In response
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Letter to the Editor on “Comparison of Locked Plating of Varus Displaced Proximal Humeral Fractures with and Without Fibula Allograft Augmentation”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

In response
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Letter to the Editor on “Early Operative Treatment of Acetabular Fractures Does Not Increase Blood Loss: A Retrospective Review”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Letters to the Editor Source Type: research

Fractures in Patients With COVID-19 Infection: Early Prognosis and Management. A Case Series of 20 Patients in a Single Institution in Lombardy, Northern Italy
Summary: Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence. Fifty-eight percent of the total infections in Italy of COVID-19 were found in northern Italy, in particular, Lombardy. From February 21, 2020, to March 23, 2020, 20 patients with a fracture and a diagnosis of COVID-19 were hospitalized. Demographic data, COVID-19 symptoms, laboratory and radiographic examinations, and treatment methods were recorded. At 1-month follow-up, patients were assessed with the SF-36 score. This case series includes 20 patients (16 women and 4 men), with an average ...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: COVID-19 Content Source Type: research

Early Orthopaedic Trauma Outcomes in COVID-19 Infected Patients: A Case Series
Summary: Orthopaedic trauma presents a unique and complex challenge in the initial phase of the coronavirus 2019 (COVID-19) global crisis. Little is currently known about the surgical practices in orthopaedic emergencies in the early days of the COVID-19 outbreak (1). This is a retrospective case series of 10 orthopaedic trauma patients who underwent fracture fixation in March 2020. Of the 10 patients testing COVID-19 positive, there were a total of 16 long bone fractures, 5 pelvic ring fractures, and 1 lumbar burst fracture. There were 7 (70%) males in this cohort. Two (20%) of the COVID-positive patients did not develo...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: COVID-19 Content Source Type: research

Usefulness of PCR Screening in the Initial Triage of Trauma Patients During COVID-19 Pandemic
Conclusions: Symptom-based screening for COVID-19 has shown to be specific but not sensitive. Negative clinical symptoms do not rule out infection. Protocols and separated areas are necessary to treat infected patients. RT-qPCR testing on admission helps minimize the risk of nosocomial and occupational infection. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: COVID-19 Content Source Type: research

Are Hospitals Safe? A Prospective Study on SARS-CoV-2 Prevalence and Outcome on Surgical Fracture Patients: A Closer Look at Hip Fracture Patients
Conclusions: Patients may be treated safely at hospitals if strict recommendations are followed. Both cohorts of hip fracture patients had similar 30-day mortality. 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 - September 25, 2020 Category: Orthopaedics Tags: COVID-19 Content Source Type: research

Laser-Assisted Indocyanine Green Angiography in the Management of Open Ankle Fractures: A Technical Trick
We describe the use of a new tool, laser-assisted indocyanine green angiography, to assist in incision planning for the definitive treatment of these injuries. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Technical Trick Source Type: research

Complications of Methamphetamine Use in Orthopaedic Trauma
Conclusions: MA use is associated with increased inpatient and outpatient complications. 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 - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Treatment of Tibial and Femoral Bone Defects With Bone Transport Over an Intramedullary Nail
Conclusions: The BTON technique is associated with low cost because of the short treatment period, low complication risk, and rapid rehabilitation and is not limited by the amount of bone transport. 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 - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Dual Antiplatelet Therapy and Surgical Timing in Geriatric Hip Fracture
Objective: To determine how timing of surgery affects transfusion, major complications, and mortality in patients who sustain a geriatric hip fracture while taking dual antiplatelet therapy (DAPT; typically aspirin and clopidogrel). Design: Retrospective cohort study. Setting: University-affiliated Level 1 Trauma Center. Patients: Patients 65 years of age or older on DAPT with a geriatric hip fracture were investigated at a single institution between 2002 and 2017. Demographic and perioperative data were collected from patient records, institutional databases, and national hip fracture registry. Intervention: ...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Effect of Wound Closure Technique in Proximal Femoral Fractures: A Prospective Cohort Study
Objectives: To compare the effect of different wound closure techniques on wound drainage, postoperative length of stay, and complications in patients with proximal femoral fractures, including femoral neck fractures (31A fractures) and peritrochanteric fractures (31B fractures). Design: Prospective cohort study. Setting: Footscray Hospital, Western Health, Victoria, Australia; an acute teaching hospital. Patients and Participants: All inpatients receiving surgery for proximal femoral fractures at our facility between May 2016 and August 2017. A total of 486 consecutive patients who presented during the study pe...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Impact of Skin Suture Pattern on Incision Perfusion Using Intraoperative Laser Angiography: A Randomized Clinical Trial of Patients With Ankle Fractures
Conclusions: Running subcuticular suture pattern resulted in the greatest incision perfusion than simple, horizontal mattress, vertical mattress, and AD techniques after ankle fracture fixation. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Ability of a Risk Prediction Tool to Stratify Quality and Cost for Older Patients With Tibial Shaft and Plateau Fractures
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Invited Commentary Source Type: research

