopaedic trauma prefer an oral anticoagulant for postoperative venous thromboembolism chemoprophylaxis and suggest that rivaroxaban may be a viable option. Furthermore, large-scale studies are needed to confirm safety and efficacy for rivaroxaban in this population as a potential alternative to enoxaparin and aspirin. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research

A Single Proximal Interlocking Bolt May Be Sufficient for Retrograde Nailing of Extra-articular Femur Fractures
Conclusions: A single proximal interlocking bolt may be sufficient when using retrograde nailing for the treatment of extra-articular femur fractures. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - November 26, 2022 Category: Orthopaedics Tags: Original Article Source Type: research