Ability of a Risk Prediction Tool to Stratify Quality and Cost for Older Patients With Tibial Shaft and Plateau Fractures
Objectives: To determine whether a validated trauma triage tool can identify the middle-aged and geriatric trauma patients with tibial shaft and plateau fractures who are at the risk for costly admissions and poorer hospital quality measures. Design: Prospective cohort study. Setting: Level-1 trauma center. Patients/Participants: Sixty-four patients older than 55 years hospitalized with isolated tibial shaft or plateau fractures. Intervention: Patients with either isolated tibial plateau fractures or tibial shaft fractures over a 3-year period were prospectively enrolled in an orthopedic trauma registry. Demo...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Impact of the Fascia Iliaca Block on Pain, Opioid Consumption, and Ambulation for Patients With Hip Fractures: A Prospective, Randomized Study
Conclusions: A single perioperative FIB for patients with hip fractures undergoing surgery may decrease opioid consumption and increase the likelihood that a patient is discharged home. 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 - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Fixation Using Alternative Implants for the Treatment of Hip Fractures (FAITH-2): The Clinical Outcomes of a Multicenter 2 × 2 Factorial Randomized Controlled Pilot Trial in Young Femoral Neck Fracture Patients
Conclusions: These pilot trial results continue to describe the results of current fixation implants, inform the challenges of improving outcomes in this fracture population, and may guide future vitamin D trials to improve healing outcomes in young fracture populations. Although the pilot trial was not adequately powered to detect treatment effects, publishing these results may facilitate future meta-analyses on this topic. 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 - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Compartment Syndrome: Evaluation of Skeletal Muscle Ischemia and Physiologic Biomarkers in Controlled Conditions Within Ex Vivo Isolated Muscle Bundles
Objectives: To identify potential physiologic markers of muscle ischemia to serve as diagnostic indicators of compartment syndrome. We hypothesize that muscle bundles in hypoxic conditions will elicit decreases in potential hydrogen (pH) and increases in lactate and potassium that correlates with decreased muscle twitch forces. Methods: We performed an ex vivo evaluation of individual skeletal muscle bundles obtained from a swine's diaphragm that were exposed to hypoxic conditions and compared with control groups. Over a 4-hour period, we evaluated the following parameters for each muscle bundle: muscle twitch forces ...
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Long-Term Outcomes of Fasciotomy for Acute Compartment Syndrome After a Fracture of the Tibial Diaphysis
Conclusion: These data suggest that when managed with urgent decompressive fasciotomies, ACS does not seem to have a significant impact on the long-term patient-reported outcome although patient satisfaction is reduced. 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 - September 25, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Another Type of Surge
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - September 25, 2020 Category: Orthopaedics Tags: Editor's Note Source Type: research

Upscaling Virtual Fracture Clinic Use Is a Safe, Effective Measure in the Delivery of Trauma Care
Summary: Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. The Virtual Fracture Clinic (VFC) has proved beneficial in reducing footfall within the hospital setting, improving the cost of running a trauma service, while satisfying the majority of referred patients. The mandatory upscaling of telemedicine use, specifically the enhancement of the VFC, amidst the COVID-19 pandemic, was analyzed. The remit of the VFC within our hospital was expanded so as to include all referred ambulatory trauma. Outcomes of our VFC review over the 6-week period follow...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Effect of Statewide Social Distancing and Stay-At-Home Directives on Orthopaedic Trauma at a Southwestern Level 1 Trauma Center During the COVID-19 Pandemic
Conclusions: Orthopaedic trauma injuries continued to occur during the COVID-19 pandemic at an overall decreased rate, however, with a different distribution in mechanism and type of injury. 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 - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Effect of Shelter-in-Place Orders and the COVID-19 Pandemic on Orthopaedic Trauma at a Community Level II Trauma Center
Conclusions: The quantity of OTEs was significantly affected by the COVID-19 pandemic and Michigan shelter-in-place order. A decrease in both high and low severity OTEs was found; however, there was no statistically significant change in the ratio of high to low severity OTEs compared with previous years. Although it is difficult to determine what portion of the decrease in OTE is attributable to the shelter-in-place order versus the COVID-19 pandemic in general, data suggest both play a role. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of Levels of Evidence. (Sour...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Lessons Learned for Orthopaedic Care Within the NYC COVID Epicenter Using the United States Naval Ship Comfort
Summary: Although elective surgeries and in-person office visits were greatly reduced during the COVID-19 crisis, orthopaedic surgeons continue to play a critical role in caring for both orthopaedic and nonorthopaedic problems during this pandemic. Orthopaedic departments provide the ability to off-load emergency departments of orthopaedic issues, redeploy staff to areas of need across the hospital system, and provide direct care to COVID-19 patients. The following will discuss the experience of a large academic orthopaedic surgery department within the epicenter of the COVID-19 pandemic with respect to redeployment of h...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Thirty-Day Mortality Rate of Patients With Hip Fractures During the COVID-19 Pandemic: A Single Centre Prospective Study in the United Kingdom
Conclusions: Our study demonstrated a significant increase in 30-day mortality among hip fracture patients during the first 30 days of the COVID-19 pandemic in the United Kingdom. A positive COVID-19 test result in patients with hip fractures is associated with a 2.4-fold increase in risk of 30-day mortality. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Modification of a Validated Risk Stratification Tool to Characterize Geriatric Hip Fracture Outcomes and Optimize Care in a Post-COVID-19 World
Conclusion: The STTGMA tool can be modified for specific disease processes, in this case to account for the COVID-19 virus and provide a robust risk stratification tool that accounts for a heretofore unknown risk factor. COVID-19 positive/suspected status portends a poor outcome in this susceptible trauma population and should be included in risk assessment models. These patients should be considered a high risk for perioperative morbidity and mortality. Patients with COVID-19 symptoms on presentation should have surgery deferred until symptoms improve or resolve and should be reassessed for surgical treatment versus def...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Invited Commentary on “COVID-19 Response in the Global Epicenter: Converting a New York City Level 1 Orthopedic Trauma Service Into a Hybrid Orthopedic and Medicine COVID-19 Management Team”
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Invited Commentary: An Invited Commentary from Dr. Hassan Mir was inadvertently omitted from the August 2020 issue of Journal of Orthopaedic Trauma.We regret this error. Source Type: research

Use of Proximal Humerus Locking Plates for Fixation of Pediatric Femoral Neck Fractures: Technical Trick
We present a novel technique for the stabilization of these fractures with commonly available implants which provides physeal sparing, fixed angle, and stable fixation. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Technical Trick Source Type: research

Technique for Removal of Entrapped Screw and Washer Fixation of the Posterior Pelvic Ring
We describe a technique for removal of large diameter cannulated screws and washers from the posterior pelvic ring, which requires no additional equipment or implants beyond the instrumentation used for implant insertion, as well as a series of 15 cases in which the technique was applied. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Technical Trick Source Type: research

A Survey to Assess Agreement Between Pelvic Surgeons on the Outcome of Examination Under Anesthesia for Lateral Compression Pelvic Fractures
Conclusions: Pelvic surgeons generally agree on what constitutes a positive or negative EUA but not necessarily the implications of a positive or negative examination. There is no clear consensus among surgeons regarding the method of performing EUA nor regarding the definition of a positive EUA. 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 - August 21, 2020 Category: Orthopaedics Tags: Opinions And Surveys Source Type: research

Biomechanical Stability of Volar Plate Only Versus Addition of Dorsal Ulnar Pin Plate: A Dorsal Ulnar Fragment, C-3–Type, Distal Radius, Cadaver Fracture Model
Conclusions: The addition of a dorsal ulnar pin plate improved stability characteristics with respect to the dorsal ulnar fragment. Clinical Relevance: The addition of the dorsal ulnar pin plate, although statistically significant, improved displacement by less than 0.3 mm on average and thus may not prove to be important in clinical scenarios. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

A Prospective Cohort Study on Accuracy of Dorsal Tangential Views to Avoid Screw Penetration With Volar Plating of Distal Radius Fractures
Conclusions: In one-third of our patients, the incidence of protruding screws that can cause iatrogenic extensor tendon rupture was reduced by obtaining additional DTVs. Although DTV reduces the incidence of dorsal screw penetration considerably, this study reveals limited sensitivity. Therefore, one should keep in mind that dorsal screw penetration may go unnoticed on DTVs, and proper surgical technique remains paramount of DTV. Level of Evidence: Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Reoperation Risk After Total Elbow Arthroplasty Versus Open Reduction Internal Fixation for Distal Humerus Fractures in Elderly Patients
Objective: To compare reoperation risk after total elbow arthroplasty (TEA) and open reduction internal fixation (ORIF) for intra-articular distal humerus fractures in elderly patients. Design: Retrospective comparative. Setting: Five percent Medicare Part B claims database. Patients: Patients older than 65 years of age with closed distal humerus fractures undergoing TEA or ORIF from 1996 to 2016. Intervention: TEA and ORIF. Main Outcome Measure: Reoperation risk based on multivariate Cox proportional hazards modeling. Results: A total of 142 TEA and 522 ORIF cases were identified. TEA patients had a gr...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Operative Management of Proximal Humerus Nonunions in Adults: A Systematic Review
Conclusions: Thirty-seven articles were included, representing 508 patients (246 ORIF, 137 HA/TSA, and 125 RTSA). Patients managed by ORIF were younger with simpler fracture patterns than those managed by arthroplasty. Regarding ORIF, locked plates achieved highest union rates (97.0%), but clinical outcomes were comparable with all plate fixation constructs [forward flexion (FF): 123–144°; external rotation: 42–46°; Constant score: 75–84]. Complication and reoperation rates for ORIF were 26.0% and 14.6%, respectively. Furthermore, subgroup analysis of locked plate ORIF demonstrated shorter conso...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Review Article Source Type: research

Tibial Nerve Dysfunction Associated With Operatively Treated Talar Neck Fractures
Conclusion: The tibial nerve and its distal branches are at risk of injury in the setting of displaced talar neck fracture, tibiotalar subluxation/dislocation, and open talar neck fracture with increasing risk among those with a higher Hawkins grade. 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 - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Open Reduction of Closed Pediatric Tibial Shaft Fractures Treated With Intramedullary Stabilization Does Not Increase Risk of Postoperative Complications
Conclusion: Performing an open reduction in a closed pediatric tibial shaft fracture before intramedullary fixation does not increase the risk of surgical site infections or wound issues, delayed union, or unplanned return to the OR. An open reduction of a closed tibial shaft fracture for purposes of improving a reduction before intramedullary stabilization may be a safe and effective clinical practice. 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 - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Combined Technique for the Treatment of Infected Nonunions of the Distal Femur With Bone Loss: Short Supracondylar Nail–Augmented Acute Shortening/Lengthening
Conclusion: This combined strategy was an effective method for treating distal femoral segmental bone defects after debridement of osteomyelitis, with a high rate of union and acceptable complication rates. 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 - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Fascia Iliaca Regional Anesthesia in Hip Fracture Patients Revisited: Which Fractures and Surgical Procedures Benefit Most?
This study was conducted at a Level 1 trauma center. Main Outcome Measurements: The primary outcome was morphine milliequivalents (MME) consumed during the index hospitalization. Fracture pattern–specific preoperative and postoperative MME consumption and surgical procedure–specific postoperative MME consumption was compared between the FIRA and non-FIRA groups. Results: A total of 949 patients were included in this study, with 194 (20.4%) patients in the prospective protocol group. There were no baseline differences between cohorts. Preoperatively, only femoral neck fracture patients receiving FIRA used ...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Standard Versus Low-Dose Computed Tomography for Assessment of Acetabular Fracture Reduction
Conclusion: A CT dose did not affect assessment of displacement, intra-articular screw penetration, or subjective rating of scan quality in the setting of a fixed posterior wall fracture. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Do Indomethacin or Radiation for Heterotopic Ossification Prophylaxis Increase the Rates of Infection or Wound Complications After Acetabular Fracture Surgery?
Objectives: To compare the rates of infection and wound complications in patients undergoing operative fixation (ORIF) of acetabular fractures receiving heterotopic ossification (HO) prophylaxis using indomethacin or external beam radiation therapy (XRT) versus no prophylaxis. Design: Retrospective cohort. Setting: Level I trauma center. Patients: We reviewed 473 patients undergoing ORIF of acetabular fractures through posterior, combined, or extensile surgical approaches from 2012 to 2017, with a median follow-up of 13 months (0.5–77 months). Main Outcome Measurement: Rates of infection and wound compl...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Thrombin Hemostatic Matrix Reduces Heterotopic Ossification in Acetabular Fractures Fixed Through the Kocher–Langenbeck Approach
Objective: To determine whether an injectable thrombin product [thrombin hemostatic matrix (THM)] at closure of a Kocher–Langenbeck approach reduces the risk of heterotopic ossification (HO) formation after an acetabular fracture. Design: Case control. Setting: Two Level 1 trauma centers. Patients: Patients with operatively treated acetabulum fractures fixed through Kocher–Langenbeck from 2013 to 2018. Intervention: Records were reviewed for demographics, history of traumatic brain injury, HO medication or radiation prophylaxis, THM (Surgiflo, Ethicon, Bridgewater New Jersey) administration, and l...
Source: Journal of Orthopaedic Trauma - August 21, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Intramedullary Nails Yield Superior Results Compared With Plate Fixation When Using the Masquelet Technique in the Femur and Tibia: Erratum
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Errata Source Type: research

Nerve Injury With Acetabulum Fractures: Incidence and Factors Affecting Recovery: Erratum
No abstract available (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Errata Source Type: research

Use of an Extensile Posterior Approach to the Elbow Joint: Early Results of the Anconeus Approach
We describe the use of a well recognized, but uncommonly used, extensile approach to the medial and lateral compartments of the elbow joint. This approach provides access to address pathology of the proximal radius, ulna, and the distal humerus and can be made extensile both proximally and distally. The anconeus approach is easy to perform and well tolerated by patients. A retrospective review of 42 patients is included. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Technical Trick Source Type: research

Overlapping Surgery for Ankle Fractures: Is It Safe?
Objective: To determine whether the practice of overlapping surgery influenced patient safety after open reduction internal fixation (ORIF) for ankle fractures. Design: Retrospective case–control. Setting: Level 1 Academic Midwest trauma center. Patients: All patients who underwent ankle fracture ORIF by a single surgeon were eligible for our study, with 478 total patients. Intervention: Cases that were overlapping were compared against cases that were not overlapping. Cases were defined as overlapping if there was greater than 30 minutes of overlap between procedural times. Patient complications were r...
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Minimally Invasive Medial Plate Osteosynthesis of High-Energy Pediatric Tibia Fractures
We report on the largest series to date of minimally invasive medial plate osteosynthesis of high-energy tibia fractures in skeletally immature patients. Design: Retrospective. Setting: Level 1 trauma center. Patients: Skeletally immature patients with high-energy tibia fractures treated with minimally invasive medial plate osteosynthesis between 2006 and 2017. We identified 28 fractures in 26 patients. Main Outcome Measure: We reviewed the record for patient, injury, and treatment factors as well as for complications and reoperation. We assessed the relationships between age, implant selection, and implant rem...
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

A Comparison of 3 Fixation Strategies in the Treatment of Neer Type IIB Distal Clavicle Fractures
Objectives: To compare the stability of NT2B clavicle fractures fixed with either a hook plating (HP), Superior Plating with Suture Augmentation (SPSA), or dual orthogonal plating (DP) with the hypothesis that DP would provide increased multiplanar stability across NT2B fractures. Methods: NT2B distal clavicle fractures were created in cadaveric specimens and fixed using (1) HP, (2) SPSA, or (3) DP. Specimens were cyclically loaded in 3 different planes of motion: (1) anteroposterior (AP), (2) superior–inferior, and (3) axial rotation while displacement was continually recorded. Afterward, a superiorly directed ...
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

The Clinical Utility of Additional Axillary and Velpeau Radiographs in the Evaluation of Suspected Shoulder Trauma
Conclusions: Additional axillary/Velpeau views of suspected shoulder trauma rarely led to a change in the final treatment plan, except in patients in which a definitive diagnosis of stability or instability could not be made based on initial radiographs. A cost/benefit analysis is required to weigh the cost of additional radiographs with the benefit of capturing infrequent yet serious dislocations (usually posterior). Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Original Article Source Type: research

Reliable Method of Radial and Ulnar Nerve Identification During the Posterior Approach to the Humerus: A Clinical and Cadaveric Correlation Study
Conclusions: Use of “fingerbreadths” is a reliable, efficient, and reproducible method of identifying both the radial and ulnar nerves during the posterior approach to the humerus. (Source: Journal of Orthopaedic Trauma)
Source: Journal of Orthopaedic Trauma - July 30, 2020 Category: Orthopaedics Tags: Original Article Source Type: research